Dear SCH Health News reader, welcome to your spring edition! Where have a couple of months of the new year gone? With blooms blooming and steadily lighter mornings and evenings upon us, please enjoy as always, these three carefully selected health-related articles from the media this past month, or so :-

4^th The Times: The Times Health Commission’s 10 Recommendations to save the NHS

It is not difficult to spot the problems in the NHS. The soaring waiting lists, overrun A&E departments, queuing ambulances and struggling GP surgeries are clear for all to see. The purpose of The Times Health Commission was to find solutions. It was supported by a prestigious group of expert commissioners from the worlds of medicine, business, policy, science, food and sport.

The commission also visited dozens of hospitals, care homes, GP surgeries and research laboratories in the UK and abroad – including visits to Japan, Denmark, Israel, Ireland and Spain. The recommendations contained in the final report are pragmatic, practical, deliverable and could be taken up by any political party or government, present or future. Some proposals could be implemented immediately, others will take longer to come into effect.

The ten-point plan

1. Create digital health accounts for patients, called patient passports, accessed through the NHS app to book appointments, order prescriptions, view records, test results or referral letters and contact clinicians.
2. Tackle waiting lists by introducing a national programme of weekend High-Intensity Theatre (HIT) lists once a month in 50 hospitals to get through a week’s worth of planned operations in a day and create seven-day surgical hubs.
3. Reform the GP contract to focus on wider health outcomes rather than box-ticking, ensure patients get prompt appointments and restore continuity of care. Encourage more super-practices and create community health centres.
4. Write off student loans for doctors, nurses and midwives who stay in the NHS to improve retention as well as recruitment. Debt should be cut by 30 per cent for those who stay three years, 70 per cent for seven years and 100 per cent for ten years.
5. Introduce no-blame compensation for medical errors with settlements determined according to need to ensure families get quick support and encourage the NHS to learn from mistakes.
6. Establish a National Care System giving everyone the right to appropriate support in a timely fashion. Equal but different from the NHS, it should be administered locally and delivered by a mixture of the public and private sectors.
7. Guarantee that all children and young people requiring mental health support can get access to treatment within four weeks and rapid follow-up appointments. Publish data on waiting times for all mental health services.
8. Tackle obesity by expanding the sugar tax, taxing salt, implementing a pre-watershed ban on junk food advertising and reducing cartoons on packaging to minimise children’s exposure to unhealthy food.
9. Incentivise NHS staff to take part in research, and put the case for research to their patients by giving 20 per cent of hospital consultants and other senior clinicians 20 per cent protected time for research.
10. Establish a Healthy Lives Committee empowered by a legally binding commitment to increase healthy life expectancy by five years in a decade and reduce health inequalities to encourage a long-term approach with cross-party agreement.  

19th BBC News – The NHS hidden waiting lists terrifying patients

Patients are facing delays stuck on hidden waiting lists that do not show up in the official figures in England, a BBC News investigation reveals. The published waiting list stands at 7.6 million – but the true scale of the backlog is thought to be much higher. This is because patients needing ongoing care are not automatically included in those figures – even if they face major delays. NHS England said hospitals should be monitoring and counting such cases, but BBC News found evidence suggesting this is not always the case. The problem affects patients receiving ongoing care, as well as those removed from waiting lists even before starting treatment. BBC News has spoken to patients waiting months and even years for vital treatment, such as cancer care, spinal treatment and others at risk of going blind because of deteriorating eyesight.

‘Really worrying’

One of those is Andy Allen, 69, from Chelmsford, who has wet AMD, which causes vision to deteriorate. He needs regular eight-weekly injections to protect his sight, but says he often waits longer with the latest gap being more than twice as long as it should be. “It’s really worrying. My eyesight is getting worse – and I do wonder if it is because of the delays.”

Macular Society charity chief executive Cathy Yelf called the delays in the system a “tragedy.” “People are terrified at the prospect of losing their sight”, she added. The official waiting list tracks patients waiting to begin treatment. Around 1.4 million treatments are recorded as beginning each month on average – with one in three affected by delays, according to data for 2022-23. But there are more than 3 million other appointments and treatments carried out for patients who are receiving ongoing care. Many will be getting timely care, but how many of those are delayed is not known. Some say millions could be affected over the course of a year.

‘Commonly ignored’

Hospitals are meant to return patients facing unnecessary delays to the waiting list to ensure that are counted in the backlog figures. But of 30 NHS trusts asked by BBC News how regularly this was happening, only three could provide figures. Karen Hyde, from Insource, a company that helps hospitals manage waiting lists, said the guidance was “commonly ignored. This is a huge issue. The NHS does not incentivise hospitals to keep a close eye on these patients. We know there are long waits for those on the waiting list. For those not on the official waiting list, it is likely to be even worse – but the figures are not published.” She said another problem was that some patients face being taken off the waiting list before treatment starts – this can be done when the patient is not ready for treatment or if they have refused it. But she said many hospitals had no reliable system for tracking these patients, who could be simply “lost and delayed.”

This has happened to Margaret Weston, who has basal cell carcinoma, a slow-growing form of skin cancer. The risk of it spreading is very low, so the 64-year-old, from Lincolnshire, has been under the care of doctors in the East Midlands for the past few years. But with three separate hospitals involved in her care, a mix-up saw her removed from the waiting list. Ms. Weston has now been upgraded to an urgent case and is waiting for surgery. “It is so easy to fall through the gaps. Hospitals aren’t monitoring these waits and not recording it properly. I’m terrified about what might happen now,” she said.

‘Irreversible damage’

Another patient BBC News has spoken to is now exploring taking legal action, after being put on a “holding” waiting list despite struggling with severe abdominal problems. Hospital letters about their case, seen by BBC News, acknowledge these lists are not “manned routinely” and patiently can be held up in the system. Macmillan Cancer Support policy head Minesh Patel said patients receiving regular chemotherapy and radiotherapy – and those under surveillance to check if their cancer had returned – also faced delays. “NHS staff are doing all they can – but with limited resources, it’s impossible for them to keep up”, he added.

The British Heart Foundation said heart failure patients were at particular risk as they needed regular check-ups to ensure treatment was working. A delay to changes in treatment could lead to “permanent and irreversible damage”, the BHF’s Dr. Sonya  Babu-Narayan said.

23^rd Jan  The  Financial Times – UK employee health has barely improved since pandemic

UK employers lost the equivalent of 50 days of work per employee last year because of poor physical and mental health – only slightly down on peak levels in 2022 at the tail-end of the Covid-19 pandemic, according to the FT – Vitality Britain’s Healthiest Workplace survey. Among 4,787 employees at 59 organisations polled in the year to October 2023, on average 43.6 days of work were lost due to “presenteeism” – unproductive time in the workplace. That was in addition to 6.1 days of sickness absence. Together, the amount of lost work was a 2 per cent improvement on the previous year. The survey also indicated continued high levels of obesity, excessive drinking, and lack of sleep, even though most indicators of ill health showed a slight improvement on 2022. The data – provided by a self-selecting group of employers and employees – was used to identify the UK’s healthiest workforces.

The survey and associated awards are funded by Vitaliy, in a partnership with Aon, Rand Europe, Cambridge university and the Financial Times, which helped oversee the survey. This year, the research showed important differences in wellbeing and productivity linked to income, gender, age, seniority, and work location. Ella West, wellbeing lead at Arqiva, (from one of three winning companies) which uses the data to track employee wellbeing and has been developing programmes for staff over the past decade, said: “We started with a physical and mental wellbeing focus, but now recognise the need to support the whole person – including professional, social and financial wellbeing.”

Across the latest BHW survey, 58 per cent of employees reported being overweight, 56 per cent said they had a poor diet, 23 per cent were obese, and 37 per cent disclosed a lack of physical activity. Some 29 per cent reported poor length of sleep and 22 per cent poor sleep quality, while 10 per cent said they were depressed. Nine per cent smoked. Productive time lost averaged 27.9 days a year for C-suite top managers and executives, rising to 51.5 days among non-managerial employees. It averaged 32.6 days for those earning more than £150,000 a year, rising to 61.6 days for those earning £20,000-30,000. Younger employees were badly affected, with days lost as high as 60.6 among 18–25 year-olds, falling to 32 days for those aged 61-65 year-olds. Those continuing with hybrid working had lower lost productivity compared with those who always worked at an office or always worked at home. Women had more productivity losses than men.

  *******************************************

So, there you have it good people for another month. Trusting that you enjoyed those informative news articles, until April, enjoy the spring sunshine, with walks in the spring countryside no doubt high on many of your weekend agendas, being so good for our health and wellbeing of course!

Take care

Yours sincerely,

Daniel Donoghue

MD, Surrey Circle Health

Specialist Whole of Market PMI Broker