A deal struck with the Association of the British Pharmaceutical Industry (ABPI) will save the NHS £1.8bn over the next five years and give pharma companies cash for R&D.

Health Secretary John Reid announced that under the new Pharmaceutical Price Regulation Scheme (PPRS):

• the NHS will get a 7 per cent discount on branded medicines for the next five years, saving £370m a year
• pharma companies will not have to pay tax on 23 per cent of sales to the NHS if they put the money back into research in Britain. Companies will also be given incentives to develop medicines for children — which has been a major concern in recent months

The NHS will put the savings back into frontline services, according to the Health Secretary. It comes into effect on 1 January 2005 and applies only to companies with NHS sales above £1m. This last came after smaller ABPI members pressured the organisation to get them a better deal.

Companies can also modulate prices — that is, make different reductions to products so they offer an overall price cut of 7 per cent.

The ABPI describes the deal as being 'imposed on the pharma industry' and the institute's president Vincent Lawton complained:

'The price cut is unnecessary given the fact that medicines prices have fallen in real terms by some 15 per cent over the past 10 years and that the NHS's medicines budget is remaining steady at about 12 per cent of expenditure.'

However, the ABPI is still encouraging members to accept the voluntary scheme as being the best available. It lists the benefit as:

• continued freedom of individual medicines pricing within the scheme's overall constraints
• stability for at least the next five years
• applying to the whole of the UK as the single price control mechanism
• continued recognition of and support for the pharma industry's R&D investment

The deal was negotiated over the last nine months. The aims of PPRS — negotiated every five years — are to:

• secure provision of safe and effective medicines for the NHS at reasonable prices
• promote a strong and profitable pharmaceutical industry capable of sustained R&D, leading to future availability of improved medicines
• encourage efficient and competitive development and supply of medicines to pharmaceutical markets in this and other countries

The NHS relies too heavily on agency nurses and nurses from overseas, a report has shown.

An ageing workforce and more nurses leaving the profession (many to work abroad), has led to the Royal College of Nursing (RCN) titling their annual nursing labour review Fragile future?

Since 2000, the nursing and midwifery workforce has grown by 16 per cent (to 292,00), outstripping government targets. However, this has mainly been achieved through the recruitment of foreign nurses and casual staff. During the same period, the use of temporary nursing staff went up by 36 per cent.

The report makes the following warnings:

• One in 10 nurses leave the NHS annually — approximately 30,000 a year. A 1 per cent reduction would mean that around 3,000 NHS nurses could be retained.
• One in four nurses have been recruited from overseas.
• The nursing workforce is increasingly ageing, with more than a quarter (27 per cent) of registered nurses now aged over 50.
• Both British and overseas nursing staff are being targeted by an American recruitment drive. 2,000 nurses left the NHS for America in 2003 — the largest figure on record.
• Plans to improve the care of older people are being hampered by the shortage of district nurses.

Dr Beverly Malone, general secretary of the RCN said:

‘Whilst the RCN acknowledges the numbers of nurses has increased, my concern is that the foundations of nursing are built on sand, not stone. We have to ask why so many nurses feel unable to commit to the NHS and prefer to work on a temporary basis? Nurses tell us that the chance to choose which hours they work is a major factor. We want employers to do more with better flexible working arrangements to significantly improve retention.’

Health Secretary John Reid has denied there is a crisis in nursing. Speaking on Radio 4's Today programme, Mr Reid said the NHS has 80,000 more nurses than in 1997, and that 18,500 nurses have returned to the profession in the last four years. He also said that reliance on agency staff was being reduced.

A report on progress in the older people’s national service framework (NSF) calls for more to be done to tackle bed blocking and improve hospital discharge care.

Professor Ian Philp, the national director for older people’s services (more commonly know as the older people’s tsar), has authored the report Better health in old age. Despite the calls and warnings of dealing with an increasingly aging population, Professor Philp does claim that real progress has been made and that older people’s health is getting better.

Achievements are highlighted in the NSF target areas of preventing age discrimination and developing services for stroke, mental health and falls.

Paul Cann, Help the Aged’s director of policy and research, said ‘the NSF for older people has been hugely significant in modernising attitudes towards older people.’

Health Minister Jane Hutt has announced a consultation into simplifying healthcare standards in Wales.

The aim is to replace the current complicated set of standards by which healthcare in Wales is inspected. They will form the basis of how providers report to Healthcare Inspectorate Wales.

The new standards apply to:

• providers of healthcare
• health managers
• commissioners
• patients
• independent and voluntary sector

The consultation finishes in the new year.

The NHS is failing millions of allergy sufferers, MPs have claimed.

The condition is not being diagnosed and GPs have little information about treatment options, says the all-party Commons Health Committee. It commented that sometimes, sufferers 'had only been referred to one after they had consulted an allergy charity and armed themselves with the names of relevant consultants and units.'

The report also criticised the shortage of such allergy clinics in the UK. There are just six in England — none west of Bournemouth or north of Manchester.

It goes on to damn poor regulation of testing services outside the NHS, claiming that the inquiry 'has illustrated that the use of expensive and often useless tests creates considerable unnecessary expense and worry for patients and may also place them at risk.'

PCT managers did not escape the wrath of the report. It accused them of failing to admit that there was an epidemic of allergies, which are believed to affect 30 per cent of adults and 40 per cent of children.

The report acknowledges that where symptoms are not readily controlled they require repeat consultations and long-term medication, incurring high costs for the NHS.

The report accuses the Department of Health of burying its head in the sand by claiming that a lack of demand for allergy services indicates that there is no unmet demand:

'It is not possible for doctors to refer patients to services where none are available. Further, there is no mechanism to measure this unmet need. Patients themselves will often not be aware of specialist services and are often in any case not properly diagnosed. The accounts we have received from hundreds of patients demonstrate the frustration felt by individuals over the difficulties in securing appropriate treatment, and over the lengthy waits and long journeys they are experiencing.'

Recommendations include:

• a primary care allergy network
• clinical quality markers for allergy
• training for GPs and endorsement of GPs with special interest in allergies
• more allergy clinics — one in each of the old NHS regions
• each allergy clinic to have specialists in adult and child allergies
• independent diagnostic services to be inspected by the Healthcare Commission
• better information about allergies for patients, professionals and managers