Tag: NHS England

Zero tolerance for failure under package of tough NHS reforms

Health and Social Care Secretary will outline how government and NHS leaders have a duty to patients and taxpayers to get the system working well

  • Wes Streeting to reveal package of reforms and announce new league table of NHS England providers, with top talent attracted to most challenging areas and persistently failing managers to be sacked
  • Turn around teams sent into struggling hospitals, while best performers given greater freedoms over funding to modernise technology and equipment
  • No more rewards for failure, with reforms to ensure every penny of extra investment into NHS is well spent and waiting times for patients slashed

NHS league tables will be introduced to help tackle the NHS crisis and ensure there are ‘no more rewards for failure’, as part of a tough package of reforms to be announced by the Health and Social Care Secretary Wes Streeting today (Wednesday 13 November).

Addressing the nation’s health leaders at the NHS Providers’ annual conference in Liverpool, he will outline how government and NHS leaders have a duty to patients and taxpayers to get the system working well and get better value for money.

NHS England will carry out a no holds barred sweeping review of NHS performance across the entire country, with providers to be placed into a league table. This will be made public and regularly updated to ensure leaders, policy-makers and patients know which improvements need to be prioritised. 

Persistently failing managers will be replaced and turn around teams of expert leaders will be deployed to help providers which are running big deficits or poor services for patients, offering them urgent, effective support so they can improve their service.

High-performing providers will be given greater freedom over funding and flexibility. There is little incentive across the system to run budget surpluses as providers can’t benefit from it. The reforms today will reward top-performing providers and give them more capital and greater control over where to invest it in modernising their buildings, equipment and technology.

The government will deliver a health service fit for the future, fixing the foundations while delivering change with investment and reform to deliver growth, get the NHS back on its feet, and rebuild Britain.

Health and Social Care Secretary Wes Streeting said: “The Budget showed this government prioritises the NHS, providing the investment needed to rebuild the health service. Today we are announcing the reforms to make sure every penny of extra investment is well spent and cuts waiting times for patients.

“There’ll be no more turning a blind eye to failure. We will drive the health service to improve, so patients get more out of it for what taxpayers put in.

“Our health service must attract top talent, be far more transparent to the public who pay for it, and run as efficiently as global businesses.

“With the combination of investment and reform, we will turn the NHS around and cut waiting times from 18 months to 18 weeks.”

Amanda Pritchard, NHS chief executive said: “While NHS leaders welcome accountability, it is critical that responsibility comes with the necessary support and development.

“The extensive package of reforms, developed together with government, will empower all leaders working in the NHS and it will give them the tools they need to provide the best possible services for our patients.”

The NHS Oversight Framework which sets out how trusts and integrated care boards are best monitored – will be updated by the next financial year to ensure performance is properly scrutinised.

Deep dives into poorly performing trusts will be carried out by the government and NHS England to identify the most pressing issues and how they can be resolved.

Louise Ansari, Chief Executive of Healthwatch England: “People value the hard work of NHS staff, but it’s frustrating when services fail to operate effectively. So, a fresh approach to improving NHS performance is welcome.

“Currently, living in an area with either an outstanding or poorly performing NHS trust feels like a postcode lottery. When a service is underperforming, it often takes far too long for patients to see the necessary improvements.

“This is because the current system focuses on evaluating service performance based on the number of tasks it completes and it does not do enough to measure patients’ overall outcomes and experiences.

“Establishing a better system that encourages NHS managers to focus on delivering the best care as efficiently as possible, and leads to quicker changes at struggling trusts, would be good news for everyone.”

NHS senior managers who fail to make progress will also be ineligible for pay increases. There will be financial implications for Very Senior Managers (VSMs) such as Chief Executives if they are failing to improve their trust’s performance, or letting patients down with poor levels of care.  

A new pay framework for VSMs will be published before April 2025. Senior leaders who are successfully improving performance will be rewarded, to ensure the NHS continues to develop and attract the best talent to the top positions. 

The changes are made in response to Lord Darzi’s investigation into the NHS, which found that: “The only criteria by which trust chief executive pay is set is the turnover of the organisation. Neither the timeliness of access nor the quality of care are routinely factored into pay. This encourages organisations to grow their revenue rather than to improve operational performance.”

The cost to the health service of hiring temporary workers sits at a staggering £3 billion a year. Under joint plans to be put forward for consultation in the coming weeks, NHS trusts could be banned from using agencies to hire temporary entry level workers in band 2 and 3, such as healthcare assistants and domestic support workers. The consultation will also include a proposal to stop NHS staff resigning and then immediately offering their services back to the health service through a recruitment agency.

Rachel Power, Chief Executive, Patients Association: “We welcome today’s commitment to improving NHS performance and accountability. These reforms signal an important drive for positive change in our health system. The focus on tackling poor performance and rewarding excellence sends a clear message about raising standards across the NHS.

“At the same time, we know from the experience of patients, that real transformation comes through genuine partnership with patients. We look forward to working with NHS England to ensure patient voices help shape how any league tables are developed and how success is measured.

“The proposed support teams for struggling trusts could be particularly effective if they include patient representatives and focus on building a culture of patient partnership. This is an opportunity to combine better management with deeper patient involvement – creating an NHS that is both more efficient and more responsive to people’s needs.

“We hope trusts who receive greater funding freedom will use this money wisely – to cut waiting times, make the waiting experience better for patients, and strengthen the ways they work with patients to improve services. These are the things that matter most to people using the NHS.”

Lord Darzi’s investigation into the NHS found that hospital productivity has ‘nosedived’ in the past five years. During that time resources have increased by 20%, but the number of patients treated has only increased by 3%.

This comes a month after the Health and Social Care Secretary kicked off the biggest national conversation about the future of the NHS since its birth, calling on the entire country to share their experiences of our health service and help shape the government’s 10 Year Health Plan. 

Members of the public, as well as NHS staff and experts, are sharing their experiences, views and ideas for fixing the NHS via the Change NHS online platform, which will be live until the start of next year, and available via the NHS App.

Starmer: Our NHS needs ‘major surgery, not sticking plaster solutions’

PM to pledge ‘the biggest reimagining of our NHS since its birth’ 

  • PM to set out plan for long term, fundamental reform to fix broken NHS 
  • Lord Darzi’s independent investigation concludes NHS is in ‘critical condition’
  • Findings provide a diagnosis of the challenges facing the health service, which will inform government’s 10 year plan to reform the NHS

The PM will pledge the ‘biggest reimagining of our NHS since its birth’ in a speech this morning [12 September 2024], following the publication today of a full and independent investigation into the state of the NHS.

Lord Ara Darzi’s probe has concluded the service is in a ‘critical condition’ amidst surging waiting lists and a deterioration in the nation’s underlying health, identifying serious and widespread problems for people accessing services.

The PM will say that the scale of the damage done to the NHS revealed by the report is “unforgivable”, recognising the tragic consequences for too many patients and their families: “People have every right to be angry. It’s not just because the NHS is so personal to all of us – it’s because some of these failings are life and death.

“Take the waiting times in A&E. That’s not just a source of fear and anxiety – it’s leading to avoidable deaths.

“People’s loved ones who could have been saved. Doctors and nurses whose whole vocation is to save them – hampered from doing so. It’s devastating.

He will also address the causes behind the state of the NHS, including the long term impacts of the 2012 Health and Social Care Act which is described in the report as “a calamity without international precedent” which “proved disastrous”, as well as the far reaching consequences of underinvestment throughout the 2010s. 

The PM is expected to say: “Our NHS went into the pandemic in a much more fragile state.

“We had higher bed-occupancy rates, fewer doctors, fewer nurses and fewer beds than most other high income health systems in the world.

“And let’s be clear about what caused that…a “scorched earth” approach to health reform, the effects of which are still felt to this day.

“Lord Darzi describes [the 2010s] as “the most austere decade since the NHS was founded”. Crumbling buildings, decrepit portacabins, mental health patients accommodated in Victorian-era cells infested with vermin.

“The 2010s were a lost decade for our NHS…which left the NHS unable to be there for patients today, and totally unprepared for the challenges and opportunities of tomorrow.”

As well as recognising the cost to people’s health, the PM will also address the inextricable link between the state of the NHS and the nation’s economy: It’s not just the state of our National Health Service in crisis – it’s also the state of our national health.

“There are 2.8 million people economically inactive due to long term sickness, and more than half of those on the current waiting lists for inpatient treatment are working age adults.

“Getting people back to health and work will not only reduce the costs on the NHS, it will drive economic growth – in turn creating more tax receipts to fund public services.

In the face of these dire findings and the growing pressures on the NHS from an ageing society and preventable illnesses, the PM will set out his belief in the ‘profound responsibility’ of government to do the hard work necessary to tackle them: “What we need is the courage to deliver long-term reform – major surgery not sticking plaster solutions.

“The NHS is at a fork in the road, and we have a choice about how it should meet these rising demands.

“Raise taxes on working people to meet the ever-higher costs of aging population – or reform to secure its future.

“We know working people can’t afford to pay more, so it’s reform or die.”

Rooted in Lord Darzi’s diagnoses of the challenges facing the NHS, the Prime Minister will outline three fundamental areas of reform and the imperative to work with staff and patients throughout this process. He is expected to say: “”This government is working at pace to build a Ten-Year Plan. Something so different from anything that has come before.

“Instead of the top-down approach of the past, this plan is going to have the fingerprints of NHS staff and patients all over it. 

“And as we build it together, I want to frame this plan around three big shifts – first, moving from an analogue to a digital NHS. A tomorrow service not just a today service.

“Second, we’ve got to shift more care from hospitals to communities… And third, we’ve got to be much bolder in moving from sickness to prevention.

“Only fundamental reform and a plan for the long term can turn around the NHS and build a healthy society. It won’t be easy or quick. But I know we can do it.

“The challenge is clear before us; the change could amount to the biggest reimagining of our NHS since its birth.”

Lord Darzi is an independent peer and practising surgeon with 30 years’ experience in the NHS. He examined over 600 pieces of analysis from DHSC, NHS England and external organisations during his investigation. His report will inform the government’s 10-year plan to reform the health service.

Lord Darzi said: “Although I have worked in the NHS for more than 30 years, I have been shocked by what I have found during this investigation – not just in the health service but in the state of the nation’s health.

“We want to deliver high quality care for all but far too many people are waiting for too long and in too many clinical areas, quality of care has gone backwards.

“My colleagues in the NHS are working harder than ever but our productivity has fallen. 

“We get caught up frantically trying to find beds that have been axed or using IT that is outdated or trying to work out how to get things done because operational processes are overwhelmed. It sucks the joy from our work – we became clinicians to help patients get better, not to go into battle with a broken system.

“We need to rebalance the system towards care in the community rather than adding more and more staff to hospitals. And we need a more honest conversation about performance – the NHS is now an open book.

“In the last 15 years, the NHS was hit by three shocks – austerity and starvation of investment, confusion caused by top-down reorganisation, and then the pandemic which came with resilience at an all-time low. Two out of three of those shocks were choices made in Westminster.

“It took more than a decade for the NHS to fall into disrepair so it’s going to take time to fix it. But we in the NHS have turned things around before, and I’m confident we will do it again.”

Despite the damning analysis, Lord Darzi insists the NHS’s vital signs ‘remain strong’ and he praised staff for their ‘shared passion and determination to make the NHS better for our patients’.

In carrying out the review, Lord Darzi brought more than 70 organisations together in an Expert Reference Group and sought input from NHS staff and patients through focus groups and frontline visits.   

Responding to the report, Secretary of State Wes Streeting said: “I asked Lord Darzi to tell hard truths about the state of the NHS. He has produced an honest, expert, comprehensive report on the appalling state our health service is in.

“Today’s findings will inform our 10-year plan to radically reform the NHS and get patients treated on time again.

“The damage done to the NHS has been more than a decade in the making. We clearly have a long road ahead. But while the NHS is broken, it’s not beaten. We will turn the NHS around so it is there for you when you need it, once again.”

Today’s report has been welcomed by NHS England and health organisations who have pledged to work closely with the government on its mission to rebuild the NHS.

Amanda Pritchard, NHS England Chief Executive, said: “As this report sets out, staff are the beating heart of the NHS with a shared passion and determination for making the NHS better for patients – but it is also clear they are facing unprecedented challenges.

“Our staff are treating record numbers of patients every day despite ageing equipment and crumbling buildings, a surge in multiple long-term illnesses, and managing the long-lasting effects of the pandemic.

“While teams are working hard to get services back on track, it is clear waiting times across many services are unacceptable and we need to address the underlying issues outlined in Lord Darzi’s report so we can deliver the care we all want for patients.

“As Lord Darzi rightly points out, many of the solutions can be found in parts of the NHS today. That is why we are fully committed to working with government to create a 10-year plan for healthcare to ensure the NHS recovers from Covid, strengthens its foundations and continues to reform so it is fit for future generations”

Key findings from Lord Darzi’s 142-page report include:

  • Deterioration: The health of the nation has deteriorated over the past 15 years, with a substantial increase in the number of people living with multiple long-term conditions. 
  • Spending: Too great a share of the NHS budget is being spent in hospitals, too little in the community, and productivity is too low.
  • Waiting times: Waiting lists have swelled and waiting times have surged, with A&E queues more than doubling from an average of just under 40 people on a typical evening in April 2009 to over 100 in April 2024. 1 in 10 patients are now waiting for 12 hours or more.
  • Cancer care: The UK has appreciably higher cancer mortality rates than other countries, with no progress whatsoever made in diagnosing cancer at stage one and two between 2013 and 2021.
  • Lasting damage: The Health and Social Care Act of 2012 did lasting damage to the management capacity and capability of the NHS. It took 10 years to return to a sensible structure, and the effects continue to be felt to this day.   
  • Productivity: Too many resources have been being poured into hospitals where productivity had substantially fallen, while too little has been spent in the community. 

Responding to the publication of Professor Lord Darzi’s Independent Investigation of the National Health Service in England, Nuffield Trust Chief Executive Thea Stein said: “Lord Darzi’s damning report underlines the stark realities experienced across almost every corner of the health service.

“Wide-ranging problems have been growing in plain sight for years and Darzi’s impressively comprehensive assessment will be familiar to anyone who has studied or experienced the slow deterioration of health care provision in England.

“While not surprising, the report’s findings are deeply troubling. As our research work has repeatedly shown, too often the NHS is not able to provide people with the timely care they need, despite steadfast public commitment to the core principles of the health service. The impacts of this are not felt equally: people in the poorest areas are particularly struggling to access healthcare.

“The big question now is what happens next.

“The Government has an early opportunity to make good on long-argued points on dysfunctional NHS funding in its first Budget next month. The health service is staring down the barrel of a significant shortfall in funding this current year [2] and the Chancellor will need to set out clear plans to tackle this, ahead of a longer-term funding settlement.

“Rightly, the report repeatedly references the interrelated, compounding pressures of the desperate state of social care and cuts to public health provision. But by design it does not dig into those issues. In future, we hope to see serious work by the government to address those broader societal issues that determine population health and impact health care access.

“Ultimately, the Lord Darzi’s diagnostic report sets out important aspirations to be delivered in the forthcoming 10-year plan to treat – and fix – the NHS. But the improvements we all hope for – and that patients desperately need – will take time, commitment and major financial, practical and system-wide support. There will be no quick fixes.”

Get Your Blood Pressure Checked

Millions at risk from ‘silent killer’ as NHS campaign warns there are often ‘no clues’ when it comes to high blood pressure

  • Up to 4.2 million people in England could be living with undiagnosed high blood pressure, according to NHS.
  • The ‘silent killer’ often has no symptoms but if left untreated, can lead to fatal heart attacks, strokes, kidney disease and vascular dementia.
  • New survey data shows that despite the majority of high blood pressure cases being asymptomatic, only one in 14 respondents (7 per cent) thought the condition has no symptoms.
  • The Get Your Blood Pressure Checked campaign has been launched to highlight that there are often ‘no clues’ as to who has high blood pressure – backed by Gloria Hunniford and Graeme Souness.
  • With the NHS expanding blood pressure checks in community pharmacies – including capacity for an additional 2.5 million tests – the national campaign is urging those aged 40 years and over to get a free blood pressure test at a participating pharmacy.
  • Campaign backed by British Heart Foundation, Stroke Association, Heart Research UK, Blood Pressure UK, May Measurement Month, British Society for Heart Failure, and more.

Today, the NHS is launching a new national campaign to find the ‘missing millions’ who have undiagnosed high blood pressure. 

High blood pressure, often described as a ‘silent killer’, affects an estimated 32 per cent of adults. As the condition rarely has any symptoms, approximately three in 10 of these remain undiagnosed, equating to 4.2 million people in England.

The public are today being warned that there are often ‘no clues’ about who might have high blood pressure – the only way to know is to have a simple test.

With the NHS announcing an additional 2.5 million blood pressure checks in community pharmacies over this year and next, those aged 40 years and over are now being urged to get a free blood pressure test at a participating pharmacy. The procedure is quick, non-invasive and you don’t need to book in advance. 

This comes as new survey data reveals widespread misconceptions about the condition among those at risk.

Despite the majority of high blood pressure cases being asymptomatic, only one in 14 respondents (7 per cent) thought the condition has no symptoms. The survey also revealed one in six (17 per cent) of those surveyed have been put off having a blood pressure check because they don’t feel unhealthy or stressed. 

Health Minister Andrea Leadsom said: “Millions of adults in England unknowingly have high blood pressure, without experiencing any symptoms. As part of our Pharmacy First programme, the NHS has expanded its pharmacy offering to include 2.5 million more blood pressure checks within local pharmacies.

“Knowing if you have a healthy blood pressure is so important and this new drive will help to prevent the potentially fatal consequences of untreated high blood pressure. I urge people to go to their local pharmacy today to get their blood pressure checked. It could be a lifesaving trip.”

Left untreated, high blood pressure can lead to heart attacks, strokes, kidney disease and vascular dementia.

However, the survey of over 2,000 adults aged 40 and over revealed worrying numbers who don’t know the potentially fatal effects of high blood pressure – with four in 10 (41 per cent) unaware that, if left untreated, high blood pressure can lead to heart disease, and over a fifth (22 per cent) being unaware that it can cause strokes and heart attacks.  

To encourage more over 40s to come forward for potentially life-saving blood pressure checks, new advertising features a fictional detective struggling to solve the mystery of high blood pressure, due to a lack of ‘clues’ and ‘insufficient evidence’.

The campaign is being backed by Graeme Souness, TV pundit and former footballer, who is affected by high blood pressure and had a heart attack, and Gloria Hunniford, TV presenter and broadcaster, whose dad and husband have suffered strokes.

The pair appear alongside other patients affected by the condition, and pharmacist Deepak Bilakhia, in a mock police line-up to demonstrate how any of us could be unknowingly walking around with the condition. 

Gloria Hunniford said: “This campaign is very close to my heart – both my husband and my father sadly suffered from a number of strokes due to high blood pressure, so I know from personal experience just how important it is to get your blood pressure checked, even if you feel healthy.

“That’s why I’m so pleased to hear that pharmacies offer free, quick blood pressure checks for people aged 40 and over – thankfully, this really will save lives.”

Graeme Souness said: “It’s so important to get your blood pressure checked – in my experience, high blood pressure doesn’t only affect the ‘usual suspects’, it can and does affect anyone so you could be at risk without knowing it.

“I’ve had high blood pressure for years but have been able to manage it with a routine of healthy eating, regular fitness and regular blood pressure checks.” 

It is hoped that the campaign will urge those at risk to prioritise getting their blood pressure checked, even if they have no symptoms – after the survey revealed that blood pressure checks are low on the list of people’s annual priorities.

The majority of those at risk currently prioritise annual tasks such as getting their car MOT’d (56 per cent), getting their boiler serviced (55 per cent) or renewing insurances (60 per cent), above checking their blood pressure (43 per cent) – despite its life saving potential.  

Meanwhile two in five (44 per cent) were not aware they could get a free blood pressure check at a pharmacy, with even more being unaware that they do not need an appointment (59 per cent). 

Chief Medical Officer for England Sir Professor Chris Whitty said: “High blood pressure usually has no symptoms but can lead to serious health consequences such as a fatal heart attack, a stroke, kidney disease and vascular dementia.

“The only way to know if you have high blood pressure is to get a simple, non-invasive blood pressure test. Even if you are diagnosed, the good news is that it’s usually easily treatable. 

“Getting your blood pressure checked at a local pharmacy is free, quick and you don’t even need an appointment, so please go for a check today – it could save your life.

Helen Williams, Pharmacist and National Clinical Director for CVD Prevention, NHS England said: “It can be easy to dismiss the risks of stroke and heart attack associated with high blood pressure, especially as it often has no signs or symptoms so I would encourage everyone over the age 40 to know their blood pressure numbers.

“With thousands of pharmacies across the country now offering free blood pressure checks with healthy living advice, it’s a quick, easy and convenient way to keep on top of your cardiovascular health at a time and place that suits you.”

Deepak Bilakhia, a Nottingham based community pharmacist, said: “Campaigns like this are so important because high blood pressure can be a silent killer and really can affect anyone, including those with no symptoms at all.

“Too many people are unaware that pharmacies offer this kind of service, without needing to book an appointment.

“So, if you’re 40 and over and haven’t had a check in the last 6 months, don’t put it off any longer.

“Checking your blood pressure at a local pharmacy is so simple to do but could save your life – and your pharmacist is here to help.”

Find a pharmacy that offers free blood pressure checks near you by searching “pharmacy blood pressure check” or visiting the NHS website here. 

Smokers encouraged to quit this new year for their health

The NHS is launching a brand new smokefree campaign to encourage all 5.3 million smokers in England to make a quit attempt this January

  • Former England goalkeeper and ex-smoker David James urges parents to quit for their kids’ sake in poignant video campaign discussing own struggles to kick the habit
  • Research shows teens more than three times as likely to smoke if their parents, caregivers or friends do
  • Comes as NHS Smokefree campaign encourages 5.3 million smokers in England to make a quit attempt this January to improve health and reduce likelihood of young people starting
  • Major new survey shows three quarters of people in England back government’s historic plans to create the first smokefree generation – regardless of age or region
  • First 259,000 vapes to be provided to authorities nationwide to support smokers to quit under world-first Swap to Stop scheme

In a hard-hitting campaign film released today, former England goalkeeper and ex-smoker David James joins a number of other ex-smokers to discuss the influence their parents’ smoking had on them taking up the habit themselves, and how being around children was their motivation to quit.

Watch the film here.

It comes as the NHS launches a brand new smokefree campaign to encourage all 5.3 million smokers in England to make a quit attempt this January – not only for their health, but also to help ensure young people are not being influenced to start smoking.

Research lays bare the stark reality – teens are more than three times as likely to smoke if their parents, caregivers, or friends do. In a new, poignant film released today, the former England goalkeeper discusses how his family members and friends smoked around him when he was a youngster, which led to him taking up the habit. In the film, he describes how smoking impacted his performance on the football world stage.  

The UK is now in the lead to be the first country in the world to create a smokefree generation by phasing out the sale of tobacco, and is set to introduce a new law to stop children who turned 14 in 2023 – or are younger – from ever legally being sold tobacco in England.

Three quarters (76%) of people in England support the principle of creating a smokefree generation a YouGov survey – commissioned by campaign group Action on Smoking and Health –has found with only 9% opposing. Support for creating a smokefree generation is similar regardless of age or region.

Former England goalkeeper, David James, said: “I smoked for about 15 years and at the time, it was normal. My mum smoked, my friends smoked, it was around me. It didn’t take long for me to be hooked.

“Looking back, it had a huge impact on my health and performance at the time, I wish I never started.

“My health, my children and my fans were huge motivators for me to quit – I didn’t want younger people to see me smoking and think it was okay.”

David James is joined by a number of other ex-smokers in the film to discuss the influence their parents’ smoking had on them taking up the habit themselves.

Watch the film here.

They are accompanied by Nick Hopkinson, Professor of Respiratory Medicine at Imperial College London, who was involved with the UK Millennium Cohort Study research, and TV doctor, Dr Sarah Jarvis, who talks through the wider impact of generational smoking.

Chief Medical Officer for England, Professor Sir Chris Whitty, said: “Smoking causes a range of diseases that affect people throughout their lives.

“Stopping people becoming addicted to smoking, and helping those who have been addicted to quit are two of the most important measures we can take to improve health.

“Quitting will improve your health whatever your age and no matter how long you have smoked, it’s never too late to stop.”

The government continues to go further and faster to support people to quit smoking. Under the world-first Swap to Stop scheme, the government has so far received requests from local authorities nationwide for an unprecedented 259,000 vapes.

Vaping is rightly used by adults as a tool to quit smoking, but the health advice is clear: if you don’t smoke, don’t vape – and children should never vape.

As part of the scheme, almost 1 in 5 of all smokers in England will be provided with a vape starter kit alongside behavioural support to help them quit the habit. This is part of a series of new measures to help the government meet its ambition of making England smokefree.

Public Health Minister, Andrea Leadsom, said: “Smoking is the biggest preventable killer in the UK and places a huge burden on our NHS.

“Cigarettes are responsible for 64,000 deaths a year in England alone – no other consumer product kills up to two-thirds of its users.

“That’s why we need to act now to prevent our children from ever lighting one. Our historic Tobacco and Vapes Bill will protect the next generation from the harms of smoking and risk of addiction.”

Watch the film here.

Smoking is still the single largest preventable cause of death in England. Almost every minute of every day someone is admitted to hospital with a smoking related disease.

Smoking costs the economy and wider society £17 billion a year. This includes an annual £14 billion loss to productivity, through smoking related lost earnings, unemployment, and early death, as well as costs to the NHS and social care of £3 billion. This is equivalent to the annual salaries of over half a million nurses, 390,000 GPs, 400,000 police officers, or 400 million GP appointments.

Reducing the prevalence of smoking will reduce those costs, lower pressure on the NHS, and help the economy become more productive.

Professor of Respiratory Medicine at Imperial College London, Nick Hopkinson, said: “We know that most people who smoke start as teenagers, and taking up smoking at a young age is linked to a greater risk of health problems later in life.

“Our research shows that the influence of family and friends is a significant driving force in young people taking up cigarettes in the first place, making them more than three times as likely to start smoking if their parents, caregivers or friends do.

“We must do what we can now to ensure our children are the first smokefree generation.”

Research suggests that people who start smoking under the age of 18 have higher levels of nicotine dependency and are less likely to quit smoking later in life.

Imperial College London’s analysis of UK Millennium Cohort Study data also found that 1 in 10 (10.6%) teenagers were regular smokers at the age of 17 – this equates to approximately 160,000 young people in the UK being regular smokers by the age of 17.

Currently, 4 in 5 smokers start before the age of 20 and smoking from a younger age is linked to being more likely to smoke in later years. This has a significant lasting impact, as someone who quits before turning 30 could add 10 years to their life.

Deborah Arnott, chief executive of Action on Smoking and Health (ASH) said: “Over three quarters of the public support the Prime Minister’s ambition to create a smokefree generation.

“Legislation to end cigarette sales to anyone born on or after the 1 January 2009 will be crucial to delivering that ambition. But as role models for their children, parents who smoke can play their part too.

“Stopping smoking will not only improve their health and put money in their pocket, but also significantly increase the chances their children will grow up to be part of the smokefree generation.”

TV doctor, Dr Sarah Jarvis, said: “Smoking is highly addictive, particularly for our children. We know that most smokers start in their youth and many want to quit – but the addictive nature of cigarettes means they cannot.

“But there’s help available for those looking to stop smoking. The NHS has a range of free support, including local stop smoking services.

Better Health offers a range of free quitting support, including a local stop smoking services look-up tool, as well as advice on stop smoking aids including information on how vaping can help you quit smoking.

For free support to quit this January, search ‘Smokefree’.

Visit https://www.nhs.uk/better-health/quit-smoking to find out more on what support is available.

NOTE: I’m sure Scots are encouraged to quit smoking too! – ED.

NHS England to roll out lung cancer screening

  • Targeted lung cancer screening to help detect cancer sooner and speed up diagnosis
  • People aged 55-74 with a GP record including a history of smoking will be assessed and invited for screenings and smoking cessation services
  • Rollout follows the success of the first phase of the targeted lung health check scheme by NHS England with 76% of lung cancers in those tested caught at an earlier stage

A national targeted lung cancer screening programme designed to catch cancer sooner or prevent it altogether has been announced by the Prime Minister and Secretary of State for Health and Social Care.

Each year the programme – which will cost £270 million annually once fully implemented – is expected to detect as many as 9,000 people with cancer, deliver almost one million scans and provide treatment earlier.

The rollout follows a successful opening phase where approximately 70% of the screening took place in mobile units parked in convenient places – such as supermarket car parks – to ensure easy access and focused on more deprived areas where people are four times more likely to smoke.

The programme, backed by a recommendation from the UK National Screening Committee – will use patient’s GP records for those aged 55 to 74 to identify current or former smokers. Patients will have their risk of cancer assessed based on their smoking history and other factors and those considered high risk will be invited for specialist scans every two years.

The Prime Minister, Rishi Sunak, said: As we approach the 75th anniversary of the foundation of the NHS, I want to ensure that it continues to thrive for the next 75 years and beyond.

“And while we focus on cutting waiting lists in the short term, we must also look to tackle some of the long-term challenging facing the NHS, including lung cancer which costs 35,000 lives every year. Rolling out screening to high-risk 55-74 year olds will save lives by detecting up to 9,000 lung cancers a year at an early stage.

“The NHS has treated record numbers of cancer patients over the last two years, with cancer being diagnosed at an earlier stage more often and survival rates improving across almost all types of cancer. Today’s announcement will help us go further and provide a lifeline to thousands of families across the country”.

The programme could also help people improve their health and reduce their risk of cancer by encouraging the use of smoking cessation services.

During the initial phase almost 900,000 people were invited for checks, 375,000 risk assessments made and 200,000 scans were carried out.

More than 2,000 people were detected as having cancer, 76% at an earlier stage compared to 29% in 2019 outside of the programme.

Health and Social Care Secretary Steve Barclay said: “Through our screening programme we are now seeing more diagnoses at stage 1 and stage 2 in the most deprived communities which is both a positive step and a practical example of how we are reducing health inequalities.

“Rolling this out further will prolong lives by catching cancer earlier and reducing the levels of treatment required not just benefiting the patient but others waiting for treatment.

“I am determined to combat cancer on all fronts through better prevention, detection, treatment and research.”

Smoking causes 72% of lung cancers, around 35,000 people die and 48,000 people are diagnosed with lung cancer each year.

It has one of the lowest survival rates of all cancers which is largely attributed to lung cancer being diagnosed at a late stage when treatment is much less likely to be effective. Treating cancer early improves people’s chance of survival with 60% of people currently surviving stage one cancer for five years or more and 4% at stage four.

It is estimated the rollout will mean 325,000 people will be newly eligible for a first scan each year with 992,000 scans expected per year in total. Additional radiographers, due to be appointed as part of the long term workforce plan, will help to support the programme.

Anyone assessed as being at high risk of lung cancer will be referred to have a low dose Computed Tomography (LDCT) scan and subsequent diagnosis and treatment if needed. Those whose scans are negative will be reinvited for further scans every 24 months, until they pass the upper age limit.

Some people who test negative but are found to have nodules will be reinvited for more frequent scans. These nodules are often the first signs of cancer developing so by monitoring more frequently if they turn cancerous they can be delt with quickly and at the early stages.

NHS chief executive, Amanda Pritchard, said: “Identifying lung cancer early saves lives, and the expansion of the NHS’s targeted lung health check programme is another landmark step forward in our drive to find and treat more people living with this devastating disease at the earliest stage.

“The NHS lung trucks programme is already delivering life-changing results, with people living in the most deprived areas now more likely to be diagnosed at an earlier stage, giving them a better chance of successful treatment.

“As the NHS turns 75, we will not stop in our efforts to detect more cancers earlier, when they are easier to treat, and to find new and innovative ways to make it as easy as possible for those most at risk to get life-saving tests as part of their daily routines.

“If you receive an invitation, please do take it up, and if you are worried about a possible symptom of cancer, please come forward to your GP – getting checked could save your life.”

The first phase of the scheme will reach 40% of the eligible population by March 2025 with the aim of 100% coverage by March 2030 following the rollout which will also help support the government objective for England to be smokefree by 2030.

During the pilot Cancer Alliances developed schemes locally. A national programme will benefit from an integrated IT system and a safe, consistent and effective programme across the country and for a number of years.

Paula Chadwick, chief executive of Roy Castle Lung Cancer Foundation, said: “This is the news we have been waiting for. This is the day we truly begin to level up the lung cancer playing field.

“Lung cancer screening allows us to get ahead of this awful disease for the first time, catching it at the earliest opportunity – often before symptoms even start – and treating it with an aim to cure.

“Through the success of NHS England’s targeted lung health check programme, we have been able to detect 76% of cancers at stages one and two, which turns current rates on their head. Now, with this announcement, many more lives will be saved, making today a very good day in our mission to beat the UK’s biggest cancer killer.”

Hazel Cheeseman, Deputy Chief Executive of Action on Smoking and Health (ASH), said: “Targeted Lung Cancer screening with support to stop smoking at its heart will help prevent as well as treat lung cancer, still the leading cause of cancer deaths.

“Around 7 out of 10 lung cancers are caused by smoking and just over a third of lung cancer patients are smoking at diagnosis. Smokers who quit then can nearly double their life expectancy after treatment and live more comfortably than those who continue to smoke.

“And it won’t just help those diagnosed with lung cancer, smokers who get the all clear but go on to quit will avoid many smoking-related illnesses. Smokers who get support and medication as part of their Lung Health Check are 50% more likely to quit than those who don’t. This is a major step forward in helping deliver the Government’s Smokefree 2030 ambition.”

Cancer Research UK’s chief executive, Michelle Mitchell, said: “This is really positive news for a cancer type that takes more lives than any other.

“Targeted lung screening across England could diagnose people most at risk at an earlier stage, when treatment is more likely to be successful.”

New drugs pilot to tackle obesity and cut NHS waiting lists in England

More people living with obesity will have access to the newest and most effective obesity drugs to help cut NHS waiting lists, following the UK Government’s announcement of a £40 million two-year pilot yesterday

  • Two-year pilot backed by up to £40 million will explore ways to make obesity drugs accessible to patients living with obesity outside of hospital settings
  • The newest weight loss drugs can help adults living with obesity lose up to 15 per cent of their body weight when prescribed alongside diet, physical activity and behavioural support
  • Pilots build on government’s work to tackle obesity, reducing pressure on the NHS and cutting waiting lists

More people living with obesity will have access to the newest and most effective obesity drugs to help cut NHS waiting lists, following the announcement of a £40 million two-year pilot yesterday.

Earlier this year, the National Institute for Health and Care Excellence (NICE) recommended the use of Semaglutide (Wegovy) for adults with a Body Mass Index (BMI) of at least 35 and one weight-related health condition – such as diabetes or high blood pressure. Other drugs are currently under consideration in clinical trials.

There is evidence from clinical trials that, when prescribed alongside diet, physical activity and behavioural support, people taking a weight-loss drug can lose up to 15 per cent of their body weight after one year. Taking them alongside diet, physical activity and behavioural support can help people lose weight within the first month of treatment.

Obesity is one of the leading causes of severe health conditions such as cardiovascular disease, diabetes and cancer, and it costs the NHS £6.5 billion a year. There were more than 1 million admissions to NHS hospitals in 2019/2020 where obesity was a factor.

Using the latest treatments to tackle obesity will contribute to cutting waiting lists by reducing the number of people who suffer from weight-related illnesses, who tend to need more support from the NHS and could end up needing operations linked to their weight – such as gallstone removal or hip and knee replacements.

NICE advise that Wegovy should only be available via specialist weight management services, which are largely hospital based. This would mean only around 35,000 people would have access to Wegovy, when tens of thousands more could be eligible.

The £40 million pilots will explore how approved drugs can be made safely available to more people by expanding specialist weight management services outside of hospital settings. This includes looking at how GPs could safely prescribe these drugs and how the NHS can provide support in the community or digitally – contributing to the government’s wider ambition to reduce pressure on hospitals and give people access to the care they need where it is most convenient for them.

Prime Minister Rishi Sunak said: “Obesity puts huge pressure on the NHS.

“Using the latest drugs to support people to lose weight will be a game-changer by helping to tackle dangerous obesity-related health conditions such as high blood pressure, diabetes and cancer – reducing pressure on hospitals, supporting people to live healthier and longer lives, and helping to deliver on my priority to cut NHS waiting lists.

Health and Social Care Secretary Steve Barclay said: “Obesity costs the NHS around £6.5 billion a year and is the second biggest cause of cancer.

“This next generation of obesity drugs have the potential to help people lose significant amounts of weight, when prescribed with exercise, diet and behavioural support.

“Tackling obesity will help to reduce pressure on the NHS and cut waiting times, one of the government’s five priorities,  and this pilot will help people live longer, healthier lives.”

Health Minister Neil O’Brien said: “We know that obesity puts additional pressure on the NHS and is linked to a whole host of health problems – including diabetes and cardiovascular disease.

“Expanding how to access these innovative new drugs will ensure as many eligible patients as possible have the opportunity to try these treatments if they are right for them to help achieve a healthier weight.

“These pilots build on our ongoing work to tackle obesity – including introducing calorie labelling on menus to empower people to make informed decisions and investing in school sport to give children an active start in life.”

NHS medical director Professor Sir Stephen Powis said: “Tackling obesity is a key part of the NHS Long Term Plan – it can have devastating consequences for the nation’s health, leading to serious health conditions and some common cancers as well as resulting in significant pressure on NHS services.

“Pharmaceutical treatments offer a new way of helping people with obesity gain a healthier weight and this new pilot will help determine if these medicines can be used safely and effectively in non-hospital settings as well as a range of other interventions we have in place.”

NICE is also considering potential NHS use of another drug known as Tirzepatide – which is currently licenced to treat diabetes but may also help with weight loss – if it receives a license for weight loss in the coming months.

NHS England is already working to implement recommendations from NICE to make this new class of treatment available to patients through established specialist weight management services, subject to negotiating a secure long-term supply of the products at prices that represent value for money taxpayers.

Losing weight can help to reduce the risk of obesity-related illness which in turn can reduce pressure on the NHS, cut waiting times, and realise wider economic benefits.

The pilot builds on the firm action the government is already taking to tackle obesity, including:

  • Introducing calorie labelling on menus, which are expected to bring health benefits of £4.6 billion and provide NHS savings of £430 million
  • Restrictions on the location of unhealthy foods in shops, which are expected to bring health benefits of over £57 billion and provide NHS savings of over £4 billion over the next 25 years
  • Introducing the Soft Drinks Industry Levy which has seen the average sugar content of drinks decrease by 46 per cent between 2015 and 2020
  • Investment to boost school sport to help children and young people have an active start to life.

Last year the government announced £20million for the Office of Life Science’s Obesity Mission. This will explore innovative ways to best utilise promising medicines and digital technologies to help NHS patients achieve a healthy weight.

The Better Health: Rewards App is also being piloted in Wolverhampton. It is offering incentives such as vouchers for shops, gym discounts and cinema tickets for people who eat healthily and exercise more.

The 2019 Health Survey for England estimated that over 12 million adults were living with obesity – 28 per cent of the population in England – while a further 16 million (36 per cent) were overweight. This means that around two-thirds of the adult population were above a healthy weight – defined as having a BMI of 25 or above.

DHSC launched a call for evidence in May to inform the Major Conditions Strategy, including further work to tackle obesity.

New Every Mind Matters campaign encourages public to get physical

Celebrities and medical experts including comedian Tom Davis, Dr Ranj Singh and Dr Linda Papadopoulos support new UK government campaign to boost mental health

Ahead of Mental Health Awareness Week (15 – 22 May), Better Health – Every Mind Matters from the Office for Health Improvement and Disparities is launching a new campaign backed by BAFTA award-winning comedian, Tom Davis, TV and NHS doctor, Dr Ranj Singh, and leading psychologist, Dr Linda Papadopoulos, to encourage the nation to make the first move for their mental health and get active.

New research released today has revealed that three quarters (75%) of adults surveyed report feeling anxious, but less than half (45%) are aware that physical activity is proven to reduce symptoms of anxiety.

The campaign is the latest action taken by government to improve people’s mental health. The government is already increasing investment in mental health services by at least £2.3 billion a year by March 2024 so that an additional two million people can get the support they need.

Last year, the draft Mental Health Bill was published, intended to modernise the Mental Health Act so that it’s fit for the 21st century and better supports people with serious mental illness, and the government has committed to publishing a Major Conditions Strategy to tackle conditions that contribute most to morbidity and mortality across the population in England, including mental ill health.

For Mental Health Awareness Week, BAFTA award-winning comedian and actor, Tom Davis, has opened up about his own mental health alongside NHS and TV doctor, Dr Ranj Singh, in support of the Better Health – Every Mind Matters campaign. In a new film released today, the pair discuss how they deal with anxious thoughts and call on the nation to make the first move for their mental health by getting active.

https://youtu.be/yV-ZUPgt9Kc

Comedian and Actor, Tom Davis, comments: “Anxiety is no laughing matter. I’ve had a colourful career, from working on building sites, to the shop floor, to being a comedian in front of thousands, and I’ve struggled with anxiety in every role.

“There’s a big difference, though, to being outside your comfort zone versus feeling overwhelmed by it and letting your anxious thoughts hold you back. And being active for just a few minutes each day can make a huge difference.

“It’s important to find something that you enjoy and do it regularly. I love boxing and try to go often, but even taking my daughter to the park can really clear my head and help to keep those anxious jitters at bay.

NHS and TV doctor, Dr Ranj Singh, has also shared his tips on how to ease anxiety (see NTEs) and advice on how the public can start getting active for their mental health: “Anxiety is part of everyday life, and it can help us focus or take extra care when needed, but when it gets too much, it can have a really big impact on how we want to live our lives.

“Physical activity is one of the simplest, but most effective, things we can do to help alleviate anxious feelings, calm racing thoughts, and give us something to distract from negative thinking.

“Regular physical activity is best, but even a few minutes each day can help. I personally love dancing because some good music instantly lifts my mood!”

New research among 2,000 adults in England has revealed around four in 10 report having trouble sleeping (38%), feeling less confident (37%) and having less energy due to anxiety (35%).

For just under a quarter (24%), anxiety has stopped them from attending social events and almost one in 10 admit it’s even impacted their relationship, as they spend less time with their partner (8%).

Physical activity releases feel good hormones and improves mental health but, according to the new research, less than half of adults are aware that it’s proven to reduce symptoms of anxiety (45%), reduce stress (45%) and distract from negative thoughts (42%). Four in 10 adults are not doing the NHS recommended 150 minutes of physical activity per week.

The research revealed that over a third (35%) of adults tend to use distraction techniques to relieve feelings of anxiety, including watching TV (47%), browsing the internet (36%) or even isolating themselves from others (33%). However, those who do regular physical activity report that it helps to boost their mood (68%), confidence (61%) and relieve anxious feelings (61%).

With almost one in five not doing any form of physical activity (19%), the research also revealed that not feeling motivated (41%), not enjoying physical activity (25%), and not having enough free time (19%) were the top barriers to getting active. Only 13% of us are aware of the NHS recommended 150 minutes of physical activity per week.

Leading psychologist, Dr Linda Papadopoulos commented: “People are often surprised to know the benefits that just a few minutes of movement can have on our mind; you don’t need to do a full body workout to reap the rewards.

“Being active increases feel good hormones, like endorphins, and can boost confidence. I always recommend getting outside for a brisk walk or gentle jog because being in nature can help us feel happier and more relaxed. And the best bit is it’s free!

Minister for Mental Health, Maria Caulfield, said: “We know poor mental health can significantly impact our quality of life, so I’m pleased to see this campaign highlighting the simple steps we can all take to reduce its impact – such as spotting and addressing the signs of anxiety early on.

“But we know sometimes more support is needed, and that’s why we’re currently investing £2.3 billion every year to expand and transform mental health services in England so that two million more people will be able to get the mental health support they need.”

Delivered by the Office for Health Improvement and Disparities, the Better Health–Every Mind Matters campaign offers NHS-approved tips and advice to help people manage their anxiety, including links to free NHS apps, such as Couch to 5K and Active 10, that will help them make the first move.

The Better Health – Every Mind Matters website also gives people the opportunity to sign up to anxiety-easing emails, offering expert advice to help them stay on top of their mental wellbeing and show them how to make these new steps part of their routine.

Social media:

#everymindmatters

#moveforyourmentalhealth

#MentalHealthAwarenessWeek

#MHAW / @NHS

Scots looking after their mental health can also find support at NHS inform’s Mind to Mind | NHS inform

England’s smokers urged to swap cigarettes for vapes in world first scheme

Pregnant women will also be offered financial incentives to help them quit as part of a sweeping package of measures to cut smoking rates in England

One million smokers will be encouraged to swap cigarettes for vapes under a pioneering new “swap to stop” scheme designed to improve the health of the nation and cut smoking rates.

As part of the world-first national scheme, almost one in five of all smokers in England will be provided with a vape starter kit alongside behavioural support to help them quit the habit as part of a series of new measures to help the government meet its ambition of being smokefree by 2030 – reducing smoking rates to 5% or less. Local authorities will be invited to take part in the scheme later this year and will design a scheme which suits its needs, including deciding which populations to prioritise.

In a speech today, Health Minister Neil O’Brien will also announce that following the success of local schemes, pregnant women will be offered financial incentives to help them stop smoking. This will involve offering vouchers, alongside behavioural support, to all pregnant women who smoke by the end of next year.

The government will also consult on introducing mandatory cigarette pack inserts with positive messages and information to help people to quit smoking.

Additionally, there will be a crackdown on illicit vape sales as part of measures to stop children and non-smokers take up the habit – which is growing in popularity among young people.

Health Minister Neil O’Brien will say: “Up to two out of three lifelong smokers will die from smoking. Cigarettes are the only product on sale which will kill you if used correctly.

“We will offer a million smokers new help to quit. We will be funding a new national ‘swap to stop’ scheme – the first of its kind in the world. We will work with councils and others to offer a million smokers across England a free vaping starter kit.”

The new policies will deliver the UK Government’s three aims to help more adults quit smoking, stop children and non-smokers from taking up vaping, and using vaping as a tool for established adult smokers to quit.

For those who quit, the risk of heart attack is halved after one year of quitting, ultimately halving the likelihood of ending up in a hospital bed or worse.

Supporting more women to have a smokefree pregnancy will reduce the number of babies born underweight or underdeveloped with health problems requiring neonatal and ongoing care. It will also reduce the risk of miscarriage and stillbirth.

Cutting smoking rates reduces the number of smoking-related illnesses needing to be treated, in turn reducing the pressure on the NHS, helping to deliver on our priority to cut NHS waiting lists.

NHS figures for 2021 showed that 9% of 11- to 15-year-old children used e-cigarettes, up from 6% in 2018.

In recognition of the sharp increase, Minister O’Brien will launch a Call for Evidence on youth vaping to identify opportunities to reduce the number of children accessing and using vape products – and explore where government can go further.

Working with enforcement agencies and learning from the government’s work with Trading Standards on illicit tobacco, £3 million of new funding will also be provided to create a specialised ‘illicit vapes enforcement squad’ to enforce the rules on vaping and tackle illicit vapes and underage sales.

As part of the measures, HMRC and Border Force will also be publishing an updated strategy this year to tackle illicit tobacco. It will lay out strategically how we continue to target, catch and punish those involved in the illicit tobacco market.

Smoking prevalence in England in 2021 was 13% – the lowest on record thanks to measures such as doubling duty on cigarettes since 2010 and continued funding to local stop smoking services

In 2021-22, £68 million of public health grant funded was spent on stop smoking services by local authorities and nearly 100,000 people quit with the support of a stop smoking service.

In addition, £35 million has been committed to the NHS this year so that all smokers admitted to hospital will be offered NHS-funded tobacco treatment services.

However, 5.4 million people in England smoke tobacco which remains the single biggest cause of preventable illness and death. Up to two out of three lifelong smokers will die from smoking and recent data shows one in four deaths from all cancers were estimated to be from smoking.

Last year an independent smoking review led by Javed Khan proposed a range of measures to help people stub out the addiction, which has informed the measures set out today.

Walking, wheeling and cycling to be offered on prescription in England

  • trials in 11 areas across England to help people’s mental and physical health
  • GPs will issue social prescriptions such as walking, wheeling and cycling, backed by £12.7 million
  • schemes will include cycling and walking groups, cycle training and free bike loans

Social prescriptions, including walking, wheeling and cycling, will be offered by GPs as part of a new trial to improve mental and physical health and reduce disparities across England, the government has announced today (22 August 2022).

The government has awarded £12.7 million in multi-year funding to 11 local authority areas in England. The funding will go towards several pilot projects in each location, including:

  • adult cycle training
  • free bike loans
  • walking groups

Other schemes include all-ability cycling taster days where people who may not have cycled before can try to in a friendly environment, or walking and cycling mental health groups where people can connect with their communities as they get active.

The pilots must be delivered alongside improved infrastructure so people feel safe to cycle and walk.

The 11 local authority areas that will trial social prescriptions are:

  • Bath and North East Somerset
  • Bradford
  • Cornwall
  • Cumbria
  • Doncaster
  • Gateshead
  • Leeds
  • Nottingham
  • Plymouth
  • Suffolk
  • Staffordshire

The pilots, a commitment in the government’s Gear Change plan published in 2020, aim to evaluate the impact of cycling and walking on an individual’s health, such as reduced GP appointments and reliance on medication due to more physical activity. For the first time, transport, active travel and health officials will work together towards a whole systems approach to health improvement and tackling health disparities.

Walking and Cycling Minister, Trudy Harrison, said:  ”Walking and cycling has so many benefits – from improving air quality in our communities to reducing congestion on our busiest streets.

“It also has an enormous positive impact on physical and mental health, which is why we have funded these projects which will get people across the country moving and ease the burden on our NHS.”

National Active Travel Commissioner, Chris Boardman, said: “As a nation we need healthier, cheaper and more pleasant ways to get around for everyday trips. Active Travel England’s mission is to ensure millions of people nationwide can do just that – so it’s easier to leave the car at home and to enjoy the benefits that come with it.

“Moving more will lead to a healthier nation, a reduced burden on the NHS, less cancer, heart disease and diabetes, as well as huge cost savings. This trial aims to build on existing evidence to show how bringing transport, active travel and health together can make a positive impact on communities across England.”

The pilots will be delivered between 2022 and 2025 with on-going monitoring and evaluation to support continued learning.

The project is bringing together a range of government departments and agencies including:

  • NHS England
  • Office for Health Improvement and Disparities
  • Sport England
  • National Academy for Social Prescribing
  • Defra
  • Department for Health and Social Care

Health Emergency: Worst ever four-hour performance “must be a call to action”

“The health service is in the middle of the biggest crisis it has ever faced“

The latest monthly Emergency Department (ED) performance figures published by NHS England for December 2021 show that four-hour performance at major Emergency Departments reached its lowest since records began at 61.2%, meaning nearly two in five patients were delayed by four-hours or more and nearly 1 in 4 admissions experienced a wait of at least four hours from the decision to admit them to admission.

The data also show the highest number of 12 hour waits ever recorded: 12,986 patients spent 12 hours or more from decision to admit to admission. This is a 22% increase on the previous month, November 2021, and it is 250% higher than December 2020.

Responding to the publication of NHS England quarterly and monthly performance figures, Dr Katherine Henderson, President of the Royal College of Emergency Medicine, said: “The situation on the ground is extremely bleak. Staff are overwhelmed and burned out; it is increasingly challenging to provide timely and safe patient care.”

Latest Quarterly performance figures published by NHS England show that in 2021-2022 there were a total of 43,218 12-hour delays which is more than all the 12-hour delays over the previous ten years put together (39,608).

The data does not paint the full picture as NHS England record 12-hour waits from decision to admit. Our Winter Flow project, which started at the beginning of October 2021, has so far recorded 71,965 12-hour waits from time of arrival.

It is critical that NHS England commit to reporting 12-hour data from time of arrival and implement the Clinical Review of Standards.

Dr Henderson said: “The health service is in the middle of the biggest crisis it has ever faced, and staff are working harder than ever before with fewer staff and fewer beds.

“When the health service is overwhelmed, it does not cease to function, it is the standards and quality of care that fall. The figures published today show the extent to which these standards have fallen already.

“Performance metrics are intended to hold clinical services to account. They are meant to identify areas in which services are failing with the aim of improving them quickly and effectively.

“The consistent and continuous decline of urgent and emergency care performance, standards, patient experience and patient safety show how this intended function is now entirely lost. With each publication around performance, we commentate with shock and dismay at the latest decline, but our comments are, more often than not, met with inaction or short-term fixes. There needs to be acknowledgment that there is a major public health crisis in emergency care.

“It is the core ability and function of the health and social care service to deliver high-quality and effective care to the acutely ill or injured that is at risk.

“We must now see a vision for recovery and a vision for the health service that includes a vital transformation of the urgent and emergency care system. There must be a plan to implement a framework that is centred around patient care, that drives action and improvement.

“The current framework is simply documenting the health system’s failure to deliver a quality service, and the failure of this framework leaves urgent and emergency care in a performance vacuum.

“We need a decision about either a phased implementation of the findings of the Clinical Review of Standards or an honest discussion about how we performance manage urgent and emergency care differently.

“The current challenges facing the health and social care service are the result of years of stagnation and decline, they are made worse by, but are not just a consequence of, the pandemic. Recognising this is vital to any step towards transformation.

“It is time we saw bolder political willingness to engage on these critical issues. Without action, performance will continue to decline, and this would be a disservice to patients and staff.”