Casebook July 2023

Casebook July 2023

Posted: July 17th 2023


In Casebook this time dentistry, physician associates, the antidote to dementia outbreaks and poor payment activities challenging rural providers of health and in other stuff a real call for you to fill in our survey seeking member responses about the rural context for the implementation of the NHS Long Term Work – see below!

NHS dentists: People having to drive hundreds of miles 'unacceptable'

This story bears out the huge challenge of accessing dental care across the UK but most acutely from my perspective in rural settings it tells us.

The pain and distress of not being able to see an NHS dentist are "totally unacceptable", an inquiry has told the government.

A review was launched after a BBC investigation found nine in 10 NHS dental practices across the UK were not accepting new adult patients.

Some people drove hundreds of miles for treatment or even resorted to pulling out their own teeth, the BBC found.

The government says it invests more than £3bn a year in dentistry.

But the damning report, by the Commons' Health and Social Care Committee, says more needs to be done, and quickly.

Dental reforms - recommended to the government more than 15 years ago - have still not been implemented, it says.

Last year's BBC's investigation found eight in 10 NHS practices were not taking on children.

Between May and July 2022, BBC News contacted nearly 7,000 NHS practices - believed to be almost all those offering general treatment to the public.

In a third of the UK's more than 200 council areas, the BBC found no dentists taking on adult NHS patients.

Researchers could also not find a single practice accepting new adult patients in Lancashire, Norfolk, Devon or Leeds.

Call for physician associate clarity after misdiagnosis death

I personally do think physician associates have a key role to play in enhancing the capacity of local health services in rural settings but this article will give some people food for thought. It tells us:

A leading health think tank has joined calls for physician associates' roles to be better defined following the death of a woman after a misdiagnosis.

Emily Chesterton, from Salford, died aged 30 after two appointments with a physician associate whom she believed was a GP.

Introduced in 2003, the role involves supporting doctors.

Nigel Edwards, from the Nuffield Trust, said patients should have the choice to say: "I'd rather see a doctor".

Mr Edwards, who is chief executive of the think tank, told BBC Radio 4 Today that "patients don't necessarily know who they are or what to expect" when dealing with physician associates, who support doctors in making diagnoses.

He said the role could help GP surgeries facing pressures but there were concerns that it could "go wrong" if there was not proper supervision.

The NHS plans to increase the number of physician associates to 10,000 by 2037, according to the Department of Health and Social Care.

The role is currently unregulated with the government planning legislation for regulations to be introduced before the end of 2024.

Community pharmacists in Wales warn they're close to burnout

A second story about the challenges of making dentistry work in a very rural milieu. It tells us:

Community pharmacists in Wales have warned they are close to "burnout".

They described being under increased pressure to deliver more services to patients without adequate financial support from the Welsh government.

Wrexham pharmacist Dhimant Patel said the profession was in "a fantastic position" to help reduce pressure on GPs but warned "the funding must follow" to make it happen.

The Welsh government said it was committed to helping the profession.

Community pharmacists - also known as chemists - dispense prescriptions, sell over-the-counter medicines and can give advice on treating minor ailments and certain conditions.

They are contracted by the NHS in Wales and received a 1% increase in funding for 2023-24, a figure described as "insulting" by one business owner.

Torbay appeal for more dementia carers to open up homes

This scheme is so brilliant from my perspective and offers real potential to support dementia sufferers in rural settings. The article tells us:

An innovative dementia day care service wants to take on more hosts who will open up their homes.

The Filo Project matches small groups of older people with early to moderate dementia with hosts for a day as an alternative to traditional day centres.

It has six hosts across Torquay, Paignton and Brixham and is looking for more people to join.

Hosts are carefully selected and trained by The Filo Project and receive a fee for their work.

Hosts collect clients from their homes, drive them to their own home, prepare a home-cooked lunch and engage them in activities that suit their interests and abilities, such as baking, singing or crafting.

The Filo Project also supports clients' families by helping them access local health and social care systems and the financial assistance they may be eligible for.

The aim is to reduce isolation of people with dementia and their carers.

Home care providers in England fear collapse over unpaid invoices

Yet more in the way of challenges for the provision of adult social care in rural settings, this story tells us:

Dozens of home care companies in England fear collapse because invoices are going unpaid by councils and the NHS.

Hundreds of millions of pounds in unpaid bills are threatening parts of a care industry already stretched by a recruitment crisis and rising wages, according to research by the Institute of Health and Social Care Management (IHSCM).

One company, which has 60 care workers, said it had stopped working with the council or people funded by the NHS because “there is a high risk of financial failure because you can’t pay the payroll”.

Caroline Southgate, the managing director of the Doris Jones care agency, said: “If they don’t address this they are never going to address their discharge problem in the NHS. We have had people die and have been chasing the NHS for a year and a half for the money.”

More than one in five home care providers surveyed said they feared the collapse of their business in the next six months because of unpaid bills.

Other Stuff

One simple call this time. Please fill in our survey about the NHS Long Term Workforce Plan. The NHS Long Term Workforce Plan 2023 is crucial to the long term sustainability of the institution. It has not been rural proofed and it makes very few references to rural issues. We are preparing a response and would welcome your views through completion of this survey.  You can logon to it here.