Weekly political news round up – 13th November 2015

November 13, 2015 in News by Whitehouse

Around the sector

Influential health think-tank the King’s Fund has published a policy paper calling for “fundamental changes” to the role of commissioners to enable the development and implementation of new systems of care. It outlines that commissioning in the future needs to be strategic and integrated, and based on long-term contracts tied to the delivery of defined outcomes. It notes that “scarce commissioning expertise” needs to be brought together in footprints much bigger than those currently covered by CCGs, while retaining the local knowledge and clinical understanding of GPs.

The King’s Fund has also published a briefing on the impact of devolution on health care in England, making particular reference to devolution in Greater Manchester and Cornwall. The think-tank concluded that devolution will lead to less fragmentation, the breaking down of local barriers to change, and an increased focus on the wider determinants of health. However, it also concluded that the changes would not constitute “genuine devolution” but rather delegation, as formal accountabilities will remain with NHS bodies. It also warned that devolution will not be a “silver bullet” and that significant upfront investment and time will be required.

Local Government Association has published a collection of short essays from system leaders on the improvement of care for children following the transfer of public health commissioning responsibilities for under-fives to local government. Included are essays by NHS England’s chief nursing officer Viv Bennett, the Association of Directors of Public Health president Dr Andrew Furber, and various senior staff from local authorities. The essays in general identify the changes as an opportunity for joined up commissioning and a more effective Healthy Child Programme, but stressed that bodies must work together to make the changes result in effective outcomes. Ingrid Wolfe, co-chair of the British Association for Child and Adolescent Public Health, said that although the transition has been “controversial to many”, this is common for big changes.

Conservative MP William Cash has tabled an Early Day Motion (EDM) ahead of World Toilet Day 2015, on 19th November 2015. The EDM notes that there are 2.5 billion without access to basic sanitation and 700 million without access to safe water. It calls on the government to increase the proportion of its bilateral foreign aid spent on water, sanitation and hygiene.

Public health organisations react to decision to cut public health budgets by 6.2% across the country

Public health organisations have said that the blanket 6.2% cuts to local authorities, confirmed at the start of November, will lead to a reduction of school nursing services and health visiting services.

Nicole Close, the chief executive of the Association of Directors of Public Health said that in areas where councils are tied to long-term contracts that are not due for renewal, they will likely make cuts to smaller nurse-led services, including breastfeeding support, weight management and mental health.

Dame Sarah Cowley, trustee of the Institute for Health Visiting, said that the cuts could “sour” relationships between health visitors and local authority commissioners. She said that the cuts have “put everyone in a state of despair” about how to convince the Government that the cuts to health services run contrary to the Government’s call for better preventative services.

Ros Godson, professional officer at the Community Practitioners and Health Visitor’s Association, suggested that local authorities will start to withdraw nurses from non-statutory services and where commissioning overlaps with NHS England – such as the school immunisation programme. Godson said that she can see local authorities saying “not in our remit”.

Local authorities welcome the transfer of child public health commissioning from national government

Local authority directors of public health and children’s services have welcomed the transfer of commissioning responsibilities for child public health services from national government.

Debbie Barnes, director of children’s services at Lincolnshire County Council, called the changes a “huge opportunity” and said that these will enable more services to be commissioned around local authority population boundaries. She said that commissioning changes will lead to the development of closer links between services like children’s centres and health visiting, as well as school nursing services. She said that the current system of having a health visitor working with 0-5s and schools nurses working with 5-16s was a model that required more cohesion.

Dr Bruce Laurence, director of public health for Bath and North East Somerset, said that any changes will not be made “just for the hell of it”. He added that councils working with their local CCGs will now control “pretty much all of the child health world”.

Dominic Harrison, director of public health at Blackburn and Darwen, said that local authorities should not insist on numbers of professionals, but should instead insist on the achievement of “x, y and z outcomes”. Dr Virginia Pearson, director of public health at Devon County Council said that the recommissioning of services should focus on “creative solutions”.

NHS England chief executive Simon Stevens reiterates call for extra NHS funding to be frontloaded

NHS England chief executive Simon Stevens has reiterated his call for £8 billion of additional funding for the NHS by 2020 to be frontloaded in the Spending Review on 25th November, amid concerns that current NHS funding arrangements for the next two years will not be workable.

Stevens commented that he is in discussions with Chancellor George Osborne on this issue, but that “considerably more progress is needed” and that agreements on funding for spending reviews “usually come down to the wire”. He added that investment now would manage current financial pressures, kick-start service redesign, and enable major savings later in the parliament.

Shadow Health Secretary Heidi Alexander responded that Stevens is “absolutely right” to issue a warning about the pressing need for the NHS funding crisis to be addressed, arguing that unless there is an urgent and significant injection of money into the NHS, then standards of care will “go backwards”.

Children’s Minister Ed Timpson addresses Council for Disabled Children annual conference

Children’s Minister Ed Timpson has addressed the Council for Disabled Children’s annual conference, which centred upon addressing questions relating to the future of SEND reform. In his address, Timpson re-stated his three reasons for the SEND reforms which were introduced last year. He noted, firstly, that families were having to fight too hard for resources within a system which does not work for them; secondly, that children with SEN do not do as well in early years education as they should do; and thirdly, that the system as it previously stood did not encourage education, health and social care agencies to work together for the benefit of children and families.

He was keen to emphasise that it had been “emboldening” to see so many people who have worked hard in support of the Government’s reforms, but stated that they were still very much a work in progress. Timpson said: “We know that these reforms will take a while to embed but with continued support – and challenge – from the parents, children and young people at the heart of them, I’m confident we will continue to see changes which empower, support and enable children and young people reach their full potential.”

Specific issues he raised as being in need of further work were the quality of local offers; areas relating to accountability; and the plans to implement joint Ofsted and Care Quality Commission local area inspections. Timpson also noted the priority his department was placing on children’s mental health, and highlighted the commencement this month of a joint pilot with NHS England to train single points of contact across 27 Child and adolescent mental health services (CAMHS) areas and in more than 250 schools. He concluded by stating that he was prepared to “keep listening, make adjustments where necessary, but above all, continue to put the case for why the vision set out almost five years ago has to be made a reality”.