Health and social care in England: tackling the myths (2022)

1. The NHS is a bottomless pit

The facts

Spending on health care has historically grown by about 4 per cent each year in real terms in the UK. This is due to acombination of factorsincluding a growing and ageing population, rising patient expectations and medical and technological advances. Like other nations, we have chosen to pay for this by prioritising investment in our health system from the proceeds of economic growth.

In the decade following the global financial crisis in 2008, the health service faced the mostprolonged spending squeezein its history: between 2009/10 and 2018/19 health spending increased by an average of 1.5 per cent per year in real terms, well below the long-term average. As a result, spending failed to keep up with demand, increasing the pressures on services and leading to staff shortages, rising waiting times for treatment and performance standards being routinely missed, well before the pandemic.

Spending on the NHS now accounts for more than20 per centof all public spending...

In 2018, the governmentannounced a five-year settlement for some areas of health spending, covering the period from 2019/20 to 2023/24. Under this deal, NHS England’s budget would rise by an average of 3.4 per cent each year in real terms. As a result of the additional pressures created by the pandemic, this was followed by anew three-year funding settlementin September 2021 to increase Department of Health and Social Care’s resource budget (day-to-day spending) by an average of 3.8 per cent each year until 2024/25. This uplift is part-funded through an increase to National Insurance Contributions, known as theHealth and Social Care Levy.


As public spending on health has increased, it has consumed a larger share of government expenditure. Spending on the NHS now accounts for more than20 per centof all public spending (and more than40 per cent of day-to-day spendingon public services), leading to trade-offs with other areas of government spending. However, this should also be seen in the context of the UK’s relatively low tax revenues compared to many other countries.

In 2019, the UK spent9.9 per cent of its GDPon health, remaining consistently around this level since 20111.This is slightly above the average for members of theOrganisation for Economic Co-operation and Development (OECD) but lower than several comparable nations, including Germany, France and the Netherlands. Evidence also suggests the NHS is relatively efficient (see Myth 2 below).


Compared to other countries, the UK does not spend a particularly high proportion of its national wealth on health care, while a decade of historically low funding increases has left services facing huge pressures and a workforce crisis. Like levels of taxation and public spending more generally, how much is spent on health is a political choice and politicians should be honest with the public about the standards of care they can expect with the levels of funding provided.

2. The NHS is inefficient

The facts

Measuring the productivity of the NHS over time can be difficult, as full data on the volume and quality of the outputs and outcomes the NHS produces are not always available. However, a study by theUniversity of York’s Centre for Health Economicsfound that NHS productivity increased by 16.5 per cent between 2004/05 and 2016/17 compared to productivity growth of only 6.7 per cent in the economy as a whole. This averaged at a year-on-year growth in productivity of 1.3 per cent.

The NHS is one of the largest and most complex organisations in the world. Yet, evidence indicates that it employs relatively few managers, withone studyrecently suggesting thatmanagers make up around 2 per cent of the NHS workforcecompared to 9.5 per cent of ‘managers, directors and senior officials'in the UK workforce as a whole.

The NHS compares well with other health systems, coming 4th out of 11 systems for efficiency in theCommonwealth Fundanalysis.

The NHS compares well with other health systems, coming 4th out of 11 systems for efficiency in theCommonwealth Fundanalysis. It also compares well on other key indicators of productivity such as the average length of stay in hospital and the proportion of drugs that areprescribedin their (cheaper) generic form instead of the (more expensive) branded version.

There is no doubt that the NHS can do more to improve productivity and reduceunwarranted variationin how services are delivered. For example,Lord Carterof Coles estimated that reducing unwarranted variation in procurement and delivery of hospital care could save around £5 billion each year. TheGetting it Right First Timeprogramme has also shown that significant gains can be made by reducing variation in the delivery of clinical services.

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At the same time, the NHS is operating in a context of intense pressure on services, with high levels ofstaff vacancies, growing waiting times for care and very highhospital bed occupancy. These factors combine to reflect a system that is ‘running hot’, with little capacity to focus on improvement and efficiencies. Against this background, the government has doubled the annual efficiency target for the service from 1.1 per cent to 2.2 percent, aiming to deliver an annual saving of £4.75 billion without setting out a plan for achieving this.


As the former Secretary of State for Health and Social Care, Sajid Javid,said recently, the NHS is already one of the more efficient health services in the world, and evidence suggests it is far from being over-managed. While it can, and must, do more to improve productivity, it is hard to see how current efficiency targets can be met.

3. GPs aren't working hard enough to meet demand for appointments

The facts

General practice delivered27.5 million appointmentsin May 2022, with 18 million of these face to face and 12 million on the same day they were booked. However, demand for appointments is outstripping supply, resulting in frustration for patients, unsustainable workload for staff, and inevitably, unmet need.

The issues around access to appointments in general practice are not new but have intensified in recent months. Over time, demand for appointments has increased, while a combination of an increasingly complex caseload, rising thresholds for referral to other parts of the system and an increasing administrative burden have all contributed to growingpressures. This has been exacerbated by the impact of the Covid-19 pandemic which has increased GP workloads, while the elective backlog means that general practice is being required to manage more complex needs whileunable to unlock access to other services.

Recentanalysissuggests that in 2021/22 there was a shortage of around 4,200 GPs in permanent roles, despite the increased numbers of GPs in training.

These pressures are affecting patients’ experience of general practice, with surveys showing a significant decline in patient and public satisfaction with GP services. The most recentGP Patient Surveyfound that only 56 per cent of respondents reported a good experience of making an appointment, 9 percentage points worse than the 2020 results. Significantly, more than one in four patients said they had avoided making a GP appointment in the past 12 months because they found it too difficult.

Many of the challenges patients face accessing their GP stem from chronic staff shortages. General practice has been facing significant workforce pressures for a number of years. Recentanalysissuggests that in 2021/22 there was a shortage of around 4,200 GPs in permanent roles, despite the increased numbers of GPs in training. While the deployment ofadditional rolesbrings some further capacity, it is clear that the government’s 2019 manifesto pledge to deliver 6,000 more GPs by 2024/25 willnot be met. On top of this, fewer GPs are choosing to undertake full-time clinical work in general practice, while large numbers are retiring and leaving the profession – withburnoutplaying a role in these decisions.


General practice is in crisis because of difficulties in recruiting and retaining GPs, alongside a growing and increasingly complex workload. As a result, GPs are working harder than ever before, but patients are still finding it difficult to get appointments.

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4. The government has 'fixed' social care

The facts

Social care has long been under-resourced. Significant reductions in local authority funding during the austerity years exacerbated this, leading to cuts to social care budgets, While more investment has been provided in recent years, in 2019/20funding has only just returned to the levels of 2010/11 despite a significant increase in demand.

Growing pressures on services have been compounded by the failure of successive governments to deliver long-promised reform. As a result, the social care system is in crisis and is failing the people who rely on it, withhigh levels of unmet need and providers struggling to deliver the quality of carethat older and disabled people have a right to expect.

In 2021 the current government finally introduced major reform to adult social care, with changes to the means test and a cap on the lifetime costs of social care which will be funded by the Health and Care Levy. Additional reform measures include further integration with health care and an intervention in the social care market intended to ensure local authorities pay a ‘fair price’ to providers for the care they commission from them.

Despite these changesone in seven peopleare still estimated to face lifetime care costs of more than £100,000.

The government deserves credit for going further than previous administrations. The cap will protect people against the very highest costs of care, while the extended means test will enable 40–50,000 more people will be able to access state-funded care each year, However, changes to how the cap and the means test work together mean that the principle beneficiaries will be wealthier people, while people with low to moderate assets in parts of theNorth and Midlandswill benefit less. Despite these changesone in seven peopleare still estimated to face lifetime care costs of more than £100,000.

The reform package does little to tackle theother fundamental problems, including high levels of unmet need, chronic workforce shortages and a fragile provider market. The pressure on services also has a significant knock-on effect on the NHS, as thousands of patients who are well enough to be discharged are unable to leave hospital due to delays in identifying social care support.


This government has acted where its predecessors failed to do so by introducing significant reforms to social care funding and eligibility. However, far from being ‘fixed’, the social system remains under intense pressure with an unstable provider market, a workforce crisis, and high levels of unmet need. Unless these problems are addressed, it will continue to fail the people who rely on it.

5. The NHS is being privatised

The facts

Private companies have always played a role in the NHS, with services such as dentistry, optical care andcommunity pharmacybeing provided by the private sector for decades, and mostGP practices are private partnerships. The NHS and the private sector have also established partnerships for the delivery of clinical services such as radiology and pathology and non-clinical services such as car parking and management of buildings and the estate, while independent hospitals have been used under successive governments to provide additional capacity in response to pressures on NHS services.

Identifying how much the NHS spends on the private sector is not straightforward but estimates can be made using data from theannual accountsof the Department of Health and Social Care.

...spending by NHS commissioners on services delivered by the private sector increased to£12.2 billion in 2020/21. However... this again represents only around 7 per cent of the total Department of Health and Social Care revenue budget.

Following the Health and Social Care Act 2012, which extended market-based principles and introduced more competition into the NHS, the number of contracts awarded to private providers increased. However, this did not lead to an increase in the proportion of the NHS budget spent on private providers, in large part because the majority of contracts tended to be smaller than those awarded to NHS providers. In 2019/20, before the pandemic, NHS commissioners spent £9.7 billion, or 7.2 per cent of the Department of Health and Social Care revenue budget on services delivered by the private sector. This proportion has remained largely unchanged since 2012.

Throughout the Covid-19 pandemic, the Department of Health and Social Care and the NHS entered into new contractual arrangements with the independent hospital sector to increase capacity. These arrangements provided access to additional beds, staff and equipment to treat patients during the peak of the pandemic and are being used now in some places to support efforts to reduce how long people wait for routine care. As a result, spending by NHS commissioners on services delivered by the private sector increased to£12.2 billion in 2020/21. However, in the context of the significant additional funding provided in response to the pandemic, this again represents only around 7 per cent of the total Department of Health and Social Care revenue budget.

The Health and Care Act 2022 removed the competition and market-based approaches introduced by the 2012 Act. This gives commissioners greater flexibility over when to use competitive procurement processes, reducing the frequency with which clinical services are put out to tender and allowing contracts to be rolled over where the existing provider, most likely to be an NHS provider, is doing a good job.


There is no evidence of widespread privatisation of NHS services. The proportion of the NHS budget spent on services delivered by the private sector has remained broadly stable over the past decade.

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What illness costs the NHS the most? ›

The cost of prescribing medication to people with diabetes in general practice has risen and remains the largest area of spending, according to analysis by Cogora.

How much does the NHS cost per day? ›

The government plans to spend around £122 billion on health in England in 2017/18, or roughly £2,200 per person. Around £108 billion will be spent on the day to day running of the NHS.

What is statutory provision in health and social care? ›

Statutory. These are services that are paid for and provided by the government e.g. National Health Service(NHS), school nursing, social services. Private. These are services that are run as a business to make a profit e.g. private hospitals, residential homes, private nurseries. Voluntary.

How many NHS trusts are there in the UK? ›

All NHS hospitals are managed by acute, mental health, specialist or community trusts and as of 2021 there were 219 trusts, including 10 ambulance trusts.

What is the biggest drain on the NHS? ›

In the year that the NHS suffers £2.7bn in cuts, 48% of Brits believe smokers are the biggest drain on healthcare. Research from the Action and Smoking Health Group has suggested that smoking costs the NHS anywhere between £2bn and £6bn per year, making it one of the leading costs for the NHS.

What is the biggest burden on the NHS? ›

Most healthcare spending is devoted to curative and rehabilitation care (around 63%). Almost half of total spending is in hospitals, and 15% in the family health services sector, which includes spending on GPs, dentists, opticians and pharmacists.

Does the NHS waste money? ›

In 2015, the NHS in England spent £142 million on prescribing paracetamol, ibuprofen and aspirin3. All products which can be purchased cheaply over the counter2. The NHS also wastes a significant amount of money prescribing antibiotics for conditions where the modest benefits do not justify their use4.

What is the problem with the NHS? ›

In 2021, a lack of resources/investment remains the top problem facing the NHS, according to the public of Great Britain, same as in 2019. Furthermore, long waiting lists/times and not enough staff were also pressing issues in both years.

How much does a hospital bed cost per day UK? ›

A stay in a hospital bed in the UK costs £400 per day.

What are the two regulators for health and social care? ›

Social Care Professional bodies

Health and Care Professions Council (HCPC) - The HCPC is the regulator of the social work profession and social work education in England. Social Care Wales (SCW) - The SCW is the social care workforce regulator in Wales.

What are the aims of health and social care provision in UK? ›

Our priorities

improve healthcare outcomes through a well-supported workforce. improve, protect and level up the nation's health, including through reducing health disparities. improve social care outcomes through an affordable, high quality and sustainable adult social care system.

What are the 3 sectors in health and social care? ›

The NHS is divided into primary care, secondary care, and tertiary care.

What is the largest hospital in UK? ›

St George's Hospital is the largest in the UK, caring for 1.3 million people in southwest London, as well as populations in Surrey and Sussex, totaling around 3.5 million. It has 1,300 beds and 8,500 staff, as well as several centres of excellence, such as its stroke care and cardiology unit.

What is the best hospital in the UK? ›

St Thomas' Hospital London

How much does a hospital bed cost UK? ›

A hospital bed typically costs between £1200 - £1600 to the NHS. Hospital beds that are available for Home use tend to be much cheaper typically for an Invacare Accent Hospital bed I have found prices as low as £459 plus vat.

How much does poor health cost the NHS? ›

Socio-economic inequality costs the NHS in England £4.8 billion a year, almost a fifth of the total NHS hospital budget, according to researchers at the University of York.

How much does obesity cost the NHS? ›

The costs of obesity

Failing to address the challenge posed by the obesity epidemic will place an even greater burden on NHS resources. It is estimated that the NHS spent £6.1 billion on overweight and obesity-related ill-health in 2014 to 2015.

How much does the NHS cost per person? ›

How much does the UK spend on health care compared to other countries? Public spending on health care in the UK totalled £177bn in 2019 (the last year for which we have comparable international data), which equates to £2,647 per person for the year.

What percentage of the NHS budget is spent on drugs? ›

The cost of medicines prescribed in primary care in England in 2020/21 was £9.42 billion, 55.0% of total expenditure. The cost of medicines dispensed in hospitals in England in 2020/21 was £7.59 billion, 44.3% of total expenditure.


We believe the better integration of health and social care services has to be the single biggest component of that new system.. Feeding into this, and future discussions, are the findings of the LGA report: Efficiency opportunities through health and social care integration .. This details work with five English health and social care systems to explore the scope for improving efficiency through the better integration of services.. “All the pressure on social care budgets is caused by older people.” Forty percent of adult social care spending is on the 18-65 age group, and the financial pressures are also particularly severe in learning disabilities, where demand is increasing.. “Delayed transfers are caused by a lack of social care.” Social care reasons remain a minority cause of delay, and while it is true that 20 councils accounted for 50% of the delayed discharges, these are also 20 of the largest councils.. “Reducing delayed transfers is the key to improving efficiency.” Person-centred care drives improved efficiency – Newton’s work proves that focusing on achieving the best and most independent outcome for the patient or service user both matters to them and saves money.. It is consistent clinical and professional decision making across care pathways which creates an efficient multi-disciplinary system – regardless of whether the organisations are formally integrated.. Moreover, inappropriately fast discharge can cost more if people are given too much care or the wrong care rather than return home with the right personalised health and social care package.. “Increased social care support will prevent unnecessary hospital admissions.” A sample analysis (referenced in the LGA report) demonstrated that only 10% of admissions had a social care component which could have prevented admission.. “Integrating structures will transform patient care and create a financially sustainable future.” Maybe, but only if transformational cultural and behavioural change underpins the structural elements of integration: clarity of roles, improved communication, shared strategic ambition, risk sharing and financial transparency.. Integrating the current inadequately funded and inefficient community health and social care services will not produce an effective and efficient new system.. Local solutions and effective local leadership demonstrate that delayed transfers can be managed if key changes are implemented in the way trusts operate, the way care markets are commissioned, the way the workforce is developed and the priority that is given to managing change over a realistic timescale.. They are acting as a framework within which discussions are taking place about how to create a sustainable future for health and social care in a different way, with a greater understanding of the respective challenges, generating a more collaborative approach.. Too many residential care placements, and too many high cost care packages designed to get people out of hospital quickly but often substituting for a lack of community health resource and primary care support.. The emergence of accountable care organisations (ACOs) as a possible solution to an integrated approach that brings opportunities in creating one workforce, engaging primary care, having a single budget and presenting a united front door to patients and the public.

Myths About the US Healthcare Model Risk the Survival of the NHS Dr Salinder Supri and Prof Karen Malone | 7 February 2012 from Pulse The coalition government claims that its reforms of the NHS wil…

The coalition government claims that its reforms of the NHS will put patients at the heart of healthcare but contrary to its stated aims however, the government is driven by the desire, not to improve healthcare, but to open the door to new healthcare providers, invariably from the private sector, marking the beginnings of the privatisation of the NHS.. Furthermore, it is argued that, with a market-orientated system of healthcare, patients will be given access to a much wider choice of treatment and drug options, and will not encounter any “rationing” of their healthcare.. However, contrary to government rhetoric, market-based reform of healthcare will not lead to unrestricted choice of treatments and drugs, because under such a system, treatment and drug decisions are led by financial considerations, rather than medical need, or the wishes of patients.. By ‘freeing up’ the NHS to competition from new providers, reformers hope to stimulate medical advances, believing that a market-driven system of healthcare will result in greater research and innovation, and bring about more and better treatments.. Its market-based system of healthcare has led, not to lower, but to much higher prices, and American patients consequently pay significantly more for treatments that are available at much lower cost in other countries.

The levy raises the overall tax burden on the UK economy to the highest it has been since 1950

Last week's package of announcements on National Insurance, health and social care, was bigger than most Budgets, substantially increasing the overall tax burden.. Small wonder that MPs were given so little time to think about its implications; both in presentation and detail, the health and social care levy, as it will become known, was something of a con.. Myth number one was that peddled by Sajid Javid, the Health Secretary, who claimed that the UK would still be a low-tax economy even after taking account of the new levy.. The levy raises the overall tax burden on the UK economy to the highest it has been since 1950, and significantly reduces the gap with our major European rivals – France and Germany.. The extra £14bn a year in national insurance contributions comes on top of £25bn of tax hikes announced in the March Budget, including a five-year freeze on income tax thresholds.. In terms of the headline rate of corporation tax, we’ll have leapt from one of the lowest among advanced economies to somewhat above the average, providing one more reason for not investing in the UK.. Myth number two is that the national insurance hike was in some way a response to the long-term costs of the Covid crisis, which is how it was partially presented.. What is certainly true is that the pandemic has offered politically useful cover for smuggling through some big increases in health and social care spending.. “The extra funding provided for the National Health Service in the recent announcement will result in spending growing at 3.9pc a year between 2018-19 and 2024-25, exactly the same rate of growth as was [previously] planned between 2018-19 and 2023-24.. It is the steadily growing health, social care and pensions costs of an ageing population, says Paul Johnson, director of the IFS, which explains the apparent dichotomy between rising levels of taxation and the ongoing squeeze we see in other forms of government spending.. Prime Minister Boris Johnson, Health Secretary Sajid Javid and Chancellor Rishi Sunak visit an east London care home. Credit: Getty. Looking again across the Channel, almost all European countries face much the same pressures, only many of them start from punishingly high levels of tax in the first place.. Whereas we worry about the growing costs of health and social care, the big Achilles’ heel on the Continent tends to be pensions.. We should of course await the detail of the Government’s social care plans – ministers promise a White Paper before the end of the year – but on the face of it they do no more than raise the means-tested threshold and cap the amounts people are expected to meet from their own pockets.. The much higher means-tested threshold will admittedly result in more people qualifying for “free” care without having to eat into savings, but the cap on personal care costs is essentially just a bung to the already relatively well off living in expensive houses in the South East.. How is that fair on the young, some of whom, taking account of student loan repayments and extra employers’ NI contributions, are facing a marginal rate of tax on any increase in earnings of an astonishing 50pc.

PLEASE NOTE: We are currently in the process of updating this chapter and we appreciate your patience whilst this is being completed. Concepts of health, wellbeing and illness, and the aetiology of illness: Section 5. Stigma and how to tackle it This section covers: 1. Causes and consequences of stigma 2. Ways to tackle stigma 1. Causes and consequences of stigma Goffman

Stigma also occurs in a health context, with some diseases or conditions more stigmatised than others, e.g. mental illness and sexually transmitted infections tend to be stigmatised, whereas appendicitis or flu are not.. Goffman's (1968) work is less concerned with the social process of labelling a particular action or pathological state as deviant, than with the stigmatising consequences of that process for an individual - what he referred to as 'The management of everyday life' .. The social stigma that results from this labelling process, derives not only from societal reaction which may produce actual discriminatory experiences ( 'enacted stigma' ), but also the 'imagined' social reaction which can drastically change a person's self-identity ( 'felt stigma' ):. For example, reducing the stigma of certain diseases or health conditions reduces barriers to seeking diagnosis and treatment; this benefits the individual through improving their health, and society by reducing the burden of disease in the population.. In order to address stigma, there need to be changes in the attitudes and behaviours of both the stigmatised person and wider society.. Positive challenges to stigma can change the attitudes leading to enacted stigma (discrimination), which in turn reduces felt stigma; this itself may reduce enacted stigma by changing behaviours such as self-stigmatisation and withdrawal, producing a ‘virtuous circle’.. An evaluation published in the British Journal of Psychiatry (Evans-Lacko et al., 2013) concluded that the first 4 years of the programme had been effective in reducing stigma and discrimination by improving public attitudes and intended behaviour, though an improvement in public knowledge was not demonstrated.. Public acknowledgement of problems is often done by those with social status such as celebrities; for example, the well-known actor and comedian Stephen Fry has endorsed the Time to Change campaign and spoken openly about his own experiences of mental illness, [2] which has been linked anecdotally to increases in numbers of people seeking help either for themselves or on behalf of family members.. Public information and awareness campaigns that openly discuss symptoms that people might find embarrassing can also help to reduce barriers to seeking diagnosis and treatment, such as Public Health England’s Blood in Pee campaign as part of the wider Be Clear on Cancer campaign.. Treatment In a health and medical context, advances in the management of health conditions can contribute to reducing their visible signs that may contribute to stigma, whether physical characteristics (e.g. skin conditions) or behaviours (e.g. manifestations of mental illness).

Published by Professional Social Work magazine - 4 February 2019

Social workers play a key role in promoting a collaborative partnership approach to managing and protecting girls from FGM, and are increasingly dealing with this dangerous practice.. The Serious Crime Act compels all health and social care professionals to report all disclosures of FGM in a girl under 18 years of age to the police.. However, reporting FGM to the police under the Serious Crime Act (SCA), is still not well understood and many social workers remain unaware about invoking and policing FGM protection orders.. Under the UK FGM Act 2003, it is illegal to take a girl aboard to have FGM performed.. An FGM Protection Order can be used to protect a girl from being taken out of the UK to have FGM performed and also protects a girl who is at risk in the UK.. If we are serious in our duty to protect girls from the abuse of FGM, education, training and empowerment is essential for social workers who manage the risks and safeguarding aspect of FGM to fill the existing knowledge gaps and help tackle this growing issue.

Major new research on women’s health issues to increase understanding of female specific health conditions and tackle the data gap to ensure diagnosis and treatment work for women. Ensuring all doctors are trained to provide the best care to women by introducing mandatory specific teaching and assessment on women’s health for all incoming graduating

Following a call for evidence which generated almost 100,000 responses from individuals across England, and building on Our Vision for Women’s Health, the strategy sets bold ambitions to tackle deep rooted, systemic issues within the health and care system to improve the health and wellbeing of women and, reset how the health and care system listens to women.. The strategy includes key commitments around new research and data gathering, the expansion of women’s health-focused education and training for incoming doctors improvements to fertility services, ensuring women have access to high quality health information and updating guidance for female specific health conditions like endometriosis to ensure the latest evidence and advice is being used in treatment.. Encouraging the expansion of Women’s Health Hubs around the country and other models of ‘one-stop clinics’, bringing essential women’s services together to support women to maintain good health and drive efficiency in the NHS, helping clinicians as they work to tackle the Covid backlogs.. “Having spent my career looking after women, I am deeply aware of the need for a women’s health strategy which empowers both women and clinicians to tackle the gender health gap.. This is on top of £95 million investment into recruitment of an additional 1,200 midwives and 100 consultant obstetricians establishing the UK Menopause Taskforce to drive forward the work on improving healthcare support for women, raise levels of awareness in the population and among healthcare professionals, encourage workplace support and consider where further research is needed to address gaps in the evidence base reducing the cost of, and improving access to, hormone replacement therapy (HRT) by identifying ways to support the HRT supply chain and addressing shortages some women face on a limited number of products, and by reducing the cost of HRT though a new bespoke HRT pre-payment certificate which we will introduce by April 2023 banning virginity testing and hymenoplasty in the UK through the Health and Care Act 2022.

The lack of data on the profession’s diversity is hindering Social Work England’s efforts to tackle inequalities in the fitness to practise system, the regulator’s equality lead has said. Ahmina Akhtar called on registered social workers to share data on their protected characteristics to enable the regulator to identify the scale of inequalities and how […]

However, in response, the British Association of Social Workers and Social Workers Union said action should be taken now in relation to “known issues of inequality”, notably, the disproportionate impact of fitness to practise cases on black and ethnic minority social workers.. ‘We haven’t got as much data as we would like’ Social Work England’s EDI action plan includes an objective to “use available diversity data to identify and monitor any disproportionate impacts of our work on different groups and take steps to understand and deal with potential bias and discrimination”.. Under the action plan, Social Work England will review, early next year, how it seeks diversity data from social workers in order to increase the response rate, and that it would make use of key “communication and engagement moments” to encourage practitioners to submit.. Social Work England EDI plan: key points Reviewing the way it seeks diversity data from social workers in order to increase the response rate (Jan-March 2023).. In response, Akhtar said: “As a regulator, Social Work England has set out professional standards that require social workers to ‘confront and resolve issues of inequality and inclusion’ and ‘challenge the impact of disadvantage and discrimination’.

The Equality Act 2010 (Specific Duties and Public Authorities) Regulations 2017 requires relevant public bodies, including the Department of Health and Social Care ( DHSC ), to publish information to show how they comply with the public sector equality duty at least annually, and to set and publish equality objectives at least every 4 years.. Table 5: comparison of age distribution between DHSC as of 30 September 2020 and Civil Service as of 31 March 2020 Age group16 to 1920 to 2930 to 3940 to 4950 to 5960 to 6465 and overNot reported DHSC (employees)079060052044070100 DHSC (proportion)0.0%32.5%24.7%21.4%18.1%2.9%0.4%0.0%Civil Service (employees)1,51066,87096,230108,100138,19034,84010,290390Civil Service (proportion)0.3%14.7%21.1%23.7%30.3%7.6%2.3%-The median age for different grade groups can be found in Table 6.. Table 11: disability declaration rate for London-based employees compared to national declaration rate as of 30 September 2020 Disability declarationYesNoUndeclaredLondon (employees)355701070London (proportion)2.1%34.0%63.9%National (employees)45380340National (proportion)5.9%49.7%44.4%Table 12 shows the proportions of staff who have declared themselves disabled, by grade group.. Table 12: count of employees and proportion who declared a disability by grade group for DHSC as of 30 September 2020 and CS as of 31 March 2020 (source: Civil Service Statistics 2020 ) Declared disabledAO and EOHEO and SEOG7 and G6SCS DHSC (employees)2035250 DHSC (proportion)25.0%43.8%31.3%0.0% CS (employees)27770106503850360 CS (proportion)65.1%25.0%9.0%0.8% Ethnicity From Table 13 below we see that 43.1% of DHSC staff have declared their ethnicity, a decrease from 60.8% last year.. Table 13: ethnicity declaration rates for DHSC as of 30 September 2020 and CS as of 31 March 2020 (source: Civil Service Statistics 2020 ) EthnicityAsianBlackChineseMixedOtherWhitePrefer not to sayUndeclared DHSC (employees)9065153010840-1385 DHSC (proportion)3.7%2.7%0.6%1.2%0.4%34.5%-56.9%Civil Service (employees)25,87012,8001,1106,8002,230320,58021,06065,960Civil Service (proportion)5.7%2.8%0.2%1.5%0.5%70.2%4.6%14.5%Table 14 shows that ethnicity declaration rates are lower in London than they are nationally.. Table 15: Number of people in DHSC in each grade group by ethnic group and proportions of ethnic minority, white and undeclared for each grade group as of 30 September 2020 Ethnic groupMinority ethnic (excluding white minorities)WhiteUndeclared AO and EO (employees)6085255 AO and EO (proportion)15.0%21.3%63.8% HEO , SEO and Fast Stream (employees)80290550 HEO , SEO and Fast Stream (proportion)8.7%31.5%59.8% G7 and G6 (employees)60380505 G7 and G6 (proportion)6.3%40.2%53.4% SCS (employees)58575 SCS (proportion)3.0%51.5%45.5%Table 16 shows the number of employees in each ethnic group by grade group and gives the corresponding proportion.. Table 16: employee count by ethnic group and grade group as of 30 September 2020 (the proportions given are the percentages for each row total) Grade groupAO and EOHEO, SEO and Fast StreamG7 and G6SCSEthnic minority – excluding white minority (employees)6080605Ethnic minority – excluding white minority (proportion)29.3%39.0%29.3%2.4%White (employees)8529038085White (proportion)10.1%34.5%45.2%10.1%Undeclared (employees)25555050575Undeclared (proportion)18.4%39.7%36.5%5.4% Religion or Belief DHSC has a declaration rate of 40.3% for religion or belief.. Table 19: employee count by type of religion or belief and grade as of 30 September 2020 (the proportions given are the percentages for each row total) Religion or beliefReligiousNo religionUndeclared or prefer not to say AO and EO (employees)8045275 AO and EO (proportion)20.0%11.3%68.8% HEO and SEO (employees)175145600 HEO and SEO (proportion)19.0%15.8%65.2% G7 and G6 (employees)170205575 G7 and G6 (proportion)17.9%21.6%60.5% SCS (employees)354095 SCS (proportion)20.6%23.5%55.9% Sexual orientation According to Table 20, the declaration rate for sexual orientation is 40.3%.. Table 23: caring responsibility types, proportion and count as at 30 September 2020 Caring responsibility typeChildren (under 18)Older people (65 and over)Disabled people (all ages)OtherEmployees320451515Proportion81.0%11.4%3.8%3.8% Working patterns Table 24 shows the proportion of staff who work full-time compared to those who work part-time.. Table 35: age, proportion and count of leavers (October 2019 to September 2020) Age20 to 2425 to 2930 to 3435 to 3940 to 4445 to 4950 to 5455 to 5960+Employee357535303530252020Proportion11.5%24.6%11.5%9.8%11.5%9.8%8.2%6.6%6.6% Table 36: gender, proportion and count of leavers (October 2019 to September 2020) GenderMaleFemaleEmployee135170Proportion44.3%55.7% Table 37: ethnicity, proportion and count of leavers (October 2019 to September 2020) EthnicityMinority ethnic (excluding white minorities)WhiteUndeclaredEmployee2070210Proportion6.7%23.3%70.0% Table 38: disability, proportion and count of leavers (October 2019 to September 2020) Disability statusDeclared disabledDeclared non-disabledUndeclared Employee585210 Proportion1.7%28.3%70.0% Table 39: sexual orientation, proportion and count of leavers (October 2019 to September 2020) Sexual orientationLGBT+HeterosexualPrefer not to sayUndeclaredEmployee57010215Proportion1.7%23.3%3.3%71.7% Table 40: religion or belief, proportion and count of leavers (October 2019 to September 2020) Religion or beliefReligiousNo religionPrefer not to sayUndeclaredEmployees460430901455Proportion18.9%17.7%3.7%59.8% Disciplinary and grievances As seen in Table 41, between 1 October 2019 and 30 September 2020, there were 5 disciplinary cases and 8 grievance cases reported involving DHSC employees.

The U.K government's initial approach to tackling the coronavirus outbreak has been called one of the country's worst ever public health failures.

LONDON — The U.K government's approach to tackling the coronavirus outbreak at the start of the pandemic has been called one of the country's worst ever public health failures, following an inquiry by British lawmakers.. The report, which examined the U.K.'s initial response to the Covid pandemic, found that the government made major mistakes at the start of the global outbreak, including its apparent decision to allow Covid to spread throughout the population in a bid to achieve "herd immunity," and its hesitation to lock down the country.. "Decisions on lockdowns and social distancing during the early weeks of the pandemic — and the advice that led to them — rank as one of the most important public health failures the United Kingdom has ever experienced," the 150-page report, which was published on Tuesday following an inquiry by two parliamentary committees, found.. Although it was never formally announced, the U.K.'s initial approach to Covid (which went from trying to 'contain' the spread of the virus, to trying to 'delay' it) was widely seen as a way to achieve "herd immunity.". The latter route is generally preferred as it avoids adverse effects such as excess deaths caused by a virus.. However, with no Covid vaccines available at the start of the pandemic, some countries, like the U.K. and Sweden, appeared to favor allowing the virus to spread among the population to some extent in a bid to achieve a level of herd immunity in their populations.. The inquiry, which involved evidence from over 50 "witnesses" including high-profile public officials and health experts who have advised the government throughout the pandemic, was damning in its assessment of the government's initial approach, noting that it "amounted in practice" to an ill-fated pursuit of herd immunity.. It also looked at the use of test, trace and isolate strategies and the impact of the pandemic on social care and specific communities and, lastly, the procurement and roll-out of Covid-19 vaccines.. Our test and trace programme took too long to become effective.. The government took seriously scientific advice but there should have been more challenge from all to the early U.K. consensus that delayed a more comprehensive lockdown when countries like South Korea showed a different approach was possible," Jeremy Hunt, chair of the Health and Social Care Committee, and Greg Clark, chair of the Science and Technology Committee, said.. The U.K government's approach to tackling the coronavirus outbreak at the start of the pandemic has been called one of the country's worst ever public health failures.. The damning assessment of the government's initial Covid response comes after an inquiry by British lawmakers.. The report found that the government made major mistakes at the start of the global outbreak, including its apparent decision to allow Covid to spread throughout the population.

People with mental health problems say that stigma and discrimination can make their difficulties worse and make it harder to recover.

People with mental health problems can also experience discrimination (negative treatment) in all aspects of their lives.. This stigma and discrimination makes many people’s problems worse.. Nearly nine out of ten people with mental health problems say that stigma and discrimination have a negative effect on their lives.. We know that people with mental health problems are among the least likely of any group with a long-term health condition or disability to:. Stigma and discrimination can also make someone’s mental health problems worse, and delay or stop them getting help.. Some people believe people with mental health problems are dangerous, when in fact they are at a higher risk of being attacked or harming themselves than hurting other people the media.. Media reports often link mental ill health with violence, or portray people with mental health problems as dangerous, criminal, evil, or very disabled and unable to live normal, fulfilled lives. Time to Change campaigned to change the way people think and act about mental health problems.. It makes it illegal to discriminate against people with mental health problems when you:. To be protected, you need to show your mental health problem is a disability.. You need to show you have a long-term mental health problem that makes your everyday life substantially difficult.. direct discrimination: if you’re treated worse than others because of your mental health problem indirect discrimination: if a person or organisation has arrangements in place that put you at an unfair disadvantage discrimination arising from your disability: if you’re treated badly because of something that happens because of your mental health problem, for example if you’re given a warning at work for taking time off for medical appointments harassment: if you’re intimidated, offended or humiliated victimisation: if you’re treated badly because you’ve made a complaint

Referral app rewards staff who encourage friends and family to apply for vacant roles

Over the past three months, 25 providers in the county, big and small, have signed up to Care Friends – a mobile app which taps into workers’ social networks.. It has already shown potential to have a transformative effect, with providers receiving job applications within an hour of staff downloading the app on to their smartphones.. The app has been masterminded by Neil Eastwood, an adviser to the Department of Health and Social Care, who has spent the past 10 years investigating how to find, keep and develop care workers.. People retire to Cornwall with no family to look after them and young people move away from the county.. Based on evidence showing employee referral schemes are the best means of recruitment , workers download the app and share job vacancies with their contacts and social networks.. Working on the same principle as a reward card, they earn points for referring a friend.. Initial trials of an early version of Care Friends at a care home in Surrey found that almost 30% of staff started to refer people – compared with about 8% in traditional (non-app) referral schemes.. “If you extrapolate that more widely across the workforce, our 120,000 vacancies in social care would be gone in a few months,” says Eastwood.. Providers are pinning their hopes on the app.. “By using this app, people can show they are proud of their work by recommending other people.. “We need to ensure that details about employment opportunities are available not just in social care, but in the NHS as well,” he says.. Kerry Munro used the Care Friends app to let friend Sam Mitchell know about a vacancy. Using the Care Friends app, she shared the opportunity with Sam Mitchell, the daughter of a friend she used to work with.. “I hadn’t considered a job as a carer before, but I am really looking forward to starting,” says 33-year-old Mitchell.. She plans to start working 16 hours a week, spread across two evenings and a weekend shift – with her partner helping out with childcare.

Drawing on interviews with NHS managers and leaders, this long read sets out insights on the role and practice of managers and the main challenges still to address.

As part of the Health Foundation’s research on management in the health service, we interviewed NHS managers and leaders in England to understand the challenges they face, what works well and what could be done differently.. Here, we conclude with a series of recommendations for the Messenger review to consider, focused around the need to: better support providers and systems to tackle variation in management practice; improve access to training and development opportunities; ensure training equips managers and leaders with the skills they need today; tackle the reporting burden facing managers, and ensure the role of managers and leaders is better understood and valued.. Proponents have argued that regulation has the potential to reduce variation in management performance, as well as bringing full-time managers in line with the medical and nursing professions and, in doing so, raising the status and profile of managers.. There is a good argument for making such training a core and non-negotiable element of the development of clinical managers and full-time managers alike, meaning that everyone with management responsibility would be expected to undertake some form of accredited training.. Broadening training access, and promoting management among staff groups from which few have historically progressed into management, will help to increase the size and diversity of the NHS management talent pool.. Patients rarely encounter an operations manager, service manager or general manager, or anyone in the dozens of other managerial roles in the NHS – unless the manager happens to be a clinician who also works as a manager.

It became clear early in the pandemic that ethnicity was a factor in both the impact and outcome of the disease.

In July 2020, Public Health England (PHE) examined the extent of that impact and found that people of Black, Asian and other minority ethnic (BAME) groups were more exposed to COVID-19, more likely to be diagnosed with it and more likely to die from it than those of white ethnicity ( COVID-19: Review of disparities in risks and outcomes ).. Tackling London’s ongoing COVID-19 health inequalities , a blog by PHE’s regional director of public health for London, Kevin Fenton, revealed that ethnicity continued to feature alongside deprivation as a major factor in the health outcomes of communities in the city during the second wave of the pandemic.. Case rate and mortality data showed London’s Asian populations were worst affected during the second wave to early February, followed by Black communities, with both communities experiencing significantly higher case rates and deaths than their White counterparts.. Ethnicity and COVID-19 mortality In addition, COVID-19 death rates per 100,000 population were 2.7 and 2.0 times higher for males and females of Black-African ethnic background compared to those of White ethnicity.. Once adjusting for all these factors, the report found statistically significant raised rates of death for males and females of Black African, Black Caribbean, Indian, Pakistani and other ethnic group.. After adjustment, compared to White males; the rate of deaths among Black African males was 2.3 times greater, for Bangladeshi males it was 1.9 times greater, for Black Caribbean males 1.7 times greater and for Pakistani males 1.6 times greater.. Black and Asian ethnic groups also have much higher rates of diabetes, with recent estimates showing BAME populations as having three to five times higher prevalence than those of White ethnicity.. Age, gender and ethnicity They found that HRQoL was worse for men or women, or both, in 15 (88·2 per cent ) of 17 minority ethnic groups, with the impact of greater magnitude on women, than the White British ethnic group.. Inequalities amongst ethnic minority groups were accompanied by increased prevalence of long-term conditions or multimorbidity, poor experiences of primary care, insufficient support from local services, low patient self-confidence in managing their own health and high area-level social deprivation compared with the White British group.. People from minority ethnic communities are more likely than those of white ethnicity to live in overcrowded multigenerational housing, making transmission of the virus easier, quarantine from household members and shielding for vulnerable groups harder.. ONS data shows that Black and minority ethnic groups suffered an impact to their mental health, incomes and life expectancy that left them more vulnerable to the coronavirus pandemic.. Of the 17 specific occupations among men in England and Wales found to have higher rates of death involving COVID-19, 11 out of 17 have statistically significantly higher proportions of workers from Black and Asian ethnic backgrounds.. It is clear that ethnicity alone is the main driver for the impact of COVID-19 amongst minority ethnic communities, but rather the combination of other factors that are prevalent within ethnic groups.. References Public Health England, COVID-19: Review of Disparities in Risks and Outcomes , GOV.UK, 2020 Public Health England (2021) Tackling London’s Ongoing COVID-19 health inequalities Office for National Statistics, Coronavirus and the Social Impacts on Different Ethnic Groups in the UK , December 2020.. Office for National Statistics, Updating ethnic contrasts in deaths involving the coronavirus (COVID-19), England and Wales: deaths occurring 2 March to 28 July 2020 Jordan, R, E, Adab, P and Cheng, K, K, (2020) COVID-19: Risk Factors for Severe Disease and Death , BMJ Public Health England Analysis of the relationship between pre-existing health conditions, ethnicity and COVID-19 , 2020 Watkinson, R, Sutton M., Turner A J; (2021) Ethnic inequalities in health-related quality of life among older adults in England: secondary analysis of a national cross-sectional survey , Lancet Public Health NHS England, Statistics - COVID-19 Daily Deaths , 2020 Centre for Mental Health Young Black men’s mental health during COVID-19 Office of National Statistics (2020) Why have Black and South Asian People been hit hardest by COVID-19 Platt L, Warwick R. Are some ethnic groups more vulnerable to COVID-19 than others?


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