Sleeping patient waking ban suggested in new green paper

The proposal is among a range of measures to tackle preventative illness in England put forward in a new green paper published this week.

“The community nursing workforce is unprepared with widespread vacancies and staffing shortages”

Helen Donovan

It is part of ambitions to give people an extra five years of healthy life by 2035 and narrowing the health gaps between the richest and poorest in our society.

In the new report, called Advancing our health – prevention in the 2020s, the government said sleep was a topic that had received “little policy attention” in terms of the prevention agenda.

Evidence suggests insufficient or poor-quality sleep is associated with physical and mental health problems, including increased risk of obesity, strokes and heart attacks, and depression and anxiety.

The government pledged to do more to support healthy sleeping including creating clear national guidance on the daily recommended hours of sleep and providing tips on getting a good night rest.

As part of this work, the NHS has been asked to determinate what more could be done to ensure those in care settings were getting the amount of rest they needed.

“This will include an assessment of whether changes are needed to existing guidance (such as national roll-out of ‘protected sleep time’ in hospitals, where staff leave patients sleeping unless clinically necessary),” said the green paper.

The document noted that lack of sleep could have a negative impact on a patient’s recovery from illness or surgery.

Despite this, more than one-third of hospital patients report being bothered by noise created by other patients, while one in five report being disturbed by noise created by staff.

The new green paper is suggesting moving to a more “targeted” and “personalised” approach during the decade starting in 2020 to help keep people healthier for longer.

The plan, which is going out to consultation, including a new ambition to make England smoke-free by 2030.

“The government will also continue to emphasise the preventative value of vaccines at every opportunity”

Green paper 

It also revealed that a new “vaccination strategy” will be published by Spring next year to “maintain and develop our world-leading immunisation programme”.

The strategy will feature an aim of reaching more than 95% coverage in the childhood vaccination programme and continuing to improve uptake of the seasonal influenza jab.

In addition, further action will be taken to challenge “anti-vax” messages being spread, the document promised.

“The government will also continue to emphasise the preventative value of vaccines at every opportunity,” said the green paper.

“This is to ensure that people have the facts they need, and that vaccine misinformation is addressed as effectively as possible.”

The government also revealed plans to “modernise” the Healthy Child Programme – the universal preventative health scheme for babies to 19-year-olds, which includes health visiting and school nursing provision.

“To support parents, we will modernise the Healthy Child Programme so it’s universal in reach and personalised in response,” said the document.

“This will enable effective, focused services where additional needs are identified; use of the latest evidence on effective practice; and help bring councils, the NHS and partners together to achieve priority outcomes for children and families.”

This modernisation will include extending the upper age range of the programme to 24 for those needing extra support and improving perinatal mental health provision.

Health Foundation

Dr Jo Bibby

Jo Bibby

The government is also proposing to “add components” including a digital support tool, new pathways for speech and language development and pre-conception and pregnancy advice.

The NHS Health Check service – which offers routine health check-ups for adults aged 40-74 – will also be overhauled and made more “tailored” for individuals based on their risk factors.

The green paper pledges to close the “prevention gap” for mental health and helping to keep people mentally as well as physically well.

The document also laid out commitments around obesity, alcohol consumption, diabetes, antimicrobial resistance and musculoskeletal conditions.

“The government has stepped back from the bold action required”

Jo Bibby

However, the report has drawn criticism from some health commentators including the Royal College of Nursing.

Helen Donovan, RCN professional lead for public health, said the long-awaited plans had been “buried in the dying days of the current government”.

She also said the plans already “start at a disadvantage”, because of the cuts to public health budgets, and noted how change would be difficult with the current staffing problems.

“One way to earn the faith of healthcare professionals would be to urgently pledge to restore cuts to the public health grant which local authorities rely on to deliver essential preventative services such as sexual health and smoking cessation services,” Ms Donovan said.

“In addition, the community nursing workforce is unprepared with widespread vacancies and staffing shortages,” she said. “Cuts to training budgets have stopped nurses from progressing in their career and, until rectified, it’s difficult to see how anything substantial will change.”

Jo Bibby, director of health at the Health Foundation think-tank, said also questioned how the ambitions would be achieved without the “necessary local government funding” to back them up. 

Royal College of Nursing

RCN warns of ‘profound public health challenges’

Helen Donovan

“With health inequalities in England widening and life expectancy improvements stalling, this green paper amounts to a missed opportunity,” she said.

“Perhaps unsurprisingly at a time of political uncertainty, the government has stepped back from the bold action required.”

Meanwhile, Professor Andrew Goddard, president of the Royal College of Physicians, expressed “disappointment” at the plans.