2012 Q2 April-June
Health and Wellbeing Policy Updates
2012 – April-June
9th July 2012
Commissioning Support Bulletin, Issue 3 from NHSCB
6th July 2012
NHS Commissioning Board announces new ‘very senior managers’ (VSMs)
[Weekly update sent out ————————————————————–]
6th July 2012
Vision for Public Health England published (2 pages)
GP ‘enhanced services’ should be put out to competition, under new guidance, unless they are of limited value or GPs are the only capable providers
5th July 2012
NAO report finds that despite an overall £2.1bn NHS surplus, some NHS organisations are struggling
‘When I’m 64’. Well, now the NHS is.
NHSCB seeks lay assessors for CCG authorisation panels. Recruitment begins on Monday 9th July.
The NHS Commissioning Board is inviting one clinical lead from each CCG to join its Executive to form a new ‘commissioning assembly’.
‘City deals’ extended beyond Greater Manchester and Liverpool to include Newcastle, Birmingham, Bristol, Leeds, Nottingham and Sheffield. They get more money in exchange for promises to deliver on particular outcomes.
‘The Week’ – Issue 254
Includes: webinar on Why Health and Local Government Joint Working is now Mission Critical, 12:00, 12 July.
4th July 2012
The Secretary of State for Health publishes: a draft mandate to the NHS Commissioning Board (open for consultation until 26 September); the Secretary of State’s Annual Report for 2011/12; and a report on the effect of the NHS constitution.
Draft mandate: http://www.mandate.dh.gov.uk/
Report on the NHS Constitution: http://www.dh.gov.uk/health/2012/07/nhs-constitution/
Annual report on the NHS and Public Health: http://www.dh.gov.uk/health/2012/07/annual-report/
Response of National Voices: http://www.nationalvoices.org.uk/mandate-strong-choice-weak-voice
Setting levels of ambition for the NHS Outcomes Framework. [This looks to me a lot like setting targets, though to be fair, with quite a good methodology. I’m not quite clear, on a quick look, how precise the ‘ambitions’ will be and whether this approach can avoid the perverse incentives of targets].
NHS and Social Care Funding: the outlook to 2021/22. Report by the Institute for Fiscal Studies, funded by the Nuffield Trust
IPPR blog on it: http://www.ippr.org/?p=832&option=com_wordpress&Itemid=17
An ICM poll finds that 9 in 10 English adults believe older and disabled people shouldn’t have to meet everyday support costs, as at present.
Bulletin for proposed CCGs, Issue 16
3rd July 2012
Telehealth is unlikely to provide value for money against NICE criteria according to new research by the LSE
The Nursing and Midwifery Council is accused of failings at every level in its duty to protect patients according to a review by the Council for Healthcare Regulatory Excellence
Survey of bereaved people provides information on end of life care
Fund to support healthcare social enterprises now open for applications. Total fund available is £19m.
The Commission on the Future of Local Government has launched its final report. It was initiated by Leeds City Council and obtained commitments from the CBI, LGA and JRF.
2nd July 2012
Blog from the King’s Fund on the allocation of funding for public health to local authorities (based on the DH announcement of 14 June):
[Weekly update sent out ————————————————————–]
29th June 2012
The National Audit Office has published a report comparing health spending across the four countries of the UK. Spending on healthcare has doubled in the last decade.
Responsibility deal first annual updates. There are more than 390 organisations signed up to the responsibility deal, including companies like BT, BP, Marks and Spencer and Whitbread. They are doing work in areas including alcohol, food, health at work and physical activity.
The smoking ban has reduced asthma and heart attacks
28th June 2012
The CQC finds that a quarter of NHS and social care services are failing to meet essential standards
DCLG Open Data Strategy
‘The Week’ – Issue 253
‘The Month’ – Issue 55. Includes update on CCGs.
Health trusts in trouble, including South London and Peterborough (lots of stories in the press on it this week)
Map showing which other trusts could be in trouble: http://www.guardian.co.uk/news/datablog/interactive/2012/jun/26/health-nhs-trusts-pfi-interactive-map
New head of the BMA, Dr Mark Porter, says NHS is under attack.
LGA publishes 48 pp guide to the Health and Social Care Act
27th June 2012
Government publishes response to consultation on Healthwatch England membership regulations.
Directions published for Health Education England, which is established as a special health authority from 28th June 2012
Introducing Health England: http://www.dh.gov.uk/health/2012/06/introducing-hee/
‘Funding Outlook for Councils’ published by the LGA, modelling future revenue to the end of the decade. If you’re currently suffering from over-optimism, have a look at the graph on p.9. After spending on social care, waste, concessionary travel, and capital financing costs, all other services would have to be cut by 90% in cash terms by 2020, leaving virtually no funding at all in real terms. (Shouldn’t the headline be ‘2020 vision sees nothing left’?)
The Community Right to Challenge (from the Localism Act) comes into force, giving local communities the right to bid to take over local services
The ‘Save Childhood Movement’ launched by academics and childcare experts, claiming that research shows British children are unhappiest in the industrialised world
Infographic from DH of the health and care system from April 2013. (However doesn’t do justice to the delicate intricacy of, in addition to CCGs, HWBs etc: 23 commissioning support services, four commissioning regions, 27 NHSCB local area teams (with 10 local area teams leading on specialised commissioning), 12 clinical senates and local professional networks.)
26th June 2012
Public health advice service for clinical commissioning groups. Guidance, (replacing previous draft guidance) for DsPH and NHS Commissioners to ensure specialist public health advice is not lost in the transition to the new system. The intention is to make it a mandatory requirement for local authorities to provide this service to CCGs.
Local Health Profiles published with an snapshot of health in each local authority in England.
The announcement: http://www.dh.gov.uk/health/2012/06/2012-health-profiles/
The profiles: http://www.apho.org.uk/default.aspx?QN=P_HEALTH_PROFILES
The Home Cure. Demos report looking at whether out-patient home care programmes can deliver better value. Suggests that home recuperation programmes should become more personalised and that social housing providers are an untapped resource.
Government urges employers to offer more flexible working to meet mental health needs under ‘responsibility deal’
25th June 2012
DH and the LGA have published guidance on the transfer of public health functions to local authorities
Government could ask supermarkets to use loyalty cards to tailor health advice:
Government task force pushes for continued expansion of public service mutuals:
Survey from Labour’s shadow health team finds a number of treatments are being rationed because of limited funding.
22nd June 2012
Single operating model for commissioning primary care published
[Weekly update sent out ————————————————————–]
Disabled people have been badly hit by the cuts with reduced income, increased costs and worsening services, a new report from Demos and Scope finds.
Telehealth could cut hospital admissions by 18% and deaths by 46%, but won’t save the amount of cash claimed by Ministers according to research based on a randomised control trial published in the BMJ.
Cabinet Office launches review of Choice, led by nef associate David Boyle
21st June 2012
Resources for Health and Wellbeing Boards, arising from the learning sets, published by the NHS Confederation
NHS Chief Executive’s Annual Report published
‘The Week’ – Issue 252. Includes: ban on unjustifiable age discrimination to be introduced from 1st October 2012; progress on plans to build 100,000 homes on public sector land; expressions of interest sought to create academic health science networks.
20th June 2012
The NHS Commissioning Board has confirmed the structure and role of its 27 local area teams and has announced that there will be 12 Clinical Senates to cover England (although there is no detail on what their role will be)
An expert panel has been chosen to guide the one year NHS Patient Feedback challenge which aims to find and share ways in which patient feedback has helped improve services
19th June 2012
Patient care at risk unless NHS changes the way it provides services – NHS heading for an iceberg
King’s Fund economist, John Appleby, says that further NHS efficiency savings of £50bn are ‘undoable’
6 of Wales’ 7 health boards are predicting a combined deficit of £230m this year.
NHS care being ‘rationed’
‘The Impact of the Economic Downturn and Policy Changes on Health Inequalities in London’ published by the UCL Institute of Health Equity
‘Games4Life’ has been launched, aiming to use the ‘summer of sport’ to inspire adults and families to get active.
Personal health budget pilots – 5th interim evaluation report published
18th June 2012
‘NHS failing mental health patients; report from the LSE mental health policy group. Minister Paul Burstow says mental illness costs £105bn per year. Mental health problems are a source of further physical problems costing the NHS another £10bn per year.
40% of carers have put off receiving medical treatment because of the pressures of their role according to a survey by eight charities
Report calls for more dignity in care:
17th June 2012
Day centres in 57% of areas have closed, particularly affecting the elderly, according to a survey commissioned by Unison from Birmingham University’s health services management centre.
15th June 2012
Four non-executive appointments to the NHS Commissioning Board announced: Lord Adebowale, Margaret Casely-Hayford, Dame Moira Gibb and Naguib Kheraj
[Weekly update sent out ————————————————————–]
15th June 2012
The consultation deadline on detailed proposals for shared decision making and choice for patients has been extended to 31st August.
Healthy school dinners – the blog so dangerous, Argyll and Bute Council had to ban it. The ban was then lifted after a storm of protest. At least it’s brought it to more people’s attention (more than the existing 3m hits).
The Government is to back a private member’s bill to remove laws that stop people with certain mental health problems from being an MP, a company director or doing jury service
The Health and Social Care Act Explained – updated
14th June 2012
A CBI Public Services Report says successfully delivering care closer to the home could improve patient outcomes and save £3.4bn p.a.
The Department of Health has published an update on public health funding for local government. This includes the Advisory Committee on Resource Allocation recommendations on distribution of such funding.
Adult social care budgets cut by £890m
The rollout of the NHS 111 number is being delayed – areas will have up to six months extra to introduce it.
An audit has found only 54% of the 2m diabetes patients are getting all nine checks that they should, putting them at increased risk.
“The NAPC, NHS Alliance and the NHS Confederation have announced they are working together to establish a new membership service to provide clinical commissioning groups (CCGs) with a single, strong and independent collective voice.”
The Government rethinks child poverty target indicators
The child poverty map of Britain: http://www.guardian.co.uk/news/datablog/interactive/2012/jun/15/poverty-map-britain
Latest edition of the Happy Planet Index published showing in which countries people have the healthiest and happiest lives
‘The Week’ Issue 251. (DH bulletin)
Bulletin for Proposed CCGs – Issue 15
‘On the Pulse’, new report launched by the National Housing Federation on housing and health for elderly people:
Wellbeing is the key to tenants’ health and longevity
13th June 2012
The Functions of Clinical Commissioning Groups is published. A 16pp document updating a similar document published last year. Covers the statutory powers and duties of CCGs.
NAO says central government needs to improve its communications with local government.
12th June 2012
‘Satisfaction with the NHS’ falls by a record amount according to the British Attitudes Survey. The Kings Fund, that sponsored the questions in this year’s survey suggested this reflected not worsening services but concern over health reform, including ministerial rhetoric to justify the reforms.
The government countered with other statistics (based on a Mori survey) suggesting satisfaction hadn’t fallen, suggesting it is more important to take the view of health service users rather than the public at large.
11th June 2012
Red cross survey finds that elderly and vulnerable people are being put at risk by cuts to home-based care:
Lansley launches a campaign to get people active this summer
Monitor publishes a report on enablers and barriers to integrated care and implications for Monitor
10th June 2012
Eric Pickles on ‘troubled families’ [with health implications as well as drawing disproportionately on health and local government services].
CLG press release: http://www.communities.gov.uk/news/newsroom/2158689
Pickles suggests the new programme will have ‘a little less understanding’ and notes that ‘sometimes we’ve run away from categorising, stigmatising, laying blame’: http://www.independent.co.uk/news/uk/politics/ios-exclusive-problem-families-told–stop-blaming-others-7834235.html
Pickles on Radio4, Today Programme: http://audioboo.fm/boos/841285-eric-pickles-outlines-problem-family-plan
Blog querying the Government’s figures: http://notthetreasuryview.blogspot.co.uk/2012/06/government-continues-to-abuse-data-on.html
Participle’s Life Programme, which began in Swindon and is being extended to other parts of the country: http://www.participle.net/projects/view/3/102/
8th June 2012
David Beehan, Director General of Social Care in the Department of Health is to be the new Chief Executive of the Care Quality Commission.
His role at DH will temporarily be taken by Shaun Gallagher, currently director of social care policy: http://www.dh.gov.uk/health/2012/06/david-behan-cqc/
A survey conducted by Liz Kendall MP, shadow minister for care, finds that nine out of ten providers think adult social care is being polarised, with wealthy pensioners able to buy places in residential care while funding is cut for the poorest.
ONS survey results on wellbeing show London as the least happy region in the UK
7th June 2012
Data published on patient experiences of GP surgeries:
The BMA says the new scores are too crude: http://www.govtoday.co.uk/index.php?option=com_content&view=article&id=11404&catid=13&Itemid=495
The Social Enterprise Fund is to reopen in the summer with £19m of new funding to help, among others, public sector workers wanting to spin out into an independent mutual.
6th June 2012
A survey by MHP consultancy, mapping social care spending, suggests that £115m funding for additional services is being used for existing services.
Exercise doesn’t reduce depression when added to other care, contrary to current clinical guidance, according to a randomised control trial. [But how does it compare as an alternative to other treatment?]
The point of view of someone with depression on how they use exercise: http://www.guardian.co.uk/commentisfree/2012/jun/06/exercise-depression-research-misses-point
Further unravelling of the arguments here: http://www.guardian.co.uk/science/the-lay-scientist/2012/jun/08/1
4th June 2012
Rising health and social care costs, amongst other things, will put pressure on public finances according to an IPPR report, ‘The Long View: Public services and public spending in 2030’
3rd June 2012
Not being promoted at work leads to more heart attacks according to research to be published this month by Michael Marmot and Michael Anderson based on the employment histories and health outcomes of civil servants.
1st June 2012
EHealth Insider reports that “Plans for 50 local offices to replace primary care trusts and strategic health authorities” have been cut 27, and renamed ‘local area teams’. Each team will work with an average of 8 CCGs. (These are different from the planned 23 Commissioning Support Services).
Report to the NHSCBA Board: http://www.commissioningboard.nhs.uk/files/2012/05/board-item4-310512.pdf
More guidance for the CCG authorisation process has been published.
31st May 2012
A&E waiting times hit eight year high – King’s Fund report
BBC Report: http://www.bbc.co.uk/news/health-18266775
Government plans to reduce council tax benefits by 10% and localise them is likely to hit the poorest hardest [with knock on effects on health and health inequality]
Guardian article on IFS assessment: http://www.guardian.co.uk/money/2012/may/31/council-tax-reforms-poll-tax-ifs
The IFS briefing: http://www.ifs.org.uk/publications/6183
DH has published delivery plans from companies which have made pledges on calorie reductions to combat obesity:
Commission calls for city planners to consider health issues
DH and DCLG Business Plans 2012-15. Include summary plans and some interesting diagrams of spending.
No. 10 link to all Business Plans: http://www.number10.gov.uk/news/department-business-plans-updated-2012/
The DH Corporate Plan was published on 14th May:
‘The Week’, Issue 250.
‘The Month’, Issue 54. (14pp). Includes: it is currently estimated that 28 community and mental health services to be commissioned using the ‘any qualified provider’ approach in 2012/13 (p.5).
Transforming Public Health Bulletin, Issue 9. (8pp)
30th May 2012
Opportunity to contribute to the development of secondary legislation on health and wellbeing boards. Feedback by 29th June. There will then be recommendations to ministers in July with regulations drafted in the summer, consulted on in the autumn and laid before the end of the year.
29th May 2012
Reforming Social Care: Options for Funding published by the Nuffield Trust. Looks at ways in which the Dilnot proposals could be funded and/or amended to make them affordable.
Paper from the King’s Fund arguing that not understanding patients’ preferences can be as important as medical misdiagnosis, that doctors are not very good at it and it isn’t taken seriously enough. [Patient centred care is one of the key principles of the health reforms]
King’s Fund Blog from 1st June talks about this report and also argues that the DH consultation ‘No decision without me’ (23rd May) confuses shared decision making and provider choice:
7/6/12 Comment on this from NHS Alliance: http://www.onmedica.com/newsArticle.aspx?id=583733da-151b-4cd9-bf53-8e479fc536e2
NHS Commissioning Board Authority business plan to October 2012
Unicef says that the austerity drive will increase child poverty, putting at risk children’s future health, education and changes of employment.
28th May 2012
A Government commissioned report says the NHS should do more to help the homeless. The NHS Confederation says the problems can’t be dealt with by the NHS alone.
Commissioning Support Bulletin, Issue 2, from NHS Commissioning Board. Includes information on ‘Checkpoint 2’, a milestone review which found 3 of 25 regional commissioning support services were not fit to continue (covered in Guardian article 17 May below). Reports that CCG running cost allowance is to be £25 per head per year. Reports on a simulation exercise of CCGs working with Commissioning Support Services. A survey of CCGs says that a majority of CCGs intend to carry on with the same CSS during 2012-13, with a half expecting to commission 50% of their support through the NHS CSS (I’m not clear how these figures relate to each other).
More detail on the survey of CCGs: http://www.commissioningboard.nhs.uk/2012/05/28/checkpoint-2-customer-survey/
London’s business case for employee health and wellbeing, suggesting that well designed employee welfare programmes can cover the costs of such a programme to the firm.
The 111 service replacing NHS direct will lead to poorer outcomes according to Doctors, the Guardian reports.
Capita’s concerns over the NHS 111 tender process
‘NHS Procurement: Raising Our Game’ published. Minister says better procurement could save the NHS £1.2bn
The Government has agreed a recommendation that from April 2013 patients should be asked if they would recommend the hospital they were treated in to family and friends. However there has been no commitment to other recommendations from the Nursing Quality Care Forum. [N.B. there is already feedback on care e.g. via NHS Choices, Patient Opinion and hospital’s surveys]
Standards of care for the elderly falling behind other countries according to WRVS commissioned research
‘The Week’, Issue 249
Academics suggest Clegg was wrong and that unequal societies tend to be less socially mobile.
Details of all new 212 Clinical Commissioning Groups, including areas covered, budgets and constituent practices has been published.
The Guardian’s interactive map of them:
The NHS Commissioning Board’s Director of Patient and Public Engagement is to be Tim Kelsey
GPs at their annual conference voted that work capability assessments of who is eligible for sickness benefits should be scrapped and replaced with a more rigorous and safe system.
Consultation on detailed proposals for shared decision making and choice for patients
NHS failings lead to the unnecessary deaths of 24,000 diabetics each year according to the National Audit Office
Social Mobility [inequality is correlated with health]:
Nick Clegg announces 17 indicators to be used to measure fairness in society.
But according to the Guardian, ‘Britain has some of the lowest social mobility in the developed world’
OECD’s Better Life Index
Andrew Lansley, in a speech last month, not widely reported at the time, is hinting that age may play a bigger role in commissioning health. He said: commissioners “should be looking at what is in… population data that is likely to give rise to a demand for NHS services” … “What is likely to make the biggest difference, therefore? Actually it’s elderly population, who were not in substantial deprivation”. This has been taken to mean an increase in spending in elderly but more affluent (and Tory voting) areas.
Short analysis by Professor of Public Health policy on what such a change would mean:
People in wealthy areas have life expectancy 20 years more than deprived wards according to figures compiled by the Church Urban Fund.
Independent [N.B. intrusive ads, takes a long time to load] http://www.independent.co.uk/news/uk/home-news/people-in-wealthy-regions-live-20-years-longer-than-those-in-deprived-areas-7769682.html
DH Information Strategy
NHS Confederation reaction (says the strategy is ‘key to the Government’s reform programme’); http://www.nhsconfed.org/PressReleases/Pages/Response-to-Government-information-strategy.aspx
King’s Fund reaction (there will be financial and technical challenges): http://www.kingsfund.org.uk/press/press_releases/information_strategy.html
Coalition plans to allow online booking for GPs and ability to see results online.
The ‘Healthspace’ system, which lets patients and clinicians access, store and amend elements of their personal medical information, is to close by March 2013 because it is too hard to use.
Draft guidance from NICE says walking and cycling should be encouraged more and should become the norm for short journeys. It suggests co-ordinated action is needed across public, private and voluntary sectors. Consultation ends 25th May.
New digital service to provide information and advice for new parents launched
Almost 50,000 fewer patients are waiting more than 18 weeks to start treatment compared to May 2010, according to DH, the third month in a row the standard had been met. But Labour said the figures showed a 39% increase in the number of patients waiting over 18 weeks. [Haven’t we been here before?]
‘The Week’ issue 248
Includes information on Sports and Exercise Medicine, “the first new medical specialty for over 25 years.”
Two out of the 25 regional support organisations which will help CCGs with commissioning have been abandoned after checks by the NHS Commissioning Board. (Useful article about these services)
Action is launched in the High Court against 3 councils, West Berkshire, Wokingham and Northumberland, over their restriction of adult social care to ‘critical’ cases. Previous actions against councils operating ‘critical’ only policies were based on the way the policies were introduced, but his action is suggesting the policy itself is unlawful.
Extra training is to be provided to 4,200 health visitors being recruited, so they can spot the early signs of post-natal depression
NICE will no longer direct the NHS on the cost effectiveness of drugs when a new Value Based Pricing systems begins on 1 January 2014, Andrew Lansley told the NICE conference in Birmingham. This was described as a u-turn on a u-turn.
The number of older and disabled people who had all their care paid by their local council fell by 11% over the last two years, according to new figures.
A survey of 500 nurses found that 3 out of 4 have seen cuts to services in their area in the last year. Those working with people with learning disabilities have ‘real concerns’ about the safety of their clients because of the cuts.
South London and Maudsley mental health Trust have launched an on-line patient record that gives patients direct access to their health records, and the opportunity to choose what information is shared and who with. It is thought to be the world’s first patient-held electronic record in the field of mental health.
A quarter of all deaths, around 117,000 a year, could be prevented with more timely healthcare and better prevention according to new figures from the ONS.
Official bathing seasons starts. Just thought you’d like to know. You can cut yourself out of your winter clothes now and bathe. Whether you need to or not.
Those receiving an extra year’s schooling have improved health after the age of 40, according to a study of post-war experience in Sweden, published in Proceedings of the Natural Academy of Sciences
Resources for Health and Wellbeing Boards are now available on Knowledge Hub (registration required), including outputs from a series of action learning sets.
The Royal College of Nursing claims over 61,000 jobs in the NHS have been lost or placed at risk since April 2010. The Government said it did not recognise the figures.
More in the NHS ‘Smart Guides to Engagement’ series published
Many academies are selling unhealthy food and drinks that are banned in state schools according to research by the School Food Trust. Of 99 academies that provided information, 89 were selling at least one type of unhealthy food banned in maintained schools.
12th May 2012
National Health Action Party started, to be led by former independent MP, Dr Richard Taylor
The Social Care Institute for Excellence has produced a briefing on sustainable health and social care for commissioners and health and wellbeing boards.
11th May 2012
A package of materials to support payment by results for commissioners including tariffs and a simple guide (first published last July) is published
A report in the Lancet says that the health service cannot cope with the increasing number of people with multiple chronic diseases (or multimorbidity)
10th May 2012
The authorisation process for CCGs has been published (letter and slide pack)
‘The Week’ Issue 247
Map of CCGs published
DH statement on decision to veto publication of the health transitions risk register (see also below)
Edited risk register published:
9th May 2012
MJ summary of implications for local government
LGA on the day briefing.
No Adult Social Care reform bill but ‘Draft Care and Support Bill’ announced in Queen’s Speech
A progress report on the funding of social care is to be published alongside the White Paper, later in the spring
Revised leaflet on personal health budgets, to which all on NHS continuing care will have a right by April 2014 (that’s a right to the budgets, not the leaflet …)
8th May 2012
Confirmation that social care reforms likely to be delayed and not to appear in the Queen’s speech.
An alliance of 85 groups has written to the Prime Minister warns that ‘social care is in crisis’ and urges him to make social care reform his ‘legacy to future generations’.
Social care should be targeted at the poorest older people according to the Centre for Social Justice, rather than reforming the rules which lead to people selling their homes to pay for care, until their assets fall below £23,250.
No GP practices have started offering commuters and others the chance to register outside the areas where they live under the Government’s patient choice pilot scheme (see also item from 23 April where London LMCs were advising practices to boycott the scheme).
The Cabinet has decided to veto publication of the NHS risk register, despite the ruling of the information commissioner that it should be published.
A US study has found higher income inequality leading to higher mortality over subsequent years.
7th May 2012
SCIE Research briefing 41: Factors that promote and hinder joint and integrated working between health and social care services
There is a cross government consultation on a long term conditions strategy
Map of life expectancy
4th May 2012
Structural Reform Plan progress reports published for each government department. Just a few pages each, with a brief description of the target and whether complete or not (and ‘reasons’ for delays).
3rd May 2012
‘Thinking About Rationing’, a discussion paper by Jo Maybin and Rudolf Klein, published by the King’s Fund
And see Jo Maybin’s blog about it here:
Does Housing Benefit Reform Spell a New Era of Big Brother? Just a short blog, but a big issue with (along with other welfare changes, e.g. the benefits cap) big implications for wellbeing and mental health.
Details have emerged of the financial arrangements under which private sector company Circle is running Hinchinbrooke NHS hospital. Circle keeps the first £2m of any surplus and a percentage of further profits before any of the hospital’s debt is paid off.
The DH lead for the QIPP programme (Quality, Innovation, Productivity and Prevention), Sir John Oldham, is to step down later in the year and says the NHS Commissioning Board needs to sign up more GPs.
The Week, Issue 246.
Includes a plug for Trevor Hopkins and Jane Foot’s ‘What Makes Us Healthy?’ webinar on 17th May. You can register for it here:
Understanding personal health budgets – revised leaflet published. By April 2014, everyone in receipt of NHS Continuing Healthcare will have a right to ask for a personal health budget, including a direct payment.
2nd May 2012
The first wave of CCGs for authorisation has been published. (Applications for authorisation take place in 4 waves from July 2012 to January 2013).
“NHS Confederation chair Sir Keith Pearson has been appointed as chair of Health Education England – the organisation that will provide national leadership to the new system of education and training in healthcare – when it is established in June 2012.” (from NHS Confederation press release)
Transforming Public Health Bulletin: issue 8, May 2012
A survey by GP magazine suggests GPs are being pressured not to send patients to hospital, in order to save money.
Spending on healthcare as a percentage of GDP grew between 1997 and 2010 but showed a fall in the the most recent year’s figures according to ONS.
1st May 2012
The Information Commissioner’s Office has warned that the NHS could face more data breach fines soon.
30th April 2012
The Care and Support Alliance, of 50 charities, argues for more money to be spent on the care system in which there is an “urgent and deepening crisis”.
But meanwhile …
No news: social care white paper delayed; according to the Financial Times.
The deadline for submitting comments on children and young people’s health outcomes has been extended to 31 May. “The independent Children and Young People’s Health Outcomes Forum is gathering views from children, young people, parents, carers, doctors, nurses and other professionals involved in providing care to children on the health outcomes that matter most for children and young people and how the different parts of the health system will work together to deliver these.” (DH website)
Bed blocking has increased by 10% in the last month and 25% over the last two years according to new figures from the Department of Health.
According to Labour, as reported in the independent, this costs the NHS £600k a day.
27th April 2012
DH announces £1.8m for eight pilot sites to develop a fairer funding system for end of life care.
DH is seeking a Chair of Healthwatch England (£35-40k for 2-3 days a week).
“Building Successful Healthwatch Organisations” published by LGA.
And new LGA webpage on Healthwatch
According to a report in the BMJ, the health reforms will have severe implications for monitoring data about the health needs of populations across the country. This is because CCGs will be able to recruit patients from beyond their boundaries and could outsource services to several providers.
Draft guidance from NICE says walking and cycling should be encouraged more and should become the norm for short journeys. It suggests co-ordinated action is needed across public, private and voluntary sectors. Consultation ends 25th May.
26th April 2012
Eight charities win GlaxoSmithKline IMPACT awards for improving health. The scheme is run in partnership with the King’s Fund.
The Week, Issue 245
The Month, Issue 53. A fourteen page newsletter for the NHS leadership community, including items on developing clinically led commissioning; developing a robust and diverse provider sector; developing the new public health system; education, training and research.
25th April 2012
DH has published a draft guide to the CCG authorisation process. The authorisation regulations still have to be passed by Parliament and the final version is to be published in October 2012 but emerging CCGs are advised to use this as the basis for their authorisation applications.
The NHS Alliance and NAPC have announced that there is to be a single body for clinical commissioning that will work with the NHS Confederation. The organisation is to be called NHS Clinical Commissioners.
NHS Confederation warns that the health reforms could put children’s health at risk. It said that children’s health would now be split between 4 different organisations at different tiers (NHS Commissioning Board, Public Health England, CCGs and Councils). There was an unease that the reforms could disrupt the improvements to safeguarding which had been made in recent years.
24th April 2012
Oxfam Scotland have launched a new ‘Humankind Index’ to measure quality of life and social justice, as an alternative to GDP. Among the 18 constituent measures are health, transport, family life and employment. The index is being evaluated by UK and Scottish Governments.
CQC Inpatient survey
Elderly people’s contribution to the economy is likely to increase considerably in future years as they are healthier and more active for longer, according to academics from University College London.
23rd April 2012
Andrew Lansley has set the the Government’s strategic objectives for the NHS Commissioning Board Authority up to October 2012, and the Board itself from October until March 2013. The Board will be held to account for strategic objectives relating to: transferring power to local organisations; establishing the commissioning landscape; developing specific commissioning and financial management capabilities, and; developing excellent relationships.
Andrew Lansley’s letter to Prof Malcolm Grant, Chair of NHSCB
The gap between male and female life expectancy could be closed by 2030 according to an adviser to the ONS.
Four London local medical committees (LMCs) have advised GPs in their areas not to participate in a DH pilot due to start at the end of the month, where people from outside the area could register with GPs. There are to be pilots in London, Manchester and Nottingham. The LMCs argue that it would increase costs locally and therefore cut services for residents.
Healthwatch Briefing No.1 from National Association of LINks Members
(See also presentation on the site on ‘consultation’ on secondary legislation for Healthwatch)
The Labour Party is proposing free end of life care for terminally ill patients.
Subsequently (see 27 April) DH announced £1.8m for fairer funding of end of life care.
21st April 2012
Andrew Lansley is backing proposals for regional pay, in line with a direction proposed in the budget, with lower pay in poorer areas. However, higher paid managers would be excluded so as to be able to “attract and retain high-calibre leaders and staff responsible for transforming delivery”.
20th April 2012
“Vulnerable Children ‘need the best possible start’. The social and emotional wellbeing of vulnerable under-fives should be at the heart of early intervention services, according to draft NICE guidelines published today.”
19th April 2012
The number of NHS patients waiting more than the 18 weeks for treatment specified in the NHS constitution has risen by 27% since the coalition came to power in May 2010 according to official figures. On the other hand, NHS Minister Simon Burns said that the number of patients waiting for more than 18 weeks for their treatment had been cut by 100,000 over the last year.
A separate report says NHS waiting times are growing. Using information from 93 of 170 acute hospital trusts, the Patients’ Association says that waiting times for 8 types of elective surgery rose 6% year on year while the number of those procedures carried out fell by 4.6% DH said data from all hospitals showed waiting times were low and stable.
I don’t normally include blogs, but this one from the King’s Fund seems a good summary of last month’s evaluation of 16 integrated care pilots. It also includes a number of interesting links.
The Richmond Group of Charities is calling on the Government to ensure patients are central to the delivery of care in the redesigned NHS, and their report sets out what they think needs to be done to achieve that.
By definition: an Audit Commission report on data definitions and their use by the NHS. (Even something as apparently straightforward as stays for under 24 hours are being recorded differently in different places, with significant funding implications).
The Week, Issue 244.
NHS Confederation briefing: “Long-term health gains: Investing in emotional and psychological wellbeing for patients with long-term conditions and medically unexplained symptoms.”
North Somerset health and social care services to merge
A new National Institute for Health Research (NIHR) School for Public Health Research has been launched. It has a budget of £20 million over five years to undertake research into public health, with an emphasis on what works practically, can be applied across the country and better meets the needs of policy makers, practitioners and the public. The school is a partnership between a number of existing academic centres.
Smart guide to engagement for CCGs – a series of short leaflets for anyone working in or with CCGs.
The Academy of Royal Medical Colleges is launching a campaign to tackle obesity. It starts with a three month evidence gathering enquiry.
Housing crisis threatens public health, according to the Chartered Institute of Environmental Health
King’s Fund report: ‘Health and Wellbeing Boards. System leaders or talking shops?’ Provides an update on where health and wellbeing boards are at, based on a survey of 50 areas and the King’s Fund’s other involvement with Boards. It sets the current arrangements in the context of past attempts to make links between health and local government. It also reports on two case study areas, Lambeth and Surrey. The survey suggests that boards are upbeat about meeting their objectives.
The Week 243
The NHS Medical Director is to investigate (in a rather unfortunate turn of phrase) ‘night discharges’.
The next President of ADASS is Sarah Pickup, Director of Adult Services in Hertfordshire.
The new Chief Executive of Public Health England is to be Duncan Selbie, currently Chief Executive of Brighton and Sussex University Hospitals Trust.
The NHS Leadership Academy is launched.
Letter on developing the public health system from the Chief Medical Officer, Professor Dame Sally Davis to the public health community.
More health data to be made available later in the year as work in the South West (initially on strokes and dementia) is rolled out across the country.
The Health Secretary explains the Health and Social Care Act
The Week, Issue 242.
A BBC poll has found that the proportion of GPs who think the health reforms will lead to a noticeable improvement in patient care has fallen from 23% last September to 12% now.
Pilot schemes are starting allowing people to choose their GP (e.g. where they work rather than live). The pilots are in parts of London, Manchester, Salford and Nottingham. The pilots will last for a year.
The Office for Fair Trading is referring the private healthcare market to the Competition Commission for further investigation. This follows an earlier OFT investigation and public consultation. This press release lists a number of features which may hinder competition.
Better management of treatable conditions like asthma and diabetes could prevent hospital admissions that cost the NHS nearly £250m a year, according to a new Kings Fund report.
Guardian report on it:
DH Social Care Bulletin, Issue 20.