Lansley gives PCTs more cash but defends their abolition
Primary care trusts will be given £70m to spend on care to keep discharged patients out of hospital, health secretary Andrew Lansley announced at the Tory Party conference on Tuesday.
The “re-ablement packages” are aimed at supporting those leaving hospital after illness or injury by providing six weeks of care, such as home visits or physiotherapy.
The extra funding must be spent this financial year, before new rules come into place in April preventing payments to hospitals for additional treatments carried out within 30 days of discharge.
In his keynote speech to the conference, Mr Lansley said: “This means better support for the most vulnerable, when they need it most.”
He also announced plans to extend the mandatory monitoring of hospital infections to include Meticillin Sensitive Staphylococcus Aureus (MSSA) and E. coli infections, both of which have been rising in recent years.
While announcing the funding for PCTs, the health secretary also defended his plans to abolish them along with strategic health authorities and arm’s length bodies.
He said: “It’s not just about spending our money wisely: Stripping out these layers of bureaucracy also sends a very important message to the NHS. You no longer have to wait for a cascade of diktats to tumble down from on high, in order to do your job.”
However, his speech was not a resounding success with conference delegates – many of whom had expressed concern at fringe meetings attended by HSJ about the lack of detail in the reform plans, particularly on the transition to the new system.
However, at an event held a few hours after his speech, Mr Lansley claimed the white paper proposals would improve patient care and help to prevent another scandal like that at Mid Staffordshire Foundation Trust.
In particular, he said the removal of top down targets would reduce bullying and make it easier for whistleblowers to report concerns.
He said: “The devolution of responsibility [to clinicians] will make a big difference. The ability to be bullied is very much associated with the fact that we have a top down system where we can focus on things that…aren’t at the forefront of clinical responsibility.”
It would also be important for hospitals to record patient experience in a more systematic way, Mr Lansley said, adding that the national patient surveys were “not fit for purpose”.
He noted the best hospitals were monitoring outcomes data on a ward by ward basis, enabling them to respond quickly to emerging concerns.
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Readers' comments (16)
Anonymous | 5-Oct-2010 6:58 pm
What a load of naive rubbish! Lansley's plans do not remove layers of bureaucracy. Abolishing PCTs only means that the responsibility of carrying a lot of much essential work transfers to GPs who are slowly waking up the fact they are being stitched up.
One thing's for sure. GPs will make sure they are remunerated properly for these new responsibilities. And it will ultimately cost the NHS more.
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Anonymous | 5-Oct-2010 7:08 pm
He has lost the plot. He needs to give money to trusts so they can treat people as no one is controlling demand which continues to rise unabated. As
for top down bullying why are the management of pct's and SHA's all getting top jobs in the new quangos.
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Anonymous | 5-Oct-2010 7:21 pm
The White Paper proposals will create exactly the climate for another scandal like Mid Staffordshire; the NHS will be going through huge organisational change - greater than was happening when Stafford erupted; Trusts will be having to make large savings - which means staff, just as in Stafford; and non FT Trusts will be driven towards becoming FTs, with an eye more on finance than quality - just as Stafford was.
I hope and pray that this won't happen, but the Secretary of State is setting the scene for something like this to happen.
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Anonymous | 5-Oct-2010 8:21 pm
Its the mad conference season, one day they announce one thing, the following day there's all sorts of caveat's. Bring on the spending review and lets see just how much of a pigs ear they can make of that, this conference is just the warm up.
Its clear the is nobody really in charge, the various departments are all at odds and I can well see the spending review turning into a farce as nobody seems to be thinking through what the strategy is, its all slash and burn with no vision, this maniacal attempt to reduce the borrowing in 5 years is a complete red herring.Their idology and fight with Beveridge's report can be traced back to 1945. Given how bad the first two days of conference I fully expect Cameron to drop in the polls, that would be a first for a new PM at their first confernce.
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Anonymous | 5-Oct-2010 9:21 pm
why yet more short term funding? PCTs are already trying to grapple with cost savings and cutting back staff - Do you really believe they will have time to invest this money properly - more likely that it will be wasted on a short term project that has not be fully thought through and will be ending almost as soon as it starts!
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Anonymous | 6-Oct-2010 4:49 am
Desperate for any possible good headline.....so much for prudence.
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Anonymous | 6-Oct-2010 6:59 am
This gentleman must be living in another world. come and spend a week on a ward or with the community nurses struggling to put into place all of these mad schemes. GP's should keep patients out of hospital by using all of the resources in the community not just admitting because its easier to do so.
you cannot undo what has gone before in a short time it will take time to make sense of it all,
who wanted PCT's? what a scandellous waste of money. not sure GP's at the helm is a good idea, i'm sure they are dreading the enormity of the task.
my priority is patient care but do not ask me to compromise on quality to save money, put more into the kitty for staffing then you may save hospital admissions. put thought into planning before wrecklessly starting the plan and knowing it will possibly fail - integrated care?
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Andy Bruce | 6-Oct-2010 8:43 am
90% of what Mr Lansley says he wants to gain from 'Liberating' the NHS could be achieved with 10% of the disruption if we just gave those few GPs with the appetite for commissioning healthcare more power within the current PCTs.
Or even better, run the NHS as one organisation with a proper management structure, proper planning and common systems, i.e., follow the example of the Scots and Welsh and get rid of the whole quasi-market which has wasted billions over the last twenty years.
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Anonymous | 6-Oct-2010 9:08 am
So up to 31st March needy people will get "re-ablement packages" because they need them, but from 1st April as if by magic no-one will need them?
These packages are merely short-term money to shore up community services that have been given away to the acute trusts under vertical integration, who are now busily moving the ex-community staff into hospital jobs.
And where will the additional staff come from?
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Anonymous | 6-Oct-2010 9:31 am
What a dangerous and naive SoS we have. Already the consultation responses to date have been ignored by the SoS. He knows best and will implement his 'final solution' ignoring all rational and reasonable advice.
We certainly are moving towards a new NHS. High cost Bureaucracy overseen by GPs with a personal interest. Rationing to a framework set by the independant board. Top ups for those who can afford it!
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Anonymous | 6-Oct-2010 10:35 am
Sending out an SOS cos of the SoS!!!
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Anonymous | 6-Oct-2010 11:18 am
To Andrew Bruce - at last a sane suggestion - - Theres far too much baby and bath water going on in the current plans and I cant see how this isnt going to decend into utter chaos!
The PCTs and SHAs arent as they would like to suggest stuffed full of incompetent idiots and against that Im pretty sure that there arent that many GPs out there who are really that interested in their new role
And as for this stopping bullying - oh come on! Is Mr Lansley really that naiive! Of course there will be times when targets have caused kicking down the chain - but from what I see bullying is simply not tackled in the NHS - if anything bullies are moved around and in many cases promoted and valued! We have a manager who has been bullying her staff for years and they simply move staff out from under her - nightmare
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Anonymous | 6-Oct-2010 11:19 am
No point giving it to the PCT's they took off £2m off the Provider Unit, without understanding that it will impact on admittances to Acute.......
Absolute shambles get rid of this deadwood of PCT's.
Perhaps they should be a thorough investigation into PCT's on how they are destroying Community providers..... I think Lansley would have a heart attack and I'm afraid he would have to stay in acute for a long time as there would be no one in the community to look after him when he came back.
Here's a few hints foi on District Nursing Days and Nights.... Reduction in numbers of nurses over the last 5 years. Apparantly they are much more efficient. Check out case loads interesting reading!
Also worth looking at Health Visitors.....
Also look at community hospitals bed numbers which have reduced. Which ultimately means that the acute beds are getting full up with DTOCs etc.
Hey you got this all for free no management consultant charging you £1000 per day for the info.
I know the GP's are worried but I tell you what you can't make a bigger shambles that it already is... A great big mess....
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Justin Dix | 6-Oct-2010 12:58 pm
Disappointingly, another set of anonymous, opinonated and unhelpful responses.
PCTs have done a lot of good work in a difficult environment. They are far from perfect. Many of the functions they carry out are essential to a well governed system (financially and clinically). It the prerogative of the government to abolish them and we have to accept that policy is policy and our job is to be responsible managers of change and stewards of the daily business of the NHS whilst change is worked through. Undoubtedly there will be changes as a result of practical and political discussions that are taking place now and in the future.
We must remember that governance of the NHS is not founded on the party political statements made at conferences. Governance is based on what the Secretary of State puts in place on behalf of parliament in terms of law, regulations and guidance. We are not at that stage yet and need to influence it in a responsible way whilst building relationships at a local level. We need to stop talking about bureaucracy and ask ourselves what a lean and well governed system looks like, one in which personal, professional and public accountability are present at every level.
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Anonymous | 6-Oct-2010 1:53 pm
I think Andrew Bruce at 8.45 above may get what he asks for when he proposes a more centrally run system. Of course the SoS talks of localisation and power to GPs (voters and clinicians are suckers for a bit of flattery) but what we will almost certainly get is a more centralised system: a single National Commissioning Board in place of nearly 200 PCTs and a smattering of GP consortia (read worthy but commercially skill-less and impotent talking shops with lots of bow ties) under that. The NCB will do all the heavy lifting and will report more or less directly to the SoS. Lets just hope the NCB is good!
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Justin Dix | 6-Oct-2010 2:38 pm
Disappointingly, another set of anonymous, opinonated and unhelpful responses.
PCTs have done a lot of good work in a difficult environment. They are far from perfect. Many of the functions they carry out are essential to a well governed system (financially and clinically). It the prerogative of the government to abolish them and we have to accept that policy is policy and our job is to be responsible managers of change and stewards of the daily business of the NHS whilst change is worked through. Undoubtedly there will be changes as a result of practical and political discussions that are taking place now and in the future.
We must remember that governance of the NHS is not founded on the party political statements made at conferences. Governance is based on what the Secretary of State puts in place on behalf of parliament in terms of law, regulations and guidance. We are not at that stage yet and need to influence it in a responsible way whilst building relationships at a local level. We need to stop talking about bureaucracy and ask ourselves what a lean and well governed system looks like, one in which personal, professional and public accountability are present at every level.
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