February 2020 Edition

In this edition of Casebook we bring you a zero carbon NHS, workers in unhealthy jobs,  health-checks for new mums,  more political interference on the cards for the NHS and the ongoing dysfunctional impact of pensions on the health agenda.

News

The NHS has a plan to tackle its huge environmental impact

2050 seems a long way off to me, notwithstanding the scale of the NHS. I wonder if there is not scope for them to do better and in part at least by helping more people, particularly in rural settings, get more treatment at home? This story tells us:

By any measure, the NHS is a behemoth. Its 1.3 million staff are spread out across 1,200 sites plus a further 7,600 GP practices in England alone. Every year NHS-related travel – including ambulance journeys, staff commutes and patient visits – adds up to 9.5 billion miles, which is further than the distance from Earth to Pluto. In England, nearly 3.5 per cent of all road miles involve the NHS. As of July 2017, the NHS dealt with more than one million patients every 36 hours.

All this adds up to a sizeable environmental impact. Health and social care in England alone is responsible for between four and five per cent of the UK’s entire carbon footprint – but the NHS has a plan to push that figure way down. On January 25, NHS CEO Simon Stevens announced its plan to reach net-zero carbon emissions ahead of 2050. It’s one of the biggest and most complex decarbonisation projects the UK has ever undertaken but can it pull it off?

Full details:
https://www.wired.co.uk/article/nhs-net-zero-carbon

More than a third of UK workers 'risk health in low-quality jobs'

This article tells us more than a third of workers in Britain (many in rural settings) are struggling in low-quality jobs that risk damaging their health, according to research.

In a report exposing the scale of precarious, low-paid or unfulfilling employment across the country, the Health Foundation said that as many as 36% of workers in Britain – about 10 million people – were in such a position.

The thinktank said young adults, minority groups and employees outside the south of England were most likely to be affected, using evidence from a survey of more than 40,000 people in the UK.

The analysis comes as employment levels have hit a record high and joblessness stands at the lowest point since the mid 1970s after a decade of gains in the labour market since the last recession.

Full details:
https://www.theguardian.com/money/2020/feb/04/more-than-a-third-of-uk-workers-risk-health-in-low-quality-jobs

New mothers in England to receive health check six weeks after giving birth

New mothers will be given a physical and mental health check six weeks after giving birth, in a victory for campaigners.

From April, the 600,000 women a year who have babies in England will undergo an assessment of their health and wellbeing with either a GP or practice nurse at their surgery.

The appointments will be dedicated to exploring the mother’s health and be separate to the six-week check that all babies already receive. However, many of them will occur immediately before or after the infant’s check, to make the best use of mothers’ and NHS staff’s time.

Until now many women have either not had a postnatal check or had only a very brief one during their baby’s appointment, often because of time pressures. That has left many feeling unable to raise issues about their own health and led to concerns that some conditions are being missed.

Full details:
https://www.theguardian.com/society/2020/feb/07/new-mothers--receive-health-check-six-weeks-after-giving-birth-nhs-england

Boris Johnson plans new law to exert more control over NHS

Boris Johnson is reportedly planning to introduce a new law to allow the government to exert more control over the NHS.

Legislation to be introduced this year will include new powers for ministers to give orders to Sir Simon Stevens, the NHS chief, who is supposed to be operationally independent.

According to the Times, Downing Street will launch an overhaul of NHS structures, having become frustrated by the slow pace of change in the health service.

They are concerned that NHS bosses have too much power and are not delivering Whitehall's demands quickly enough, and want "more levers to pull".

Full details:
https://www.telegraph.co.uk/politics/2020/02/07/boris-johnson-plans-new-law-exert-control-nhs/

NHS pensions: ‘I'm scared of getting a shock tax bill’

Pension liabilities and failures are at the tap root of problems in many aspects of public service and in rural settings I suspect this issue will add a further unhelpful pressure to the challenge of recruiting clinicians. This article tells usk:

NHS doctors up and down the country have been grappling with a “double whammy” of punitive pension rules for higher earners and incomplete pension records. 

Savers can put up to £40,000 into pensions each year while getting tax relief. But this “annual allowance” is gradually reduced by £1 for every £2 of “adjusted” income over £150,000 – down to a minimum of £10,000 under a “taper”.

Faced with paying hefty tax charges, some doctors have already been forced to reduce their working hours or even retire early. 

To make matters worse, many GPs have found gaps in their pension records, which make it difficult to keep track of increases in their income that could trigger more tax charges.

Full details:
https://www.telegraph.co.uk/money/consumer-affairs/nhs-pensions-scared-ofgetting-shock-tax-bill/

Other Stuff

Rural Proofing Toolkit – the pace is quickening on this piece of work.  We’d like your help with our call for evidence via this hyperlink:
https://www.surveymonkey.co.uk/r/rural-proofing-health-toolkit-survey-1

Research Priorities – our recent consultation with members identifies that the key priorities for this year are mental health and technology, which promotes independence. If you’d like to get more involved in our work on either of these fronts let us know

Parliamentary Inquiry – With the re-constitution of the All Party Parliamentary Group on Rural Health and Care session 6 of the Parliamentary Inquiry into systems is set to run. We have a number of key witnesses lined up including the CEO of the Kings Fund. If you like to raise a question or come along in person just let us know. The session is around lunchtime on 28 February.

International Perspectives – I’m very excited about beginning to explore links with the US National Rural Health Association thanks to the links created by our Board Member John Wynn Jones – watch this space for more information.

Coastal Innovation – We’re working actively with partners including the University of Lincoln on the development of the concept of a new Campus for Future Living to coordinate key aspects of the challenges facing vulnerable people in coastal settings. If you’d like to know more please do get in touch.