Agenda item

Media Issues

Minutes:

The Principal Overview and Scrutiny Officer provided the Committee with a presentation of the following press articles which related to the remit of the Adults, Wellbeing and Health Overview and Scrutiny Committee;

 

·         'Best possible care' promised to North-East patients from vascular changes – Northern Echo 6 June 2018

HEALTH chiefs say a shake-up of hospital services affecting patients requiring vascular surgery will provide the best possible care.

A strategic review has advised that services in the North-East should be reconfigured to a maximum of three hubs. The clinical review also advised that there is a strong case to remodel vascular services in the North East and that there is only sufficient specialised vascular activity and vascular clinicians to support three centres. It recommends that full vascular services should be delivered from Sunderland, Middlesbrough and Newcastle. The recommendation means that around 12 patients a week, who live in County Durham, would have their vascular surgery done at the Royal instead of University Hospital of North Durham. University Hospital of North Durham should continue to see around 3,600 patients a year for vascular outpatient appointments. Treatment of varicose veins would also remain in Durham.

 

·         The 35 medicines no longer available on NHS prescription from this month – Sunderland Echo 18 June 2018

The NHS has banned free prescriptions for some 'over the counter' medicines such as treatments for constipation and athletes foot, starting from this month. NHS England is hoping to free up almost £100 million for frontline care each year by bringing in the changes. The NHS will no longer be funding treatments such as paracetamol, probiotics, cough mixture, eye drops and laxatives. However, the rule changes will not affect the prescribing of over the counter items for 'longer term or more complex conditions', officials have confirmed.

NHS England has said that curbing these routine prescriptions for minor conditions, many of which will cure themselves, will free up vital funds. The NHS announced the move at the end of the March and the new guidance to GPs across the country started from May 31.

Councillor Temple was concerned that the real issue with these changes were for the people on free prescriptions and therefore could affect children, the poor and elderly.  Children would be reliant on their parents to medicate them and if it was a choice between feeding their family or medicating them it was concerning.  He believed that as some conditions could be symptoms of a more serious condition such as diarrhoea, this was taking risks with people’s lives.

 

Councillor Quinn also expressed concerns about home carers not being able to give non prescription drugs and as such people could be left in pain.

 

The Principal Overview and Scrutiny Officer said that there were concerns raised about the equality impact assessment at a national level but queried what was happening at a local level.  He asked what the CCGs had shared with GP practices and had patients been advised in writing of the new rules.  The Committee were concerned about the potential adverse impact on vulnerable groups.

 

The Director of Commissioning, DDES CCG advised that there were two levels to these changes.  NHS England had introduced the changes at a North East level where CCGs would be working together on medications for hayfever, paracetamol and travel medicines and that it was now up to them to make these changes locally.  The Deputy Director of Public Health had been tasked with looking at the implications for Durham.  GPs may use their judgements until guidance was published.  She confirmed that children would be exempt from this. 

 

The Medicines Optimisation Lead, North Durham CCG was introduced to the Committee.  She advised that regionally across the North East and Cumbria the general public would be expected to self medicate for minor illnesses for example hay fever and aches and pains.  Questions had also been asked about funding vaccines for holiday medication by the NHS when people chose to go abroad should they not pay themselves.  She highlighted that the changes focussed on acute and not chronic conditions.  She assured the Committee that at no point had GPs said that they would not prescribe and that the CCG did not want to disadvantage anyone.  With regards to paracetamol, she advised that £1.78m was spent across the DDES and North Durham areas.  People could buy up to 96 paracetamol from a pharmacy provided that a pharmacist was present.

 

She went on to explain that there would be a definite list of people excluded from these changes including young people and women who were pregnant however this was still being finalised.  The guidance was expected to focus on conditions as opposed to individual medication, with the vast majority of those conditions being suitable for self care.

 

The Chairman referred to the travel medication and the fact that GPs can often interpret it differently.  For example some GPs provide vaccines free of charge, some charge and some refuse to administer it.  He suggested that this needs to be addressed and be fair across the board.

 

Councillor Bell was concerned about what was driving this change and whether this was associated with cost or a procurement issue.  He also expressed concern about people self medicating as this could lead to further complications.

 

Councillor Temple stated that letters had been sent to patients for three of the thirty five conditions affected and he was concerned that no advice had been given that generic medicine would be available from a pharmacist.  He believed that some pharmacists had also not been advised if they would still be providing these drugs.  He said that the Committee should have been appraised of these changes and on what advice the CCG had been giving.

 

The Director of Commissioning advised that a huge amount of work had been undertaken on this including discussions with GPs, patient reference groups and regional groups and all information had been considered carefully.  She confirmed that there would be exemptions from this and they would be clearly defined.  The CCG had already been looking at the three conditions and this was the reason why letters had been sent out about those.  With regards to the remaining 32 conditions these would be looked at following further guidance and through impact assessments.  The guidance would be used for implementation locally. 

 

Members were informed that the Regional group were interested in appointing a lay member and that they were welcome to join.

 

The Director of Commissioning explained that these changes were about using the NHS funding as wisely as possible and that by allowing people to self care this could save money.

 

The Chairman said that it would have been preferential to have been consulted and that the Committee were concerned about the affect this would have on those people could not afford to pay.   The Medicines Optimisation Lead confirmed that the only medications affected at present were for hay fever, paracetamol and travel.  She advised that there was a minor ailments scheme whereby people exempt from paying could ask for a small range of medication at a pharmacy without needing a GP appointment.

 

The Principal Overview and Scrutiny Officer said that feedback from the CCG would be welcomed on the work to be undertaken so that the committee were aware of the changes from a local perspective.

 

·         Council creates £130,000 role to lead health and social care integration – Northern Echo 21 June 2018

A NORTH-East authority has agreed to create a new position to lead a programme aimed at integrating social care and health services.

The new director of integrated community services at Durham County Council will help develop the Health and Social Care Plan for County Durham. Referenced in the Adult and Health Services update report.