Weekly political news round up – 29th August 2014

August 29, 2014 in News by Whitehouse

Around the sector

The Children’s Society has published the findings of a poll on children’s happiness, in which England ranked ninth of 11 countries polled on how happy children were with their lives. The report, based on a survey of 16,000 children from the countries, warned that low wellbeing could impair children’s health, education and family life. The 11 countries ranked in the report are England, Romania, Spain, Israel, Brazil, USA, Algeria, South Africa, Chile, South Korea and Uganda.

Education Minister David Laws has announced that the Liberal Democrats would more than triple the pupil premium, to £1000 per child, if they form part of the Government again in 2015. The proposal, which will be included in the party’s 2015 general election manifesto, would apply to three and four year olds from disadvantaged backgrounds in nursery education, who currently receive £300 in extra funding. Laws said: “This extra investment will mean a huge amount of support for the people who need it most and demonstrates our strong commitment to education”.

Department of Health launches consultation on refreshing the NHS Outcomes Framework 2015-2016

The Department of Health has published a new consultation seeking views on how the NHS Outcomes Framework could be improved.

The NHS Outcomes Framework is a set of 64 indicators which measure performance in the health and care system; it presents a national-level narrative on how the NHS in England is working. It is not intended to be an exhaustive list of health indicators, but rather a set of outcomes that together form an overarching picture of the current state of health and care services in England. It was developed in December 2010, following a public consultation, and has been updated annually to ensure that it remains robust.

It asks specific questions on four main areas in each of the five Domains of the NHS Outcomes Framework, including:

  • mental health;
  • children and young people;
  • health inequalities; and
  • patient experience/safety

The Department of Health has identified several areas where the coverage and scope of the NHS Outcomes Framework could be improved, as well as the emergence of new developments and challenges facing the NHS and the wider health and care system since the first Outcomes Framework was published in 2010.

Of relevance to the PCF are the questions relating to children and young people.

Children and young people

In July 2012, the Children and Young People’s Outcomes Forum published a report highlighting that many aspects of children’s healthcare exhibited “substantial and unexplained variation” throughout the UK. It specifically recommended that the NHS Outcomes Framework should be revised to do more to identify failures of care in this area. In 2013, as a consequence of this recommendation, the Government outlined a series of indicators that would be introduced into the NHS Outcomes Framework 2014/15, to begin to tackle this issue.

Although an indicator (4.8) was introduced to measure children and young people’s experience of outpatient services, the consultation only suggests the addition of one further indicator child indicator on tooth extractions. Consequently, childhood continence (and continence in general) continues to receive no specific attention in the NHS Outcomes Framework.

In terms of future plans, the Department of Health stated that it would continue to assess the robustness of children and young people indicators in the NHS Outcomes Framework, to look to develop new and current indicators which will best assess the level of care received by children from birth. The following question is suggested:

Question 11: Do you agree with the long term direction that the Department of Health is taking regarding indicators for children and young people in the Outcomes Framework?

Department for Education publishes guidance on transferring children’s health commissioning to local authorities

The Department of Health has published guidance on transferring 0-5 year old children’s public health commissioning to local authorities. Planning and paying for public health services for 0 to 5 year olds will transfer from the NHS to local authorities in October 2015. As part of the transfer, local authorities will be obliged to provide certain universal elements of the Healthy Child Programme.

These are:

  • antenatal health promotion review;
  • new baby review, which is the first check after the birth;
  • 6-8 week assessment;
  • 1 year assessment; and
  • 2 to 2 and a half year review.

The factsheet explains how and why the commissioning and associated funding are being transferred to local authorities, saying evidence shows that these milestones are key times to ensure that parents are supported to give their baby/child the best start in life, and to identify early those families who need extra help.

One of the key reasons behind the transferring of these responsibilities is to ensure better joined up health, care and early years education support for 0-5s. Theoretically children identified with needs should more quickly receive assessments for Education, Health and Care Plans and this should lead to early intervention services, should local authorities put good identification and intervention services in place.

The transfer of responsibility will be subject to an 18 month “sunset clause” meaning that the regulations will expire in July 2017. A 12 month review will be put in place following the transfer of commissioning to local authorities and the learning from this review will be used to either retain current arrangements or encourage further change from 2017 onwards.

Study finds that bullying at school damages career prospects

A study commissioned by the Oxford Open Learning Trust and undertaken by YouGov has found that almost one in three adults who were bullied at school believe it had a negative impact on their career prospects. Of those bullied at school, 65 per cent said it had damaged their self-confidence, 36 per cent said it had affected their ability to make friends and 27 per cent said it had affected their mental health. The study also found that, at age 50, those who were bullied were less likely to have a qualification, less likely to live with a spouse or partner, and had less social support.

Similar research published in April highlighted the academic impact that bullying can have on children. Victims of bullying, the report suggests, stand a 26 per cent chance of achieving a top grade in their GCSEs, compared with 41 per cent for those who have grown up without being victimised.

Weekly political news round up – 22nd August 2014

August 22, 2014 in News by Whitehouse

Around the sector

Ofsted has published updated guidance for inspectors conducting inspections of early years settings, such as nurseries and pre-schools, as well as childminders.

The Department for Education has published leaflets for young people explaining the changes to the special educational needs and disability (SEND) support system which come into effect on 1st September 2014. The areas covered include help in making decisions about support; the local offer; education, health and care plans; and post-16 options for support.

The Department for Education has launched a consultation on the provision of Initial Teacher Training (ITT) in England. The call for evidence was initiated as a result of the Carter Review, an independent review led by Sir Andrew Carter which examined the quality and effectiveness of ITT courses. It asks for views on what effective ITT looks like, how effective ITT provision can be delivered (including to support pupils with arrange of SEN), and the transparency of ITT provision.

NurseryWorld has reported that the government has backtracked on plans to require applicants to have at least a grade C in English and maths before they can begin an early years apprenticeship. In response to concerns from the early years sector that the bar was set too high, the two GCSE qualifications will become an exit, rather than entry, requirement for those taking the apprenticeship. The entry requirements are set to be reviewed again in a year’s time.

Children and Young People Now (CYP Now) has reported that data obtained from Freedom of Information (FOI) requests shows that half of local authorities will be unable to provide free childcare places for disadvantaged two-year-olds, despite an investment of £755m by the government. The FOI requests, carried out by CYP Now, found that 70 of 131 responding local authorities would not be able to deliver the offer to all eligible children. A shortfall of 34,854 places was reported – indicating that 185,000 of the 219,854 eligible two-year-olds will have access to a free childcare place.

NHS England publishes overview of its forthcoming five year strategy

NHS England has published an overview of its forthcoming five year strategy, called the NHS Five Year Forward View (5FYV).  According to the overview, the strategy will set out a clear vision for the role of the NHS in improving the health of the nation, and the required transformation to meet the changing needs of current and future patients. It will set out priority areas for targeting transformation, as well as actions that could be taken nationally to create the conditions for local action.

The overview notes that the 5YFV will examine several issues, including supporting patients be more active and engaged in their own health, the cost and value of the NHS to the UK, and also the role of technology and innovation in “future proofing” the NHS. The strategy is also expected to set out the future prospects for NHS finances, including the potential consequences of not increasing its budget.

Weekly political news round up – 15th August 2014

August 15, 2014 in News by Whitehouse

Around the sector

NICE has launched a consultation on a draft quality standard for urinary incontinence in women (aged 18 and over). NICE also published the outcome of the four year surveillance review for lower urinary tract symptoms in men (aged 18 and over), which found that no changes will be made other than to provide an update on the effectiveness of PDE5 inhibitors in treating lower urinary tract symptoms.

Both the House of Commons and House of Lords are currently in parliamentary recess. The House of Commons will return on 1st September 2014 for two weeks before rising again for the party conference season. The House of Lords will sit again on the 13th October 2014.

Government confirms the responsibilities of Childcare Minister Sam Gyimah

The Government has confirmed the responsibilities of the new Childcare Minister Sam Gyimah. Gyimah, who was appointed a little over three weeks ago, will be responsible for the following areas:

  • early years funding and delivery of free entitlements
  • childcare availability and market
  • childcare workforce, quality and regulation
  • early years education and the early years foundation stage (EYFS)
  • wraparound childcare provision
  • DfE links to Child and Adolescent Mental Health Services (CAMHS)

Department for Education publishes update on SEND pathfinders

The Department for Education has published the results from the second stage of its evaluation of the special educational needs and disability (SEND) pathfinder programme. It includes:

  • an overall evaluation of the SEND pathfinder programme;
  • an evaluation of collaborative working with health;
  • an evaluation of engagement of schools; and
  • an evaluation of the transition to and engagement of post-16 providers.

The pathfinder evaluations found that the pathfinders were more effective in areas where relevant bodies are working together and communicating effectively – especially where health bodies are involved throughout the process. The overall conclusion of the evaluation is that where practitioners and parents are well informed, the reforms are working well. However, the evaluations imply that where implementation has been poorly managed and when those involved – whether they are parents or practitioners – do not know their rights, responsibilities or options, the reforms are not functioning. This is highlighted in the evaluation of EHC Plan assessments, where satisfaction is linked to levels of communication between parties. Ultimately, the evaluations imply that resources will determine how well the reforms work, as those responsible for implementation may find themselves too stretched.

The Department for Education also published guidance for parents on how the new SEND system works, including the law and statutory guidance on which the system is based; places to go for help and further information; and details about changes to the system from 1st September 2014.

Health Education England board approves proposals for restructuring

Health Service Journal has reported that Health Education England’s (HEE) board has approved proposals for the restructuring of its organisation. The proposals, which were drawn up to save money and improve efficiency, will see all 13 local education and training boards (LETBs) lose their managing directors, directors of finance and directors of education. Replacing them will be four new national directors responsible for geographical regions across England.

Weekly political news round up – 8th August 2014

August 8, 2014 in News by Whitehouse

Around the sector

Information obtained under a Freedom of Information request has revealed that a quarter of early years providers have not been inspected for at least four years, despite Ofsted requirements which state that all early years providers must be inspected at least once within 47 months. The information obtained revealed that out of 77,509 nurseries and child-minders, 19,204 had been waiting for four years or more for an inspection. Of the 19,204 waiting for inspection, 342 have never been inspected by Ofsted, while 3,655 who were judged to be “satisfactory” are now reclassified as “requiring improvement.”

Ofsted considers merging early years, schools and FE inspections

It has been reported that Ofsted is looking at plans to merge its early years, schools and further education inspections under a single framework. The inspectorate has confirmed its intention to change the way education institutions are inspected from September 2015. The announcement comes two months after Ofsted unveiled plans to bring the management of all school and further education inspections back in-house. In May, the inspectorate said it will not renew contracts with CfBT Education Trust, Serco Education and Tribal Group for the inspection of schools and FE institutions when they expire in August 2015.

Play helps boost children’s development, study reaffirms

A new study for the Children’s Play Policy Forum, has shown the importance of play in improving children’s physical and mental health and emotional well-being. The report, the Play Return, reviews a wide range of research, finding playtime in the school playground enhanced academic skills, attitudes and behaviour, social skills and social relations between different ethnic groups. The research also showed play and youth facilities in public spaces led to reductions in levels of anti-social behaviour and vandalism, and that families who lived near playgrounds and visited them often reported higher levels of family happiness. The study, was in response to a meeting between the chairman of the Children’s Play Forum, Robin Sutcliff, and Nick Hurd MP, former minister for civil society on the 29th October 2013. It looked at four types of intervention  – improving opportunities for free play in school break times; unstaffed public play facilities; supervised out-of-school play provision; and street play initiatives – that each involve setting aside time and space for children to play. It concluded that:

  • Play initiatives lead to improvements in children’s physical and mental health and well-being, and are linked to a range of other cognitive and social developmental benefits. While evidence of beneficial outcomes is strongest for play in schools, it is reasonable to expect that they will also be seen in other contexts where children have comparable play experiences.
  • Families and communities also benefit from play initiatives – and want action to improve them. Play initiatives generate high levels of volunteering and community action. This finding is echoed by the consistently strong support for play provision stated in opinion polls over the years.
  • Play initiatives are associated with inter-related benefits across a range of health and developmental domains. These benefits need to be thought of as a whole rather than in a piecemeal fashion.
  • The improvement in opportunities for play is a valid outcome in its own right.

Weekly political news round up – 1st August 2014

August 1, 2014 in News by Whitehouse

Around the sector

Children and Young People Now has reported that the Government is set to miss its target for recruiting health visitors unless it recruits 1,900 more in the next 12 months. Shortly after coming into power in May 2010, the Government said that it would increase the number of health visitors from 8,100 to 12,300. In the past four years only 2,300 have been recruited – almost half of what is required for the five year period.

The Government has announced businessman and academy chain trustee David Hoare as the new chair of Ofsted. Hoare, who has over 30 years’ business experience with companies including DX Group and Virgin Express, has been a trustee of the Academies Enterprise Trust (AET) academy chain since January. Education Secretary Nicky Morgan said he has “crucial” experience in leadership and governance. Hoare will take up his new post in September.

Education Secretary Nicky Morgan has appointed Luke Tryl, former head of education at gay rights charity Stonewall and a Conservative activist in south London, as her latest special advisor – joining former lobbyist Chris Wilkins.  The appointment is attracting media attention because Morgan, the new Education Secretary and equalities minister, voted against same sex marriage in May last year. Tryl had worked closely with former Education minister Elizabeth Truss MP in her Norfolk constituency, suggesting he was a recommendation of the Environment Secretary.

The House of Lords started its parliamentary recess this week, and will sit again on the 13th October 2014. The Commons entered recess last week and will return on the 1st September for two weeks before rising again for the party conference season.

Care Quality Commission launches consultation on guidance for the new fundamental standards of quality and safety

The Care Quality Commission (CQC) has launched a consultation on draft guidance outlining how providers of health and social care should meet the CQC’s new fundamental standards of care. These standards were published following a consultation by the Department of Health on the requirements for registration with the CQC, which ran from January 2014 to April 2014.

The guidance is intended to replace the CQC’s current Guidance about compliance: Essential standards of quality and safety and the 28 outcomes that it contains. As with before, all registered providers of health and social care must demonstrate that they are meeting regulatory requirements in order to register with the CQC and continue to deliver regulated services.

Despite the new regulations being introduced due in large part to the outcome of the Francis Inquiry, where the subsequent report repeatedly mentioned failures with regards to continence care, continence is not explicitly mentioned. Moreover, provisions for children are virtually absent from this guidance.

However, four of the fourteen regulations are still of relevance to the PCF as they impact on continence care and general patient experience. These are highlighted below:

Regulation 9: Person-centred care

The intention of this regulation is to ensure that each service user receives care that is personalised specifically for them, that meets their needs and reflects their preferences. Specifically, it states that:

9.—(1) The care and treatment of service users must—

(a) be appropriate,

(b) meet their needs, and

(c) reflect their preferences.

It then outlines a number of actions that a registered person must undertake to comply with paragraph one, including provisions that:

  • Care and treatment is designed to ensure it meets all of the service user’s (relevant person’s) needs and, if a service user’s preferences in any way affect the provider’s ability to meet their needs, the impact is explained to the service user, including exploring any alternatives so that they can make informed decisions about their care and treatment.
  • A clear plan of care and treatment should be developed and should be available to all staff and others involved in the delivery of care.
  • Each service user (or relevant person) is provided with all the necessary information about their care and treatment, in a way they can understand.
  • Service users (or the relevant person) are given opportunities to be involved in making decisions, for example, participating in any discussions, invited to meetings, encouraged to ask questions and provide suggestions.

Breaching this regulation does not constitute a prosecutable offence itself, however breaches may be subject to regulatory action by the CQC.

Regulation 10: Dignity and respect

According to the guidance, this regulation is intended to ensure that service users are treated with respect and dignity while receiving care and treatment. The regulation states that:

10.—(1) Service users must be treated with dignity and respect.

(2) Without limiting paragraph (1), the things which a registered person is required to do to comply with paragraph (1) include in particular—

ensuring the privacy of the service user;

supporting the autonomy, independence and involvement in the community of the service user;

having due regard to any relevant protected characteristics (as defined in section 149(7) of the Equality Act 2010) of the service user.

Of particular relevance is the following guidance provided by the CQC:

10(2)(b) supporting the autonomy, independence and involvement in the community of the service user;

  • Service users are offered support in order to maintain their autonomy and independence in accordance with their needs and stated preferences. Service users are offered support when needed; however, staff respect any expressed wishes to act independently.

Again, breaching this regulation does not constitute a prosecutable offence itself, however breaches may be subject to regulatory action by the CQC.

Regulation 12: Safe care and treatment

The intention of this regulation is to ensure that all service users have given consent in accordance with this regulation before any care or treatment is delivered. The regulation includes the following requirement for providers:

12.—(1) Care and treatment must be provided in a safe way for service users.

Below are relevant regulation components for self-care and treatment:

b) doing all that is reasonably practicable to mitigate any such  risks;

  • Plans and pathways are followed by staff.
  • Medication reviews are part of, and align with, service users’ care and treatment assessments, plans or pathways and are completed and reviewed regularly in relation to changes in medication.

(e) ensuring that the equipment used by the service provider for providing care or treatment to a service user is safe  for such use and is used in a safe way;

(f) where equipment or medicines are supplied by the service provider, ensuring that there are sufficient quantities of  these to ensure the safety of service users and to meet their needs;

  • Service users’ medications should be available at all times in the necessary quantities, in order to prevent risks associated with medication not being administered as prescribed, including when service users manage their own medicines.
  • Equipment, medicines and/or medical devices necessary to meet service users’ needs are available (e.g. at hand when needed/obtainable within a reasonable time without posing a risk) at all times in sufficient quantity, and devices are in full working order.
  • The equipment, medicines and/or medical devices that are needed to meet service users’ needs are available when they are transferred between services or providers.

(h) assessing the risk of, and preventing, detecting and controlling the spread of, infections, including those that are health care associated;

Breaches of these fundamental standards constitutes a prosecutable offence.

Regulation 13: Safeguarding service users from abuse and improper treatment

This regulation is intended to safeguard service users from suffering any form of abuse or improper treatment, such as discrimination or unlawful restraint, while receiving care and treatment. The regulation states that:

13(4)(d) significantly disregards the needs of the service user for care or treatment.

The following piece of guidance is relevant:

  • Care and treatment is planned and delivered in such a way that all of the service user’s needs are able to be met, including ensuring that enough time is allocated to allow staff to deliver care and treatment in accordance with the service user’s assessed needs and preferences.

Breaches of this regulation constitute a prosecutable offence, subject to investigation by the CQC.

The consultation asks the following questions relevant to the PCF:

  1. Is it clear what providers should do to meet the requirements of the fundamental standards (regulations 9 to 19)? If not, how could it be made clearer?
  1. Is there anything missing from the guidance?
  2. Is there anything that should be taken out of the guidance?

SEND Code of Practice passes Parliament after Lords debate

This week, after four years of debate and nearly two years of legislative scrutiny, Parliament has passed the secondary legislation that underpins the Children Families Act, allowing the SEND reforms to come into law in September.

The guidance for implementation of these reforms is the statutory SEND Code of Practice, which the House of Lords debated and passed this week. The peers who steered the progression of the Children and Families Bill to ensure it was fit for purpose also had the final say on the Code. Almost all the peers in attendance welcomed the Code, notably Lord Storey and Baroness Hughes – speaking for the Liberal Democrats and Labour respectively.

The chief concerns raised in the debate included how children and young people without plans would be supported; how education and health authorities would be held accountable; how young children would have their needs identified and met; and how the workforce would be prepared to meet needs.

Schools Minister Lord Nash said:

  • The Government acknowledges that the Code is “not perfect” and therefore it will be kept under review (opening the door for future tweaks through statutory instruments).
  • Short term, to ensure accountability over implementation, local authorities and parent carer forums will be asked to complete implementation surveys on a termly basis.
  • Longer term, the Government will develop “an accountability framework for monitoring the delivery of the reforms”, which they expect to have in place by September 2015.
  • Ofsted is completing its survey of how local areas are working on the reforms and will make recommendations “soon” about the possible role of inspection in monitoring and accountability.