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Webchat with Simon Stevens, Chief Executive of NHS England, Friday 8 September at 1pm

(127 Posts)

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BojanaMumsnet (MNHQ) Wed 06-Sep-17 17:12:50

Hello

We’re pleased to announce a webchat with the CEO of NHS England, Simon Stevens, on Friday 8 September at 1pm.

NHS England leads the National Health Service in England, setting the priorities and direction of the NHS to improve health and care. Simon is accountable to Parliament for over £100 billion of annual health service funding. You may know him from his appearances in front of Commons select committees which have occasionally hit the headlines.

Simon joined the NHS in 1988 and became a frontline NHS manager, leading acute hospitals, mental health and community services, primary care and health commissioning across different parts of England. He also served seven years as the Prime Minister’s Health Adviser at 10 Downing Street, and as policy adviser to successive Health Secretaries at the Department of Health. He has been leading NHS England since 2014. Simon is married with two school-age children.

Please do join the chat on Friday at 1pm, or if you can’t make it, leave a question here in advance. Please do share the webchat on social - the more, the merrier!

As always, please remember our webchat guidelines - one question each, follow-ups if there’s time and please keep it civil.

Thanks
MNHQ

SimonStevens Fri 08-Sep-17 13:10:03

LapinR0se

When are mental health services going to be properly funded & staffed? In London the waitlist for CBT for postnatal depression is 6 months. That is simply unacceptable considering it is an acute condition that can be greatly improved with appropriate intervention

I completely agree. We're in the middle of a huge sea change in awareness and attitudes towards mental health and wellbeing. That is rightly putting a spotlight on the gap that has existed for decades between how we look after people with physical health problems and the support available at times for mental health stress and crisis. So, what are we doing about it?

First, a step change in the money going into mental health services. Second, a big expansion in staff numbers over the next 3-5 years aiming for well over another 10,000 , and up to 21,000, mental health professionals.
Third, for the first time ever clear waiting time standards to make sure people get the care they need more quickly and then on the specific point you specifically make about postnatal mental health services - we're putting another £365m in over the next few years.

And today in fact - breaking news for Mumsnet! We are announcing 4 new specialist mother and baby units covering the North West of England, the East of England, Kent, and Devon.

SimonStevens Fri 08-Sep-17 13:14:05

Carriemac Fri 08-Sep-17 12:30:39
What is the NHS going to do after BREXIT?

deaddeadgood

What contingencies are you going to put in place if government policy ensures a mass exodus of EU staff due to Brexit? Some Italian/Spanish nurses ( of which there are many) have been told by their professional bodies that their work in the UK will no longer count towards their professional development due to Brexit. They've said they'll leave. The NHS will fall down.

The NHS has always benefited from committed, and talented health staff both trained here in Britain and who have chosen to work here from abroad. So we need to both expand training opportunities for people in this country and continue to say a big thank you to our current staff from the rest of the European Union, who we want to keep. So, from the NHS point of view, as Brexit goes forward, and the government is able to fully control our immigration policy, it's no surprise that the public say that one of the groups of employees they most want to see Britain be able to attract and retain are NHS staff from the rest of Europe. But as I say, alongside that, we need a big expansion in training opportunities for nurses, doctors, therapists and other health staff in this country, and that's what we are doing.

Becles Fri 08-Sep-17 13:15:36

@SimonStevens
First, a step change in the money going into mental health services. Second, a big expansion in staff numbers over the next 3-5 years aiming for well over another 10,000 , and up to 21,000, mental health professionals.

Please could you confirm how much of this is new money and not money stripped from another service area? How is this reconciled with current staff experiences of huge instability caused by painful slash and burn cuts otherwise known as CIPs in acute and especially mental health sectors?

Ouchiebum Fri 08-Sep-17 13:15:40

How are you going to fill those mental health staff numbers when the universites have not filled all the places for mental health nurses this year?

deaddeadgood Fri 08-Sep-17 13:15:42

But their professional bodies are not going to make it easy for them to stay. Most theatres are made up of European professionals. Most of the time the patient is the only Brit in the room.

SimonStevens Fri 08-Sep-17 13:17:59

Pooks123

I understand that the Better Births Report suggests that Commissioners use alternative providers in order to widen the choices for women. Can Mr Stevens advise what examples of this have occurred or are commissioners simply maintaining the status quo.

Most women say they get great support from the NHS and are very satisfied with the maternity services on offer, but there obviously are things that we can do better.

One of those is that nearly 9 in 10 women have their baby in a hospital obstetric unit but half of women say all things being equal they would be interested in having their baby in a so-called alongside midwifery unit next to the hospital obstetric unit.

So, in 7 parts of the country local maternity services are now offering women greater choice about their safe childbirth options - but the key thing to remember is there is no ONE right way of having your baby. It's a question of what's safe for the individual mum and the individual choices the mum, perhaps with her partner, wants to make.

Ouchiebum Fri 08-Sep-17 13:20:24

we need a big expansion in training opportunities for nurses, doctors, therapists and other health staff in this country, and that's what we are doing.

Great to hear this. Please can you tell us how many extra clinical staff will be trained in 10 years time compared to 2015 as a baseline. How does this match against predicted demand for workforce? What will the gap be in 2025?

SimonStevens Fri 08-Sep-17 13:20:46

terryfolds

What do you think is the biggest challenge for the NHS in the next five years?

I think we've got several big challenges. We've got to be a better employer, supporting our brill 1.3 million staff better. We've got to square the circle between the funding that the country commits to the NHS and the expanding range of treatments and care that we want to offer. And we've got to change the way we provide that care, recognising that some of our historic ways of working no longer make sense. But we've got a lot going for us, and the most important thing we've got going for us is the huge support of the British people for what the NHS is trying to do.

beafrog Fri 08-Sep-17 13:21:32

I would like to know what you are planning to do about the cuts to fertility services across England? It's so easy to underestimate the impact infertility has on people's lives if it hasn't happened to you or to someone you care about. At the moment access to treatment depends entirely on where you live and that can't be right. What's worse is that individual CCGs seem to have little idea how much a cycle of IVF ought to cost. What are your plans to ensure an end to the postcode lottery and to make sure NICE guidance on cost-effective and clinically effective treatment are followed?

SimonStevens Fri 08-Sep-17 13:24:54

lljkk

Which worries keep you awake at night?

Sometimes my dog when the planes start going over at Heathrow.

SimonStevens Fri 08-Sep-17 13:25:21

Becles

*@SimonStevens*
First, a step change in the money going into mental health services. Second, a big expansion in staff numbers over the next 3-5 years aiming for well over another 10,000 , and up to 21,000, mental health professionals.

Please could you confirm how much of this is new money and not money stripped from another service area? How is this reconciled with current staff experiences of huge instability caused by painful slash and burn cuts otherwise known as CIPs in acute and especially mental health sectors?

Hi Becles,
Over the next three years, it's going to be at least £1bn of genuine new money, and to make sure we are kept honest on that, we're publishing every three months the information on what's happening on mental health spending and services in every part of the country, on our website. Btu it's not just about the money going in, it's about the extra staff available. Part of what we want to do is make sure there's quicker access to mental health talking therapies in your local GP surgery. So, by this coming March, 2018, there are going to be 800 more therapists working alongside GPs across England and 1500 by the following March. All of this information is going to be completely transparent, and if that's not happening, everyone will be able to see that.

andidb Fri 08-Sep-17 13:28:11

Hi Simon. I work in the Improvement Team at Musgrove Park Hospital in Taunton, Somerset. We provide improvement coaching and internal consultancy to our trust and this is a new model to the NHS. We know that trusts all over the country are doing similar improvement projects. Do you have plans for regional improvement hubs or networks to prevent us all doing the same thing in our local silos?

SimonStevens Fri 08-Sep-17 13:28:53

moonbells

I could ask many questions but we are supposed to ask only one.

Psychologically, having family members and friends around to visit helps keep stress levels down and means inpatients recover faster and thus cost the NHS less. Stress also stops outpatients recovering quickly (stress > changes in blood pressure and inflammatory response > prevents recovery and can lead to mental health issues)

How is paying ridiculous amounts of money on hospital car parking going to help this? My local hospital is £1.60 an hour pay and display and you have to guess how many hours you are going to be in there or you get hit by a £35 fine! How stressful is that?

Has anyone done a costing for money made on car park fees (allowing for extra staff costs for parking wardens) against the extra costs of longer recovery or long-term induced anxiety/depression?

I do understand your point about car parking - my mum tells me that one of the frustrations she has when she has to go to an outpatient appointment at the hospital in Reading is the difficulty of car parking. But what the hospital says is if they made all their car parking free all the spaces would be taken up by people going shopping in the town.

The other honest fact is that hospitals would have to make more than £100m of cuts in other services if they didn't have the parking income.

Ivytheterrible Fri 08-Sep-17 13:29:44

Can you do more with helping people with mental health problems earlier on? I recently spent 6 months requesting help as I got more poorly. The first time I was seen I was immediately assessed under MHA. Why can't these issues be fixed when surely they must save £ in the long term through reduced admissions?

SimonStevens Fri 08-Sep-17 13:34:48

Oly5

Isn't it time we just accepted that the NHS needs more money and start funding it properly, even if this means raising taxes?

Well Oly5, for better or worse, it's not the NHS that decides what we spend on the NHS. In a democracy, it's our elected government and parliament that makes that decision. Looking to the years ahead, most people would accept that if we want a brilliant health service we'll have to continue to fund it properly. And I expect that's choice that we, the voters, will continue to make.

SimonStevens Fri 08-Sep-17 13:41:33

cowgirlsareforever

I have a DP with a disability and have spent years attending hospital with him, dealing with the most serious issues (having to have limbs cut off) to the mundane. My view is that there are definitely "Cinderella' services, in particular in our experience orthotics (and to a slightly lesser degree) prosthetics. Trying to access decent orthotics from the NHS has been one of the most frustrating, soul destroying and tiring aspects of the disability. It's chronically underfunded and undervalued. We have been in situations where the health professional has been an overworked man nearing retirement age who was literally working out of a cupboard. We are manically saving up so we can pay privately because the brightest and best people in orthotics and prosthetics are all going straight into the private sector, where they can work with paralympians. Meanwhile the crisis in NHS orthotics continues.
My question is are you aware of how dire the situation is for people like us and secondly, is there a plan to improve things?

Furthermore I always thought it would be a good idea for children to be given information to help them if they have loved ones in hospital. My children have both spent a long time visiting hospitals and it is bewildering and scary. A booklet, preferably written for children by children would be a great idea. Mine, no doubt with lots of other Mumsnetters' children, would be happy to contribute their stories!

Hi cowgirlsareforever - I'm really sorry to hear that has been your family's experience and I completely accept that there are these real pressures and service gaps in some parts of the country; there have been similar problems with wheelchair services in some areas and there is now a big push together with WhizzKids to give wheelchair users more choice and to enable them to get more modern equipment faster.

Cowgirlsareforever - on your point about children in hospital, I've seen this with my own children. In fact, I had the experience as a primary school aged child myself of having to spend several months in hospital and I still remember that first night as the scariest and most upsetting night of my life. Fortunately in the years since then, hospitals have got a lot better at trying to make children's clinics and wards more like a fun environment for kids with art work, books and play areas, but it is still a very difficult experience.

LaraGransnet (GNHQ) Fri 08-Sep-17 13:44:59

Hi Simon
Over on MN's sister site, Gransnet our users are often talking about similar issues, most recently about their concerns about mental health care support you were talking about earlier. Another issue they've been talking about is the cost of prescriptions. For those who aren't yet 60, but still have chronic health issues requiring multiple prescriptions, this can end up costing them a huge amount of money. What can be done about this?

SimonStevens Fri 08-Sep-17 13:46:17

beafrog

I would like to know what you are planning to do about the cuts to fertility services across England? It's so easy to underestimate the impact infertility has on people's lives if it hasn't happened to you or to someone you care about. At the moment access to treatment depends entirely on where you live and that can't be right. What's worse is that individual CCGs seem to have little idea how much a cycle of IVF ought to cost. What are your plans to ensure an end to the postcode lottery and to make sure NICE guidance on cost-effective and clinically effective treatment are followed?

Hi Beafrog and the several others who have asked about this topic,
You're right. Not being able to have a baby when you want to can be a very distressing and stressful time for a woman and for a couple, and I'm not going to pretend there's an easy, cost-free answer here. As it happens, the NHS is spending about £100m per year on IVF, and actually the number of IVF cycles we've been funding has been going up over the last three years., but there's absolutely no disputing the fact that the NHS cannot currently afford to do all the IVF that people would like. There is a difficult balance between the number of cycles per person that we're able to fund within that £100m, versus the number of couples that can be helped, but there are also quite big differences in the cost of IVF services across the country, so we're looking at whether we can free up money from that to expand services in some areas.

Ouchiebum Fri 08-Sep-17 13:47:59

Hi simon,

How do you think the NHS can communicate clearly with the public about the changes needed e.g. consolidating services, reviewing the treatments on offer so that the public understands the tough decisions that need to be made to balance the books?

SimonStevens Fri 08-Sep-17 13:50:04

RowanMumsnet

Hello Simon

I'm Rowan, the Head of Policy and Campaigns here at Mumsnet.

We at MNHQ wanted to ask you about our campaign for Better Postnatal Care. Our aim is to make sure that every new mother in the UK receives good postnatal care: things like well-staffed postnatal wards where women are given the care and clinical attention they need, well-trained and prompt infant feeding support, good mental healthcare and support for wounds and long-term health issues caused by pregnancy and birth.

For many years now, we've read discussions on Mumsnet in which women talk about the rocky state of postnatal care in some parts of the NHS. Some Mumsnet users have shared really distressing accounts of being left in pain on postnatal wards, or being hungry and thirsty and unable to get staff attention, of not being able to access infant feeding support, and dismissive attitudes among some HCPs when it comes to painful birth injuries (sometimes many months or even years after birth).

We took part in NHS England's maternity review a couple of years ago, and we're following the maternity transformation programmes closely - but what our users would like to see is the same focused thinking and resources being applied to postnatal care.

Can you help us to address this issue? We're already in touch with some very impressive ward managers and maternity workers who are doing their utmost to change things in their trusts, but we'd love to know how we can get NHS England on board.

Thanks
MNHQ

I'd start with a big thank you to Mumsnet for your advocacy and campaigning on this, and related, issues. Part of the answer here, as you say, is the support that new mums get before coming home with their baby and I'd like to invite you to work directly with us and our national team on this.

cowgirlsareforever Fri 08-Sep-17 13:52:01

Thanks Simon for your answer but in respect of the second point I made, this wasn't about children's experiences as patients themselves. I was making the point that for children who have parents, siblings, relatives and other loved ones in hospital, there is no support. A booklet explaining what happens to people in hospital, who people are etc would be great.

SimonStevens Fri 08-Sep-17 13:53:10

Sillybillypoopoomummy

What % of NHS finances is currently spent on management and how has this changed in the last 5 years?

The NHS spends about 2-3p in every pound on administration, compared with 5p in Germany and 6p in France, so we are almost certainly the world's most efficient Western healthcare system. But we also think there's more savings to be made, in administrative costs, to the tune of at least another £250m over the next three years, which will be put into patient care instead.

JustineMumsnet (MNHQ) Fri 08-Sep-17 13:55:22

SimonStevens

RowanMumsnet

Hello Simon

I'm Rowan, the Head of Policy and Campaigns here at Mumsnet.

We at MNHQ wanted to ask you about our campaign for Better Postnatal Care. Our aim is to make sure that every new mother in the UK receives good postnatal care: things like well-staffed postnatal wards where women are given the care and clinical attention they need, well-trained and prompt infant feeding support, good mental healthcare and support for wounds and long-term health issues caused by pregnancy and birth.

For many years now, we've read discussions on Mumsnet in which women talk about the rocky state of postnatal care in some parts of the NHS. Some Mumsnet users have shared really distressing accounts of being left in pain on postnatal wards, or being hungry and thirsty and unable to get staff attention, of not being able to access infant feeding support, and dismissive attitudes among some HCPs when it comes to painful birth injuries (sometimes many months or even years after birth).

We took part in NHS England's maternity review a couple of years ago, and we're following the maternity transformation programmes closely - but what our users would like to see is the same focused thinking and resources being applied to postnatal care.

Can you help us to address this issue? We're already in touch with some very impressive ward managers and maternity workers who are doing their utmost to change things in their trusts, but we'd love to know how we can get NHS England on board.

Thanks
MNHQ

I'd start with a big thank you to Mumsnet for your advocacy and campaigning on this, and related, issues. Part of the answer here, as you say, is the support that new mums get before coming home with their baby and I'd like to invite you to work directly with us and our national team on this.

That's brilliant - we'd love to work directly with you and your team on Better Postnatal Care. Thanks and we'll be in touch!

SimonStevens Fri 08-Sep-17 13:56:31

LaraGransnet

Hi Simon
Over on MN's sister site, Gransnet our users are often talking about similar issues, most recently about their concerns about mental health care support you were talking about earlier. Another issue they've been talking about is the cost of prescriptions. For those who aren't yet 60, but still have chronic health issues requiring multiple prescriptions, this can end up costing them a huge amount of money. What can be done about this?

Hello LaraGransnet - thanks for the question. As you know, you can get free NHS prescriptions if you're 60 or over, but also if you have certain chronic health problems. You can also get discounted prescriptions if you have a lot of prescriptions - all the information is on the NHS Choices website.

YoungKA Fri 08-Sep-17 13:56:56

Simon, can I ask for your source from your statement 'the number of IVF cycles we've been funding has been going up over the last three years'?

Fertility Fairness collects data on this which strongly suggests the opposite is true.

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