Ruislip Residents' Association

Board Meeting in public of NHS England, 17th December 2014

NB   The notes below are only items of particular interest –  not a summary of the agenda.

1. Cancer Drugs Fund: The Department of Health agreed to increase this year’s budget from £200 million to £280 million, but on current trends this is expected to hit £380 million this year – an unsustainable overspend of £100 million on top of the already increased budget.

Therefore, following public consultation, apparently less effective drugs are being reviewed and companies invited to consider adjusting prices of drugs whose price appears to be out of line with their clinical benefit, thus creating head room for new and better cancer medicines, as well as other cancer treatments such as radiotherapy. In doing so, three important patient safeguards were established:

  • No drug would be removed if it were the only systemic therapy available for a particular indication
  • Patients already in receipt of a drug would continue to  receive it
  • If a drug had been removed, individual requests from a patient’s oncologist would be considered.
2. Allocation of resources to NHS England and the commissioning sector  for 2015/16: The Autumn Statement on 3 December 2014 will enable NHS England to deploy £1.98bn of additional funding next year for frontline health services and to help kick start the transformation agenda set out  in the NHS Five Year Forward View. The proposals for allocation of this funding suggest that:
  • £1.5 billion of the extra funding should be used to support  frontline services, and £480 million should be used to support transformation in primary care, mental health and local health economies.
  • Primary care funding should be increased by at least as much as local CCG-commissioned community and hospital allocations.
  • The extra frontline funding routed via CCGs should particularly be used to move parts of the country furthest below their ‘fair share’ of NHS funding towards it at a faster pace than was possible under the previously notified 2015/16  allocations.
3. Mental health: NHS England is committed to work towards parity of esteem between mental and physical health services. As part of this wider effort, in 2015/16 NHS England will invest £80m to deliver waiting time standards for mental health services for the first time.
  • £40m of this spending will be on Early Intervention in Psychosis services, and this will be funded through local contracts, requiring a combination of improved services and increased activity.
  • The remaining £40m is for improving liaison psychiatry services and reducing waiting times under the Improving Access to Psychological Therapies (IAPT) programme. This will be managed centrally and  targeted towards those areas with greatest need.
  • In addition, £30m of additional funding has been provided to improve treatment for children and young people with eating disorders, which will also be distributed on a national basis.
4. Better Care Fund: Changes to the delivery approach for the Better Care Fund (BCF) mean that at least £1bn of the £1.9bn additional NHS contribution to the BCF must be spent on NHS - commissioned services or linked to a reduction in total emergency admissions.

5. Performance: 90% of admitted patients and 95% of non-admitted patients should be treated within 18 weeks of referral and 92% of those still waiting should have waited less than 18 weeks. Activity from June to November did not reduce the backlog as intended but these targets should be met from December following £250m of additional funding.   99% of patients should have diagnostic tests within 6 weeks of request, but this standard is not yet being met. Other standards not being met include the cancer two month from urgent referral to treatment target, the four hour wait or discharge target for 95% of A&E patients, and ambulance targets - particularly the London Ambulance Service despite it having £17m resilience funding, but LAS is facing an outflow of paramedics eg to the 111 telephone service.

6. Dementia: The national aim is to identify 2/3rds of the estimated total cases by March 2015, to support carers, as dementia cannot be cured.

7. Winter pressures: Planning this year has been earlier and more complex and wide ranging.  £400m was provided in June for operational resilience and later £300m to increase staffing and beds.

8. NHS England’s Specialised Services: The annual cost is £14bn.  This year’s month 7 forecast is a deficit above £150m, mostly due to cancer drugs.  In seeking economies there are four principles:  transparent decisions /  priority for effective treatments / fair and equitable treatment / reasonable cost.

The next meeting:
This will be in London on 29th January 2015.                                                    

Published in NHS National News on 23 December 2014. Updated on 03 January 2015
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