ESA benefit payments- retests axed for chronically ill claimants

Claimants of long term sickness benefits will no longer face repeated medical assessments to keep their payments.

Claimants of long term sickness benefits will no longer face repeated medical assessments to keep their payments.

Work and Pensions Secretary Damian Green said it was pointless to re-test recipients of Employment and Support Allowance (ESA) with severe conditions and no prospect of getting better.

More than two million people receive ESA, which is worth up to £109 a week. The move has been welcomed by charities supporting those with severe illness.

Shadow work and pensions secretary Debbie Abrahams said it was “a welcome U-turn” by the government, but “the devil was in the detail”. What about mental health conditions, conditions that are fluctuating, conditions that may not necessarily have a physical manifestation?” she said.

Applicants for ESA have to undergo a work capability assessment to find out if they are eligible and they are re-tested to ensure their condition has not changed. Some are re-tested every three months and others up to two years later.

Under the government’s change, those who are deemed unfit for work and with conditions that will not improve will no longer face re-testing.

Illnesses such as severe Huntington’s, autism or a congenital heart condition are among those that are likely to qualify for continuous payments without reassessment. The criteria will be drawn up with health professionals.

Mr Green said a “key part” of making sure those who were unable to work received “full and proper support” included “sweeping away any unnecessary stress and bureaucracy”.

Currently, those in the “work-related activity group” – deemed unable to work at the moment but capable of making some effort to find employment – receive up to £102.15 a week in ESA payments.

Those in the “support group” – deemed unable to work and not obliged to do anything to improve their chances of finding work – receive up to £109.30 a week.

From April 2017, payments will fall to £73 for new claimants in the “work-related activity” category as ministers argue that too few people in the category are moving into work.

Former Work and Pensions Secretary Iain Duncan Smith, welcomed the “progressive” reform to the re-testing regime, which he had set up when in office.

“I hope that the government will… move on to the fuller reform… where we lock together with the health department much more to be able to get a better health assessment of people, rather than a just strictly work assessment.”

Tim Nicholls, policy manager at the National Autistic Society, said ESA was a vital benefit for those unable to work, covering basic daily living costs such as food, heating and clothes.

“The flawed assessment process can be highly stressful for autistic people who can experience high levels of anxiety meeting new people or when their routine is broken, particularly when the stakes are so high,” he said. “We will be looking out for more details from the government.”

UK pays less for cancer drugs than some countries

The UK is paying less for new cancer drugs than a number of other high income countries, according to a report in The Lancet Oncology.

The UK is paying less for new cancer drugs than a number of other high income countries, according to a report in The Lancet Oncology

While the UK, Greece, Spain and Portugal pay the least, on average, for the drugs they use, Germany, Sweden and Switzerland pay the most.

The authors said more transparency was needed because some countries risked overpaying for drugs. The pharmaceutical industry said the UK was getting a fair deal on medicines.

Prices of cancer drugs have risen steeply in recent years, placing major stress on many healthcare systems, including the NHS.

The report said drugs had accounted for nearly a third of the EU’s £37 billion cancer healthcare spending in 2009.

And the researchers then compared the 2013 price of 31 cancer drugs in 18 high-income countries, including the UK, Australia, New Zealand, France, Greece, Switzerland, Sweden and Portugal.

Prices in Greece were the lowest for 14 out of the 24 cancer drugs available there.

The price of drugs in the UK was also low.

Prices of drugs in Switzerland, Germany and Sweden were frequently the highest – and for some drugs, such as interferon alfa 2b to treat leukaemia and skin cancer, were twice as high.

The price figures come from the Pharma Price Information service in Austria, which details what manufacturers charge per unit – a single tablet or vial of a drug, for example.

But although the official list prices published in this report are freely available, any further discounts – which are often negotiated by organisations in different countries – remain confidential.

David Watson, director of pricing and reimbursement at the Association of the British Pharmaceutical Industry, said the report was evidence that newer medicines “are affordable in the UK”.

He said the UK was “getting a fair deal with regards to medicines pricing” and the NHS was “getting good value for money”.

Sugar Tax- how will it work?

A new sugar tax on the soft drinks will be introduced in the UK the chancellor announced yesterday.

A new sugar tax on the soft drinks will be introduced in the UK the chancellor announced yesterdayThe move has been hailed by campaigners as a significant step in the fight against child obesity.

So how will the sugar tax work?

The levy is squarely aimed at high sugar drinks- particularly fizzy drinks, which are popular among teenagers.

Pure fruit juices and milk based drinks will currently be excluded and the smallest producers will have an exemption from the scheme.

It will be imposed on companies according to the volume of the sugar sweetened drinks they produce or import.

There will be two bands – one for total sugar content above 5g per 100 millilitres and a second, higher band for the most sugary drinks with more than 8g per 100 millilitres. Analysis by the Office for Budgetary Responsibility suggests they will be levied at 18p and 24p per litre.

Examples of drinks which would currently fall under the higher rate of the sugar tax include full strength Coca-Cola and Pepsi, Lucozade Energy and Irn-Bru, the Treasury said. The lower rate would catch drinks such as Dr Pepper, Fanta, Sprite, Schweppes Indian tonic water and alcohol free shandy.

When it comes to the sugar tax, all the emphasis has been on drinks. There are a number of reasons for this.

Firstly, unlike a chocolate bar or slice of cake, they are not automatically seen as a treat. People who drink them tend to have them every day.

Secondly, some of the drinks are incredibly high in sugar. A typical can contains enough sugar – about nine teaspoons – to take someone over their recommended sugar intake in one hit.

For teenagers they are the number one source of sugar intake while overall, children get a third of their daily sugar intake from them.

They have also been dubbed “empty calories” as they have no nutritional benefit.

Mr Osborne said the money raised – an estimated £520 million a year, will be spent on increasing the funding for sport in primary schools.

There has been pressure on ministers to increase spending in this area to build on the legacy of the 2012 Olympic Games and in light of the low numbers of children who take part in regular activity.

But while the tax applies to the whole of the UK, Mr Osborne announcement on where the money is spent applies solely to England. The devolved administrations in Scotland, Wales and Northern Ireland are free to decide how to spend their share.

The issue has been described as one of the most serious public health challenges for the 21st Century by the World Health Organization, while NHS England’s Simon Stevens has dubbed it “the new smoking”.

Health Direct applauds this new initiative and is sure that this will be just the start. Mr Osbourne has a habit of returning to existing taxes and constantly increasing them- like to tobacco and wine.

Overseas patients to be charged for emergency healthcare

Foreign patients could be charged for emergency treatment under new government plans for the NHS in England.

Foreign patients could be charged for emergency treatment under new government plans for the NHS in EnglandVisitors from outside the European Economic Area already pay for planned hospital care. The EEA covers the European Union, Iceland, Liechtenstein and Norway.

Health Secretary Jeremy Hunt wants to save the NHS millions of pounds by extending the charges to A&E care. A consultation is expected to be set up in the next few weeks.

Overseas visitors can currently receive A&E treatment, ambulance services and GP visits free of charge, but if the plans go ahead some treatment could be withheld until fees are paid.

The Department of Health said exemptions would be put in place for refugees and asylum seekers, and pregnant women would not be turned away from maternity units if they had not paid upfront.

A department spokesman said: “International visitors are welcome to use the NHS, provided they pay for it – just as families living in the UK do through their taxes.”

“This government was the first to introduce tough measures to clamp down on migrants accessing NHS care and have always been clear we want to look at extending charges for non-EEA migrants.”

“No-one will be denied urgent treatment and vulnerable groups will continue to be exempt from charging.”

All visitors to the UK and British expats are charged 150% of the cost of non-emergency NHS treatment in order to discourage people travelling to the UK just to use health services – so-called “health tourism”.

The latest crackdown is expected to reclaim around £500 million.

A spokesman for the Royal College of Emergency Medicine told the newspaper that A&E doctors “cannot reasonably be expected to take on the burden of identifying who is eligible for free treatment, and who should be charged”.

The British Medical Association agreed, saying: “A doctor’s duty is to treat the patient in front of them, not to act as border guard. Any plans to charge migrants and short-term visitors need to be practical, economic and efficient.”

In April new rules came into force which mean non-EU citizens settling in the UK for longer than six months are required to pay a “health surcharge” as part of their visa applications.

Fraud could be costing NHS in England £5.7 billion a year

The NHS in England could be losing up to £5.7 billion a year to fraud from its £100bn budget, a new report suggests.

The NHS in England could be losing up to £5.7 billion a year to fraud from its £100bn budget, a new report suggests.A review – led by former NHS anti-fraud boss Jim Gee – highlighted fraud by pharmacists, dentists, GPs and patients.

Among the areas it found to be affected were procurement, prescriptions, registration of patients and payroll.

To work out how much fraud is being committed, the review had to rely on estimates as well as detected fraud. It said the level of fraud was likely to be between £3.7 billion and £5.7 billion a year- out of a budget of more than £110 billion.

Among the scams highlighted were dentists claiming money for NHS care they did not carry out and GPs falsifying records for extra payments.

To illustrate the scale of some of these cases, it highlighted the jailing of a Birmingham dentist in 2012 after she stole £1.4m from the NHS.
The biggest sources of fraud in the NHS
Area                                                     Scams used                                                          Estimated value per year
Payroll                  False allowance claims and incorrect qualifications used                   £555m – £1.49bn
Procurement          Overcharging for goods and services or under-delivery                      £1bn – £1.27bn
General practice     Claims for services not provided and for ghost patients                          £348m
Patients       Claim for free prescriptions, dental care and optician services they are not entitled to     £304m
Dentistry                 Claims for dental work not carried out                                                        £121m – £137m
Pharmacy     Staff claiming for more drugs than actually dispensed or for services not provided     £83m – £96m

Patient fraud identified included wrongful claims for free prescriptions, dental and optician care.

But the biggest area of fraud was estimated to be payroll, at between £555m and £1.49bn – although the report said this mainly consisted of lots of small-scale cases.

Mr Gee, who carried out his work for PFK Littlejohn accountants, said: “There is a vast, honest majority who find fraud against the NHS to be completely unacceptable. However, there is also a dishonest minority who can cause significant financial damage.

“The best way of stopping this is not to wait for fraud to happen and then act after losses have been incurred, but to proactively deter and prevent them. Fraud is a cost to be measured, managed and minimised like any other.”

There is nothing new about fraud in the NHS. The scams are all too familiar – whether it’s health service managers purchasing hospital supplies and taking backhanders or corrupt GPs claiming they have patients who don’t actually exist.

But the report’s authors argue that, even though the NHS’s fraud problem is no worse than in other healthcare systems, the need for a crackdown is as urgent as ever because of the intense financial pressure on the NHS and the need to make efficiency savings.

They accuse the government of failing to carry out a detailed audit of the extent of health service fraud. The Department of Health said it didn’t recognise the figures, but there has been no official denial that there is a problem that needs fixing.

Fraud officers work in each local area while at a national level, fraud work is co-ordinated by NHS Protect.

Ministers accused of failing to keep mental health pledge

A row over spending on mental health in England has broken out after Labour accused the government of failing to honour promises to boost funding.

A row over spending on mental health in England has broken out after Labour accused the government of failing to honour promises to boost fundingFreedom of information requests made by Labour to NHS commissioning bodies in England suggest on average mental health budgets fell in 2015-16.

However, the Department of Health said it rejected the figures and called mental health a government “priority”.

Guidance from NHS England published in December 2014 said funding in 2015-16 should increase “by at least as much” as the increase in overall allocation.

It is part of a wider goal laid out in the NHS five-year plan to put mental health on a par with physical health.

Dr Phil Moore, chairman of the NHS Clinical Commissioners Mental Health Commissioners Network stressed that CCGs understood the importance of investing in mental health, but financial pressures may leave no room for increased spend in any one area.

He said commissioners were also looking into different ways of funding mental health including using the voluntary sector and more community schemes.

“It is important to note that many CCGs are not simply looking to invest more in the same models of care that have failed in the past.”

The figures collected by Labour suggest that 50 of the 130 CCGs who responded plan to reduce the proportion of the budget they allocate to mental health for this financial year.

On average the figures suggest that in 2015/16 CCGs are planning to allocate 10% of their budgets to mental health, compared with 11% in 2014/15. But NHS England said CCGs would spend 13% of their budgets on mental health this year.

Labour also said there was wide variation between what CCGs had set aside for mental health.

Shadow public health minister Luciana Berger said ministers had repeatedly promised that the amount spent on mental health locally would increase in line with local CCG budgets.

A Department of Health spokesperson said: “We do not recognise these figures – NHS England has shown mental health spending has increased by £400 million this year.

“Mental health is a priority for this government and to say otherwise ignores the fact we have given mental and physical health conditions equal priority in law, we’ve increased central funding by millions of pounds, and introduced the first ever treatment targets which will make sure funding goes to where it’s needed.”

National Living Wage will damage care homes

The National Living Wage could result in a “catastrophic collapse” in the number of care homes, according to the five biggest providers.

 National Living Wage could result in a catastrophic collapse in the number of care homes
In a letter to the chancellor, they say staffing accounts for 60% of the cost of care. The companies said they supported the National Living Wage, but efforts would be needed to rescue the care system.

The government said social care would be considered as part of the spending review later this year.

Under plans announced in the Budget, workers aged over 25 in the UK will be paid a minimum of £7.20 an hour from April next year, rising to £9 by 2020.

Four Seasons Health Care, Bupa, HC-One, Care UK and Barchester said the measure would cost the care sector £1 billion by 2020.

They warned any shortage of care places could put huge pressure on the NHS.

Martin Green, the chief executive of Care England which represents the industry, said: “Without adequate funding to pay for the National Living Wage, the care sector is at serious risk of catastrophic collapse.”

He said there was a “grave and very real possibility” that a provider could fail within the next two years.

Mr Green added: “We want to work with the government to find a fair solution that will ensure the care sector can provide a safe and comfortable environment for older people who live in care homes.”

The UK Homecare Association made a similar warning last month, saying services to care for people in their own homes would become “unviable”.

A government spokesman said: “The National Living Wage will benefit hundreds of thousands of care workers who will see their pay increase.

“The overall costs of providing social care will be considered as part of the spending review later this year and we are working with the care sector to understand how the changes will affect them.”

Drug firms accused of overcharging by CMA

Pfizer and Flynn Pharma have been accused by the Competition and Markets Authority of charging “excessive and unfair” prices for an anti epilepsy drug.

Pfizer and Flynn Pharma have been accused by the Competition and Markets Authority of charging excessive and unfair prices for an anti-epilepsy drug.
Phenytoin sodium capsules, used by 50,000 people in Britain, are made by Pfizer and sold by Flynn.

When Pfizer made the drug under its Epanutin brand name, the NHS spent about £2.3 million on the drug, the CMA said. This amount soared to £50 million in 2013.

The CMA said Pfizer sold UK distribution rights to Flynn in 2012, but continued to make and supply the drug to the company.

This is a provisional report, with allegations made by the Competition and Markets Authority. The companies now have a chance to give formal responses and a final ruling may not be made until next year.

But it comes at a time of intense debate about NHS finances, as patient demand and the cost of treatment rise faster than budget increases. NHS England is grappling with the need for ambitious efficiency savings. It has been under fire for reducing the number of treatments available to patients through the Cancer Drugs Fund.

So today’s provisional findings, with renewed scrutiny of drug spending, are the last thing the pharmaceutical industry needs.

It was after this deal that prices rose, said the watchdog in a provisional finding.

“The CMA’s findings on dominance and abuse are provisional and no conclusion can be drawn at this stage that there has, in fact, been any breach of competition law. We will carefully consider any representations from Pfizer and Flynn Pharma before deciding whether the law has been infringed.,” said Ann Pope, CMA senior director of anti trust enforcement.

Companies can be fined as much as 10% of annual sales for abusing a dominant position in a market, depending on the seriousness of the abuse.

Pfizer and Flynn can now supply their own views and evidence before the watchdog makes a decision, it said.

“Ensuring a sustainable supply of our products to UK patients is of paramount importance to Pfizer and was at the heart of our decision to divest the product,” said Pfizer in a statement. “Pfizer is co-operating fully with the CMA’s ongoing investigation.”

NHS trusts told financial plans unaffordable

Hospitals and health trusts in England have been told by regulators to look again at their financial plans as current ones are “simply unaffordable”.

Hospitals and health trusts in England have been told by regulators to look again at their financial plans as current ones are "simply unaffordable
Monitor has written to the 46 foundation trusts with the biggest deficits “challenging” their plans. It urged money saving measures such as filling only essential staff vacancies.

David Bennett, chief executive of Monitor, said the NHS was facing an almost unprecedented financial challenge this year.

“We are already reviewing and challenging the plans of the 46 foundation trusts with the biggest deficits,” he wrote in a letter to trusts.

NHS trusts are caught between a rock and a hard place. On the one hand they have the number crunchers – like Monitor – demanding they keep a tight control on the finances and on the other they are being asked to ensure standards don’t slip.

This is only likely to get worse. While the NHS has been promised an extra £8bn a year by the end of this Parliament, it is being asked to make £22 billion in efficiency savings to plug the predicted shortfall of £30bn by 2020. That is a monumental task.

Within the health service there is a desire for the £8 billion to be front loaded in November’s government spending review – that is to say they want all or most of it from next year rather than seeing it gradually dripped fed in over the years.

That, so the argument goes, would allow them to get a grip of the deficits and make the changes needed to (hopefully) improve efficiency. The next year or two is crucial for the NHS.

“However, it is clear that this process will not close the funding gap and so we need all providers – even those planning for a surplus this year – to look again at their plans to see what more can be done.”

He urged trusts to leave non-essential vacancies unfilled, and to follow guidelines on safe staffing in a way which was “proportionate and appropriate”.

Rosters should be rigorously managed to deploy staff efficiently across all required shifts, including evenings and weekends, he said.

In May, NHS trusts in England reported a total deficit of £822 million in 2014-15, compared with £115 million the previous year.

A big rise in spending on agency nurses contributed to the deficits.

At the time, Monitor said figures for this financial year were likely to be even worse.

Recruiting foreign nurses is frustrating and expensive

It is “distracting, frustrating and expensive” to have to recruit large numbers of nurses from overseas.

It is distracting, frustrating and expensive to have to recruit large numbers of nurses from overseasDr Keith McNeil, who runs Addenbrooke’s Hospital in Cambridge, urged officials to “figure out” what resources were needed and improve UK recruitment.

Around 7,500 nurses from countries such as Spain, Romania and Italy registered to work in the UK last year.

Figures from the Nursing and Midwifery Council (NMC) show the recruitment of overseas staff to the UK is growing.

The number of nurses coming here from other parts of the EU has risen steadily during the past six years – now making up the vast majority of new overseas recruits – while the number of foreign nurses from beyond Europe has dropped.

The trend has been driven partly by the financial crisis in countries such as Spain and Portugal – and because of extra demand for NHS nurses in the wake of the Mid Staffordshire scandal.

The number of training places for nurses in England fell in 2011 and 2012.

Cambridge University Hospitals NHS Foundation Trust has taken on 303 foreign nurses in the past year. Half were from the Philippines – with significant numbers from Italy, Spain and Portugal.

Dr McNeil, the trust’s chief executive, told BBC News: “Nurses are the backbone of the NHS. You can’t run services effectively in an acute hospital like this without adequate numbers of trained nursing staff.

“It’s distracting, frustrating and expensive to do international recruitment. It would be nice not to have to do it and to have a more targeted approach.”

He added: “We don’t have enough home grown nurses, but we know the demographics. The health service has to figure out what resources are needed for our activity.”

“We need proper planning; I think the people at Health Education England are doing that now.  At least doing it now means avoiding having to do this in the years to come.”

Nursing experts fear that shortages could be fuelled in the coming years by retirement among the baby-boomer generation, and limits on the number of skilled workers from outside the EU who are allowed into the UK.

Last month, NHS Employers issued guidance to trusts on how to plan successful international recruitment.

Addenbrooke’s believes it costs £3,000 to recruit each nurse from elsewhere in the EU. New arrivals are given their first month’s accommodation and also £400, so long as they stay for 18 months.

They are also sent on a language course if they need to boost their conversational skills in English – as well as being given 10 weeks of support in the hospital to help their technical and clinical language.

The Cambridge hospital believes the big recruitment drive is paying off, because it is now using fewer temporary staff from agencies.

But there have been concerns that some overseas nurses leave the UK after just a short period here.

Commenting on the need for more UK training, the head of the Royal College of Nursing, Dr Peter Carter, said: “Last year there were 57,000 applicants for 20,000 nurse training posts.

“Isn’t that a matter of huge regret that you’ve got people in the four countries of the UK who want to train as nurses. They’re being turned away, while we’re going off and raiding the often impoverished workforce of other countries.”

He added: “It’s hugely regrettable and the UK is not exactly covering itself in glory in this.”