Hancock launches yet another set of NHS reforms


The Health and Social Care Secretary, with the support of NHS England and health and care system leaders, have set out new proposals to ‘build on the successful NHS response to the pandemic’. They say that the proposals will bring health and care services closer together to build back better by improving care and tackling health inequalities through measures to address obesity, oral health and patient choice.


The measures have been set out in a government white paper to be published on GOV.UK.


The measures include proposals to make integrated care the default, reduce legal bureaucracy, and better support social care, public health and the NHS. Officials have said that the reforms will enable the health and care sector to use technology in a modern way, establishing it as a better platform to support staff and patient care, for example by improving the quality and availability of data across the health and care sector to enable systems to plan for the future care of their communities.


The proposals are designed to be flexible, allowing the health and care system to continue to evolve, and are designed to better equip the NHS and local health services to meet the longer-term health and societal challenges over the coming decades.


Key measures included in the ‘Integration and Innovation: working together to improve health and social care for all’ white paper include:


  • The NHS and local government to come together legally as part of integrated care systems to plan health and care services around their patients’ needs, and quickly implement innovative solutions to problems which would normally take years to fix, including moving services out of hospitals and into the community, focusing on preventative healthcare
  • Hardworking NHS staff currently waste a significant amount of time on unnecessary tendering processes for healthcare services. Under today’s proposals, the NHS will only need to tender services when it has the potential to lead to better outcomes for patients. This will mean staff can spend more time on patients and providing care, and local NHS services will have more power to act in the best interests of their communities
  • The safety of patients is at the heart of NHS services. The upcoming bill will put the Healthcare Safety Investigations Branch permanently into law as a statutory body so it can continue to reduce risk and improve safety. The Healthcare Safety Investigations Branch already investigates when things go wrong without blaming people, so that mistakes can be learned from, and this strengthens its legal footing
  • A package of measures to deliver on specific needs in the social care sector. This will improve oversight and accountability in the delivery of services through new assurance and data sharing measures in social care, update the legal framework to enable person-centred models of hospital discharge, and introduce improved powers for the Secretary of State to directly make payments to adult social care providers where required
  • The pandemic has shown the impact of inequalities on public health outcomes and the need for government to act to help level up health across the country. Legislation will help to support the introduction of new requirements about calorie labelling on food and drink packaging and the advertising of junk food before the 9pm watershed


The legislation will fold Monitor and the NHS Trust Development Authority into NHS England while maintaining the clinical and day to day operational independence of the NHS. Corresponding reforms will ensure the Secretary of State for Health and Social Care has the right levers to ensure accountability back to Parliament and taxpayers.


The white paper sets out the government’s proposals for legislation, building on the extensive consultation that has already been undertaken by NHS England. A bill will be laid before Parliament later in the year.


The government intends to bring forward separate proposals on social care reform later this year.


Health and Social Care Secretary Matt Hancock said:


“The NHS and local government have long been calling for better integration and less burdensome bureaucracy, and this virus has made clear the time for change is now.


“These changes will allow us to build back better and bottle the innovation and ingenuity of our brilliant staff during the pandemic, where progress was made despite the legal framework, rather than because of it.


“The proposals build on what the NHS has called for and will become the foundations for a health and care system which is more integrated, more innovative and responsive, and more ready to respond to the challenges of tomorrow, from health inequalities to our ageing population.”


Sir Simon Stevens, Chief Executive of the NHS, said:


“Our legislative proposals go with the grain of what patients and staff across the health service all want to see – more joined-up care, less legal bureaucracy and a sharper focus on prevention, inequality and social care.


“This legislation builds on the past seven years of practical experience and experimentation across the health service and the flexible ‘can-do’ spirit NHS staff have shown in spades throughout the pandemic.”


Prof Helen Stokes-Lampard, Chair of the Academy of Medical Royal Colleges, said:


“We welcome the central proposals to drive integration and support greater collaboration through integrated care systems (ICS), that go beyond the traditional NHS boundaries. This is absolutely the right direction of travel for health and care more widely.


“Legislation won’t make collaboration happen, but it can remove barriers and facilitate the changes that the NHS really needs as we move into the post-pandemic recovery stage.


“It is vital that we see genuine clinical engagement at every level of the operation of the ICS to drive collaboration.


“We will look forward to reviewing the full range of proposals and engaging in the development of the legislation.”


Ed Garratt, Executive Lead for the Suffolk and North East Essex Integrated Care System, said:


“I welcome the white paper, as the lead of an integrated care system, as it gives clearer accountability for the NHS and at a system level formalises shared governance across the NHS, local government and other partners. The proposals will support greater collective effort on improving outcomes for our population, which is the ultimate purpose of our work.”


Commenting on the publication of the government’s White Paper, Malcolm Harrison, Chief Executive of the Company Chemists’ Association (CCA), said:

“We hope the proposed changes in this White Paper will create an environment that allows the community pharmacy sector to do more to help relieve pressure within the rest of the NHS. With waiting times for hospital treatment at their highest for ten years, community pharmacies are needed now more than ever to provide patients with clinical care, close to home. However, to deliver on this, pharmacies need fair funding for both the services they currently provide and for any additional workload they are ready and willing to deliver.

“It is not yet clear how the national and local commissioning of services will work in this new system. It is vital that everyone can access consistent care across the country, and that the good intentions of the White Paper do not lead to a healthcare “postcode lottery”. We also welcome the intention to improve data sharing. The ability for records to be easily accessed and shared by those providing patients with care could transform levels of safety and efficiency, helping to deliver the joined-up NHS that the White Paper is calling for.”


Royal Pharmaceutical Society England Chair Claire Anderson said:

“Steps to facilitate more efficient ways of working are welcome but must be backed by investment and a comprehensive workforce strategy.

“These changes must help not hinder our health and care staff, who are focused on looking after patients during a global pandemic.

“Staff are already under pressure and I’d urge the Government to ensure they get the help they need, supporting their wellbeing, boosting recruitment, and investing in education and training.

“Long-term reforms must also ensure we make the most of the whole of the pharmacy workforce to deliver patient care and reduce health inequalities.

“The white paper includes a welcome focus on patient safety and we know pharmacists’ clinical leadership will be key to supporting this across the health service.

“National plans must be backed by sufficient resource to support local delivery and it will be vitally important for the Government to engage with both patients and health professionals as the proposals move forward.”


Some parts of this article are being shared under the Open Government Copyright licence.


Why do NHS reorganisations continually ignore community pharmacy?



And so another NHS reorganisation will come and go without making any of the necessary changes to community pharmacy contracting, funding, structure or integration.


Why community pharmacy isn’t recognised as ‘part of the NHS’ is beyond me.


Central commissioning which is at odds to local strategy and integration means it will continue to be ‘managed’ centrally and prevents it being a core part of locally directed integration, resulting inevitably in exacerbating health inequalities.


If you see community pharmacy as a business pure and simple, then the ‘shops’ in areas with a higher deprivation index will be adversely affected. When will the NHS recognise these are core services and need to be supported and protected?


By the way, I don’t mean just paying them more money.


I mean encouraging or requiring them to be part of local healthcare planning and strategy.


Primary Care Networks (PCNs) are a good start, but there is still no formal or financial arrangement so the success of PCNs working with community pharmacy will always depend solely on relationships.


Which isn’t equitable.


And it also doesn’t remove the semi-competitive relationship which can exist between GPs and community pharmacy. The flu vaccine service is an example and it looks like the Covid vaccine is heading that way.


If you did a proper stakeholder mapping of the healthcare system from a patient perspective (rather than from a commissioner or provider one) community pharmacy would be a lot closer to the top right than many other ‘true’ NHS services.


Essentially we need to decide, is community pharmacy a private or public provider.


If private then good luck to them, but the NHS needs to change the way it interacts with them. If public, then they need to be brought in properly, and take everything that goes along with it.


Either way, continually ignoring it isn’t the right answer.


Ewan Maule is a pharmacist.



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This circular is being shared under the Open Government Copyright licence. Whilst we will publish alerts relevant to pharmacists, pharmacy technicians and pharmacy teams we recommend you also keep an eye on the SHOW website.



Ade Williams represents pharmacy in portraits of NHS heroes


Powerful and personal portraits of pharmacists, doctors, nurses and other NHS staff who responded to the COVID-19 pandemic, captured by acclaimed photographer Rankin, have been unveiled to celebrate the NHS birthday.


In a mark of respect and thanks to the NHS, the renowned photographer, who has previously shot the Rolling Stones, Kate Moss and the Queen, offered to take portraits of 12 people playing a vital role in the NHS response to COVID-19.


The collection will be showcased across the country at bus stops, roadside billboards and iconic pedestrian areas including the world-famous Piccadilly Lights in central London this week to mark the 72nd birthday of the NHS.


Those photographed include an ICU consultant, a COVID-19 critical care nurse, a midwife, a psychiatrist, a hospital porter, a COVID-19 ward cleaner, a paramedic, a GP, a pharmacist, a district nurse, a 111 call centre worker, and a Chief Information Officer. All have played a vital role in managing the response to COVID-19 and supporting people impacted by the disease.


British photographer, director and cultural provocateur, Rankin, said:


“As the coronavirus pandemic began to unfold, I was moved by the incredible efforts of people across the NHS and I wanted to document who they are and their role in fighting this disease. Taking a portrait is a unique and intimate experience, even with social distancing in place. Everyone had their own inspiring story which to them was just doing their job. I hope these images portray the resilience and courage they show every day in the face of real adversity.”


Sir Simon Stevens, NHS Chief Executive, said:


“This has been the most challenging year in the NHS’s history, with our amazing staff providing care to almost 100,000 hospitalised Covid patients, and many more in the community. Nurses, doctors, physios, pharmacists, cleaners and countless others have pulled together, bolstered by thousands of former NHS staff who came back to help, alongside a new generation of students who stepped up. As we approach the NHS’s anniversary, these striking portraits pay tribute to all NHS staff and their extraordinary dedication. On July 5th we also want to say thank you to those from all walks of life who have played their part in helping the NHS and our communities deal with this unprecedented health emergency.”


Emma Kelly, a critical care nurse at the Manchester University NHS Foundation Trust, said:


“At first, I thought it must be the wrong Emma as I feel like I’m just doing the job I’ve been trained to do. While all of us who work for the NHS do the job because we want to care for and support our patients – it is lovely to be recognised in this way and to be able to share our stories with the world”


Dr Farzana Hussain, a GP at Project Surgery, Newham, said:


“It’s difficult to put into words how privileged I feel to be able to go to work every day and make a difference to people’s lives and to help battle this global pandemic.


“Now more than ever, it’s important that we see the humanity that makes up our GP practices, community services and hospitals. Every member of staff has their own story, fears and hopes for the future. I think Rankin’s photography brings this out really well.”


Sarah Jensen, Chief Information Officer, Barts Health NHS Trust, said:


“I was very surprised and flattered to be chosen – to be at the forefront of the coronavirus story was not something I was expecting. I feel privileged to be representing my profession, as working for the NHS provides such a rewarding career. I feel very strongly that we set a good example and help get messages into schools with the younger generations who are experiencing this and run grass root campaigns to recruit and show people at a young age what is possible.”


All portraits are being donated by Rankin to the NHS as an ongoing legacy for years to come. Advertising space to display the portraits has also been donated free of charge.


View the full selection of portraits and their stories.


This circular is being shared under the Open Government Copyright licence.



Dr Ollie Hart on being a PCN Clinical Director, the importance of patient activation and why coaching is so important in healthcare

Dr Ollie Hart


Dr Ollie Hart is a GP partner, Primary Care Network (PCN) Clinical Director and also owns Peak Health Coaching. Ollie Practises in Sheffield and I met him recently for the first time at a meeting in London. We got talking and went for a coffee after the meeting. Unfortunately, we ran out of time as I had to catch a flight but we agreed to chat again soon. He didn’t bargain that said chat would be on the PIP podcast but here we are.


Ollie describes himself as a ‘typical GP who spins a few plates’. He is a PCN Clinical Director in Sheffield, has experience of commissioning for the NHS, still practises as a GP and also finds time to run his own health coaching company called Peak Health Coaching.


Ollie talks passionately about chronic pain and his desire to inform and coach these people. “The more people are engaged with their own health the better their outcomes will be. People have so much thrown at them in life so how we deal with adversity is crucial. I’ve been very involved with patient activation and care planning as part of my commissioning role in Sheffield.


“Good skills are missing to help people take much more of a partnership. It’s not easy. This is how Peak Health Coaching evolved.  Dr Tim Williams and I founded the business then and we have had good success so far.”


The conversation flowed from here. Below are some questions I asked Ollie. Tune in to the podcast to hear his fascinating approach to coaching.


Do you think your interest in chronic pain was the trigger to start a business?

Do you think pharmacists and GP’s over-prescribe medication in the chronic pain space?

What does a typical interaction look like?

Is this a move away from the paternalistic model of healthcare?

PCNs are the promised land. What do you think PCNs are a reinvention of?

What does the role of PCN Clinical Director actually involve?

One of the consequences of the development of PCNs has been a rush for pharmacists to work in general practice. Are pharmacists welcome guests in general practice or is it their home?

What are your thoughts on the workforce pressures that the inception of PCNs has driven?

What’s next for you?

What is your advice for pharmacists or doctors joining the register?



Ollie runs Peak Health Coaching in partnership with Dr Tim Williams. You can find out more about their business by clicking here. They also produced a really fun video to explain what they do. We have included the video below.


Dr Ollie Hart and Dr Tim Williams




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Alexa the latest member of the NHS family


The NHS is collaborating with Amazon to provide health information from the NHS website through voice-assisted technology.


The technology will help patients, especially the elderly, blind and those who cannot access the internet through traditional means, to get NHS-verified health information, through simple voice commands.


Amazon’s algorithm uses information from the NHS website to provide answers to voice questions such as:


“Alexa, how do I treat a migraine?”


“Alexa, what are the symptoms of flu?”


“Alexa, what are the symptoms of chickenpox”


Officials from within the NHS say the technology has the potential to reduce the pressure on the NHS and GPs by providing information for common illnesses.


NHSX is set to look at ways of making more NHS services available to all patients through digital technology. The announcement is aimeed at supporting the commitment in the NHS Long Term Plan to make more NHS services available digitally.


Secretary of State for Health and Social Care Matt Hancock said:


“We want to empower every patient to take better control of their healthcare and technology like this is a great example of how people can access reliable, world-leading NHS advice from the comfort of their home, reducing the pressure on our hardworking GPs and pharmacists.


“Through the NHS Long Term Plan, we want to embrace the advances in technology to build a health and care system that is fit for the future and NHSX will drive this revolution to bring the benefits to every patient, clinician and carer.


Matthew Gould, Chief Executive of NHSX, said:


“The public need to be able to get reliable information about their health easily and in ways they actually use. By working closely with Amazon and other tech companies, big and small, we can ensure that the millions of users looking for health information every day can get simple, validated advice at the touch of a button or voice command.


“Part of our mission at NHSX is to give citizens the tools to access services and information directly, and partnerships such as this are an important part of achieving this.