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S22 – Statement of Intent from the Secretary of State for Health Watch

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    S22 – Statement of Intent from the Secretary of State for Health



    The Department of Health recognises the need to make smart choices to keep the NHS working at a safe, effective level, underpinned by the care value base that should flow throughout our healthcare system. The DoH also recognises the need for better preventative measures in a healthcare system that is feeling the increasing pressure of an ageing population.

    The government has already introduced legislative proposals (that have since been adopted) to establish an NHS Executive Council which will formally form later this year and to reform NHS prescriptions and will be seeking parliamentary approval for a further reform relating to organ donation.

    NHS Prescriptions
    One of the first steps was to decrease the medication available on the NHS that was not essential to live a life that was healthy and well, for those that can afford this. This allowed us to make savings at a minimum level of £117,000,100. Despite this, it is just the first step in a year focusing on the prescription service not just in England but in the four constituent countries of the United Kingdom. For years now, experts have recognised that free prescription provision in Wales, Scotland and Northern Ireland is unaffordable. When 60% of the population is eligible for free prescriptions, and 90% of all prescriptions administered are to individuals who qualify for free prescriptions, it is this Department's opinion that it is time to bring parity to the country as a whole. This Department seeks to reform prescription services into a centralised system which, while bringing in short term cost rises in the smaller nations of the UK, will see a price fall in England. Once the scheme has been introduced, the aim will be to lower the cost of prescriptions across the entire UK, no longer making prescription charges a political tool to be used dangerously in the face of economic uncertainty.

    Occupational Therapy Departments
    To continue our aim of greater economic efficiency whilst removing unnecessary bureaucracy, the DoH will expand the therapeutic capabilities of the largest A&E departments in the UK. We will attach an Occupational Therapy department to every A&E in the country under the supervision of relevant OT Departments already in situ in respective Trusts. This will expand job opportunities for people starting the new Occupational Therapy apprenticeship whilst giving NHS Trusts the opportunity to make relevant adaptations to people's homes quicker than we are able to at present. We predict minimum savings of roughly £81,386,328 over all 184 A&E departments in UK. It is difficult to quantify the preventative measures in the long term that stem from the increased ability to prescribe assistive technology and assess falls risks. The cost will not be as high as stated due to some A&Es already having OT departments, as well as replacing Occupational Therapy Assistants (OTA) with those starting the new apprenticeship scheme.

    Maintaining the NHS Bursary
    This Government welcomes the steps taken by the previous two TSR Governments to protect the NHS Bursary. As there is an ever increasing need to cut down expensive, temporary locum posts within our NHS, this Government shall also pledge to keep the NHS Bursary scheme wholly intact. The Bursary is a vital aid to the training that future Allied Health Professionals undertake, many of whom simply do not have the time to have a part time job due to either education, family, health or time commitments.

    Independent Living Centres
    The NHS will build 10 new Independent Living Centres (ILCs) around the country, at a total cost of £30m. These ILCs will provide jobs for approximately 10 staff per centre, including receptionists and managers. A further £10m will be put aside to invest in the latest assistive technologies for the centres, as well as ensuring access is suitable for all individuals. The ILCs will offer a wide range of equipment and professional services to support people who need help to live independently, including people with disabilities and older people. Whilst the centres will not directly provide equipment, they will be able to refer service users to the most suitable provider, whether this is private or the NHS. In turn, it is hoped that this process will be able to streamline accessibility to relevant equipment whilst identifying recognised and trusted private suppliers.

    Organ Donation Policy
    To address potential concerns about the latest proposed change to organ donation in the country, the Department of Health intends to release a publication detailing the proposed change. Every household in the country will receive a leaflet that will explain what this means for their family, why organ donation is important, what an opt out system is, and when, should the bill pass, changes will begin to take effect. The leaflet will further explain how individuals can opt out of the system, should they wish. Projected costs are £9.3 million.

    Mental Health
    The Department of Health welcomes the work of the last two Governments in paying appropriate attention and taking proportionate action to try and address the scale of the mental ill health problem in this country. Whilst the last two ministers have seen it fit to address the issues from within the system and raise awareness of the stigma surrounding mental ill health, this Government will take a different approach. With the NHS spending £280,000,000 on anti-depressants every year (and rising), it is becoming clearer that medication is not the answer. It is not just depression that people are faced with every day, however. We will commit £4 million to purchase and renovate brownfield or allotment sites in areas across the nation to create 25 recreational therapy centres to assist in the recovery of all mental health conditions where possible. The centres will have a dedicated team of 4 full time staff (approx. £100,000 p/a) who will specialise in providing three services; mechanical engineering, woodwork and horticulture (inc. pottery). This allows us to provide a wide range of activities which can be developed with the service user to provide a truly holistic and person centred approach to care. Centres will be able to recruit volunteers from the local community or from ex-service users, utilising a peer-led therapy setting. At running costs estimated to be roughly £3 million for all centres p/a, we will provide a further £15 million fund to allow an initial set up time of 5 years. Funding can be reassessed after this point, with the hope that centres will sell their own wares to contribute to increased service provision. We firmly believe this will place the UK at the forefront of practical approaches to mental health group therapy.


    Sources:



    Costings:
    Spoiler:
    Show

    Costs for A&E Changes:
    Saves ~£500,000 a year.
    Band 6 OT salary - £26,302 - £35,225.
    Band 4 OT Assistant salary - £19,217 - £22,458.
    184 A&E departments.

    (Top of Band salary x 184)
    OTA - £4,132,272
    OT - £6,481,400
    = £10,613,672

    £500k x 184 = £92,000,000

    £92,000,000 - £10,613,672 = £81,386,328 savings.
    ________________________________ ________
    Costs for prescription changes:

    Prescription Limitation Bill: £117,000,100 savings
    ________________________________ ________

    ILCs = £40,000,000
    ________________________________ ________

    Recreational Therapy Centres:

    £13,000,000 staff costs
    £19,000,000 purchase and running costs

    = £32,000,000 total.
    _______________________

    Leafleting £9,300,000 - approx same as EU ref (1 per household).

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    Why use the Daily Mail as a reference?
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    The content is rather safe with nothing overtly disagreeable in the Statement of Intent, however, I do not believe the figures. £600000 to build one mental health facility is a low figure for purchase of the land, renovation, and construction; £3m to build an Independent Living Centre is cheap; and I may be misunderstanding something but introducing more things at stretched A&E departments would be an extra cost, I cannot see where the very precise figure comes from.
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    Can I get a TL;DR, other than "wemahgerd funding crisis we aren't doing anything about!"
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    Nothing majorly ground breaking in this if I'm honest, and as such, not much that people will massively disagree with in my opinion (perhaps apart from the Organ Donation bit). I will look into the figures more closely when time allows, but on first reading, I don't think there's enough I don't like to give it a no (dependant on the organ donation bill probably). I will give more detailed responses to specific sections, again, when time allows!

    A safe bit of output from the Government.
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    'Recovery' of a mental illness. Lol. Plus the Organ Donation Bill probably isn't the best move.

    But yeah, apart from that this is all great
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    How about funding for less accessible therapies such as DBT, hmm?

    edit: this holistic approach is already in mental health hospitals. Personally, I have experienced it, it was compulsory to take part in group activities such as art, cooking etc in order for me to be discharged.

    Medication is not always the answer, yes, but it is chucked at people like me because the therapy I need is underfunded/unavailable.
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    Whilst this is generally an agreeable SOI, I find it incredibly disappointing that the Government has decided to completely overlook Sexual Health, especially with an increase in the Spreading of STI's and the continued shocking FGM.

    Edit: Actually, not too sure on the Mental Health section, but I'll come to that later
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    (Original post by Airmed)
    How about funding for less accessible therapies such as DBT, hmm?
    (Original post by PetrosAC)
    Whilst this is generally an agreeable SOI, I find it incredibly disappointing that the Government has decided to completely overlook Sexual Health, especially with an increase in the Spreading of STI's and the continued shocking FGM.
    I see no reason why there can't be more SOI's related to Health this term and would be happy to discuss anything that you think should be considered - I'm sure the Health Secretary would agree.
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    (Original post by RayApparently)
    I see no reason why there can't be more SOI's related to Health this term and would be happy to discuss anything that you think should be considered - I'm sure the Health Secretary would agree.
    I would be happy to discuss more in relation to mental health; I am disappointed, as you can see by my edited post.
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    (Original post by RayApparently)
    I see no reason why there can't be more SOI's related to Health this term and would be happy to discuss anything that you think should be considered - I'm sure the Health Secretary would agree.
    I look forward to future discussions
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    Wonderful SOI with regards to health from the government.
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    (Original post by PetrosAC)
    Whilst this is generally an agreeable SOI, I find it incredibly disappointing that the Government has decided to completely overlook Sexual Health, especially with an increase in the Spreading of STI's and the continued shocking FGM.

    Edit: Actually, not too sure on the Mental Health section, but I'll come to that later
    I agree with my right honourable friend here, the mental health section is particularly lacking and the lack of reference to STIs is pretty shocking.

    All in all, it's fine though, apart from the organ donation proposal which I have voiced my concerns about already.
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    A safe SOI, but I can only echo Petros and Airmed in their collective concerns about FGM, the spreading of STIs and Mental Health.
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    (Original post by Nigel Farage MEP)
    The content is rather safe with nothing overtly disagreeable in the Statement of Intent, however, I do not believe the figures. £600000 to build one mental health facility is a low figure for purchase of the land, renovation, and construction; £3m to build an Independent Living Centre is cheap; and I may be misunderstanding something but introducing more things at stretched A&E departments would be an extra cost, I cannot see where the very precise figure comes from.
    The idea for the recreational centres would be to use Brownfield sites, 'wasteland' or areas that are considered unusable, as they did at Lindengate. Their start-up costs were £100k so I inflated this to take into account the possible need to build an office/kitchen/pottery shed and to buy the initial equipment. I believe £600k is reasonable though considering the land we're targeting would be unused areas of land.
    Sorry, this source must have got missed out, I've had a lot of trouble editing this on my phone whilst being away from home on placement. The building itself will be £3m but would not need to double up as a central base for healthcare staff to work from as in the Shetlands; the ones I envisage being built would be more traditional in just having full time staff working on a referral basis.
    The specific figures come from the top end of the salaries for relevant staff that would be needed in such a department, offset against potential savings. Obviously I can only approximate.

    (Original post by Emily Porter)
    'Recovery' of a mental illness. Lol. Plus the Organ Donation Bill probably isn't the best move.

    But yeah, apart from that this is all great
    I didn't use the term illness because it implies a life-long diagnosis, I think conditions and recognising this is only "if possible" is a more positive way to aim for complete recovery from various degrees of mental ill health.

    (Original post by PetrosAC)
    Whilst this is generally an agreeable SOI, I find it incredibly disappointing that the Government has decided to completely overlook Sexual Health, especially with an increase in the Spreading of STI's and the continued shocking FGM.

    Edit: Actually, not too sure on the Mental Health section, but I'll come to that later
    Sexual health will be tackled in a later SOI should I be in place post-reshuffle, as will palliative care.

    (Original post by Nirvana1989-1994)
    Why use the Daily Mail as a reference?
    I think if you read the article it's fairly clear why it was easy to use. While I'm not a fan of the Daily Mail, the article is fair in it's reporting.

    (Original post by Airmed)
    How about funding for less accessible therapies such as DBT, hmm?

    edit: this holistic approach is already in mental health hospitals. Personally, I have experienced it, it was compulsory to take part in group activities such as art, cooking etc in order for me to be discharged.

    Medication is not always the answer, yes, but it is chucked at people like me because the therapy I need is underfunded/unavailable.
    I think the problem is that DBT is an incredibly complex therapy to train in, more so than CBT. It also requires practitioners to receive their own talk therapy after use due to the depths of discussions reached which automatically includes another team member trained in relevant skills. While it's got empirical evidence in a treatment for BPD and may address symptoms prevalent in other conditions, it would be difficult to introduce DBT in a wide ranging roll-out scheme when CBT is much more widely available. In the same way, I would love to roll out Sensory Integration across the country for Mental Health and Autism/Learning Disability but due to better, more widely available techniques and still relatively weak empirical evidence, it just isn't right at this time.

    I also think it'd be difficult to ignore the amount of money that has already been pumped into the TSR UK's NHS Mental Health service over the last two SOIs (£5.82bn from LabLib & £500m from ConLib). That is a huge amount that would presumably be used to train people in DBT, SI and other such therapies that are currently quite exclusive, hopefully reaching more people.

    Recognising the difference between 'art therapy' (as a communication tool or emotional outlet) and using activity as a therapeutic tool is important. The ability to take part in what these centres offer reaches far wider than can be felt on an inpatient ward (social communication, self-care, cultural & environment etc.). They're entirely different concepts and from my personal experience art/music/cooking are readily available on mental health wards, which is great, but the missing link comes after someone is discharged. I don't want to confuse the focus between inpatient mental health and community mental health provision.

    I think your points are very valid with regards to the RL state of Mental Health provision but after the work of Kay_Winters & MattElves I'd like to think we were in a slightly better position where the need is specific targeting as opposed to a universal blanket approach.
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    Any step towards improving mental health must be a welcome one. Good statement from the government, not the action I would have taken but it isa good step.

    + How will you decide where to place these centre? Many people now have to travel very far to access an institution for mental health.
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    This will not be the only health SoI this term, I would hope. The Budget will likely allocate more funding to the department.
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    (Original post by TheDefiniteArticle)
    This will not be the only health SoI this term, I would hope. The Budget will likely allocate more funding to the department.
    Inflating output by publishing two SoIs is a dirty trick, the government should be communicating to find out how much money the Chancellor is giving a department to spend.
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    (Original post by Nigel Farage MEP)
    Inflating output by publishing two SoIs is a dirty trick, the government should be communicating to find out how much money the Chancellor is giving a department to spend.
    This SOI is already more substantial than the last government's Health SOI - writing another would just be us producing even more content for discussion. Nothing dirty about it and certainly no trickery.
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    (Original post by TitanCream)
    Any step towards improving mental health must be a welcome one. Good statement from the government, not the action I would have taken but it isa good step.

    + How will you decide where to place these centre? Many people now have to travel very far to access an institution for mental health.
    We'd look at current trusts that are struggling to meet targets with regards to community mental health and situate them where appropriate. Attaching them near current NHS hospitals/mental health facilities is another option as the establishments could make use of the facilities as St Andrew's Hospital in Northampton does (very successfully).

    (Original post by Nigel Farage MEP)
    Inflating output by publishing two SoIs is a dirty trick, the government should be communicating to find out how much money the Chancellor is giving a department to spend.
    There's no rule about having one SOI a term. I'd like to put a specific focus on palliative care and sexual health in the next SOI which is a damned sight harder to gather information for than the subjects in this one. The output is still my department's output, I don't see why that is a bad thing.
 
 
 
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