The latest reaction to health secretary’s Local Government Association Conference speech, plus the rest of today’s news and comment.

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5.40pm The NHS will not be able to afford many new drugs and treatments in the next few years because it is prioritising out of hospital care, a senior NHS England director has warned.

James Palmer, NHS England’s clinical director for specialised services, said the price the health service would pay for new medicines would be “different to what we’ve experienced in the last few years” and “decreasing”.

He said the prioritisation of out of hospital care by the NHS would mean “significant growth” in funding for specialised drugs “is not going to happen”. Mr Palmer was speaking at the IMS Health UK Market Access Summit on Monday.

3.31pm Pharmacy Voice, a group representing community pharmacists, has issued a response to today’s speech by Jeremy Hunt at the LGA. The main focus is on the plan to display the cost to the NHS of medicines over £20:

“Today the secretary of state announced that he would like medicines to have the indicative price displayed on the packaging where they cost more than £20. 

“Pharmacy Voice believes that although this may seem superficially attractive, there is little evidence that it will have the desired effect, and there may be unintended negative consequences. 

“We strongly hope that any system will not rely on, or require, community pharmacy teams to have to explain medicines pricing to patients and the public; that’s complicated enough at the best of times.  We would caution that any further administrative or bureaucratic burdens to frontline pharmacy teams would be difficult for the sector to sustain.

“The value of a medicine to an individual is about a good deal more than the price.  Research shows that some patients, particularly older people, could be deterred from taking the medicines they need because they are worried about the impact on the public purse. 

“We agree that the estimated £300m cost of wasted medicines each year in England should be tackled. 

“Through services such as Medicine Use Reviews, and the New Medicines Service, community pharmacy already plays a significant role in supporting people in getting the most from their medicines and reducing waste. 

“Clearly there is potential to do far more. Pharmacy Voice believes that the best way to tackle medicines wasting NHS resources is to focus on adherence and correct usage, and the wider implementation of services that focus on patients’ need for medicines, such as repeat dispensing, rather than highlighting the price of some medicines to some patients.

“Pharmacy Voice is pleased that the secretary of state has placed emphasis on developing care for the elderly, and it is reassuring that he is interested in exploring new ways of working. Community pharmacy’s role in providing care for the elderly is a priority for Pharmacy Voice.

“We are aware of the vital role that the sector can play, providing patient care within the community, and supporting patients to help avoid unnecessary emergency admissions.”

3.10pm Responding to Jeremy Hunt’s speech today, which includes calls for a social contract between public, health and care services and an announcement that the indicative cost of medicines will be published on packs of medicines costing more than £20, Rob Webster, chief executive of the NHS Confederation, said: “It is refreshing to see a genuine focus from the secretary of state on prevention, public health and changing the relationship between people and services.

“This is essential in the 21st century, when our population is changing. By 2025, 18 million people in England will have at least one long-term condition and many will have three or more. We should find ways of ensuring they are able to live full and happy lives.”

On labelling of medicines

“We think it’s important for the public to be better informed about how money is spent in the NHS. Polling we commissioned from YouGov about the public’s views on the NHS found that less than half (40 per cent) of people thought they had enough knowledge to contribute to an open debate about the future of the NHS.

“Of those who said they don’t feel they have the necessary information to contribute to an open debate about the future of the NHS, 74 per cent said that to do so, they would need more information on how the NHS is funded and how money is spent. We will be interested in seeing more detail about how the labelling policy will be implemented.”

On self-management

“Supported self-management is a great way to improve services and to help people for whom a condition is a daily reality. Ninety six per cent of our members in a recent survey told us it is important for the government to focus on engaging people more in their own care.

“In doing so, they recognise it is a partnership and that organisations also need to make practical and cultural changes to be able to effectively support people to manage their own care. We want to see a national sector-led programme to support health and social care organisations to adopt participation and self-management approaches so patients can benefit.

 “It is also right that the secretary of state recognises the hugely valuable work done by volunteers and carers, caring for older people. They are a part of the team and need to be engaged too.”

On social issues such as loneliness 

“We know social issues such as loneliness and isolation are often a contributing factor to elderly people being admitted to and staying in hospital, highlighting the real need to do more to prevent isolation and loneliness. We urge the secretary of state to encourage and support locally-developed schemes.

“Earlier this year we set up a Commission on Improving Urgent Care for Older people and are seeking patient-centred solutions to address the challenges of caring for the frail elderly across the country.”

On the Better Care Fund

“Integrating health and social care meets peoples’ needs and our memebers recognise it is important to have appropriate metrics to evaluate the progress made by introducing policies such as the Better Care Fund.

“Equally, it is important to recognise that integration is not an ‘end’ in itself and the metrics used need to properly reflect the underlying aspiration of integration, to improve care for patients. 

It is also unlikely that greater integration alone can address the funding issues facing some local health and social care economies.

“Without adequate funding for local authorities, many of the preventative, social care based services to prevent elderly people from becoming isolated and supporting them to maintain their health outside of hospitals may not be able to function properly in the future.

2.31pm The chief executive of Somerset Partnership Foundation Trust has announced that he will retire in January 2016.

In a letter to trust staff Edward Colgan said he would spend the next few months preparing the organisation for a Care Quality Commission inspection due in September.

Mr Colgan has led the community and mental health provider since April 2006, having previously been chief executive of Taunton Deane Primary Care Trust for four years.

12.13pm The Department of Health has just released a statement rounding up key passage’s from health secretary Jeremy Hunt’s speech to the Local Government Association conference earlier today:

In a speech to the Local Government Association annual conference in Harrogate the Health Secretary urged the public to take more personal responsibility:

  • for looking after the elderly
  • for their own health
  • in using finite NHS resources

He argued that, while integration of health and social care is vital to delivering the highest standards of health and care, personal responsibility needs to sit alongside system accountability.

Jeremy Hunt said: “By the end of this Parliament we will have a million more over 70s, one third of them living alone. Yes the health and social care system must do a much better job of looking after them. But so too must all of us as citizens as well.”

On taking personal responsibility for our own health, he said: “The best person to prevent a long term condition developing is not the doctor – it’s you.”

On using NHS resources responsibly, he said that proper funding for all public services depends on a strong economy and personal responsibility: “We are insisting on a laser-like focus from the hospital sector to make sure every penny counts for patients.

“But there is a role for patients here too. There is no such thing as a free health service: everything we are proud of in the NHS is funded by taxpayers, and every penny we waste costs patients more through higher taxes or reduced services.”

He also announced that Minister for care services Alistair Burt will develop a new carers’ strategy to support both existing and new carers.

A transcript of the full speech will be published soon

12.06pm HSJ’s David Williams tweets:

11.51am Simon Stevens is now speaking at the LGA Conference, discussion Greater Manchester and devolution:

11.20am More from Jeremy Hunt:

11.16am The Department of Health tweets:

11.12am The plot thickens:

11.10am And there’s more from Mr Hunt:

11.09am Sarah tweets:

11.07am Both Jeremy Hunt and Simon Stevens are speaking today at the Local Government Association’s annual conference. Sarah Calkin, of HSJ’s sister publication LGC tweets:

11.04am NHS finance directors in England have forecast a further deterioration of NHS finances for this year, in the first research into their financial projections since the 2014-15 year end and the new Government taking office. 

According to the Healthcare Financial Management Association 78 per cent of provider trust finance directors expect to be in a worse financial position at the end of 2015-16 than they were in 2014-15.

63 per cent are also forecasting a deficit for the end of this financial year, up by a third compared to the 47 per cent that finished 2014-15 in deficit.

The figures come from HFMA’s latest biannual NHS Financial Temperature Check survey with 196 finance directors in England contributing to the research, representing 47 per cent of provider trusts and 37 per cent of clinical commissioning groups.

The survey also reveals that the vast majority of finance directors (92 per cent in England) don’t feel the health organisations in their local area have sufficient financial resources to implement the Five Year Forward View, without the need for additional support.

Paul Briddock, director of policy at the HFMA, said: “The NHS’s financial performance continues to nose-dive at an alarming rate.

“Our members have told us 2015-16 is looking even worse than last year, with increasing numbers expecting to end the year in the red.

“Add to this the fact that many finance directors don’t feel they have sufficient resources to achieve longer-term financial plans without further cash injections – something the government has made clear is not going to happen beyond the £8bn promised as a result of the Five Year Forward View

“To help with financial planning, we urgently need details on how and when the £8bn will be deployed.”

Risk associated with achieving the 2015-16 plans was also assessed as high or medium, with only 16 per cent of CCG and 10 per cent of provider finance directors rating risk as low.

Key risks to achieving 2015-16 plans were cited as slippage in cost savings (74 per cent), increased demand (64 per cent), emergency activity (55 per cent) and spending on agency staff (50 per cent).

Mr Briddock added: “Finance directors have ambitious plans to save through improving efficiency, from procurement savings to supporting staff to work in different ways.

“While this will help protect and maintain services, we can’t rely on these measures alone to plug the remaining £22bn gap in NHS finances.

“Increasing demand for services and an ageing population mean transformation of service provision is the key to a sustainable, fit-for-the-future NHS.

“This will require short term investment before long term benefits are realised.”

In contrast to the gloomy picture painted by trust respondents, 83 per cent of CCG CFOs expect a surplus at the end of this financial year and half expect to be in a similar or better position than they were at the end of 2014-15 by the end of 2015-16.

Mr Briddock concluded: “It’s a tale of two health systems – CCGs appear on the face of it to be doing relatively well compared to the trust sector which is experiencing further decline.

“However, while more CCGs are forecasting a surplus than trusts are forecasting a deficit, what we expect to be a small overall net CCG surplus is likely to be dwarfed by a much larger net trust deficit.”

Despite the significant financial challenges, finance directors in both sectors across the UK are optimistic that quality in the NHS can be maintained at current levels or improved in 2015-16.

A full 66 per cent believe quality will stay the same, with 26 per cent believing it will improve. 

Only 8 per cent felt that the quality of services being provided would reduce.

10.18am Green Party MP Caroline Lucas is to present a private members’ bill to parliament which aims to reverse large parts of the last government’s Health and Social Care Act 2012, The Guardian reports.

The bill, named the NHS reinstatement bill, has received cross-party support, including the backing of Labour leadership candidate Jeremy Corbyn, Liberal Democrat MP John Pugh and the SNP’s health spokesperson Philippa Whitford.

10.05am The Independent reports that many people in Britain now lead such “atomised lives” that they do not have “any idea” when their elderly relatives are ill or dying, the health secretary Jeremy Hunt, will warn today.

In a stark call for the public to take more responsibility for the care of elderly relatives and neighbours Mr Hunt will say that local authority care and the National Health Service cannot alone shoulder the burden of looking after the elderly. And he will call for a new “national conversation” about how the elderly are looked after in Britain, compared with those in other countries where multi-generational households are much more common.

10.03am An investigation by The Daily Telegraph has revealed that patients who call the NHS 111 service are being denied ambulances even if they are experiencing symptoms of a heart attack.

The 111 call centre staff are expected to dispatch ambulances if patients describe symptoms of a serious illness.

However, amid a shortage of paramedics, call handlers are being put under pressure not to send out ambulances at certain times.

A reporter from the newspaper spent seven weeks working undercover as a call handler on the 111 helpline uncovering what the paper calls a ‘catalogue’ of failings.

9.43am Jeremy Hunt and Simon Stevens will be speaking at the Local Government Assoication Conference this morning. Mr Hunt is expected to say that Britain is failing to meet its obligation to the elderly because some people lead such “busy, atomised lives” that they don’t even know whether their relatives are dying, the Daily Telegraph reports. Check this blog for updates.

7.00am Good morning and welcome to HSJ Live. If staff are aware of issues that have the potential to cause harm and do nothing about it, the end result can cause considerable harm, staff must feel comfortable reporting issues in order to ensure patient safety, writes James Titcombe, national adviser on safety for the Care Quality Commission and the father of Joshua, who died as a result of preventable errors during his care in 2008.