Weekly political news round up – 26th September 2014

September 26, 2014 in News by Whitehouse

Around the sector

In an interview with the Health Service Journal, Shadow Health Secretary Andy Burnham has announced that healthcare regulator Monitor will be placed in charge of overseeing the financial sustainability of whole health economies and driving integration between different organisations, should Labour win the election in 2015.

The Department for Education has published statistics on the planned expenditure on schools, education, children and young people’s services by local authorities, for the financial year 2014 to 2015. The statistics showed that planned local authority expenditure for two year olds is set to virtually double from £281.8 million to £563.3 million, with expenditure for three and four year olds increasing by £46.1 million to £1,980.9 million.

Forthcoming events

Parliament has been recalled to discuss matters in the Middle East, with both Houses still set to return to discuss all business on 13th October. Party conferences will be taking place on the following dates:

  • Conservative  – 28th September to 1st October
  • Liberal Democrat – 4th – 8th October

Overview of Labour Party conference – health and education

Labour’s final party conference before the 2015 general election took place in Manchester this week, with speeches being given by Labour leader Ed Miliband, Shadow Health Secretary Andy Burnham and Shadow Education Secretary Tristram Hunt. Below are summaries of their speeches:

Labour leader Ed Miliband

In his speech, Miliband announced that should Labour win the election in 2015, they would repeal the Health and Social Care Act 2012 and introduce a £2.5 billion NHS ‘time to care fund’. Part of this fund would be used to recruit 20,000 more nurses, 8,000 more GPs and doctors, 5,000 more care workers, and 3,000 more midwives. In order to pay for the reforms, Miliband said that there would be a crackdown on tax avoidance – including avoidance by hedge funds, a mansion tax on homes worth above £2 million, and more fees imposed on tobacco companies.

Miliband also announced a commitment to reform the House of Lords in order to make it a representative senate. In terms of devolution, Miliband only mentioned that more power would be devolved to local government. He also promised to raise the minimum wage to £8 an hour by 2020, and to lower the voting age from 18 to 16.

Shadow Health Secretary Andy Burnham

Building on Miliband’s speech the day prior, Burnham criticised the Government’s “top-down reorganisation” of the NHS and what he considers as a plan to “run it down, break it up, sell it off”. In addition to reiterating the pledge to repeal the Health and Social Care Act, he stated that that hospital and other NHS bodies will evolve over a 10-year period into “NHS Integrated Care Organisations”, coordinating all care – physical, mental and social, provided from home or from hospital. He also stated that patients and relatives will have a single contact person for all their needs and a personalised care plan to reflect these needs.

Prior to his main speech, Burnham spoke at a fringe event and said that local government would take a lead in commissioning health services under a Labour administration, in a model that would re-establish “the link between health and education, health and planning, health and leisure, but crucially health and housing”.

Shadow Education Secretary Tristram Hunt

Education Secretary Tristram Hunt’s speech stated that Labour would end the Conservative “attack” on Sure Start, and increase free childcare from 15 hours per week to 25 hours per week for the 3 and 4 year old children of working parents, with the support continuing into primary years. He added that disadvantage begins in the early years, and that inequality must be tackled early to address the gap, especially for those with special educational needs.

Department of Health publishes guidance for Health and Wellbeing Boards on children with special educational and complex needs

The Department of Health has published guidance for Health and Wellbeing Boards (HWB) on supporting children with special educational needs and disabilities (SEND) to get joined up care from local services.

It highlights that from September 2014, the Children and Families Act 2014 requires local authorities and clinical commissioning groups to work together to secure services for children and young people – up to the age of 25 – who have SEN or a disability. Each CCG has a statutory duty to co-operate with the relevant local authority, in a co-ordinated assessment of the needs of the individual child or young person assessed as having special educational needs and agree an individual outcomes-focused Education, Health and Care (EHC). It notes that cooperation must also occur for children who have a disability but might not qualify as having special educational needs.

Specifically, the guidance states that HWBs should, or may wish to:

  • Recognise that local services must seek to meet a wide range of disabilities and complex needs, far wider than the cohort of children who would qualify for an EHC plan.
  • Consider how local health services are meeting the needs of children and young people with long-term conditions.
  • Act as a forum for strategic discussions between local authorities and CCGs.
  • Act as a system driver where here there are existing formal joint commissioning arrangements between a local authority and CCG or CCGs

In developing joint strategic needs assessments (JNSAs) and joint health and wellbeing strategies (JHWS), the guidance advises that HWBs:

  • Consider how integrated approaches to meeting local need care provide better outcomes for the child and their family
  • Work with their CCG members to identify local needs, drawing on previous commissioning plans and strategies, and utilising their commissioning support units and local providers of paediatric services as key contacts.
  • Seek to address the issue of the absence of key data on outcomes for children with complex needs, highlighting this as a barrier to effective local commissioning.

The guidance provides HWBs with a number of questions that they should think about when considering how their work supports children and young people with special educational needs and disabilities locally. These include questions about:

  • Whether HWBs are engaging with local children with a wide range of conditions
  • Whether their Joint Health and Wellbeing Strategy specifically refers to children and young people with complex health needs
  • To what extent the needs of children and young people with complex health needs or special educational needs are already addressed in existing multiagency strategies and plans.

The guidance also calls for better utilisation of parent carer forums to help HWBs collect both quantitative and qualitative evidence to feed into the JSNA and JHWS, as they provide specialist knowledge of the wide range of services children access and can provide insight into how services can be better integrated across health, education and social care. It also suggests that parent carer forums work with commissioners to make sure services are commissioned that meet their children’s needs and help commissioners monitor how well these services are provided.

Liberal Democrats publish policy paper on public services

The Liberal Democrats have published a policy paper, Protecting Public Services and Making Them Work For You, in advance of the Liberal Democrat conference in October. Although the paper is relatively broad in scope, it suggests a number of important changes to health services – most notably stronger commissioning powers for Health and Wellbeing Boards (HWBs).

In particular, it suggests that HWBs should take over NHS England’s current responsibility for commissioning GPs in their area, and potentially wider responsibility for local services. It argues that HWBs are better placed to commission services than national bodies as they are more democratically accountable than NHS England, given that there is greater scope for involvement by patients, residents and local services. As such, the paper does not prescribe an exact way in which HWBs should take a lead in local commissioning, stating that it is a matter for themselves to organise locally.

Where clinical commissioning groups (CCGs) and local authorities must collaborate, the paper argues that HWB should act as a forum for agreeing approaches, or could even be given direct commissioning responsibility. It also argues that HWBs should be able to amend the commissioning plans of local commissioners.

National Institute for Health and Care Excellence publishes Evidence Update on infection control

The National Institute for Health and Care Excellence (NICE) has published an evidence update for NICE clinical guideline 139, the ’prevention and control of healthcare-associated infections in primary and community care’.

Evidence updates are intended to increase awareness of new evidence amongst individuals, managers and commisioners, rather than replace current NICE guidance. They do not provide formal practice recommendations.

Six items were selected for the evidence update, following a three year evidence search conducted between April 2011 and April 2014. Of the six, only one item (covering vascular access devices) was identified as having a potential impact on the guidance.

New evidence was found for long-term urinary catheters, specifically the maintanence of catheters and other indwelling devices, but this was found not to have a potential impact on guidance. It was found that people in community care who have both feeding devices and urinary catheters were most at risk of infection with antibiotic-resistant microorganisms. Those with one of the two were more at risk than those without.

Royal College of Physicians publishes five point plan for the government

The Royal College of Physicians (RCP) has published their five point plan for the next government.

The RCP called on the next government to increase health service funding in order to avoid a ‘crisis in care’, stating that the level of funding was a political choice that impacts on the level of care available to patients. It also suggested that the next government should make medical education and training a priority when designing health services, stating that good care in the future depended on good training now.

In terms of long term planning, the RCP said that the next government should avoid ‘big bang’ changes to national NHS structures, instead focusing on achieving long-term transformation. They also called for a national programme for sharing good practice, and the promotion of clinical leadership and clinically led quality improvement projects.