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Are we ready for a grown-up election debate on the NHS and social care?

Reported in The Guardian (21 April): In an age when experts are no longer de rigeur, it may be asking too much for the political debate about the future of health and social care to be nuanced, balanced and informed. Were it to be so, it would surely be the first time we had achieved such dizzy heights in the bare knuckled fight of an election campaign.

So what would be good to hear? First, an acknowledgement that all the main parties are culpable for severe underfunding of social care – arguably both at national and local level. The additional sums announced in the budget are welcome but not sufficient. The government has promised fundamental reform but again all parties, including the Conservatives, have made such promises before and then failed to deliver.

Second, a commitment to health and social care funding linked to GDP over the next parliament. We can only afford what the country can afford so it is right to link it to the size and success of the economy, but we can do much better than the current 10% well below the levels seen in the comparable economies of France and Germany. 

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Major Trauma In Older People

Reported by the Major Trauma Audit and Research Network, 6 April 2017): Falls now the commonest type of major trauma in England and Wales report reveals.

The first national report on major injury in older people has been released by the Trauma Audit & Research Network, hosted by The University of Manchester, showing that falls from a standing height are now the most common cause of major trauma. 

The ten-year report, based on 8, 176 injured patients aged 60 years and above in England and Wales reveals that the typical severely injured patient isn’t the traditional young male injured in a road traffic incident, but now older and injured as a result of falling, with a lower male predominance. 

The report shows that the older injured patient may be at a disadvantage in terms of receiving optimal care. Older people with major injury are less likely than younger adults to be taken directly to a major trauma centre for specialist treatment - due to the challenges of reliably identifying major injury in older people at the scene. 

Read more.

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Long-term sustainability of NHS and Adult Social Care under threat

The Select Committee on the Long-term Sustainability of the NHS has slammed the 'short sightedness' of successive governments for failing to plan effectively for the long-term future of the health service and adult social care.

The BGS fed into the Committee’s Inquiry by providing a written submission which is already published here

Lord Patel, Crossbench Peer and eminent obstetrician provides a good summary of the Committee’s recommendations.  

The Department of Health at both the political and official level is failing to think beyond the next few years. There is a shocking lack of long-term strategic planning in the NHS. This short sightedness stems from the political importance of the NHS and the temptation for politicians to reach for short-term fixes not long-term solutions.  

To solve this we need a new body that is independent of government and is able to identify clearly the healthcare needs of a changing and ageing population and the staffing and funding the NHS will require to meet those needs. This new Office for Health and Care Sustainability should be a trusted, independent voice as the Office for Budget Responsibility has become on economic forecasting and on public finance matters. It will need to look ahead and plan for 15-20 years into the future. 

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2016/17 NHS Benchmarking Network’s Older People’s Care in Acute Settings national report

The NHS Benchmarking Network's Older People’s Care in Acute Settings national report has now been published. It presents the findings from the 2016/17 Older People’s Care in Acute Settings project. All data presented in this report is 2015/16 outturn data. It is the third iteration of the project and has included data from 47 trusts / UHBs who between them made 56 submissions. The data the participating organisations have provided has enabled benchmarked comparisons to be made which are not available elsewhere in the NHS. The service user audit has provided further granularity on the service user’s episode of care.

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Next steps on the NHS Five Year Forward View: NHS sets out action to deliver NHS care fit for the future

NHS England, 31 March 2017: As the NHS approaches its 70th anniversary the health service has today published the plan setting out how it will deliver practical improvements in areas prized by patients and the public – cancer, mental health and GP access – while transforming the way that care is delivered to ease pressure on hospitals by helping frail and older people live healthier, more independent lives.

These measures, probably the biggest national move towards integrated care currently underway in any Western country, will also help to put the service on a more sustainable footing for the future.

With the NHS under pressure this plan, Next steps on the NHS Five Year Forward View, also details an accelerated drive to improve efficiency and use of technology in order to deliver better care and meet rising demand within the constraints of available resources.

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