The U.K.’s health system breaks down

The ideas and innovators shaping health care

Jan 20, 2023 View in browser   By Ruth Reader, Erin Schumaker and Ben Leonard WEEKEND READ Getty The U.K.'s National Health Service is in crisis — a crisis that has ramifications for the debate around health care reform in the United States. POLITICO's Helen Collis detailed the U.K.'s problem and scouted possible solutions. The signs of crisis are legion: —The return of the flu and other viral diseases, combined with the toll of missed care during the pandemic, has more people dying now than during the height of the previous Covid-19 winter waves. — Wait times are out of control. In November alone, 37,800 patients waited more than 12 hours to be seen in emergency rooms, compared to 10,600 in November 2021 and 1,111 in November 2019. A growing number of people are waiting eight to 14 days to see their family doctor. — The NHS is chronically understaffed. At the end of last September, staff vacancies in England numbered 133,446. That's a 29 percent increase compared with September 2021 and a 52 percent jump from two years ago, according to NHS Digital figures. — Strikes, most recently by paramedics, have exacerbated those problems. What can the U.K. do? Health Secretary Steve Barclay said the NHS will move 2,500 medically fit patients from hospitals to care homes, use modular units to expand capacity in emergency rooms, and pause hospital inspections. But, Collis writes, specialists in emergency care, hospital and primary care, nurses and leaders of NHS facilities say much more is needed. Their recommendations: — Pay staff more. Miriam Deakin, director of policy at NHS Providers, which represents hospitals and ambulance, community and mental health services, called on the government and unions involved to "get round the table immediately to talk specifically about pay." Last month's strikes meant thousands of appointments had to be rescheduled, she said. — Reduce paperwork. Many time-consuming administrative tasks required of NHS doctors "really don't need to be done" by them, said Kamila Hawthorne, chair of the Royal College of General Practitioners. Tasks include paperwork on routine checkups of people with chronic conditions, forms for insurance companies, letters about medication for flights, driving forms and sick notes to schools for short-term illnesses. — Relieve the burden on ERs. Admit patients that need hospital care directly from the community. — Free up hospital beds. One of the biggest bottlenecks in moving patients onto the right ward is so-called bed-blocking — medically fit older patients unable to be discharged because of a lack of community care. "Sustainable investment in social care is the obvious short-term fix," said Deakin.   STEP INSIDE THE WEST WING: What's really happening in West Wing offices? Find out who's up, who's down, and who really has the president's ear in our West Wing Playbook newsletter, the insider's guide to the Biden White House and Cabinet. For buzzy nuggets and details that you won't find anywhere else, subscribe today.     WELCOME TO FUTURE PULSE Herbert Zeller This is where we explore the ideas and innovators shaping health care. Mad mango, loud lemon, peach dream. Health experts are criticizing marketing tactics used by New York's fledgling legal cannabis industry, which they say could appeal to children. As it stands, New York's adult-use law bans marketing and advertising "designed in any way to appeal to children or other minors." Packaging with bubble letters, rainbow colors and flavors riffing on candy brands, such as "Stony Patch Kids" and "Banana Runtz" are under fire, according to the Associated Press. The concern follows a years-long fight between states and e-cigarettes companies over marketing practices. Last year, the e-cigarette company Juul agreed to pay $438.5 million to settle an investigation into the company's marketing of vape products to kids. Share any other thoughts, news, tips and feedback with Ben Leonard at bleonard@politico.com, Ruth Reader at rreader@politico.com, Carmen Paun at cpaun@politico.com or Erin Schumaker at eschumaker@politico.com. Send tips securely through SecureDrop, Signal, Telegram or WhatsApp. Today on our Pulse Check podcast, Ruth talks with Ben about a congressional watchdog report that said HHS needs to better oversee its funding of research into "enhanced potential pandemic pathogens" — and why this adds fuel to a contentious debate in the capital over so-called gain-of-function research. Listen to today's Pulse Check podcast THE NEXT CURES Boiling peanuts may help people with allergies overcome them. | AP Peanut allergies could be treated … with peanuts? A new study suggests that giving kids with peanut allergies small and increasing doses of boiled peanuts might help. Among the 70 participants, 80 percent were successfully desensitized to peanuts, according to the research published in the journal Clinical and Experimental Allergy. For three months, researchers at Australia's Flinders Health and Medical Research Institute gave kids peanuts that had been boiled for 12 hours. They then gave them peanuts boiled for two hours for 20 weeks and, finally, roasted peanuts for 20 weeks. After that, kids were given 12 roasted peanuts a day to maintain their desensitization. Will this regimen cause kids to hate peanuts? The study doesn't say. This approach is not without issues. Researchers reported adverse reactions in more than 60 percent of kids, though the study notes emergency epinephrine was used by only three participants. Peanut allergies affect less than 3 percent of the U.S. population, according to one estimate. However, the allergy can lead to emergency room visits and, in extreme cases, death.   LISTEN TO POLITICO'S ENERGY PODCAST: Check out our daily five-minute brief on the latest energy and environmental politics and policy news. Don't miss out on the must-know stories, candid insights, and analysis from POLITICO's energy team. Listen today.     AROUND THE NATION Farmers aren't immune from mental health challenges. | AP "There's a lot of downtime, a lot of solo hours that you spend in your day." Reb Wayne, spokesperson for the Texas Department of Agriculture, on why farmers face mental health challenges. The Texas Department of Agriculture is asking the state legislature for $500,000 a year to continue funding a suicide and crisis hotline for farmers as part of the state's Farmer Mental Health & Suicide Prevention Program. The hotline launched last February with funding from a one-time federal grant and is staffed by mental health professionals trained in the nuances of farming and ranching stressors like weather, crop prices and tariffs. Why it matters: While the farming and mental health communities might seem like strange bedfellows, the reality is that suicide rates are higher in rural areas than they are in urban ones, and within rural communities, farmers carry an especially high risk. The suicide rate for farmers is 3.5 times higher than in the general population, according to the National Rural Health Association. "Stress-related work is no different in that job than any other," Reb Wayne, spokesperson for the Texas Department of Agriculture, told Erin. The anonymous and discreet hotline, Wayne said, is well-suited for farmers and ranchers who tend to value independence and self-reliance and might not otherwise seek help. Measuring results: Wayne says evaluating Texas' program will take time. State officials are still trying to figure out what the best yardstick is, he said. "Programs like this usually take three to five years to see if you're making progress."   Follow us on Twitter Ben Leonard @_BenLeonard_ Ruth Reader @RuthReader Carmen Paun @carmenpaun Erin Schumaker @erinlschumaker   Follow us

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