Weekly political news round up – 23rd December 2015

December 23, 2015 in News by Whitehouse

Around the sector

NHS England has announced that a further 52 CCGs have been authorised to take on delegated responsibility for commissioning GP services, allowing them to improve out of hospital services and support the development of new models of care. These CCGs will operate under the new arrangements from April 2016, meaning that approximately half of the 209 CCGs wil have delegated responsibility in 2016/17.

Healthcare regulator Monitor, due to be merged with the NHS Trust Development Authority in April 2016 to create NHS Improvement, has published the new draft national tariff prices for NHS services for 2016/17. These services include outpatient attendance fees for paediatric urology, as well as A&E attendances and admitted care and outpatient procedures costs for urinary tract infections.

Former Healthwatch England chair Anna Bradley, who left the role in mid-December, has said that the patients are so grateful for the care that they receive that they are unwilling to criticse the NHS over its failing. She also said that doctors and managers should actively encourage patients to discuss ways in which services could be improved, also calling on them to demand rights to services in the same way that they would highstreet products.

Ofsted has been instructed to make £38 million of savings over the four-year period to 2019/20. Ofsted’s existing budget for 2015/16 is £142.8 million, meaning that the proposed cuts will represent a 26.6% drop in funding. Minutes of the board-level discussions also show that Ofsted will reduce the number of inspectors taking part in inspections to ease pressure on resources.

Forthcoming events

The House of Commons and House of Lords have now both risen for the Christmas recess period. The Commons will return on 5th January, with the Lords returning on 11th January.

NHS England publishes planning guidance for CCGs, local authorities and NHS trusts on delivering the Five Year Forward View

NHS England and its associated bodies have published planning guidance for clinical commissioning groups (CCGs), local authorities and NHS trusts on delivering the Five Year Forward View (FYFV) between 2016/17 and 2020/21. The guidance instructs every local health and social care system to work together to develop a local sustainability and transformation plan (STP) to take forward the FYFV. This guidance also sets out nine ‘must dos’ for 2016/17 for every local health system.

The guidance outlines that STPs must focus on three main areas: addressing the health and wellbeing gap; driving transformation to close the care and quality gap; and closing the finance and efficiency gap. STPs must focus primary medical care from a local CCG perspective and reflect health and wellbeing strategies. They will act as an umbrella plan, encompassing a number of different specific delivery plans. The geographical scope of each STP is not yet defined, with local health system leaders required to determine them and inform NHS England by the end of January 2016.

Plans will act as the single application for additional transformation funding for 2017/18 onwards. The earliest that funding can be secured through this route is April 2017, with STPs being judged on criteria such as the quality of plans and the scale of ambition and record of accomplishment of progress made. STPs will also be judged on the reach and quality of local engagement, the strength of local leadership and the likelihood that the activities in the plans will be taken forward.

Each local system will also be required to develop an operational plan for 2016/17, which will form one of the five years of an STP. This plan must establish how financial balance will be attained, contributions to efficiency savings, and quality and safety improvement.

Developing an STP is one of the nine ‘must dos’ for each local system, with the others requiring an aggregate financial balance to be attained whilst reducing unwarranted variation in demand and access. Local systems are also required to implement a local plan to address the sustainability and quality of general practice, including workforce and workload issues, as well as ensure quick referral to treatment (less than 18 weeks) that accounts for patient choice. The other five ‘must dos’ cover areas such as access standards for A&E and ambulance waits, cancer waiting standards, mental health, learning disabilities, and improvements in quality for organisations in special measures.

Weekly political news round up – 18th December 2015

December 18, 2015 in News by Whitehouse

Around the sector

The Department of Health has announced that £1.8 billion of the £3.8 billion frontloaded NHS funds will be invested in a “sustainability and transformation fund”, which will help trusts reduce their deficits and enable them to focus on transforming services to deliver improved care seven days a week. Trusts will be required to agree a plan with NHS England and NHS Improvement to break even by 2016/17, as well as develop plans to report on achieving savings outlined by Lord Carter as part of his review into NHS productivity. Trusts will be required to reduce agency spend, deliver core standards for patients, and achieve seven day services for patients by 2020.

Care Quality Minister Ben Gummer has announced the creation of a new nursing support role – provisionally called nursing associates – which will work alongside healthcare support workers and fully qualified nurses focusing on patient care. It is intended that nursing associates will be trained through on-the-job learning via an apprecenticeship leading to a foundation degree. The Department of Health will consult on the specifics of the role, including the title, with representatives from the nursing profession, in the New Year.

Department of Health permanent secretary Una O’Brien has announced that she will leave her role at the end of April 2016. O’Brien, who took up the position in 2010, said that she felt that the time was right for her to leave.

Healthwatch England has announced that Anna Bradley has stepped down from her position as chair of the organisation, and that the Department of Health has begun advertising for her replacement.

Crossbench peer Lord Kerslake, who was head of the civil service between 2012 and 2014, has rejected criticism by current civil service head Sir Jeremy Heywood that Freedom of Information (FoI) legislation has a “chilling effect on the government”. Sir Jeremy’s comments come following rumours that the Government are considering curbs on FoI usage due to concerns about administrative burdens.

Forthcoming events

The House of Commons has now risen for recess and will return on 5th January. The House of Lords will rise on 22nd December and return on 11th January.

Department of Health publishes its mandate to NHS England for 2016-17

The Department of Health has published its mandate to NHS England for 2016-17, setting out NHS England’s short-term objectives to 2016-17 and its long-term objectives to 2020, as well as NHS England’s budget for the next five years.

The Department of Health consulted on the underlying principles of the mandate in October and November 2015. The PCF submitted a response, which argued that the mandate should outline CCG duties to work in a joined up manner with other bodies in the health system, such as local authorities.  The PCF called on CCGs to be assessed on service provision as well as service quality, with better accountability measures for CCGs that underperform. The PCF also called for clarification on what metrics will be used to assess the quality of CCG services. Finally, the PCF called for NHS England to ensure better uptake of clinically approved guidance.

The consultation received over 125,000 responses – significantly more than the 300 that the Department of Health expected. The majority of concerns focused on the level of private sector involvement in the NHS, funding, staffing levels, poor support for 7-day services, a lack of integration of health and social care services, NHS England not holding CCGs to account, and the short duration and lack of publicity around the consultation.

Responding to comments received as part of the consultation process, the Department of Health acknowledged that arrangements for joining up accountability between NHS England, CCGs and other local bodies are “still evolving”, and that these will be informed by the outcomes of NHS England’s vanguard sites.

The Department of Health also recognised concerns about the variation of services offered by CCGs, and subsequently updated objective one of the mandate to explain the role and fit of the NHS Outcomes Framework and the CCG assessment framework, committing NHS England to work with CCGs to reduce unacceptable variations in access to treatment. NHS England will also be conducting work to improve CCG engagement with the public to help create a person-centred NHS.

The Department of Health also noted that NHS England is still working to develop the CCG assessment framework and will be meeting with NHS partners on selected indicators in December. Both the Department of Health and NHS England will be providing ratings for CCGs on a four-point scale, based on six clinical areas. These will be decided by an independent panel of experts.

The Department of Health added, “Inconsistent application of guidance is one of numerous factors that can contribute to inequalities of access and outcomes, and we would expect this to be addressed”.

Chancellor George Osborne announces health and social care devolution plans for London

Chancellor George Osborne has announced plans for five devolution pilots in London, as part of a new broader strategy, which will see London health bodies take responsibility for health and social care in their region. The agreement was reached between all 32 London clinical commissioning groups (CCGs), all 33 local authorities (LAs), and the Greater London Authority (GLA), as well as with HM Treasury, the Department of Health, NHS England, Health Education England, NHS Improvement, Public Health England and the Department for Communities and Local Government (DCLG).

The devolution deal will be delivered by “London Partners” – a collective of all London’s CCGs, LAs, the GLA and NHS England and Public Health England’s regional teams for London. The precise governance arrangements will be developed in coordination with the Government and national health bodies, who will also assist with the programme of transformation.

The five devolution pilots will focus on:

  • Exploring the use of flexibilities in existing planning and licensing powers to develop new approaches to public health issues (Haringey)
  • An Accountable Care Organisation, where primary and secondary care are more closely integrated and patient pathways are redesigned with a focus on intervening early and managing the chronically ill (Barking and Dagenham)
  • Testing new approaches to collaboration on estate asset use in North Central London (Barnet, Camden, Enfield, Haringey, Islington)
  • Seeking to integrate physical and mental health services alongside social care (Lewisham)
  • Aiming for full integration of health and social care budgets and joint provision of services (Hackney)

As part of the agreement, the Government and national bodies will discuss the local flexibilities relating to tariff and payment mechanisms, with the scope for London to test new payment mechanisms – notably those being developed for the NHS England’s New Models of Care programme.

London Partners has committed to developing “detailed and credible” multi-year sustainable strategic plans for health and care to “restore London’s health economy to fiscal equilibrium whilst maintaining and improving quality and outcomes”. The agreement also notes that the Department of Health and NHS Improvement will explore collaborative and co-operative decision-making with London Partners on provider cash support for financial recovery and strategic change.

London Partners has also committed to support providers to design and implement new models of care. London Partners will work with national bodies to explore adaptations to provider regulations on a local level, including working with the CQC to ensure national registration requirements on safety and quality do not pose a barrier to adopting new models of care provision.

London Partners will be working with the Government, NHS England and NHS improvement to best prioritise plans to reduce hospitalisation in a cost effective manner. NHS England will discuss devolving London’s share of transformation funding, allowing it to have access to new and/or additional health and/or social care funding streams that are made available during the Spending Review period.

Simon Stevens raises doubt over NHS devolution outside Manchester

NHS England Chief Executive Simon Stevens has given an interview in the Health Service Journal noting that “not many” local areas will be given control of devolved NHS budgets outside of Greater Manchester in the next few years. He said the few devolution deals that did include health would not quickly bring about the full integration of health and social care. He used Cornwall as an example and said a lot of work needed to be completed “before it would be in a position to assume more responsibilities over and above those which they are currently grappling with”. He said some London boroughs would “make serious steps towards integration”, while the West Midlands may invest in mental health services to reduce the benefits bill.

He also did not think that the tests that councils have to meet to receive NHS budgets were “unreasonable”, but said that it should be expected that some councils will not meet them. He noted that the Cities and Local Government Devolution Bill did not currently include a provision to change the accounting officer for NHS budgets where funding was devolved, despite the potential to transfer NHS functions to local authorities.

On integration, he said NHS and social care commissioning budgets could not be joined up until there was a “viable” funding proposition for social care. He said, “Until we have clarity and a viable social care funding proposition, I see no way in the real world in which you could blend £100 billion plus of NHS funding with, in effect, an open ended liability for local authority financing.”

NHS England agrees budgetary spending for the next five years

NHS England has agreed the funding allocations for NHS for the period 2016/17 to 2020/21, establishing individual allocations for clinical commissioning groups (CCGs), primary care, specialised services, as well as a ‘sustainability and transformation fund’, other direct commissioning and NHS England’s central budget. Below is a summary of the allocations:

  • NHS England’s total budget will increase from £105.8 billion in 16/17 to £109.2 billion in 17/18, before rising to £111.7 billion in 18/19, £114.8 billion in 19/20 and £118.9 billion in 20/21.
  • The overall budgetary allocation for all CCGs will rise from £71.9 billion in 16/17 to £73.4 billion in 17/18, £74.8 billion in 18/19, £76.5 billion in 19/20, before hitting £79.4 billion in 20/21.
  • The primary care budgetary allocation will rise from £7.7 billion in 16/17 to £8 billion in 17/18, £8.3 billion in 18/19, £8.7 billion in 19/20, and then £9.2 billion in 20/21.
  • The specialised services budgetary allocation will rise from £15.7 billion in 16/17 to £16.4 billion in 17/18, £17.2 billion in 18/19, £17.9 billion in 19/20, and then £18.8 billion in 20/21.

NHS England’s sustainability and transformation fund allocation will be £2.1 billion for 2016/17, with £1.8 billion of this to be deployed on stabilising NHS operational performance and £340 million for the continuation of the Vanguard programme. The budget for this will increase to £3.4 billion by 2020/21, with an increasing share to be spent on transformation.

NHS England also agreed to earmark £450 million of new funding to deliver NHS England’s support for the Devo Manc partnership deal.

Northern Irish Department for Health, Social Services and Public Safety launches consultation on health and social care administrative reform

The Northern Irish Department of Health, Social Services and Public Safety (DHSSPS) has launched a consultation on proposed changes to the structure of the health and social care system in Northern Ireland.

The key proposal is the abolition of the Health and Social Care Board (HSCB), which operates between the DHSSPS and the five regional health trusts, and decides where the majority of the Northern Irish health budget is spent. The consultation asks whether the current system is too complex, whether it inhibits innovation and delays responses to changing demands, and if changes will improve accountability. It fundamentally asks whether the decision to scrap the HSCB is the correct one.

The consultation asks whether the current process for commissioning provider services is “too complex and transactional” for an area as small as Northern Ireland. It asks whether Trusts are best placed to assess local needs and whether they should have a greater level of responsibility and autonomy for planning services in their area.

The consultation came as a result of Health Minister Simon Hamilton’s response to the Donaldson’s Report, published in January 2015, which identified a number of longstanding structural elements within the Northern Irish care system which fundamentally impacted its quality and safety, such as the configuration of health facilities serving rural and semi-rural populations. Ten recommendations were made, including setting up an international panel to review and configure health and social care services in Northern Ireland (which may involve closing hospitals), redesigning commissioning, expanding the role of pharmacists and paramedics, a programme for long-term condition management, better incident reporting, metrics for benchmarking clinical performance, the establishment of a technology hub and better patient involvement.

NHS England Five Year Forward View partners publish updated national support package for all 50 vanguard sites

The NHS England Five Year Forward View (FYFV) partners have published an updated national support package for all 50 vanguard sites following the initial programme of support published in July for the first 29 sites. A further 21 sites have been selected, including eight urgent and emergency care (UEC) and thirteen acute care collaboration (ACC) vanguards.

The updated package reflects the needs of the UEC and ACC vanguards and includes the learning to date from the first 29 vanguards. The number of areas of support has also been extended from eight to ten, with new areas including “new operating models” and “governance, accountability and provider regulation”.

The “new operating models” has been included to support the ACC vanguards, which are linking hospitals together to improve their clinical and financial viability, to develop the right operating model. They will also support the UEC vanguards to explore models to ensure they are working effectively as integrated communities.

“Governance, accountability and provider regulation” will help the vanguards develop the right organisational form and governance model, as well as understand the impact on how they are regulated.

Overall, the package has been developed to allow the vanguards to make the changes they want effectively and at pace. It aims to maximise the sharing of learning across the vanguards, as well as spread good practice nationally across the wider NHS and care system.

NHS England also published a directory of the national support on offer for the vanguards and the wider NHS and social care, alongside the support package. The directory aims to help vanguard sites develop new partnerships with patients, the public and communities. It outlines the services available from seven NHS FYFV partners, as well as some voluntary sector strategic partners, which have been compiled with the FYFV People and Communities Board.

This first directory will be followed by a comprehensive directory of national and local support in April 2016.

National Audit Office publishes report on the sustainability and financial performance of acute hospital trusts

The National Audit Office has published a report on the sustainability and financial performance of acute hospital trusts, which called on the Department of Health and its arm’s length bodies to “take a more holistic, coordinated approach to tackling trust’s persistent financial problems and move beyond quick fixes to cut trusts’ spending”. This report does not examine primary care, social care, public health or similar services.

The report found that the financial performance of NHS trusts and NHS foundation trusts is not sustainable, and that their financial problems are “endemic”. It also found that trusts’ financial management has been undermined by “turbulent planning and multiple interventions” by the Department of Health, NHS England, Monitor and the Trust Development Authority (TDA).

The report identified that the £22 billion of efficiency savings needed by 2020-21, as outlined in the Five Year Forward View, will “not help the immediate financial position of trusts, as the savings will not be realised until nearer the end of the five years”. The report argued that it is “not yet clear how and when” most of the £22 billion of efficiency savings will be made, or the contribution that individual organisations and sectors are expected to make.

The report found that “running a deficit seems to be becoming normal practice for acute trusts”, and that there is a risk that poor financial performance is not taken as seriously as poor healthcare provision. It notes that the Government’s commitment to increase NHS funding could be a “significant” step towards acute trusts achieving financial balance, but this depends on how funding is used. It notes, “Until there is a clear pathway for trusts to get back to financial stability, we cannot be confident that value for money, defined as financial and service sustainability, will be achieved”.

The report recommends that:

  • The Department of Health must “move ambitiously and more thoroughly” to set out savings goals to secure financial sustainability.
  • The Department of Health, NHS England, Monitor and the NHS TDA should work together to improve the trust planning process and their oversight of financial risk.
  • The Department of Health, NHS England, Monitor and the NHS TDA should put in place a clear plan for improving financial sustainability.
  • The Department of Health should consider how to mplement controls on trusts’ spending.
  • Price and service tariff setters (NHS England and Monitor) should move faster to ensure that payment systems change and promote financial sustainability.

Scottish Government publishes draft budget for 2016-17

The Scottish Government has published its draft budget for 2016-17, which proposes an extra £500 million of additional funding for the Scottish NHS – an increase of 6.5% on 2015/16 levels – taking the total level of funding to almost £13 billion.

Of the £500 million, £250 million will be invested directly into health and social care partnerships, to ensure improved outcomes in social care. There will be a £45 million investment in improvements to primary and community care, focusing on the development of new models of care – supporting the development of multidisciplinary teams of nurses, doctors, pharmacists, allied health professionals and other clinicians, as well as social care specialists.

An investment in £30 million will be made to support transformational change, with an additional £50 million over five years to improve mental health services. Other priorities include reducing healthcare associated infections and antimicrobial prescribing, as well as better services for hip and knee replacements, cancer, end of life care, health visiting, and nutrition and healthy eating.

Health Education England considers radically overhauling children and young people’s nursing

Professor Lisa Bayliss-Pratt, director of nursing at training body Health Education England (HEE), has revealed that the organisation is examining replacing the current system of health visitors and practice nurses with a single 0-19 nursing role. Speaking at the HEE board meeting, Bayliss-Pratt asked whether HEE really wanted “to be radical”, adding that there is “more work to do in that field”.

During the board meeting, HEE accepted all 34 recommendations made by March 2015’s Shape of Caring Review, which sought to ensure that nurses and care assistants receive consistent high quality education and training that supports high quality care. Although HEE has begun making plans to introduce some of the recommendations, board papers at the meeting suggested a desire to continue with three-year specialist degrees (in areas such as learning disabilities and mental health) rather than two years of general training followed by one year of specialisation.

Weekly political news round up – 11th December 2015

December 11, 2015 in News by Whitehouse

Around the sector

The Welsh Government’s draft budget for 2016/17 has outlined a £278 million increase for the NHS – raising total health spending by 4.1%. Of the additional funds, £260 million will be assigned to revenue spending, with £33 million to capital spending. However, there will be a reduction of £15 million from other parts of the health budget – the majority from the delivery of targeted NHS services, covering specific primary care services such as eye care initiatives, as well as funding for the delivery of IT solutions and support for undergraduate medical education. Local government funding is set for a 2% decrease.

Research by health think-tank the King’s Fund has found a net improvement in patient experience over the last nine years, but one that they described as “modest” with “considerable potential to do better”. The survey began in 2002, receiving 62,000 responses across 156 NHS trusts, with additional data between 2005 and 2013 for all acute trusts in England. The survey asked 20 questions, covering how they were spoken to, privacy, any change in admission dates, as well as feelings of dignity and respect.

Jim Mackey, the chief executive of newly created NHS trust regulator NHS Improvement, has said that he will be required to ensure that the provider sector achieves financial balance in 2016/17. Mackey said that measures to increase the national tariff rate by 1% in cash terms in 2016/17 will help bring 80% of NHS trusts into surplus. Providers reported a combined deficit of over £800 million in 2014/15, and have forecast a deficit of more than £2 billion for 2015/16.

NHS England national clinical director for long term conditions Dr Martin McShane calls for improved continence care

NHS England’s national clinical director for long term conditions, Dr Martin McShane, has called for improvements in continence care through the utilisation of NHS England’s recently published Excellence in Continence Care guidance for commissioners, providers, health and social care staff and information for the public.

In a blog post, McShane described great continence care as the “Holy Grail”, as it can drive better quality of life and reduce costs. He said that the standards of continence care need to be raised, with better knowledge for professionals and individuals with continence problems on how to source help, access resources and understand that standards can be achieved. He added that continence is an area where health and social care can work together to “support and enable independence, support less reliance on pads and products by using alternative treatments, reduce admissions to hospitals and care homes and avoid complications”. He stressed the need to “empower people to self-manage and live independently with personal dignity”.

McShane commented that continence is something which “embarrasses” people, adding that those with continence problems “suffer in silence” and “often get ignored”. He said that it is not just a physical problem, but “psychologically distressing”, quoting research from the Bladder and Bowel Foundation that half of those with continence problems have never spoken to a healthcare professional about their problems.

Health Select Committee launches inquiry into the impact of the Spending Review on heath and social care

The Health Select Committee has launched an inquiry on the impact of the Spending Review on health and social care. In particular, the Committee will look at:

  • The distribution of funding for health and social care across the spending review period;
  • Achieving efficiency savings: their source, scale and impact;
  • Achieving service transformation set out in the FYFV at scale and pace through transformation funds;
  • The impact and management of deficits in the NHS and social care;
  • The effect of cuts to non-NHS England health budgets e.g. public health, health education and Department of Health, and their impact on the Five Year Forward View;
  • Impact of the spending review on the integration of health and social care;
  • Progress on achieving parity of esteem through funding for mental health services.
  • Quality and access in health and social care including the cost and implications of new policy objectives such as 7 day services;
  • Social care funding.

The Committee is inviting written submissions by Friday 22nd January 2016, with oral evidence to take place later in 2016.

Answer to written question on the future of the Healthy Child Programme for children aged zero to five

Shadow Health Minister Andrew Gwynne has received an answer to a written question asking the Health Secretary what his policy is on the future of the mandated universal elements of the Healthy Child Programme for children aged 0 to five.

Public Health Minister Jane Ellison responded that the mandated elements of the Health Child Programme, which include antenatal health visits, the new baby review, the six to eight week assessment, the one year assessment and the two to two-and-a-half year review, have sunset clause which ends their effect on 31st March 2017 – 18 months after coming into operation.

She added that the regulations make provision for a review of the operation of the mandated elements by the Health Secretary, which will inform future arrangements. She said that in the interim, the Department of Health is working with Public Health England to monitor the progress of the new arrangements.

Harrow Council to cut public health services by up to 60% over the next three years

Harrow Council has drafted proposals to cut public health services by up to 60% over the next three years – from £10.7 million in 2015/16 to £5.9 million in 2018/19. These cuts coincide with the possible removal of the government ring fence around their budget in 2017/28.

Included are plans to remove the entire budget for health visiting services by 2018-19. A spokesperson for Harrow Council said that it remained “committed to providing a quality health visiting service to families in the borough” despite the proposals.

The spokesperson confirmed that the proposals did not include cuts to school nursing staff or those working in sexual health. The spokesperson said that the local authority will “move towards delivering statutory services only”, with staff working in services that “support wider determinants of health” – such as workplace health, long-term conditions and unemployment – would be line for cuts.

The spokesperson added that “from 2014 to 2018, Harrow Council has had £83m of cuts imposed on it already – this is over 50% of our

Public Health England chief executive Duncan Selbie calls 10% cuts to public health budgets “reasonable”

Public Health England chief executive Duncan Selbie has described the 9.6% cuts to the £3.4 billion public health budget as a “reasonable ask” of local government, as “that’s thought to be a manageable efficiency saving over five years for any local authority”.

Selbie rejected criticisms of the cuts, adding that the “single most important thing that drives the health of the people is economic development and prosperity” and that “no amount of money from public health would have come close to solving the problem in the NHS”. He said that it is “intellectually inadequate” to say that the frontloading of NHS funds at the expense of the public health budget indicated a preference for the NHS. However, he commented that the reduction in funding was a surprise to him.

Selbie also dismissed concerns about the removal of the public health ringfence in 2018, adding that public health funding will likely come through the retention of business rates.

Public Accounts Committee publishes report on the Care Quality Commission

The Public Accounts Committee, which scrutinises public spending and the delivery of public services has published its report on the Care Quality Commission (CQC. The report found that even though the CQC has made “substantial progress” since 2012, it is “behind where it should be” and is “not yet an effective regulator of health and social care”.

The Committee found that staff shortages have limited its ability to carry out inspections of hospitals, adult social care and primary care, and that draft inspection reports may not be consistent and accurate. It also found that the CQC is not yet ready to implement new responsibilities to assess the efficiency with which hospitals use their resources. The Committee was also critical of the lack of quantified performance measures, such as explicit targets, which are required to show whether it is satisfactorily performing its statutory duties.

The Committee recommended that the CQC better demonstrates how it plans to deliver scheduled inspections, as well as setting out how it should improve the quality of draft reports. The Committee recommended that the CQC publish quantified baselines and targets for its performance, as well as outline he approach that it will take to provide assurance about the use of resources by hospital providers.

Weekly political news round up – 4th December 2015

December 4, 2015 in News by Whitehouse

Around the sector

The Department of Health and HM Treasury have agreed to transfer £1.2 billion from the Department of Health’s capital budget to support revenue spending in 2016-17, to address the £1.4 billion reduction in non-NHS England revenue budget announced in the Spending Review last week. The capital budget covers all Department of Health and NHS spending on items such as buildings, medical equipment and IT.

Forthcoming events

The House of Commons will rise for Christmas recess on 17th December, returning on 5th January. The House of Lords will rise on 22nd December and return on 11th January.

Welsh Health and Social Care Committee publishes Stage 1 report on the Public Health (Wales) Bill

The Welsh Health and Social Care Committee has published its Stage 1 report on the Public Health (Wales) Bill. This Bill outlines changes to improve public toilet provision in Wales.

The PCF submitted a response to the Committee’s call for evidence, which broadly welcomed the changes but emphasised:

  • Local authority toilet strategies will only be effective if they are inclusive of the views of patient groups.
  • The Welsh Government should issue best practice to local authorities on how to develop a national strategy, and that this best practice should be developed in consultation with stakeholders.
  • Local authorities should be mindful of the toileting needs of people with continence problems, but who are not physically disabled.

The report directly referred to the PCF and its argument that more could be done to strengthen monitoring arrangements so that strategies would include a specific measurable outcome. Welsh Health Minister Mark Drakeford responded to calls for progress to be monitored by saying that “if the local authority hasn’t done what it ought to do…the people will have the ability to pass their verdict on that at the ballot box”. The Committee outlined that it did not agree with the Health Minister and would prefer to see a more robust mechanism for measuring the implementation and success of the schemes.

The report also recognised that toilets are not a public convenience but a public necessity, and that insufficient provision may impact disproportionately on people with a disability, older people and those with continence problems (referencing the PCF’s submission in a footnote on this point). It recognised that “many stakeholders” support the provision in the Bill for local authorities to prepare local toilet strategies, with local authorities questioning the additional paperwork and overall contribution.

The PCF’s submission was also cited in a footnote referencing a comment by the Committee that stakeholders wanted the Welsh Government to issue guidance for local authorities how to develop their strategies, including producing a template.

The Committee recommended that the Health Minister amends the Bill to:

  • Require local authorities to periodically publish a progress report of public toilet provision detailing how the needs of communities are met. (Recommendation 15)
  • Require local authorities to consider the geographical distribution of facilities, including their availability throughout the week (Recommendation 16)
  • Require the Welsh Government to monitor the extent to which local toilet strategies address national needs, to avoid the risk of poor provision at national sites and on main transport corridors. (Recommendation 17)
  • Include a duty on local authorities to increase awareness of toilet facilities by promoting their availability for public use, with requirements for publically and private hosted toilets (Recommendation 18)

NICE launches consultation on a draft scope for a clinical guideline on the assessment, diagnosis and referral of neurological problems

The National Institute for Health and Care Excellence (NICE) has launched a consultation on a draft scope for a future clinical guideline on the assessment, diagnosis and referral of neurological problems.

The focus of the guideline will be children, young people and adults, particularly children under five who have been identified as needing specific consideration. It will cover primary and secondary care settings, but not tertiary care.

The guideline will cover the following key areas:

  • The identification of ‘red flags’ or circumstances within which referral is or is not appropriate for people presenting to non-specialist with possible neurological symptoms
  • The identification of simple examinations, assessment tools and tests that could be used by non-specialists to aid decision-making about investigation or referral.
  • Information, support and initial management advice for patients, families and carers during the referral process.

However, the guideline will not cover assessment and management after the point at which patients are seen in secondary care. It will also not cover neurological conditions on which NICE guidance already exists or is in development, unless recognition of symptoms by non-specialists has not been covered by specific guidelines; these will be cross-referenced instead. It is explicitly stated that faecal incontinence and urinary incontinence will not be covered.

NHS England appoints three new senior leaders

NHS England has appointed Matthew Swindells as national director for commissioning operations and information, and Anu Singh as director of patient and public participation and insight.

Swindells replaces Dame Barbara Hakin, who retires at the end of the month. He has 18 years management experience in the NHS, having been chief executive of various hospitals, as well as director general at the Department of Health and the health team leader at the Cabinet Office. He is currently managing director for population health at health technology company Cerner.

Singh joins NHS England from Staffordshire County Council, where she was head of business improvement, responsible for the commissioning of mental health, social care, community safety and education.

NHS England also appointed Pauline Philip as national urgent and emergency care director.