Painkillers, cough remedies and gluten-free foods will no longer be available on the NHS.
GPs will have to stop prescribing items that can be bought cheaply in supermarkets and chemists.
Unveiling a major cost-cutting plan in the Daily Mail today, the head of the NHS says patients will also be expected to pay for their own indigestion pills, hayfever remedies and sun cream.
NHS chief executive Simon Stevens (centre) talks with staff during a visit to Consett Medical Centre in County Durham, northeast England
Simon Stevens says that free travel vaccinations will come to an end.
His new national guidance will say these should no longer be ‘routinely’ prescribed on the NHS. There will also be a big drive to recover the costs of treating European Union citizens.
The crackdown is part of a blueprint to be formally announced by Mr Stevens later this week to save the Health Service up to £1billion in two years. He wants to use the savings to improve patient care and pay for lifesaving drugs.
The reforms come as the NHS struggles to keep pace with the pressures of both a growing and ageing population.
Following one of the worst winter crises in its 69-year history, doctors and MPs are calling for an urgent debate on funding, with suggestions including a special ‘NHS tax’.
But Mr Stevens today puts the emphasis on efficiency.
His proposals include:
- New health tourism rules for GPs to ensure they record all EU patients and enable the NHS to claw back money from their home countries;
- Fresh bed-blocking targets for hospitals to free up a set number of beds currently occupied by elderly patients who should be at home;
- Plans to ensure that NHS managers stop hiring expensive locum doctors who earn up to £200,000 a year.
In his interview today, Mr Stevens also suggests families can help take the pressure off the NHS by watching their children’s diets more closely and by ensuring their elderly relatives do not become isolated.
The chief executive of NHS, Simon Stevens has his blood pressure taken at Consett Medical Centre in County Durham
He suggests that parents should give their children carrots and apples when they get home from school rather than chocolate or cereal bars to help tackle childhood obesity.
The NHS is in the grip of a financial crisis exacerbated by having to foot the bill for increasingly expensive new drugs and operations for cancer, heart disease and other serious illnesses which were previously incurable.
But Mr Stevens believes hundreds of millions of pounds could be saved by the NHS simply ‘getting its own house in order’ and reducing waste.
He estimates up to £400million could be saved a year by instructing GPs not to hand out ‘low priority’ items.
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But his proposed clampdown will prove particularly controversial for the one in 100 Britons with coeliac disease – an intolerance to wheat.
They will now have to pay from their own pockets for gluten-free food.
Mr Stevens says these products can now be bought in supermarkets and there is no longer a need for NHS prescriptions. And he says it is wrong for patients to be prescribed pizza bases, digestive biscuits and cakes.
His crackdown will also upset the one in ten patients eligible for free prescriptions – including the elderly, pregnant or those on low incomes.
Mr Stevens, who is chief executive of NHS England, says GPs hand out more than a billion prescriptions a year – a 50 per cent rise in a decade, costing £9.3billion.
Simon Stevens in a previous role with NHS England
But he says that the measures he unveils today will free up GP appointments as fewer patients need to book up slots to obtain a free prescription.
‘We’ve got to tackle some of the waste which is still in the system,’ he said.
‘The NHS is a very efficient health service but like every other country’s health service there is inefficiency and waste.
‘There’s £114million being spent on medicines for upset tummies, haemorrhoids, travel sickness, indigestion, that’s even before you get on to the £22million-plus on gluten free that you can also now get at Morrisons, Lidl or Tesco.
‘We will be backing them in new national guidelines that say those should not routinely be prescribed on the NHS.
‘Part of what we are trying to do is make sure that we make enough headroom to spend money on the innovative new drugs by not wasting it on these kind of items.
‘The price of gluten-free alternatives has come down substantially.
‘There’s no doubt that coeliac disease is an important medical condition that’s increasingly being recognised.
‘But when you look at the list of prescribable items it extends to digestive biscuits, pizzas and other products – there are legitimate questions to be answered.’
Mr Stevens will launch a consultation next month into new guidelines urging GPs to stop prescribing low priority items.
This will start off by looking at ten groups of medicines or products including gluten-free foods, omega 3 vitamin supplements and travel vaccinations.
It will also include some very strong painkillers for terminally ill cancer patients which health experts say are expensive and not necessarily effective.
As part of the consultation, GPs, medical experts and patient groups will all have the chance to air their views – including representatives of coeliac disease sufferers.
Once that stage is finished, officials will launch a second consultation looking at other items including paracetamol, cough and cold remedies, hayfever pills, travel sickness tablets and suncream.
The review was prompted by research by NHS Clinical Commissioners – a membership body for groups of GPs – which compiled a lengthy list of low priority items.
Several health trusts have already imposed their own bans within the last six months. Mr Stevens’ cost-saving measures – the NHS Delivery Plan – will be formally announced on Friday.
Shambles as consultants get through LESS work each year
Hospital consultants are seeing fewer patients as NHS productivity falls, a report reveals.
The number of senior doctors employed in NHS hospitals increased by 26 per cent between 2009/10 and 2015/16.
But their overall output, largely determined by the number of patients they see and treat, has not kept up, increasing just 10.4 per cent over the same period.
The NHS is ‘not using the skills of its consultant workforce’, the report by the Health Foundation think tank finds.
Hospital consultants are seeing fewer patients as NHS productivity falls, a report reveals
The authors say productivity by hospital consultants is falling 2.3 per cent a year.
They stress this does not mean senior doctors are slacking but rather poor hospital systems and inadequate planning mean they cannot reach their peak productivity.
While consultant numbers have soared 26 per cent, for example, the number of nurses vital to support them has only increased 1 per cent.
The report also reveals that nearly half the additional money injected into the NHS before the general election was spent on private providers for patients.
Almost £900million of the £2billion real-terms increase for NHS England in 2015/16 was spent on outside care.
Anita Charlesworth, of the Health Foundation, said: ‘The NHS has got to use the skills and talents of its work force much better.
Consultant productivity has been falling but not because staff aren’t working incredibly hard.
NHS consultants work in a system and if that system isn’t well designed they can’t be productive.
Increasing the number of consultants by a fifth without investing in nurses is a prime example of short term cost savings undermining the essential task of improving long-term productivity.
An NHS ambulance outside accident and emergency at Yeovil District Hospital, Somerset
Professor Jane Dacre, president of the Royal College of Physicians, said last night: ‘We have another report which outlines that our consultant work force is overstretched in an underfunded NHS.
‘Money alone will not solve this issue – work force planning is crucial.
‘Consultants need to be supported by strong teams encompassing nurses, management and support staff.’
Niall Dickson, of the NHS Confederation, which represents hospital trusts, said: ‘The limited extra funding in recent years was supposed to bring the system back into balance and change the way services are organised.’
He added: ‘The reality is that there is still a long way to go on both fronts.’
The Department of Health said the report simply shows the NHS is judging how best to deliver care and added that it spends less than eight pence of every pound on independent providers.
Health tourism crackdown: GPs are told to check care for EU patients will be paid for by home country
BY SOPHIE BORLAND FOR THE DAILY MAIL
GPs will be told to identify patients from Europe in a major crackdown on health tourism.
From July they will have to check whether patients registering at a surgery have a European Health Insurance Card.
Issued by their home country, the cards entitle them to NHS care on the proviso that their government pays back the costs.
GPs will have to check if patients registering at a surgery have a European Health Card from July (file photo)
Receptionists will hand a form to all new patients which asks them whether they hold an EHIC not issued in the UK.
If they tick a box saying ‘yes’, they will be asked to show the card and the details will be recorded on a national database.
If patients from the EU go to hospital for an operation or scan, staff will be able to bill their home country for the costs.
Simon Stevens, who is chief executive of NHS England, tells the Daily Mail it is time the UK is ‘properly compensated by other countries’. At least £300million is lost each year through failure to recoup the costs of treating overseas patients.
The NHS is especially bad at identifying EU patients and billing their governments.
A scathing report by MPs last month revealed that the NHS only managed to claw back £49million from European patients in 2014/15. By comparison it paid out £675million for UK patients who were treated in EU member states.
The NHS’s annual budget is £120 billion and each year some £300 million is spent on health tourism, although some experts believe this is far higher
The new rules depend on EU patients declaring they have an EHIC card.
Patients from the EU who have lost their card – or who were never issued one – can avoid ticking the box and still obtain free hospital treatment. By law, GP appointments and checks are free for all patients regardless of their nationality.
Hospital treatment – on the other hand – is only free for those patients who have been resident in the UK for at least the past six months. But many hospital staff fail to check a patient’s nationality or how long they have been living here.
Many overseas patients leave hospital without ever being identified. The new rules have been written into GP contracts for 2017/18 and, from July, EHIC checks will be mandatory.
20 hospital trusts are carrying out a pilot scheme in which patients are asked to show passports or other forms of identification (file photo)
They follow a successful pilot in 2015 involving dozens of practices which scrutinised EHIC cards on a voluntary basis. The checks were heavily criticised by leading GPs, who claimed they would create too much work and deter some patients from registering.
Mr Stevens says: ‘The principle is that the National Health Service is here for people who are entitled to its care. We should be properly compensated by other countries or other payers. People who aren’t entitled to care – doesn’t mean they shouldn’t get that care – but taxpayers shouldn’t be paying for it.
‘The principle is clear. What we’ve got to do now is find easy ways that can be put into practice.
‘Traditionally you have been able to get care just because you are here. We’re collecting £200million and it could be up to £500million so that’s why that’s got to be part of the efficiency plan.’
Mr Stevens says 20 hospital trusts are carrying out a pilot scheme in which patients are asked to show passports or other forms of identification at their first outpatient appointment. They include Peterborough in Cambridgeshire, Stamford in Lincolnshire and King’s College Hospital, London.
The checks vary between hospitals and departments but some demand to see two forms of ID – a passport and a utility bill or bank statement.
Patients who cannot supply these documents are still treated but warned beforehand that they will also be handed an invoice.
Two years ago the Mail exposed serious flaws in the EHIC system which partly explained why the NHS was losing so much money.
If patients from the EU go to hospital for an operation or scan, staff will be able to bill their home country for the costs (file photo)
We revealed that European migrants could obtain EHIC cards in the UK – with no checks – which were intended for British citizens.
They could then travel back to their home country or elsewhere in Europe, showing their UK EHIC card whenever they needed healthcare.
This meant the UK was left with a huge bill for their treatment on the assumption that they were a British citizen.
Last month MPs on the Commons public accounts committee warned that the NHS was losing millions a year to health tourism due to a ‘chaotic’ billing system.
Their report also singled out GPs for failing to carry out checks on foreign patients that would alert hospital staff they would need to hand out an invoice. Last month a BBC documentary revealed that a Nigerian woman had racked up a bill of £500,000 after giving birth to quadruplets in Britain.
The mother, known only as Priscilla, arrived at Heathrow having been turned away by the US where she had intended to give birth.
Two of the babies died because they were so premature.
But NHS staff could not turn her away despite the fact she had no means of paying for her care.
The NHS visionary who won his own battle against the bulge
BY DAILY MAIL REPORTER
Simon Stevens kicked off his NHS career doing a week of work experience as a hospital porter.
He has now been chief executive of NHS England for three years and in that time has rarely held back from making bold and controversial statements.
In October 2014, just six months after landing the job, he asked ministers for an unprecedented £8billion cash injection, as a minimum.
Simon Stevens has been CEO of NHS England for three years and admitted he once became overweight when he was living in Minnesota. He managed to shed three stone in three years
He has also repeatedly urged parents to be tougher on children by restricting unhealthy snacks.
Last December he revealed plans to put 50,000 people at risk of diabetes on an NHS diet that includes lifestyle coaching, cookery classes and fitness sessions.
He told his own staff to slim down and exercise more to set an example.
Prior to the post, he spent nine years working for the world’s largest private health company, US-based UnitedHealth.
Before that he had worked for the NHS for almost 20 years, on the graduate management training scheme and then as a Labour Government senior adviser.
The 50-year-old is married to Maggie, an American public health expert. He has a son, 13, and daughter, eight.
Despite his anti-obesity mantra, he has had his own weight-loss battle and admitted he was once ‘fat’.
He became overweight while living in Minnesota, in the US, and blamed it on oversized, calorie-laden portions and a sedentary lifestyle.
Families should stop elderly loved ones becoming lonely
Families could do more to improve care of the elderly and prevent them becoming lonely, the head of the NHS said.
Simon Stevens said there were already 1.4 million unpaid carers – including relatives, neighbours and volunteers – the same number as paid Health Service employees.
But he added that family members had an important role to play in preventing elderly loved ones becoming isolated and helping them back on their feet.
He said: ‘Loneliness and isolation is a big concern for our parents’ generation. There’s no doubt the NHS benefits hugely from volunteers and carers but also from family members or neighbours.’
But he acknowledged that it wasn’t always easy for full-time workers to drop everything and care for ageing sick relatives recently discharged from hospital.
He said: ‘If you’ve got a full-time job you can’t necessarily be there throughout the day. It’s part of the answer but it’s not a silver bullet.’
The NHS is in the grips of a bed-blocking crisis with as many as 6,500 of the 100,000 hospital beds in England taken up by an older patient who doesn’t need to be there. They cannot be discharged as the necessary care has not been set up for them at home due to spending cuts.
This could include a handrail not being installed, care visits not arranged or a residential home place not found.
Hospitals will be given a share of a £2 billion cash injection for social care to free up as many beds as possible.
The initiative was announced in the Budget earlier this month.
But he managed to shed three stone in three years, partly with the help of a UnitedHealth incentive scheme.
It offered reduced health insurance premiums if staff met weight-loss targets.
Mr Stevens has encouraged UK companies to take on similar schemes.
To set an example to staff, and avoid wasting scarce NHS resources, Mr Stevens never claims expenses for hotels, meals, taxis or flights.
He also volunteered to take a 10 per cent pay cut when accepting the post, bringing his salary down to £190,000.
This is a stark contrast to his predecessor Sir David Nicholson, who earned £211,000 a year, claimed a further £50,000 in expenses and insisted on travelling first class.
Mr Stevens was born in Shard End, Birmingham. He was educated at St Bartholomew’s, an academy school in Newbury, Berkshire.
To set an example to staff, and avoid wasting scarce NHS resources, Mr Stevens never claims expenses for hotels, meals, taxis or flights. He also volunteered to take a 10 per cent pay cut
He went to Balliol College, Oxford University, and is said to have been close friends with Boris Johnson. From there he joined the NHS management training scheme and worked as a hospital porter and in a mortuary. Eventually he became a general manager of the Guy’s and St Thomas’ hospital in London.
He was later appointed adviser to two Labour health secretaries, Frank Dobson and Alan Milburn and in this role he oversaw policies that dramatically increased NHS funding.
Mr Stevens said his happiest experience of the NHS was the birth of his son, at St Thomas’ on Christmas Day in 2003.
There were very few patients and staff and he and his wife were allowed to stay in an empty ward ‘where we spent a very happy first night’.
His worst NHS memory was aged seven when he spent a school term in hospital with a complicated hip problem.
Give children carrots or apples when they get home from school rather than a packet of sweets, NHS chief tells parents in fight to cut obesity
BY SOPHIE BORLAND FOR THE DAILY MAIL
Parents should give their children carrots and apples when they get home from school rather than chocolate or cereal bars, the head of the NHS will say today.
Simon Stevens is urging families to adopt ‘draconian’ household rules to help prevent obesity.
He also said children should have water to drink when they get home because they would need to run around for an hour to burn off a bottle of cola.
Parents are being encouraged to give their children fresh fruit and water when they get home from school rather than chocolate and a bottle of cola (file photo)
Latest figures show as many as a third of pupils are overweight when they leave primary school aged 11. A fifth of them are obese.
These rates have steadily risen over the past decade and the Government and food manufacturers have been accused of failing to take action.
Yesterday a scathing report by MPs described the current anti-obesity strategy as ‘inadequate’ – and called for an outright ban on discount deals for junk food.
Mr Stevens, who has a 13-year-old son and eight-year-old daughter, said it was about ‘creating the right habits for children from a very early age’. He added: ‘As parents, do we spot that children are often not having the greatest diet and are piling on the pounds?
‘One in ten children are obese when they start primary school, one in five when they leave primary school. It’s a higher proportion in certain parts of the country.
‘It’s a day by day, week by week effect of snacking on sugary drinks, crisps and chocolate.
‘Some of this is about creating the right habits for our children from a very early age.
Latest figures show as many as a third of pupils are overweight when they leave primary school aged 11. A fifth of them are obese (file photo)
‘That means after school, come home, water not a fizzy drink and it means an apple or a carrot rather than a bar. This may sound a bit draconian but it can be simple.
‘Even thinking about grown-ups now as well as children when you look back over 20 years why we’ve become so overweight it’s really only 100 calories a day, day in day out, which is what piles it on over time.’
He said that if a ten or 11-year-old child drank a 500ml bottle of fizzy drink, they would need ‘to go running for nearly an hour to burn that off.’
He said: ‘No child is going to go running for an hour having had one bottle of fizzy drink. Those are the kind of things parents have got to help with.’
Mr Stevens also criticised the supermarket discounts at the end of aisles and checkout tills on biscuits, chocolate bars and crisps to tempt parents and children.
‘These till-based promotions, end of aisle deals, we’re more exposed to that than we used to be and more exposed than lots of other countries as well,’ he said.
Yesterday MPs on the Commons health committee said the Government’s obesity strategy – published in the summer – was disappointing and inadequate.
Far tougher measures were needed to address the crisis, they said in a report – including a ban on supermarket discounts on crisps, biscuits and chocolate.