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

[BojanaMumsnet]

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

Hi Simon

My question is about the closure of local services. My local hospital is looking to close its A and E and ship everyone over to its partner hospital 20 miles away. Both departments are already overrun, and the closure of one will mean utter chaos for the other as it becomes the only ED in the region - a fairly large county. The 'public consultation' has been quite blatantly merely a box-ticking exercise, it's clear this is going to be pushed through, however much protest - and there's a lot.

This is all down to budget, but what it's going to do is endanger lives. I was in our local A and E the other week and was on a trolley in the corridor as there were not enough cubicles - left 6 hours before being taken to a ward. The place was incredibly busy, staff were hassled, resources thinly stretched. And this is going to be closed down. How can this be justified?

Hi simon,
It's clear that given our large bank and agency bills we do not train enough clinical staff and specifically enough doctors and nurses. What plans are there centrally to significantly increase the number of university places and associated training places, so that we can ensure we no longer have to rely on bank, agency, eu and non eu workers?

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 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?

Simon,

Why does every advert calling for managerial expertise and consultancy to sort the NHS out from NHS England, require candidates to have "mandatory NHS experience"?

So, you are only open to hiring the very same people who got you into this mess in the first place.

Why are you as CEO allowing such blinkered and regressive thinking in your hiring practices?

This week Cambridge and Peterborough CCG decommissioned fertility services - suspending treatment for all new patients till at least March 2019.
They did this contrary to the local support for the service which their own consultation demonstrated - 82% of respondents said it should be kept. What is your message to all the women and men TTC who now have to find the money to pay for treatment? For some this will mean they cannot access treatment at all and will lose any chance they had just to try to have a child. For others it will mean that their chance is reduced as their biological clock is ticking while they save up to pay for treatment. How do you plan to turn the cuts in fertility services that are preventing women from having the chance to become a mum?

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

As you are likely aware, an increasing majority of CCGs fail to adhere to NICE fertility guidelines -data collected in 2016 by ‘Fertility Fairness’ shows that just 16% of CCGs offered the NICE recommended three cycles of IVF treatment. This deeply troubling trend of disinvestment continues to deteriorate and will not be reversed unless immediate action is taken.

What work is being done by NHS England to address the postcode lottery of NHS IVF provision which is profoundly affecting couples suffering from infertility across the country?

Why did you shave your beard! It was so nice. (But you also look nice without it)

Test

What is the NHS going to do after BREXIT?

Why does the model of services we have only seem able to look at a bit of your body at one time rather than considering your symptoms as a whole? It takes such a long time to get things sorted out when you've waited ages to see one consultant and they decide it's a problem with something else and you have to wait all over again to see someone different who then looks at a different subset of your symptoms and doesn't / can't relate them to the first area of investigation.

Can we look at developing a holistic technical strategy, with approved vendors (champion, challenger approach so there is still competition).

Trusts spend a fortune developing their own strategies, and procuring solutions. If these were specified centrally there would be better alignment and economies of scale.

This would mean that the doctors who move from trust wouldn't need as much training on systems. It would improve clinical safety and improve data consistency across trusts.

It should also support data sharing between trusts

Do you trust this government to look after the NHS?

Put only 1 CCG in place. Make decisions nationally on services to be delivered.

CCG seem to aim for competition between hospitals to reduce costs but it doesn't make any sense. The trusts deliver the services as cost effectively and efficiently as possible so completion doesn't help.

You would be better to spend the money wasted at the CCG level providing transformational support for best practice sharing and deployment to improve delivery across the board

Hello , the NHS has a lot going on , but when trust put no smoking policies in force , and then don't uphold them , due to 40 % overall of staff smoking and when you don't why should you tell people not to smoke , when so many staff within the trust , flaut the rules , thanks

Hi everyone,
Looking forward to chatting.

How can we ensure that CCGs are offering NICE recommended treatments? For example, NICE recommends that eligible women under 40 are offered 3 rounds of IVF, yet a growing number of CCGs are cutting IVF services entirely.

Some CCGs have ceased to provision IVF treatment despite very strong resistance in their public consultations (77% Croydon, 82% Cambridgeshire & Peterborough only this week).

Infertility is not a regional problem, it is a national problem. I think a national policy (not a national guideline) and a national tariff are required because there is such variation between what some CCGs pay per cycle: £2,000 - £11,550.

We attended a parliamentary debate in January this year where commitment was made to write to all CCGs reiterating NHS England’s expectation that 3 cycles of treatment be provisioned as per NICE guidelines. I have just received Freedom of Information responses from two CCGs, both confirmed they have not received their letters.

I therefore respectfully request that immediate action takes place to prevent CCGs from attempting to remove treatment. I also request a single national policy and a single national tariff for what is clearly a national problem.

Thank you.

@TresDesolee

Is the British public's attachment to the NHS funding model - free at the point of delivery, no private insurance - a bit of a stumbling block to clear-eyed reform? Do you wish people were more rational about it?

Put another way: do you have a picture of Clement Attlee in your office, and if so is it on a dartboard

I haven't got a dartboard, but I do have pictures - mainly of my kids and family holidays.

But on the real question, I think the British public are being completely rational in their support for the NHS and in wanting to see it continue to be successful.

And that's for 3 reasons: First up. individual patients generally get brilliant care across the NHS. Second, the fact that you get care when you need it without having the worry of whether you can pay for it is a huge relief for families - and third, the NHS provides incredible value for money for taxpayers and for the country as a whole. We'd be mad to forget all that.

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

@ragz134

I qualify as a nurse in 2019. Can you give me your best reason why I should work for the NHS? (Aside from moral/ethical/political obligations).

You will have a brilliant career as a nurse in the NHS. Not without its challenges, not without its stresses, but one of the most important and fulfilling jobs that anyone can do in modern Britain. What will make it such a great job? Obviously you're going to be looking after vulnerable patients who will - hopefully! - be incredibly grateful for your care. You're going to be working along side other health professionals who are some of the most committed and compassionate people you could ever hope to meet, and you will have great flexibility over the course of your career, in terms of where you work, how much you work and what sort of specialty you work in. You could be working in an inner city GP surgery, you could be working in a high tech intensive care unit, you could be running your own clinics for people using mental health services. The choice is yours!

@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.