Alarm Bells: Alan Milburn joins the Department of Health and Social Care’s board to ‘support the government’s ambitious plans for reform’
Alan Milburn has been appointed Lead Non-Executive Member to the board of the Department of Health and Social Care.
Mr Milburn ‘brings experience at the highest levels to help transform the health and care system‘
This (Labour) government is determined to work with experts who can provide the best advice to help rebuild an NHS fit for the future
Alan Milburn has been appointed Lead Non-Executive Member to the board of the Department of Health and Social Care.
The former New Labour Health Secretary has a ‘proven track record of reducing waiting lists and improving satisfaction in the NHS’.
Milburn is also a strong advocate of private healthcare involvement in the NHS. Back in 2015, Milburn intervened in the British election campaign to criticise Labour’s health plans, which would limit private sector involvement in the NHS. Milburn was criticised for doing so while having a personal financial interest in the private health sector.
The current Labour government says the NHS is broken and it is the mission of this government to fix it and make the health service fit for the future. As part of this national mission, experts are being brought in to help develop policy, and NHS staff and patients have been invited to share their experience and ideas to change the NHS at Change.NHS.gov.uk.
Members of the department board provide independent advice and expertise to inform the department’s strategy, performance and governance and the Lead Non-Executive Member provides additional support to the Secretary of State for Health and Social Care in his role as Chair of the board.
The Labour government says that, as a former Secretary of State, Alan brings experience at the highest levels of helping transform the health and care system – but health trade unions will be very wary of Milburn’s appointment.
Health and Social Care Secretary Wes Streeting said: “As Secretary of State, Alan made the reforms which helped deliver the shortest waiting times and highest patient satisfaction in the history of the NHS.
“This government has inherited a broken health service with some of the longest waiting times and lowest patient satisfaction in history. I am delighted to welcome Alan to the department board, where he will offer advice on turning the NHS around once again.
“His unique expertise and experience will be invaluable and he has an outstanding track record of delivering better care for patients.”
Lead Non-Executive Director Alan Milburn said: “I am delighted to be appointed to this role.
“Having spent three decades working in health policy, I have never seen the NHS in a worse state. Big reforms will be needed to make it fit for the future.
“I am confident this government has the right plans in place to transform the health service and the health of the nation. I’m looking forward to working with them to achieve that mission.”
Due to ‘the requirements of the role and the unique expertise and experience Alan Milburn brings’, he was appointed directly by the Secretary of State on following consultation with the Commissioner for Public Appointments, and in compliance with the Governance Code on Public Appointments.
The Department of Health and Social Care would like to thank Samantha Jones for all her work and support as non-executive director since February 2023.
A new strategy is being published to radically cut the number of single-use medical devices in the health service
Move to scrap single-use MedTech as Health and Social Care Secretary launches waste blitz
Tens of millions of disposable items are binned after just one use
MedTech companies incentivised to produce sustainable products – pumping millions back to NHS frontline and cash into economy
The government is launching a major crackdown on waste in the NHS to save millions of pounds a year, helping to divert more resources to frontline care.
A new strategy – the Design for Life Roadmap – is being published to radically cut the number of single-use medical devices in the health service and reduce our reliance on foreign imports.
Disposable medical devices substantially contribute to the 156,000 tonnes of clinical waste that the NHS produces every year in England alone. The roadmap paves the way to slashing this waste and maximising reuse, remanufacture and recycling in the NHS.
Doing so will create thousands more UK jobs and help transform the country into a life sciences superpower. As it stands, millions of devices like walking aids and surgical instruments are thrown away after just one use.
Harmonic shears – surgical devices which seal patients’ wounds using ultrasound waves – each cost more than £500 and around 90% of them are binned after a single use. Innovative companies are already purchasing these used devices and safely remanufacturing them at a lower price.
The government will encourage more of this kind of innovation to safely remanufacture a wider range of products and drive costs down, including by changing procurement rules to incentivise reusable products and rolling out examples where hospitals are already leading the way on cutting wasteful spending and practices.
Approximately £10 billion each year is spent on medical technology like this in the NHS, but too much of it is imported via vulnerable routes that risk disrupting patient care.
A Circular Economy Taskforce has already been created to foster more highly skilled green jobs and smarter use of our resources. An economy wide shift to a circular economy could add £75 billion to the economy and create 500,000 jobs by 2030.
Health and Social Care Secretary Wes Streeting said: “The NHS is broken. It is the mission of this government to get it back on its feet, and we can’t afford a single penny going to waste.
“Because the NHS deals in the billions, too often it doesn’t think about the millions. That has to change. This government inherited a £22 billion blackhole in the public finances, so we will have a laser-like focus on getting better value for taxpayers’ money.
“Every year, millions of expensive medical devices are chucked in the bin after being used just once. We are going to work closely with our medical technology industry, to eliminate waste and support homegrown medtech and equipment.”
The below case studies illustrate the potential savings:
Mid Yorkshire Trust uses 330,000 single use tourniquets in a year, but a single reusable tourniquet can be used 10,000 times. In a one-year trial, reusable alternatives saved £20,000 in procurement costs and 0.75 metric tonnes of plastic waste.
In Northampton Hospitals NHS Trust, a single Ophthalmology department saved 1,000 pairs of disposable scissors and £12,000 in a year by switching to reusable pairs. Single-use scissors are often used in surgical settings. NHS procurement data shows that several million pairs of single-use scissors were purchased by the NHS in a single year (2022-23). That is the equivalent of hundreds of pairs of scissors thrown away every hour.
Leeds Teaching Hospitals Trust saved £76,610 in costs purchasing 604 remanufactured Electrophysiology (EP) Catheters, and generated a further £22,923 for selling used devices for collection. If the same approach were to be scaled up across the UK, the NHS could save millions of pounds per year on EP catheters alone, just a few product lines among hundreds of thousands.
Harmonic shears are complex devices for performing surgical procedures and cost more than £500 each, yet around 90% are binned after a single use. Leeds University Teaching Hospitals Trust has demonstrated that companies can safely remanufacture them, giving up to 50% cost savings.
The Design for Life programme will reduce this kind of waste and achieve an NHS-wide move to sustainable alternatives– also supporting the government’s net zero goals.
A new roadmap sets out 30 actions to achieve this shift – including how the government will work with companies to encourage the production of more sustainable products, along with training for NHS staff on how to use them.
Taking this approach will mean more money can be spent in the UK, driving growth, creating more engineering, life sciences and research jobs – all while securing savings for the NHS budget.
Many of these products include precious metals such as platinum and titanium which are in high demand but go to landfill when they could be recovered and sold. A reduction in the amount of disposed single-use devices will also reduce the country’s carbon footprint and plastic pollution.
The government will encourage industry figures to innovate by making sure benefits of reusable MedTech are part of how the NHS chooses the products it buys.
Baroness Merron visited University College London Hospital yesterday (Tuesday, 15 October). The hospital is a member of the Circular Economy Healthcare Alliance, which advocates for sustainable practices within the NHS.
Health Minister Baroness Gillian Merron said: “Design for Life doesn’t just deliver on the Health Mission, to build an NHS fit for the future, it also delivers on our Growth Mission to make the UK a life science superpower and our commitment to get the NHS to net zero by 2045.“
She toured a mock operating theatre and was shown various sustainable products its NHS staff use – from simple products like gowns and scissors to sophisticated, expensive products like harmonic shears.
Professor Sir Stephen Powis, National Medical Director of NHS England, said: “While the NHS is treating record numbers of patients, we know there is much more to do to ensure taxpayers get value for money.
“The NHS made a record £7.25bn worth of efficiency savings last year and is targeting a further £9bn of savings for 2024/25. But we are rightly still looking for ways to get our money’s worth for every penny we spend.”
Plans to boost UK employment through widening access to high-quality health support in the workplace are being unveiled today by the Westminster Government
Ministers are urging employers to do more to keep workers healthy and reduce the numbers out of work due to long-term sickness
Consultation launching on measures to increase employer uptake and widen reach of Occupational Health
Plans include a new standard for businesses to adopt to boost health in the workplace
Better workplace support expected to grow the economy and tackle inactivity by improving productivity and preventing health-related job losses
The Department for Work and Pensions (DWP) and Department of Health and Social Care (DHSC) are today publishing a consultation on ways to increase uptake of Occupational Health provision.
Employers will be encouraged to take up Occupational Health offers to help employees access vital mental and physical health support at work, particularly for those working in small and medium-sized enterprises.
These proposals include introducing a national “health at work” standard for all employers to provide a baseline for quality Occupational Health provision, which includes guidance, an option to pursue accreditation, and additional government support services – for example outreach workers to support SMEs to meet the standards.
It also seeks views on developing longer-term workforce capacity to help meet any increased demand for Occupational Health services in the future by:
Encouraging NHS leavers or those who are considering a career change to pivot towards the Occupational Health specialism
Developing a longer-term, multi-disciplinary workforce to provide Occupational Health services
The consultation will also ask employers to share their examples of good Occupational Health provision to help inform other businesses and encourage them to provide the same.
Secretary of State for Work and Pensions, Mel Stride MP, said: “This Government is investing billions in getting people back to work and growing the economy. We need employers to keep playing their part too.
“Healthy businesses need healthy workers – employers will benefit from higher retention rates, more productive workers, and fewer work days lost due to sickness. Improving health in the workplace is a vital piece of the puzzle in our drive to increase employment.”
Minister for Disabled People, Health and Work, Tom Pursglove MP, said: “Long-term sickness is a huge contributor to economic inactivity, and while of course some people are unable to work, better accommodation of health problems in the workplace will open up a wider workforce to employers and support employees with a range of needs.
“Many small and medium-sized business owners already invest significantly in the health and wellbeing of their workforce, but this will be a gamechanger in identifying and removing obstacles to people with health conditions starting, staying and succeeding in work.”
To also help keep people in work, the government will today also publish a separate consultation looking at options to increase investment in Occupational Health services by UK wide employers through the tax system.
This follows its announcement at the Spring Budget where it committed to consult on incentivising greater provision of Occupational Health through the tax system.
The government wants to explore the case for providing additional tax relief to businesses on their Occupational Health costs.
In particular, the consultation asks respondents for their experiences of providing Occupational Health, including what services they provide and any barriers they experience. It also asks for evidence on the effectiveness of existing tax incentives and asks respondents for their views on the merits of expanding the existing Benefit-in-Kind relief, and thoughts on any alternative tax incentives.
Tax reliefs on Benefits-in-Kind are already available for certain occupational health services. This consultation will test if expanding these reliefs or introducing new ones could be an effective lever to achieve greater Occupational Health provision, as well as thoughts on any alternative tax incentives. The consultation will determine if expanding tax incentives is an appropriate measure to boost Occupational Health provision.
This is all a key component of the measures in the 2023 Spring Budget to grow labour market participation, reduce economic inactivity and get more people into work. The Department is helping millions to return to work with inactivity falling by 360,000 since the peak of the pandemic.
Long-term sickness is currently the main reason people of working-age give for being economically inactive, but just under half of workers have access to Occupational Health services. Over 90% of large employers offer Occupational Health support, compared to under a fifth of small ones.
Occupational Health provision can help employers provide work-based support to manage their employees’ health conditions, leading to better retention and return-to-work prospects, and improving business productivity, which can be adversely impacted by sickness absence.
Secretary of State for Health and Social Care, Steve Barclay said: “High quality Occupational Health support in more workplaces would not only help to reduce economic inactivity, but it can lead to a healthier, happier workforce.
“The individual health benefits are clear and by focusing on preventative measures, we can reduce the burden on the NHS and help to bring waiting lists down, which is one of the government’s top priorities.”
Angela Rowntree, Occupational Health Physician for the John Lewis Partnership, said: “At John Lewis Partnership we are moving away from reactively managing sickness to proactively supporting our Partners’ health and wellbeing at work.
“Our founder, Spedan Lewis understood this when he launched an in-house health service for all Partners in 1929 – nearly 20 years before the NHS was established – and we’re proud to be part of his legacy today, providing advice and support to help our Partners achieve their potential in the workplace.
“We welcome this new focus on ensuring other businesses and their employees are able to access better workplace health.”
The Occupational Health consultation will run until 23:59 on Thursday 12 October .
The latest Emergency Department performance figures for September 2021 published today by NHS England show the highest number of 12-hour stays on record, the highest number of four-hour stays on record, and the worst four-hour performance ever recorded.
The latest figures were published on the day the UK Government set out it’s Plan to improve access for NHS patients and support GPs.
The data show in September 2021 there were 1,392,542 attendances to Type 1 Emergency Departments in England.
Four-hour performance has deteriorated for the sixth consecutive month, once again reaching a record low. Just 64% of patients in Type 1 Emergency Departments were admitted, transferred or discharged within four-hours.
A record breaking 5,025 patients stayed in an Emergency Department for 12-hours or more from decision to admit to admission. This is an 80% increase on the previous month, August 2021, and it is the highest number of 12-hour stays since records began and is almost a third higher than the previous highest, recorded in January 2021. The number of 12-hour stays from time of arrival is not published but is likely to be significantly higher.
Dr Katherine Henderson, President of the Royal College of Emergency Medicine, said: “This data is bleak and is a stark warning of the crisis that we are heading towards this winter.
“Dangerous crowding has returned to Emergency Departments, exit block is preventing a flow of patients through the hospital, and there have been widespread reports of ambulances queuing outside hospitals facing long handover delays.
“For patients, this means long and potentially frustrating waiting times in the Emergency Department. For staff it is incredibly challenging, as they do all they can to continue to deliver care quickly amid rising attendances and pressures.
“At the same time the health service continues to manage covid as cases have been rising steeply, with the NHS now treating around 14 times as many patients as the same time last year.
“Trusts also continue to deliver elective care but there is a real threat that in the coming months this may once again have to be paused to manage pressures on urgent and emergency care and the rising number of covid cases.
“The winter presents a significant challenge for the health service; staff are increasingly worried about the NHS’ ability to cope. The Government need to recognise the potential crisis and support the health and care service as it tackles the challenges ahead.
“NHS England’s Urgent and Emergency Care Recovery 10 Point Action Plan is a blueprint on how to manage these pressures in the short and medium term. Trusts must do all they can to follow this guidance to mitigate pressures across the system and prevent further deterioration in performance.
“But the underlying cause of all of the problems facing the NHS is a decade of underfunding. The health service has for a long time struggled to meet the demand of the population. It is short on staff across the board; capacity has not risen in line with demand. Existing staff are exhausted, with many looking to leave after having to shoulder an ever-increasing workload.
“So far promises to increase the workforce have fallen short. The forthcoming spending review is an opportunity for the government to signal it’s intent to boost staffing with a long-term workforce plan and rescue the NHS in the long run.”
Meanwhile the NHS, working closely with the Department of Health and Social Care, has today published a blueprint for improving access to GP appointments for patients alongside supporting GPs and their teams in England.
Surgeries will be provided with additional funding to boost their capacity to increase the proportion of appointments delivered face to face, as part of a major drive to support general practice and level up performance, including additional efforts to tackle abuse against staff.
The measures, including a £250 million winter access fund from NHS England, will enable GP practices to improve availability so that patients who need care can get it, often on the same day if needed. The investment will fund locums and support from other health professionals such as physiotherapists and podiatrists, with a focus on increasing capacity to boost urgent same-day care. This is in addition to £270 million invested over the previous 11 months to expand capacity and support GPs.
Amanda Pritchard, chief executive of the NHS, said: “Improving access to high quality general practice is essential for our patients and for the rest of the NHS too.
“It is a personal priority and today NHS England is taking both urgent and longer term action to back GPs and their teams with additional investment and support.”
Secretary of State for Health and Social Care Sajid Javid said: “I am determined to ensure patients can see their GP in the way they want, no matter where they live. I also want to thank GPs and their teams for their enormous efforts in the most challenging times in living memory.
“Our new plan provides general practice teams with investment and targeted support. This will tackle underperformance, taking pressure off staff so they can spend more time with patients and increase the number of face-to-face appointments.
“Alongside this we are setting out more measures to tackle abuse and harassment so staff at GP surgeries who work so tirelessly to care for patients can do so without having to fear for their safety.”
The NHS England document makes clear that every GP practice must seek patients’ input and respect preferences for face to face care unless there are good clinical reasons to the contrary.
The extra investment will help to increase the number of appointments delivered, while local health systems will be free to determine how best to tackle particular challenges to access and provision of care in their own community, which could include putting in place additional resource for walk-in consultations.
Local plans will need to deliver these improvements in access, with practices that do not provide appropriate levels of face to face care not able to access the additional funding, and instead offered support to improve.
Under the plan, the NHS will also support upgrades to telephone systems, ensuring that more patients can quickly and easily speak to general practice staff, and help the public avoid long waits when contacting a surgery by phone.
The government will also reduce administrative burdens on GPs by reforming who can provide medical evidence and certificates such as FIT notes and DVLA checks – freeing up time for more appointments.
UKHSA will complete its review of infection prevention and control (IPC) guidance in general practice and set out practical steps on IPC measures in GP settings which could increase the number of patients that can be seen.
As part of this package, the NHS will increase its oversight of practices with the most acute issues in relation to access, and GP appointment data will be published at practice level by spring next year. This will enhance transparency and accountability, as monthly data is currently only published by clinical commissioning group.
In addition, patients will get the opportunity to rate their practice’s performance, via text message, based on their most recent experience of accessing support. This survey, which has been previously agreed with the profession, is being piloted in around 60 practices and will be rolled out next year.
Together with the government and Academy of Medical Royal Colleges, the NHS will also develop a zero-tolerance campaign on abuse of NHS staff, including GP teams.
General practice teams have delivered more than 300 million appointments over the last year as well as delivering the vast majority of Covid vaccinations, saving lives and protecting millions of people against the virus at speed.
Health Minister Maria Caulfield said: “As a nurse on the frontline during the pandemic I know how hard GPs and their teams have worked, while recognising how badly so many people want to see their GPs in person.
“This plan will give our dedicated general practices the support needed to increase capacity, boosting the number of appointments for patients to see and speak to their GP practice.
“I look forward to continuing to work with the sector to ensure patients can get the care they need.”
Patients will also be able to see different types of clinicians in general practice, who can best meet their needs and conditions, including pharmacists, paramedics, advanced nurse practitioners and nursing associates.
NHS England will also work with the government to consider how far and fast the role of pharmacists can be increased in the supply of medication, as part of relieving workload on GPs.
Government’s ‘rescue package’ for GPs is flawed and patient care will suffer as result, warns BMA
“It’s truly frightening that we have a government so ignorant to the needs of such a core part of the NHS”
Responding to the publication by the Department of Health and NHS England and NHS Improvement today, outlining their plans to improve access for NHS patients and support for GPs, BMA GP committee chair Dr Richard Vautrey said: “After weeks of promising an ‘emergency package’ to rescue general practice, we’re hugely dismayed that whilst additional funding has been promised, the package as a whole offers very little and shows a Government completely out of touch with the scale of the crisis on the ground.
“GPs and their teams will now be facing the worst winter for decades, and as a result, patients’ care will suffer. Appointments will be harder to book, waiting times will get longer, more of the profession could leave and GPs will struggle to cope.
“It is also disappointing to see that there is no end in sight to the preoccupation with face-to-face appointments; we need a more intelligent conversation about the variety of appointments and care that are available to patients to meet their needs.
“While in-person consultations are a key feature of general practice and absolutely necessary for some patients and certain conditions, the pandemic has proven that in many other cases, phone or video appointments are entirely appropriate and appreciated by patients, and a crude focus on percentages or targets is completely unhelpful.
“Throughout our discussions with ministers and NHS England in recent weeks, the BMA has been clear that without a concerted effort to reduce bureaucracy, admin and red tape in practices, patient access and care was at risk.
“Unfortunately, today’s offer merely tinkers around the edges, and will not reduce the unnecessary burden practices carry and therefore free up any more time for doctors to see more patients. We need an end to target-driven, payment-by-results, care and allow practices to look after patients in a way that is flexible and right for the person in front of them and the Government have missed an opportunity to tackle this.
“Reducing the administrative burden on GPs by reforming who can provide medical evidence and certificates such as Fit notes and DVLA checks, won’t happen for some time and is a mere drop in the ocean as what is needed is urgent action now to free up sufficient time for more appointments.
“While the additional £250m is welcome, it must be easy for practices to access rapidly and they must not be forced to have to produce reams of plans or try to meet unattainable targets to get it – which has often happened in the past.
“We had four simple asks – and only one appears to have been fully answered. Increased sentencing for assaulting healthcare workers is something we asked for, but meaningless if the same Government refuses to address the crisis fuelling such abuse. The Secretary of State has started to address a second, by talking more positively about general practice but he needs to do much more to publicly support the profession when we are under such pressure and facing a torrent of abuse on a daily basis.
“These proposals will only confirm the profession’s belief that ministers and NHS England fail to understand the dire state of general practice – or that they, not hardworking GPs, are to blame.
“It’s truly frightening that we have a government so ignorant to the needs of such a core part of the NHS. GPs want to improve the care we offer to our patients, but today’s offer will not enable us to do that as we had hoped.
“GPs across England will be truly horrified that this is being presented as a lifeline to general practice, when in reality it could sink the ship all together. There can be no doubt that this lack of action at such a critical time will force many GPs to hang up their stethoscopes and leave the profession for the last time.”
