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Major NHS reform will see Brits' access to GP services transformed

Major NHS reform will see Brits' access to GP services transformed

Daily Mirror7 hours ago

Health Secretary Wes Streeting is set to announce a GP overhaul that will see working class areas being given more funding to tackle the 'inverse care' being delivered
GP practices in working class areas will get more government funding diverted to them thanks to a major NHS reform.
Health Secretary Wes Streeting will today announce a plan to tackle the 'inverse care' being delivered after over a decade of Tory rule. He will tell how poorer areas where people generally live shorter lives also have fewer GPs, worse performing hospitals and longer NHS waits. The current GP funding formula favours areas with more older people, which are generally more affluent. In a speech in Blackpool, Mr Street-ing will say: 'The truth is, those in greatest need often receive the worst quality healthcare. It flies in the face of the values the NHS was founded on.


'The circumstances of your birth shouldn't determine your worth. Where towns have the greatest health needs and the fewest GPs, we will prioritise investment to rebuild your NHS and rebuild the health of your community.'
Currently, GP surgeries which serve working class areas receive on average 10% less funding per patient than practices in more affluent areas. Royal College of GP data shows that practices in some of the country's poorest areas have roughly 300 more patients per GP than the most affluent regions.
The government will review how health needs are weighted in the distribution of funding through the GP contract, drawing on evidence from experts on the Advisory Committee on Resource Allocation in consultation with doctors' unions. Dr Amanda Doyle, NHS England's director for primary care said: 'It is essential that GP practices serving our most deprived communities, where health challenges are often greatest, receive a fair share of resources that reflects their need.
'The NHS is committed to ensuring people can access the help they need as quickly and easily as possible and ensuring funding reflects this will help us to do just that.'
GP funding reform will be part of the government's 10 Year Health Plan being announced next month. ACRA provides recommendations and advice on the funding formula for health services in England, including GP funding, to ensure fair access based on population need.

BBC analysis last year found each permanent GP in England has 2,300 patients on average. This is up 17% in a decade. Areas where the problem is worst have over 3,000 per GP.
NHS data analysed by the BBC last year showed Thurrock in Essex has the worst ratio with 3,431 patients for every GP while Leicester has an average of 3,262. The government is also diverting £2.2billion, which has been set aside to support NHS hospital trusts which run up a deficit, to poorer areas.
Mr Streeting had already said there will be 'no more rewar
ds for failure' and deficit support funding will be phased out entirely from 2026/27. Today he will announce this £2.2bn will now be diverted to pay for NHS resources like staff, medicines, new technology and kit in areas that have been left behind such as rural areas, coastal towns and inner cities. Many of these more isolated areas struggle to attract GPs and dentists.
Mr Streeting will say: 'Thanks to the reforms we've made to bear down on wasteful spending, we can now invest the savings in working class communities that need it most. Last year we sent crack teams of top clinicians to hospitals in areas with the highest waiting lists and levels of economic inactivity. It has seen waiting lists in those areas falling twice as fast as the rest of the country.'

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Poorest parts of England to get £2.2bn more for NHS to cut care inequalities
Poorest parts of England to get £2.2bn more for NHS to cut care inequalities

The Guardian

time30 minutes ago

  • The Guardian

Poorest parts of England to get £2.2bn more for NHS to cut care inequalities

England's poorest areas will get billions in extra health funding under new government plans to tackle stark inequalities in access to care and health outcomes. NHS services in deprived and coastal places will receive a £2.2bn boost this year to pay for more staff and equipment to help them close the wide gap in resources between them and well-off areas. Wes Streeting, the health secretary, will announce the move on Wednesday and hail it as a significant step towards ensuring that all patients get the same standard of care wherever they live. In a speech in Blackpool, he will decry that areas with the highest levels of illness and need for care often have low numbers of GPs, the longest waits for treatment and the poorest performing NHS services, a longstanding phenomenon known as 'the inverse care law'. He will portray the £2.2bn extra this year as a downpayment on a major redistribution of NHS funding, which is intended to improve the NHS in deprived areas. 'The truth is, those in greatest need often receive the worst quality healthcare. 'It flies in the face of the values the NHS was founded on. The circumstances of your birth shouldn't determine your worth,' he is expected to say. The £2.2bn is money that was due to be handed to England's 215 health trusts for 'deficit reduction' – to cover budget overspends – but has been freed up because Sir Jim Mackey, NHS England's chief executive, has told them to balance their books. Streeting has ordered a review of the Carr-Hill formula, which is used to decide the allocation of GP funding. The review, involving the advisory committee on resource allocation, will examine ways of ensuring that places with more illness get more money. The Nuffield Trust said the formula is 'inequitable', 'deeply flawed' and does not take account of levels of deprivation in areas covered by GP practices. The review will be the fourth such exercise since the formula came into use in 2004, without major changes resulting, it pointed out. Dr Becks Fisher, a GP and director of research and policy at the Nuffield Trust thinktank, also cautioned that while 'the government plans to pay for these changes by making savings in other parts of the NHS, there is no guarantee this will be successful.' Louise Gittins, the chair of the Local Government Association, said: 'Health inequalities are estimated to cost the NHS an extra £4.8bn a year, society around £31bn in lost productivity, and between £20bn and £32bn a year in lost tax revenue and benefit payments. Health is therefore a major determinant of economic performance and prosperity.' Prof Kate Pickett, an expert in health inequalities at York University and academic director of Health Equity North, said that recent years had brought 'worse health and more inequalities and a bigger north-south divide. 'We have repeatedly called for government to target spending to the places that are most in need. So Wes Streeting's drive to increase health spending in the most deprived places is very welcome.' But, she added, ministers should also cancel planned cuts to welfare benefits and start a public discussion about the merits of a basic income to improve population health in poor areas.

Dogs pulling on leads cause large number of hand and wrist injuries in UK, study shows
Dogs pulling on leads cause large number of hand and wrist injuries in UK, study shows

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time30 minutes ago

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Dogs pulling on leads cause large number of hand and wrist injuries in UK, study shows

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Watchdog acted ‘irrationally' in registering private gender clinic, court told
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Watchdog acted ‘irrationally' in registering private gender clinic, court told

Former nurse Susan Evans and a mother known as XX are taking legal action against the Care Quality Commission (CQC) over its decision to register the Gender Plus Hormone Clinic (GPHC) in Birmingham in January last year. The two are also challenging the regulator's decision to continue the clinic's registration and to allow it to prescribe cross-sex hormone treatment to 16 and 17-year-olds without conditions, made last December. The clinic, which was rated outstanding by the watchdog last year, treats people aged 16 and older, including through prescribing gender-affirming – masculinising or feminising – hormones, but, in line with the NHS, does not prescribe puberty blockers. Lawyers representing the two women told a hearing on Tuesday that the watchdog did not consider aspects that were 'obviously material' when making its decision, including the NHS's stance on hormone treatment for children aged 16 and 17 in light of the Cass Review. The watchdog is defending the claim, telling the court that it was 'abundantly clear that there was ample evidence' for its decision, while lawyers for the company which runs the clinic, Gender Plus Healthcare Limited, said the legal action was 'fatally flawed'. Opening the women's case on Tuesday, barrister Tom Cross KC said the clinic was believed to be the only hormone treatment provider to 16 and 17-year-olds in England, and that the claimants' concern was about safety, with Ms Evans previously stating she believed the registration 'creates a significant risk of a two-tier approach'. Mr Cross said: 'At arriving at the conclusion that the provider should continue to be registered without any conditions … the CQC has acted irrationally.' He added: 'It has not factored into its conclusion a number of aspects of the process on the NHS, informed by the Cass Review, which serve as important safeguards for children within the cohort and were obviously material.' The barrister said that had the CQC factored these in, it would have 'decided to exercise its power to halt the treatment' of under-18s, and that its decision was 'simply not open to them'. He claimed that 'at the very least' the court 'should require the CQC to think again about the adequacy of the safeguards'. Hormone treatment was previously provided on the NHS at the now-closed Gender Identity Development Service (Gids) run by the Tavistock and Portman NHS Foundation Trust, where Ms Evans previously worked. But a review published by Baroness Cass in April last year said that 'extreme caution' should be demonstrated when deciding to prescribe the treatment to 16 and 17-year-olds, and that there should be 'clear clinical rationale for providing hormones at this stage rather than waiting until an individual reaches 18'. The NHS has opened three specialist children's gender clinics and has plans for a further five covering the seven NHS regions in England by the end of 2026, but has said that all recommendations for hormone interventions must be endorsed by a national multi-disciplinary team (MDT). It is understood that the MDT has not yet received any recommendations for hormone treatment for 16 and 17-year-olds, since the Cass Review. GPHC was set up by Dr Aidan Kelly and is led by nurse consultant Paul Carruthers, who both worked at Gids, and has previously said it primarily treats patients aged between 16 and 25, using its own MDT. But Mr Cross said in written submissions that in the year up to June 2024, GPHC has 'accepted almost every single patient that it considered' for hormone treatment, and that the contrast with the NHS 'could not be more stark'. He said there were 'a number of key differences' between GPHC and the NHS safeguards, including that referrals to the former came from Dr Kelly's company, Kelly Psychology, which is unregulated. He said: 'It is, and ought to have been, obvious that the unregulated nature of the referrer enhanced the risk of patient safety.' He concluded: 'Either the CQC had to impose a condition which rationally ensured patient safety, or, if that were not possible, had to decide not to continue the registration.' Jamie Burton KC, for the CQC, said that there was 'ample evidence' that Kelly Psychology 'did not pose an unacceptable risk' to patients, and that a 'significant number' of those assessed by the company were not referred for treatment at GPHC. The court was told that the CQC found no evidence of 'improper decision making or anything that might flag a concern', and that the clinic was found to be 'committed to the safety and best interests of its patients'. He continued: 'CQC found GHPC to be acting in line with national guidance, including the NHS England 2024 Criteria. 'It found nothing to suggest that this was merely lip service or that GPHC management held an ideological commitment that was undermining its professional and regulatory commitments, or otherwise threatening the safety of patients.' He also said that the CQC 'had regard' to NHS processes, and that there could not be 'any legitimate doubt about the correctness of the ultimate outcome, or GPHC's continued registration'. He said: 'In its professional judgment, it found that the provider was taking reasonable steps to safeguard 16 and 17-year-olds by way of its existing processes.' Peter Mant KC, for Gender Plus Healthcare Limited, said that there was no legal requirement for a private provider to mirror NHS care and that the claimants' concerns 'do not have a high-quality evidence base'. He continued that the clinic's model was 'entirely consistent' with the Cass Review and NHS policy, and that patients 'no longer routinely have any input' from Kelly Psychology. He added that concerns related to the rate of accepting new patients were 'unjustified', and that the court should not 'go behind' the CQC's decision. The hearing before Mrs Justice Eady is expected to conclude on Wednesday, with a judgment expected in writing at a later date.

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