Tag Archives: Healthcare

Maternal Health: Where does the government go from here?

In September 2024, Secretary of State for Health and Social Care Wes Streeting labelled the state of maternity services in England a ‘cause for national shame’, describing it as one of the ’biggest issues that keeps him awake at night’.

His comments followed the publication of a damning report by the Care Quality Commission (CQC) which brought together findings from 131 inspections and found that almost half of maternity units inspected were rated as ‘requires improvement’ or ‘inadequate’. The report called for increased national action and ring-fenced investment into services, warning that poor quality NHS maternity care will become normalised if action is not taken.

In January 2024, the APPG on Birth Trauma launched an inquiry to investigate the factors in maternity care that contribute to birth trauma and develop policy recommendations. By May, the APPG’s report, Listen to Mums: Ending the Postcode Lottery on Perinatal Care, presented findings from over 1,300 submissions by women recounting harrowing stories of inadequate and traumatic care. The report identified an overwhelming narrative that women felt belittled, ignored, and neglected at a time when they were most vulnerable, and concluded that a base standard in maternity services is needed across the UK.

Streeting has inherited a bleak forecast: urgent need for reform; mounting pressures on the NHS as a whole; and a poor fiscal climate. So where does Labour go from here?

Labour’s 2024 election manifesto promised to ensure that NHS trusts failing on maternity care are ‘robustly supported into rapid improvement’, to train thousands more midwives as part of the NHS Workforce Plan, and to set an explicit target to close the black and Asian maternal mortality gap.

However, the party’s manifesto lacked any concrete policies aimed at fixing the broken maternity system. This means all eyes now turn to the government’s 10-Year Health Plan, due to be published in spring this year, as the potential roadmap for change.

While the plan will focus on prevention, the transition from hospital to community care, and the digitalisation of health services, the government has given no indication of whether it will give maternal health the attention it desperately needs.

Despite rising demand, current services are stretched and under-resourced, meaning many women face significant delays receiving the support they need, if they receive it at all. Investing in early intervention, services that understand the needs of new and expectant mothers, and workforce growth is essential to ensuring that patients can access timely and effective support.

Various campaign groups are putting pressure on Streeting to make improving maternal health services a priority. The Maternal Mental Health Alliance is calling for all parties to demonstrate their support for new and expectant mothers. The Alliance claims ‘there is a vital opportunity for the new government to create positive change for current and future generations.’

The 10-Year Health Plan provides the government with the opportunity to address the alarming findings from both the CQC and APPG on Birth Trauma, restore public confidence in NHS maternity services, and show its commitment to fixing the systemic issues within maternal care. Inadequate support has devastating effects on families and adds huge costs to the UK economy, meaning it is vital that organisations engage with the government during the development of the 10-Year-Health Plan to ensure maternity services receive the focus they need. By leveraging industry platforms and policy development support, advocacy campaigns can emphasise the importance of maternal health and the challenges faced by women.

To discuss the government’s plans for maternal health in more detail, please contact Annabelle Black at annabelle@gkstrategy.com.

The Dash Review: the future of the CQC

Steve Brine @BrineHealth is a Strategic Adviser at GK Strategy. He was a Health Minister (2017-2019), Government Whip, and is a former chair of the Health & Social Care Select Committee. Here, he reflects on the future regulatory landscape for adult social care.  

Context is everything when it comes to social care. Well, almost everything because you can’t forget the politics. On one hand, despite a grand pledge in the Labour Party manifesto to “undertake a programme of reform to create a National Care Service”, we have nothing happening at all. 

On the other we have the Dash Review (and now Dash 2.0), the Ten Year Plan, the next phase of the spending review and of course, the Budget which brought a further £600m to prop up the service. 

Taken on face value, a national care service is of course a very (very) big deal. This could literally mean the nationalisation of the entire social care sector – akin to how local voluntary hospitals were brought under national public ownership in the 1940s – or it could mean, well, whatever you want it to. Perhaps that’s the point. The truth is, right now, we’re none the wiser and nor I suspect are Ministers. 

More immediate, not least for investors and those looking for a little certainty in the sector, is the major NHS Ten Year Plan consultation launched last week. As I understand it, everything is in scope for this programme of work led by Paul Corrigan and Sally Warren with the exception of, wait for it, adult social care. Meanwhile, the Dilnot reforms have been kicked down the road (again) which means the spending cap will now not be introduced next year as planned. Andrew Dilnot is reportedly furious and the great immovable object of NHS reform seems further away than ever before.  

What we do know is Penny Dash is in the ascendancy with this government. Shortly after Lord Darzi produced his 163-page diagnosis of the NHS, Dash published her full report into the operational effectiveness of CQC. The Dash review found significant failings in the organisation which it said ’has lost credibility in the health and social care sectors’ and led Wes Streeting to say it was no longer fit for purpose. It found that the CQC’s ability to identify poor performance and support quality improvement has deteriorated and says this has undermined the health and social care sector’s capacity and capability to improve care. 

Alongside Dash, a parallel review was led by Prof Sir Mike Richards (former chief inspector of hospitals) looking at CQC’s controversial single assessment framework. Sir Mike (one of the best officials I worked with while a Minister) recommends a fundamental reset of the organisation and a return to the previous organisational structure, with at least three chief inspectors leading sector-based inspection teams at all levels. 

And as if that weren’t enough, Dash gets a 2.0 moment as this month we learn the way patient safety is regulated and monitored is to be completely overhauled in England. With the swoosh of a Minister’s pen; the CQC, the National Guardian’s Office, Healthwatch England and local Healthwatch services, the Health Services Safety Investigations Body, the Patient Safety Commissioner and NHS Resolution are all set to be reviewed. 

Whatever the future of Henrietta Hughes (the Patient Safety Commissioner) or Helen Vernon (who leads NHS Resolution) one name here is to stay is Julian Hartley. Currently Chief Executive of NHS Providers he will take over as the head of the CQC in December. Julian is a smart appointment. A nice guy (but don’t be fooled) who exudes calm and is fiercely organised. He will find an organisation on its knees and I am sure a massive rebuild on his hands. 

It is clear that Penny Dash has listened to the voices of care providers, resulting in a clear set of recommendations so Julian Hartley will benefit from that oven-ready piece of work. Equally, I suspect the Richards review findings will not meet too much resistance. Expect a re-set to a standardised approach to inspections and for line management of such to come back under the auspices of the Chief Inspector of Hospitals. I wouldn’t be surprised to see a completely re-born and re-branded CQC that focuses on safety as well as efficiency, outcomes and use of resources – you can be sure Rachel Reeves will make that a red line. 

Ministers will, in my experience, find that the desire to do the Ten Year Plan minus adult social care doesn’t survive contact with political reality. And so between now and the Spring, and indeed the final throes of the comprehensive spending review to come, furious negotiations between DHSC, Angela Rayner (who is responsible for council funding) and HMT are the order of the day. 

And when all is said and done, we will find out whether the work of change has great substance or everything looks and feels very familiar. 

gk - The Medicines and Medical Devices Bill- the impact and opportunity

The Medicines and Medical Devices Bill: the impact and opportunity

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On the 2nd March 2020, the Medicines and Medical Devices Bill 2019-20 went through its second reading in parliament. It has been one of the first pieces of domestic legislation to be introduced since the Queen’s Speech in December 2019 and represents a critical area of post-Brexit regulatory change.

The Bill is politically uncontroversial. It passed first and second readings unopposed by the Labour Party and is more about the need for legislation to return regulatory powers to central government rather than a Brexit-fuelled political move.

Nevertheless, the legislation can define the medicines and medical devices regulatory environment for years to come.

Specifically, the legislation could have a significant impact on contract research organisations (CROs) whose interest is in stymying excessive divergence from US and EU clinical trial regulation. The following are just a few areas the bill might interfere:

  1. The speed of approval processes for clinical trial applications

The UK has a reputation for world-leading standards in clinical research. It has several world-leading universities, research organisations, institutes and scientists operating around the ‘Golden Triangle’ (London, Cambridge and Oxford) and beyond. These hubs ensure pharmaceutical companies get the most out of phase I-III research, while also having applications approved quickly by the renowned Medicines and Healthcare products Regulatory Agency (MHRA). The combination of an effective and accessible regulator in the MHRA and its close relationship with NICE must be protected.

  1. Alignment to the EU Clinical Trial Regulations (CTR)

The UK and, specifically, the Clinical Trials Unit of the MHRA played an active and leading role in the development of the EU Clinical Trial Regulations over the past five years – due for implementation during 2020. The regulations aim to create a single set of standards across the EU, establish a single method for submissions to assessment processes and increase transparency, collaboration and information sharing across EU Member States.

While the UK’s departure from the EU means that it won’t be implementing the regulations it helped to develop, CROs across the country will want to ensure that the future of the UK’s clinical research regulation is as closely aligned to the EU as possible. This will ensure its ability to deliver competitive, expeditious and high-quality research. The Medicines and Medical Devices Bill should facilitate this alignment.

  1. The introduction of bureaucratic processes and regulatory burden for CROs

There is some anxiety in the CRO sector that the new regulatory environment will cause a significant bureaucratic burden when it comes to clinical trial applications. If the legislation oversees a divergence in regulatory standards and processes from other markets, applications to the MHRA could require more and different information to the U.S. Food and Drug Administration and the European Medicines Agency. CROs will be eager to mitigate this risk.

These are just a handful of areas where the Bill might affect CROs and the life sciences industry. Others include patient safety, pharmacies and medicine supply chains, as well as manufacturing, labelling and packaging.

GK Strategy are experts in political and government engagement, with long-standing experience and understanding of the life sciences and clinical research sectors. To discuss further with our team, please do get in touch via ian@gkstrategy.com