Weekly political news round up – 27th March 2015

March 27, 2015 in News by Whitehouse

Around the sector

This week has seen the end of the 2010-2015 parliamentary session. Purdah, the period pre-election period between the dissolution of parliament and the general election, will officially begin on Monday 30th March. During this period, there will be restrictions on the activities of civil servants and government departments. For example, no consultations can be published and no major announcements can be made that may influence the outcome of the election.

The General Election will be held on 7th May.  Parliament will be returning on 18th May, with the State Opening of the new Parliament on 27th May.

The Guardian has published an interview with the new Children’s Commissioner, Anne Longfield. In the interview, which is her first in her new post, Longfield said that the “the current system [for children] is cumbersome, inefficient and wasteful. We can do more with less. Children’s interests, for instance, are spread across several departments in central and local government. Children need a joined-up, holistic approach, with clear objectives and proper monitoring to track progress. Until that happens, the system will continue to fail.”

Children and Young People Now has reported that the Children’s Strategic Partnership, which involves 4Children and the National Children’s Bureau working with the Department for Education (DfE), has been extended until into 2016, having previously been planned to run until 2015. Imelda Redmond, 4Children’s chief executive, commented that she was “delighted that the DfE has recognised the value of having a strategic partnership between government and the voluntary and communities sector, especially when it comes to our approach to supporting children”.

The National Children’s Bureau has launched guidance, commissioned by the Department of Health, to support early years practitioners and heath visitors as they deliver integrated reviews for two-year-olds. The guidance explains how the integrated review has the potential to bring together a parent’s views and concerns about their child’s progress with early years practitioners’ detailed day-to-day observations, and the health visitors’ expertise in the health and development of young children. The guidance provides links to the NHS potty training homepage, and to the ERIC website.

Health Service Journal has reported that all 32 London clinical commissioning groups (CCGs) have pooled a very small portion of their budgets – a total of around £20 million – to create a shared fund to make improvements to healthcare across London. The groups have devised 13 programmes where improvements could be made, including programmes to improve primary care and address the poorer health outcomes in London for children and young people compared to the rest of the country. HSJ understands that work is already underway to make improvements to primary care in London, but that the other programmes are in their early stages.

NHS England has published its CCG Assurance Framework for 2015/16, which sets out five components that reflect the key elements of a well led effective clinical commissioner and underpin assurance discussions between CCGs and NHS England, whilst identifying on-going ambitions for CCG development. The components include being well led; performance; financial management; planning; and delegated functions.

The Joint Committee on Human Rights has published a report on the UK’s compliance with the UN Convention on the Rights of the Child. The report found the UK was broadly compliant with Article 23 (children with disabilities), and acknowledged the “considerable” improvements the Government has made in this area, particularly in the Children and Families act. The report made no concrete assessment of the UK’s compliance with Article (health and health services).

The King’s Fund publishes report on NHS performance since 2010

Influential health think-tank The King’s Fund has published a report assessing the performance of the NHS since 2010.

The report found that NHS performance held up for the first three years of the parliament, but has now slipped, with waiting times at their highest since the 1990s and an unprecedented number of hospitals reporting deficits. Despite this, limited data has shown that there has been improvement in the outcomes, safety and quality of care of patients. This has led to patient experience of the NHS remains generally remaining positive, with public confidence at an all-time high.

Funding was identified in the report as an area of concern, with the main approaches to reducing spending, such as limiting salary increases and reducing the prices paid to hospitals for treatment, “largely exhausted”.

The report concluded that the prospects for NHS performance during the next parliament are “extremely challenging”, and that greater funding is required to avoid an accelerating decline in performance.

Financial performance

The report found that the financial position of most NHS provider organisations has deteriorated towards the end of the parliament. NHS trusts and foundation trusts have moved from surplus to deficit in increasing numbers since 2012/13. This is an indication of the mounting difficulties that trusts have faced: responding to the downward pressure on tariff prices; increasing difficulties in realising cost savings; and the need to ensure quality standards are met (through increasing nurse staffing, for example) in the wake of the Francis Inquiry.

Patient activity

The report noted that there has been a clear increase in the level of patient activity, driven by a complex combination of changes to the demographic profile of the population (for example, increasing numbers of older people), changes in the way that services are provided, and changes in clinical practice. However, it noted that there was little or no information on the output and activity of general practice and community services.

It also noted that whilst real-terms funding has increased by around 2% in total between 2009/10 and 2013/14, secondary care activity, as measured by referrals, attendances and admissions, has increased much more. For example, first outpatient attendances have increased be 8.3% and follow-up outpatient attendances have increased by 14%.

Outcomes, experience and access

The report has found that health care-acquired infections have reached historic lows, and that patient and public satisfaction with the NHS has increased – with 65% of the public recording satisfaction, down from the high point of 70% in 2010, but an increase in the low point of 58% in 2011.

It concluded that greater funding is needed to avoid an accelerating decline in NHS performance. It warns that potential staffing cuts could affect patient safety and quality of care. It states that savings could be improved through increasing productivity, which can be done through smarter procurement, better use of the estate and changes to clinical care.

Staff

The report found a marginal increase in staff numbers 2010, with a decrease in the number of managers and a general increase in the number of consultants, GPs and nurses. However, the increases for the latter have not kept pace with population growth; there was a reduction in full-time equivalents (FTE) per 1,000 population for qualified nursing staff. The report also found that there had been a reduction in the number of community nurses since 2009, although the trend is now beginning to reverse.

Department for Education publishes overview of arrangements to support the local and national accountability of the SEND reforms

The Department for Education has published a document describing their vision for the whole SEND system, and the roles and responsibilities of local and national organisations in delivering the requirements in the Children and Families Act 2014. It also looks ahead to the data and analysis that will enable judgements on how well the new arrangements are working, as well as providing information about the new arrangements for independent assessment, including the proposed Ofsted/CQC inspection framework.

The document states that  Ofsted and the CQC will jointly expect all local areas, with an inspection interval of up to five years. Inspection will look at effective identification of need; effectiveness in meeting needs; and local arrangements to achieve better identification and outcomes. The three-person team will compromise of an Ofsted inspector, a CQC inspector and a trained local authority inspector, who will review national data, including within-rea inspection outcomes form CQC and Ofsted, and local area self-assessment.

Their field work will include visits with a wide range of people, including key local area officers from health, education and social care, education and health providers, schools and colleges.

Proposals will be put to public consultation in late spring, with further details to be published on Ofsted’s and the CQC’s website.

Answer to written question on paediatric services

Labour MP Frank Field has tabled a written question asking the Health Secretary what steps he is taking to improve diagnosis and treatment times in paediatric services.

Care and Support Minister Norman Lamb responded with an overview of initiatives to support child mental health, as well as genetic testing and cancer treatments.

Lamb also noted that £2 million of funding had been provided to the Royal College of Paediatrics and Child Health for the development of Paediatric Care Online – a resource for the clinical workforce across a full range of children’s health issues. He added that this promises to have a far reaching impact on ensuring the effectiveness and consistency of paediatric care, and will be launched later in 2015.

Department of Health publishes NHS Choice Framework for 2015-2016

The Department of Health has published the NHS Choice Framework for 2015-16. This framework sets out patients’ rights to choice in healthcare, and where to find information to help choose, as well as how to complain if choice is not offered.

The Framework covers the following key areas:

  • Choosing:
    • your GP and GP practice
    • which organisation you can go to for your first appointment as an outpatient for physical or mental health conditions
    • who carries out a specialist test if you need one
    • services provided in the community
    • to take part in health research
    • to have a personal health budget
    • to travel to another European country for treatment
  • Where you can get more information to help you choose
  • What you can do if you are not offered these choices

The Framework is virtually unchanged from 2014-15.

Weekly political news round up – 20th March 2015

March 20, 2015 in News by Whitehouse

Around the sector

Compact Voice has published two practical guides for voluntary sector organisations on effective engagement with CCGs and Health and Wellbeing Boards. The guides provide an overview of who is who in health commissioning, as well as what the purpose of both bodies are, how they operate, who sits on them, and what they are responsible for. The guides also provide advice on approaching both bodies, and how the impact of the approaches can be maximised.

BBC News has reported that a Freedom of Information study conducted by BBC 5 Live has found that families of children with special educational needs are facing a postcode lottery to get extra help at schools. It was discovered that there was wide variation in the provision of assistance between local authorities, with Southampton City Council turning down all 15 parental requests it received, with Portsmouth, which received 13, refusing only one. The study also noted that parents who asked for an assessment were twice as likely to be turned down as a school or professional making the request.

BBC News has reported that early years education experts and teachers are calling for plans for new baseline tests for four-year-olds in England to be scrapped. The baseline assessment, which is due to be introduced in September 2015, will assess children on communication and language, literacy, and numeracy. Beatrice Merrick, chief executive of the British Association for Early Childhood Education, said that “it is not in the interests of young children, whose learning and other developmental needs are better identified over time”.

Labour MPs back plans to devolve the NHS health and social care budget

The Manchester Evening News has reported that Labour MPs will now support plans to devolve health spending in Manchester, and will push forward with the plans should they win the general election in May.

This comes following a dispute between local Labour MPs and the leadership of the Labour-led council, which negotiated the plans; prior to the announcement there was a crisis meeting between the council leaders and all 22 Labour MPs in the Greater Manchester area. The MPs were said to have been upset over being kept in the dark over the plans, with some raising questions about its democratic accountability. Shadow Health Secretary Andy Burnham had previously warned that the plans would create a “Swiss cheese NHS where some bits of the system are operating to different rules or have different powers and freedoms”.

Labour has now released a statement pledging a better deal for Greater Manchester under Labour rule – and claiming the Chancellor’s plan forms only ‘a framework’ for devolved decision-making and commissioning, with questions over funding, accountability and reorganisation remaining. A party spokesperson said that “Labour fully supports devolution; the integration of health and care services and the steps Labour councils are taking to achieve that”, adding that they are “committed to devolution and believe that councils, as the local elected and accountable bodies, are well-placed to receive further power and devolved budgets”.

It was announced by NHS England in late February that Greater Manchester will become the first region in England to have full control of its health and social care budget, following an agreement with 10 local authorities, 12 clinical commissioning groups (CCGs) and 14 NHS providers in Manchester, along with NHS England and the Government.

Budget 2015

Chancellor of the Exchequer George Osborne delivered his final Budget for this Parliament, which he used to emphasise the progress that the Coalition has made over the last five years, and to outline his ambitions for the economy in the next year and beyond.

Osborne stressed throughout his speech that the UK was “on the right track”, noting that jobs had been created, and that the UK had grown faster than any other advanced economy. He also emphasised that investment in the North had resulted in faster growth than the South, and that in general people were better off at the end of this Parliament than they were at the beginning.

He added that a further £30 billion of cuts were necessary by 2017-18 in order to ensure that the share of GDP as national debt continues to fall. He said that of the £30 billion, £13 billion will come from government departments, £12 billion from welfare savings, and £5 billion from tax avoidance, evasion and aggressive tax planning

However, Osborne did note that public spending will grow in line with the growth of the economy from 2019-2020 onwards

There were no policy announcements that were of relevance to the PCF, with the only health related announcements referring specifically to mental health. The Budget document itself contained no references to the Department of Health, whilst Labour leader Ed Miliband used the opening part of his response to Osborne’s speech to criticise the omission of further investment for NHS services.

Association for Continence Advice (ACA) Paediatric Workshop – Combatting Challenges in Children’s Continence

March 17, 2015 in Admin by Whitehouse

Association for Continence Advice (ACA)

Paediatric Workshop – Combatting Challenges in Children’s Continence

Thursday 4th June 2015, Hilton Brighton Metropole

Registration available online: www.eventsforce.net/acapaediatricworkshop

ACA Paediatric Seminar Website Banner

Weekly political news round up – 13th March 2015

March 13, 2015 in News by Whitehouse

Around the sector

The Department for Education and the Department of Health have announced £2.2 million of funding for local authorities to implement the ‘integrated review’, which brings together the Healthy Child Programme (HCP) and the Early Years Foundation Stage (EYFS) assessments of child development. It was also announced that, following successful pilots, the review will be extended to cover the 275,000 two-year-olds who are not currently attending early education settings.

The Department for Education and 4Children have produced a booklet for parents that allows them to check how their child is learning and developing during their first five years, in relation to the social, physical and communication milestones outlined in the EYFS. References to being able to use the toilet, or to tell an adult that access to a toilet is needed, are made throughout the booklet.

The Department of Health has published case studies of good practice in the health visitor programme, divided into 6 high impact areas, including the two-year review. The two-year review case study focused on the introduction of a universal 3.5-year core contact in Calderdale as part of the core health-visiting programme delivered to families. The case study found that establishing the contact led to better school readiness, referencing toilet training as an example of an improved area.

Health Service Journal has published a map showing which clinical commissioning groups will be taking on full-delegated responsibility for general practice from April, as well as those who will be jointly commissioning services.

Children and Young People’s Health Outcome Forum publishes annual report for 2014-2015

The Children and Young People’s Health Outcomes Forum (CYPHOF) has published its annual report for 2014-15, in which it reviews progress on improving health outcomes for children and young people. The report found that whilst progress is being made, the pace in the UK lags behind countries in northern and western Europe, such as Sweden.

The CYPHOF was established in January 2012 as an independent expert advisory group to provide expertise, constructive challenge and evidence-based advice to improve children and young people’s health outcomes and healthcare and to drive up standards.

The report updated that there has been progress with the introduction of new indicators in the NHS and Public Health Outcomes Framework, as well as through getting key organisations, such as NHS England, Public Health England and Health Education England, to identify the need for and appoint national clinical leaders on children and young people.

The CYPHOF has developed a short paper for the Chief Medical Officer, to be published as part of the Health Outcomes Theme Group report, which will conclude that there are “worrying negative trends”, notably in terms of emergency department attendance for children and young people with long term conditions, as well as worsening geographical variation and disparities among different socioeconomic groups.

The report recommended that the next Government should develop and implement a Children and Young People’s Health Strategy, closely working with stakeholders, including children and young people.

Paediatric Continence Forum launches 2015 election manifesto

March 12, 2015 in News by Whitehouse

Paediatric Continence Forum calls for all parties to support better continence care for children

The Paediatric Continence Forum (PCF) has published a manifesto ahead of the general election calling on  all parties to sign up to a pledge to ensure that all children and young people have access to high quality continence care.

Approximately 1 in 12 children and young people are affected by continence problems, causing them significant difficulties in terms of family and social relationships, as well as the risk of medical complications.  Constipation and bedwetting are now the most common reasons for referral to paediatric outpatient clinics.

Yet research performed by the PCF in August 2014 revealed that clinical commissioning groups (CCGs) in England are failing to provide proper integrated paediatric continence services. Only 32% of CCGs who responded to our Freedom of Information (FOI) request said that they commission all the four main continence services (covering bedwetting, daytime wetting, toilet training and constipation/soiling) – with just over 22% of responding CCGs commissioning services that are fully “joined-up”.

The PCF has realised a manifesto which identifies actions in four key areas to help children across the country access high quality care:

  • All children should have access to timely and effective treatment – whether they are suffering from bedwetting, daytime wetting, or constipation and soiling, there is a need for prevention, early detection and effective intervention to improve health outcomes and prevent potential emotional difficulties.
  • All areas should have an integrated paediatric continence service which provides the four key services (bedwetting, daytime wetting, toilet training and constipation/soiling) – a single, integrated, community-based service under the leadership of a specialist paediatric continence adviser provides the best quality of care.
  • The Paediatric Continence Forum’s Commissioning Guide should be used widely to improve the quality of services – accredited by NICE and endorsed by the RCPCH, the RCN and the CPHVA, this Guide provides clear advice to commissioners and healthcare professionals on how to commission proper integrated, community-based paediatric continence services.
  • Continence should be considered when making policy on childhood health, disability and education – this includes issues such as the effect upon children with disabilities, the impact of continence on educational opportunities and the need for each school to have a written continence policy, plus good quality toilet and washroom facilities.

The PCF is calling for candidates from all parties to sign up in support of our manifesto. Whichever parties form the Government after the next election, action needs to be taken to improve the quality and consistency of continence care for children and young people across the country.

Dr Penny Dobson MBE, Chair of the PCF, commented:

“Good quality paediatric continence services ensure that children get the care they need at a crucial stage of their development. Access to such services prevents problems such as emotional distress, bullying and disruption to education. It also saves the NHS money through reducing complications such as kidney infections and chronic constipation/ impaction which may require hospital admission. We are calling on all parties to pledge to support action to improve the quality of services during the next Parliament.”

The full copy of the manifesto can be found here.

 

Notes to editors:

  1. The PCF is an independent group of healthcare professionals that engages with the Government and healthcare organisations, with the aim of improving paediatric continence services nationally. Formed in 2003, the PCF has close links to the charities ERIC (Education and Resources for Improving Childhood Continence) and PromoCon. Its membership includes paediatricians and specialist nurses, with formal representation from the Royal College of Paediatrics and Child Health (RCPCH), the Royal College of Nursing (RCN) and the Community Practitioners’ and Health Visitors’ Association ( CPHVA).
  1. In September 2014, the PCF published a comprehensive guide, called the Paediatric Continence Commissioning Guide, which provides clear information and guidance to commissioners and healthcare professionals on how to commission integrated, community- based paediatric continence services. The guide was accredited by NICE and was formally launched in conjunction with the NICE Nocturnal Enuresis Quality Standard.
  1. For further information, please contact Frances Powrie on powrie@whitehouseconsulting.co.uk / 020 7793 2537 or Ben Chiu on ben.chiu@whitehouseconsulting.co.uk / 020 7089 2607

Weekly political news round up – 6th March 2015

March 6, 2015 in News by Whitehouse

Around the sector

The Scottish Government has announced that Dr Catherine Calderwood has been appointed as Scotland’s new Chief Medical Officer. Prior to her appointment, Dr Calderwood worked as a consultant obstetrician and gynaecologist for NHS Lothian, with a special interest in maternal medicine, and was previously National Clinical Director for Maternity and Women’s Health for NHS England.

The Royal College of Paediatrics and Child Health has published the results of a survey which found that 94% of UK adults believe that children’s healthcare should be an important priority for the NHS, with 67% believing it should be a very important priority. Dr Hillary Cass, the President of the RCPCH, said that disproportionate attention was being given to elderly health care, saying “whilst caring for our ageing population is important, it shouldn’t mean that children’s health falls to the wayside”.

The King’s Fund’s Chief Executive, Chris Ham, has published a blog post in which he discusses what the devolved health powers in Manchester – ‘Devo Manc’ – could mean for health, social care and wellbeing in Greater Manchester. Ham notes that devolution will allow councillors to have a bigger influence on decisions, but points out that the extent to which public sectors leaders will depart from national policies remained an unanswered question. He also warned that the structural changes could distract staff from improving outcomes, and said that effective governance arrangements must be made to ensure positive outcomes.

Health Secretary Jeremy Hunt says CCGs will be measured on a new set of core metrics

Speaking at the Nuffield Trust’s annual health policy summit, Health Secretary Jeremy Hunt said he will be making sure that that every CCG, including the new devolved Manchester body, will be reporting on their progress on implementing the NHS Five Year Forward View using a set of metrics which he believed mattered to all patients. He said that these metrics were: quality of care for people with mental health conditions; proactive care for vulnerable older people; and the sharing of electronic health records across different organisations.

Hunt emphasised that there will be a “more scientific rigour in terms of assessing the quality of commissioning throughout the country is going to be a critical next step”.

Care and Support Minister Norman Lamb argues for a single government department for health and social care

Care and Support Minister Norman Lamb has stated that he would like to see the creation of a “new department for health and care” immediately after the general election in May. Lamb argued that “it’s ridiculous that we have funding for the health and care system flowing through two different government departments and endless negotiations between two. It has to be one department”.

According to the article, the proposal is not official Liberal Democrat policy, but is being considered for the party’s manifesto.