Weekly political news round up – 28th August 2015

August 28, 2015 in News by Whitehouse

Around the sector

The National Audit Office has published an interactive guide which provides an overview of how local government is funded, the pressures that local authorities face, as well as information on staffing and major recent and future developments. The guide highlights that the Government has reduced funding for local authorities by 37% in real terms between 2010-11 and 2015-16.

The Department for Education has published a guide for local authorities on data submissions for the 2017 special educational needs survey. This document outlines changes from the 2016 survey, including the number of requests made for education, health and care plans. It also establishes age groupings for individual items of data, setting out five year intervals (under 5, aged 5 to 10, 11 to 15 and so on) until the age of 25.

The Department for Education has also published updated guidance for local authorities and providers of services for children and young people with SEND on the transition to the new 0-to-25 SEND system, introduced by the Children and Families Act 2015. The guidance, which is valid from September 2015 onwards, now outlines that the time required to conclude a transfer review of SEN statements to education, health and care plans has been extended from 14 to 18 weeks, as well as various other smaller changes.

Workforce statistics published by the Scottish Government show that NHS Scotland expects to recruit over 1,000 more full-time members of staff – 640 of which will be nurses and midwives, and 170 being other medical staff. The Scottish Government also published figures showing a reduction in the number of senior managers in NHS Scotland by 33.1%.

Royal College of Nursing warns of a child health crisis caused by a lack of investment in school nurses

The Royal College of Nursing (RCN) has warned that a lack of investment in school nursing is leading to an escalating health crisis amongst children and young people. The RCN identified that school nurses have a key role to play in supporting the 6% of children with a disability and the 15.4% of pupils in England with identified special educational needs, arguing that they are “essential in educating children and their families about these issues, while providing support and care for those in need”. However, despite an increase in the prevelance of the health problems that children face, the provision of school nurses is under threat as a result of £200m of cuts to public health budgets in England.

According to the RCN, the number of school nurses has fallen to 3,053, with Health Education England reporting that there is a 24% vacancy rate. The RCN notes that poor financial investment and a lack of time has resulted in many school nurses being unable to do their jobs.

Department for Communities and Local Government publishes statistics on local authority financing and expenditure

The Department for Communities and Local Government has published an overview of the expenditure and financing of local authorities in England, which show that revenue expenditure was £95.8 billion in 2014-15, a decrease of 0.7% from £96.4 billion in 2013-14.

The biggest decrease was in education, which decreased 4% from £35.9 billion in 2013-14 to £34.4 billion, as a result of schools changing status to centrally funded academies. The biggest increase was in children and families social care expenditure ‒ from £6.91 billion in 2013-14 to £8.1 billion in 2014-15 ‒ as a result of the definition of expenditure on services for young people being moved from education to children’s social care. The public health budget, which currently includes the provision of school nurses, as well as health visitors from October 2015, increased from £2.5 billion in 2013-14 to £2.7 billion in 2014-15.

Weekly political news round up – 21st August 2015

August 21, 2015 in News by Whitehouse

Around the sector

Kezia Dugdale MSP has been elected as the new leader of the Scottish Labour Party, with Alex Rowley MSP elected as deputy leader. Dugdale, who had been deputy leader under former leader Jim Murphy, who stepped down in June, announced that Jenny Marra MSP will continue as equality spokesperson (with responsibility for health), and that Iain Gray MSP will be opportunity spokesperson (covering schools and childcare).

A survey of 4,000 people by health and wellbeing provider Benenden has found that the public has very little understanding of how much common NHS procedures cost, and had little idea about how many procedures were carried out. Dr John Giles, medical director at Benenden, commented that it was “no surprise” that the public has a “staggering and destructive ignorance” regarding the costs of treatments on the NHS.

Health Service Journal has reported that NHS England will intervene to issue “direction” to Northern, Eastern and Western Devon CCG, as a result of significant financial problems. NHS England have drawn up an improvement plan, including a financial recovery plan, and will conduct a separate review into the CCG’s in-house commissioning support services.

An article in the Guardian has criticised the NHS Constitution, outlining that official reviews by the Department of Health have shown that public awareness of the constitution is low, with little evidence that patients or staff use it to exercise rights or expectations. The article also criticises the lack of measures within the constitution for NHS providers, as well as a general lack of enforceability for the articles in the constitution, particularly the lack of legal grounding for the pledges within the constitution.

In a letter to providers of early years services, Ofsted chief inspector Sir Michael Wilshaw has outlined that Ofsted are considering bringing inspections of early-year settings in-house, amid ongoing concerns in the sector around consistency and quality.

Virgin Care shortlisted to become the interim provider of children’s community services in Bristol and South Gloucestershire

Healthcare provider Virgin Care has announced has been shortlisted for a contract to provide children’s community services in Bristol and South Gloucestershire on an interim basis between March 2016 and March 2017. The decision came after the existing provider, North Bristol NHS Trust, announced that it would not extend its contract, which expires in March 2016, as it wanted to focus its “energies and resources” on acute and hospital based care. Bristol and South Gloucestershire clinical commissioning groups subsequently contacted North Bristol NHS Trust to express “concerns over the safety of the service and handover of the service”.

The five joint commissioners responsible for the shortlisting and the final decision – Bristol and South Gloucestershire clinical commissioning groups, Bristol and South Gloucestershire Councils and NHS England – issued a statement outlining that safety was “of paramount importance” and that the service would be delivered “to the highest possible standard”, adding that there “are no plans” to change the care and support provided during the period of the interim contract. Also in the running is a partnership involving Sirona Care and Health Community Interest Company, Bristol Community Health Community Interest Company and Avon and Wiltshire Mental Health Partnership NHS Trust. Sirona currently provide children’s community services in Bath and North East Somerset.

Weekly political news round up – 14th August 2015

August 14, 2015 in News by Whitehouse

Around the sector

The Royal College of Nursing (RCN) has argued that heavily populated areas like London will lose out the most should the Government apply a blanket 6.2% reduction in local authority public health budgets across the country. RCN London regional director Bernell Bussue warned that a £40m funding reduction would cause more problems for the NHS in the future, noting that “we are [already] seeing school nursing posts lost and other preventative health schemes squeezed out, and that “it is no good claiming to protect the NHS budget but then making huge cuts to local authority services which are there to keep people well and out of hospital”.

Public Health England (PHE) has published a report which found that in 2013/14, two in every five children, or 39,500 children, in London did not achieve a “good level of development” by five years old – a measure used to assess school readiness. PHE used eleven metrics to determine whether children were school-ready, including an assessment over whether they are independent in getting dressed and going to the toilet.

Healthcare inspectorate the Care Quality Commission (CQC) will launch a pilot programme focusing on the assessment of whole health systems, rather than just individual providers, as part of a move towards a place-based approach to regulation. Professor Steve Field, the CQC’s chief inspector of general practice, described the pilot, which will run in North Lincolnshire and parts of Greater Manchester, as the “most important thing [the CQC is] doing at the moment”. The CQC will produce a report on the outcomes of the pilot, but will not assign a rating to the health systems.

Community Practitioners’ and Health Visitors’ Association survey finds an escalating workload despite an increased workforce

A survey conducted by the Community Practitioners’ and Health Visitor’s Association (CPHVA) of 750 health visitors found that 89% of respondents said their workloads have increased in the last 12 months, despite figures from March 2015 showing that there are 12,077 full time equivalent positions – the highest ever and almost 4,000 more than five years ago. Almost 75% of respondents said that it was not always feasible for the health visiting team in their area to carry out the five expected health checks (antenatal, new baby, six to eight weeks, nine to 12 months, two to two-and-a-half years) with every child before they reach the age of two-and-a-half.

Unite professional officer Dave Munday commented that despite the boost in numbers, health visitors are not reporting the benefits on the frontline. Discussing the Government’s planned £200m reduction to the local authority public health budget, Munday said that “the Government needs to reverse this decision as it will impact negatively both on health visiting services, as they are not ‘protected’ from the cuts in themselves, and the associated services that support families.

Restructuring of children and young people’s public health services in Stoke could result in a reduction of the school nursing services

Nursing Times has reported that a decision by Staffordshire and Stoke on Trent Partnership Trust to replace its school nursing service with a wider initiative, called the Children and Young People’s Health and Wellbeing Programme, could result in the loss of up to 50 school nursing jobs in the region.

The new initiative will see support extended to children aged five to 19 covering areas such as emotional wellbeing and sexual health, as well as specialist support for children in care and those with disabilities. Staffordshire and Stoke on Trent Partnership Trust did not comment on potential job losses, but did confirm that the structure of the service would be different. The trust’s chief executive Stuart Poynor said that “the specification for the service is determined by the council as our commissioners and we are aware that the service will require a different staff model and skill mix than previously provided by the school nursing service”.

Weekly political news round up – 7th August 2015

August 7, 2015 in News by Whitehouse

Around the sector

Influential health think-tank the King’s Fund has announced that it will use its submission to the 2015 Spending Review to argue that £200 million cuts to public health spending are “the falsest of false economics”, especially for the NHS. It highlighted that health system leaders such as NHS England chief executive Simon Stevens, Health Secretary Jeremy Hunt and Public Health England chief executive Duncan Selbie have emphasised the importance of prevention and public health – which are at the heart of the NHS Five Year Forward View.

Healthcare regulator Monitor has written to all 152 NHS foundation trusts to inform them that their financial forecasts for 2015/16 are “simply unaffordable”, and that the spending plans for each of the organisations must be revisited – even those with a surplus. The letter states that trusts should “ensure vacancies are only filled where essential”, and that financial impact should be considered as a factor when managing waiting lists. A similar letter was sent to all non-foundation trusts by the NHS Trust Development Authority (TDA), which is due to merge with Monitor after September 2015 to form NHS Improvement.

The Department of Health has published a factsheet setting out why 7-day services are needed. The factsheet argues that there is a “clear link” between poorer outcomes for patients and uneven service provision in the health service at weekends, attributing this to the inconsistent availability of diagnostic tests at weekends. The document also specifies the right of consultants to opt out of non-emergency work at weekends as a major barrier to 7-day services, and the salary benefits – of up to £30,000 a year in bonus payments.

NHS England has published the NHS Standard Contract 2015/16, which states that from April 2015 onwards all healthcare services except GP services, opticians, dentists and chemists must provide clear information to patients, carers and representatives about how to contact their local Healthwatch. Healthwatch organisations identify common problems with health and social care services, recommend changes, and hold service providers and decision makers to account.

Shadow Health Secretary has launched his manifesto ahead of the Labour leadership election, which pledged that Labour will be the party that “helps everyone get on in life” under his leadership. Burnham is the bookmakers favourite in the race, followed very closely by veteran far-left MP Jeremy Corbyn, with Shadow Home Secretary Yvette Cooper in third place and Shadow Care Minister Liz Kendall a distant fourth.

The National Audit Office has published a short graphical guide providing an overview of what the Department for Education focuses on, what it does, how much it costs and any recent and planned changes.

The Department for Education has backtracked on plans to strengthen the requirements for higher level childcare qualifications. Although it had been proposed that nursery practitioners were to be required to achieve a GCSE grade C or above in maths and English before starting their advanced qualification, it is now required that candidates obtain a C in both subjects by the time they complete their studies.

Department of Health launches consultation on £200m cuts to local authority public health budgets

The Department of Health has launched a consultation on the technical options for implementing a £200 million reduction in the public health grant for 2015/16. The document states that Chancellor George Osborne has already decided that £200 million cuts will be going ahead, but that it has not been determined how much each local authority will contribute to this figure.

Stressing that the Department of Health wants local authorities to have “optimum flexibility” when making savings, the consultation sets out three questions:

  1. How should the Department of Health spread the £200 million saving across the local authorities involved? The options floated are to:
    1. Devise a formula that claims a larger share of saving from local authorities that are significantly above their target allocation
    2. Identify local authorities with surpluses and claim a larger share of savings by them.
    3. Reduce everyone local authority’s allocation by a standard flat rate of 6.2%. This is the Department of Health’s preferred option.
    4. Reduce every local authority’s allocation by a standard percentage (not yet defined) unless the authority can show that this would result in particular hardship
  2. How can the Department of Health, Public Health England and NHS England help local authorities implement the saving and minimise any possible disruption to services?
  • This cannot include a transfer of statutory duties from local authorities to any of the three aforementioned organisations.
  1. How can the Department of Health best assess and understand the impact of the saving? For example, should it:
    • Undertake a national survey of directors of public health and other key stakeholders
    • Commission PHE centre directors to review the local impact and contribute to a national report.
    • Work through representative bodies to gather feedback on local impact.

Care Quality Commissions asks for views on the development of its five year strategy

Health and social care inspectorate the Care Quality Commission (CQC) has announced that it will be developing a new five year strategy for 2016 to 2021, to be launched in spring 2016.

This strategy will set out their vision for health and social care quality regulation in the future, and will focus on three areas: how well providers make the best use of their resources (staff, budget, equipment); the possibility of reporting the quality of care across a geographical area rather than an individual service; and how well the CQC uses its own resources to carry out its inspection duties

As part of the development of this strategy, the CQC has launched an informal web survey for interested parties to feed in comments.

The survey asks whether it is right to focus on the three areas outlined, as well as comments on the following questions:

  • Are there any other areas that you think are important?
  • Do you think the CQC has done a good job in the last three years – why or why not?
  • What impact has the CQC’s work had on your life in the last three years?
  • What drafting the new strategy, can you think of one area where we could improve or change the CQC’s work to benefit you?

Prime Minister David Cameron states that more can be done to ensure the availability of public toilets

Responding to claims that high business rates were responsible for the closure of public toilets across the country, Prime Minister David Cameron told a local radio station in Cornwall said that the concern about business rates affecting public toilets is a “very important issue”. Cameron added that although toilet closures sounded like a “fringe issue”, high levels of tourism meant that toilet availability is a “really important issue”.

Derek Liddell, from the National Association of Local Councils, said that said public toilets were “important for people with certain medical conditions, for older people, disabled people, pregnant mums and families with kids”, arguing that “the Government needs to act now to help parish and town councils keep these all-important facilities open”. Raymond Martin from the British Toilet Association called for the Government to offer financial support for councils to keep toilets open.

Department for Communities and Local Government is currently carrying out a review to consider the impact of local exemptions from business rates.