Rolling coverage from the NHS Confederation conference 2014

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6.25pm Alan Milburn says Jeremy Hunt’s “obsession” with regulation has “gone too far”.

6.16pm A lot of consensus from the former health ministers on the need to remove “artificial” divisions in the health and care system.

A tweet from HSJ’s James Ilman: “Dorrell tells #nhsconfed14 diff between primary care and comm care was a deal by Nye Bevan to get BMA on board in 1948. Its time to move on.”

6.05pm Alan Milburn says he is sick of people constantly talking about the “challenges” facing the NHS, and that the service should focus instead on the huge opportunities offered by technological change.

5.58pm Frank Dobson says “if you want a first class service you need to pay a first class fare”.

5.57pm Alan Milburn tells the conference that Jeremy Hunt is a good political tactician but less good as a policy maker.

5.54pm Four former health ministers - Alan Milburn, Frank Dobson, Stephen Dorrell and Edwina Currie - are currently having a lively debate at the NHS Confederation conference on the politics of the NHS.

4.42pm Here’s another interesting tweet from Heart of England Foundation Trust chief executive Mark Newbold on today’s big speech:

“Simon Stevens has gone for intellectual rigour rather than inspiration. Start of a new #nhs culture and operating style?”

4.25pm Our story on Sir Stuart Rose’s speech to the NHS Confederation conference is now live.

4.22pm The Mid Staffordshire Foundation Trust special administrator has announced that the transfer of services from the organisation to two neighbouring will be delayed. Here’s what the TSA said:

“We can now confirm that the transfer of services and the dissolution of the Trust will take place at the start of November 2014, due to Parliamentary recess in October. For dissolution to occur, both the House of Lords and the House of Commons must be sitting.

“We fully comprehend the fragile state of the Trust, and are equally aware of the need to achieve the transfer of services quickly, which is why we were originally seeking to transfer services and dissolve the Trust on 1 October.

“However, the revised date of the start of November reflects a legal technicality in relation to the dissolution process. It is no reflection on the tremendous hard work that everyone continues to do in preparation for the separation of services.”

4.12pm Here’s our article on NHS Confederation chief executive Rob Webster’s speech, in which he outlined a package of commitments which he wants politicians of all parties to sign up to before the 2015 general election.

3.56pm Here’s what Nuffield Trust chief executive Nigel Edwards had to say about Mr Stevens speech:

“This is a refreshing departure from the pre-existing ways of working. After years of top down rhetoric about the ‘N’ in the NHS, Mr Stevens rightly recognises that in a country as large and diverse as England, it is not possible to adopt a single approach or plan. His vision could yield real benefits for the quality and efficiency of care.

“Mr Stevens’ call for a systematic approach to evaluating new models of care is particularly welcome in a system which relies too heavily on small, fragmented and one-off pilots.

“But there will be two real tests for Simon Stevens’ approach. First, will NHS leaders, who have grown used to a system in which national plans are issued from on-high, be able to step up to the plate and lose the habit of following a centrally imposed blueprint? Second, can his relaxed approach to local variation in health and care be sustained in a public debate, which is impatient for results and where there is frequent concern about the ‘postcode lottery’ in the run up to the election?

“As Mr Stevens himself acknowledges, it’s time to focus on solutions rather than describing the problem. His solutions will challenge many of the fundamental assumptions that people, both within and outside the NHS, have about how healthcare is delivered.  Some may find it hard to adapt to this.”  

3.27pm A second district general hospital trust has ruled out being run by a private company under a franchise agreement.

Weston Area Health Trust has ruled out being run by a private company under a franchise agreement.

It is the second of the small number of trusts - for which this type of agreement had been an option - to rule it out so far this year.

3.00pm Simon Stevens: Sometimes rather rigid hand-offs exist between primary care and the rest of the health and social care sector.

2.46pm Meanwhile, Niall Dickson, Chief Executive of the General Medical Council, responds to the Queen’s Speech:

“We are disappointed that the government has not taken this opportunity to improve patient safety by modernising the regulation of healthcare professionals. If taken forward, the Regulation of Health & Social Care Professionals Bill would allow us to respond more quickly and effectively to protect patients and maintain the standards of good medical practice.

“Healthcare is changing rapidly and the law which governs professional regulation is cumbersome and outmoded. We have already introduced a wide range of reforms but in going further we are hamstrung by processes which are no longer fit for purpose. As the Law Commission and the government have recognised, there is a better way which will encourage reform and innovation in the interests of improving standards of medicine and patient safety.

“The Bill represents a once in a generation opportunity to future-proof medical regulation and better protect patients. We strongly believe these long-awaited reforms will be good for patients, doctors and the healthcare system. We therefore strongly urge the government to use the final year of this Parliament to continue working on the Bill.

“We will also continue to work with the UK government to make urgent amendments to the Medical Act which will enable us to introduce long-awaited and badly needed reforms to our powers to protect patients. These include granting us the right to appeal against fitness to practise panel decisions that we believe do not sufficiently protect patients and the public and a power to strike-off doctors who have been convicted of serious criminal offences without the need for a fitness to practise panel hearing. We will be seeking assurances from the government that it will be possible to make these urgent changes before Parliament is dissolved in 2015.”

2.45pm Simon Stevens now taking questions…

2.42pm Press statement from the Health committee:

The Speaker announced today that the Rt Hon Stephen Dorrell MP had written to him to tender his resignation as Chair of the Health Committee. Mr Dorrell has now ceased to be a Member of the Committee.

In his letter, Mr Dorrell said: “I have tried to chair the Committee in a way which emphasises the broad measure of agreement which I believe exists across party divisions on the key objectives of health policy. Far from being a point of difference, I believe the commitment to address health inequalities and to secure equitable access to high quality care is shared by all parties across the political spectrum.

“Although these objectives are widely shared, however, I believe it is becoming obvious that in future we shall need to think in a completely different way about how they are best met and I have concluded that in a pre-election period I can make a more effective contribution to this developing thought process from a less overtly political position. “

The Speaker also told the House that the election to choose Mr Dorrell’s successor will be held on Wednesday 18 June.


2.34pm Stevens: If we get our act together we can offer something the US will not be able to in the field of bio medical research.

2.30pm Mark Newbold, chief executive of Heart of England Foundation Trust, tweets:

2.28pm Simon Stevens tells the conference that the NHS needs to improve specialised commissioning but confirms that this will not mean centralising whole £14bn budget.


2.25pm Stevens: Our vital interest as patients is in care and health, not bricks and mortar.

2.15pm Stevens: ‘Let’s get serious about how we commission care pathways’. He cites the example of the separate commissioning of bariatric surgery and obesity treatment.

2.12pm Simon Stevens has said he wants to “accelerate the redesign of care delivery” and create “far greater local flexibility” in services, structure and system rules.

The new NHS England chief executive, in his speech at the NHS Confederation conference today, also indicated he was working on changes to payment rules, including making “a steadily increasing proportion of payments [to providers] tied to performance, quality and outcome

2.10pm NHS England Chief Executive Simon Stevens today sets out critical steps the Health Service must take to address head-on the challenges it faces over the next five years and beyond.
The NHS faces a “defining moment” in its history, he will tell the NHS Confederation annual conference in Liverpool.

“I know there are enormous pressures, but the NHS is up for change, and necessity truly is the mother of invention. Great effort has gone into analysing the challenges. People now want to get on with developing solutions.”

Mr Stevens highlights three particular approaches the NHS will now be taking: First, “unleashing more health and care bangs for the buck” - by far reaching changes in how hospitals and community services are funded.  An increasing proportion of their payments from NHS England and local Clinical Commissioning Groups will be explicitly tied to prevention, quality of care, and patients’ own views. 

Second, new local options to radically redesign the way GPs, local hospitals, social care and community health services work together - ending many of the historical demarcations that have existed since the creation of the NHS 1948.

“We need different solutions for diverse communities. Horses for courses, not one size fits all,” he argues. “In some places mergers and reconfigurations will of course be needed. But in other cases the changing needs of our patients - often frail, some with dementia, many with multiple other health problems - coupled with the opportunities of new technology may mean we can better support people at home and locally. 

“It’s the energy and commitment of NHS staff, of our patients and our partners that can generate the answers.”

Third, Mr Stevens says the NHS must aggressively harness wider global changes in modern medicine, adding:  “The NHS should be at the forefront of the coming revolution in personalised medicine, the use of data to drive transparency and proactive care, and the full engagement of patients in their own care.”   

He will announce the launch of a new process to select the nation’s leading teaching hospitals and clinical research centres to join the UK’s new 100,000 genome programme – one of the world’s highest profile initiatives in this area.

He will explain how the process will kick off later this month, with the first wave of trusts announced in the autumn, and beginning their work in early 2015.

Mr Stevens adds: “As a country we should be  rigorously pro-science, pro-research, and pro-the rapid spread of useful health improvement.”

He will also argue that investment in the NHS has supported a healthy and growing Britain, adding: “The British people’s support for our health service is undimmed.  The need for the superb care our staff strives to offer has never been greater. If we all pull together, I am optimistic we can get this right.”



1.55pm HSJ reporter Shaun Lintern, in the audience, tweets:


1.55pm The NHS faces exceptional pressure, day in, day out, says Rose.

1.49pm Sir Stuart Rose: “I’m here to listen and to learn.”

1.46pm Rob Webster’s last words of his speech:

“As CEO of the Confederation my job is to help you get there. So let’s ditch the burning
platform, embrace a burning ambition for the future of the NHS and get on with doing what
we do best. Leading the way through tough times and being accountable for something truly
remarkable. The NHS.”

1.45pm Six NHS leaders have been appointed as trustees on the NHS Confederation board, it has announced today.

The trustees oversee the work of the organisation, which represents both commissioners and providers in the NHS.

The new appointees are:

  • Jonathon Fagge, chief executive, Norwich Clinical Commissioning Group
  • Matthew Kershaw, chief executive, Brighton and Sussex University Hospitals Trust chief executive, and who was previously the trust special administrator for South London Healthcare Trust
  • Mark Newbold, chief executive, Heart of England Foundation Trust
  • Prem Singh, chair, Derbyshire Community Health Services Trust
  • Heather Tierney Moore, chief executive, Lancashire Care Trust, and
  • Owen Williams, chief executive, Calderdale and Huddersfield Foundation Trust

NHS Confederation chair Michael O’Higgins said in a statement: “We’re very pleased to welcome so many talented new trustee members today. Their wealth of skills, enthusiasm and experience will ensure that they can effectively deal with all the challenging issues so vitally important to our members and the broader health system in the 21st century.

“We look forward to working with them as they contribute genuine strength to the board of trustees and bring valuable perspectives. These six appointments are a major benefit for the NHS Confederation and I’m really pleased that we could choose from this very impressive skill base of candidates.”

1.40pm Webster lays out what the NHS needs from national bodies:

1. Accelerate genuine co-commissioning

2. Unblock the foundation trust pipeline and create viable health and social care systems

3. Enable improvements in information sharing

1.36pm Ask 3: Deliver parity of esteem for mental and physical health. Achieving parity of esteem requires a rebalancing of investment in physical and mental health, focused on delivering
improved outcomes and better value. This is not just about investment in mental health
services, but in a whole-person/whole system approach to improving mental and physical
health and wellbeing.

1.35pm Ask 2: Invest in the short term over and above this with £2bn a year in a transition fund, to support the development of new, sustainable models of integrated care. Change often costs before it saves. Establishing new models of care will take time and require investment
and stability.

The development of new models of care should enable a rebalancing of investment in
physical and mental health and wellbeing, so that within local health economies funding
matches need more closely, and allows mental health services to keep up with growing

1.33pm Webster lays out a set of asks to political leaders over the coming years.

Ask 1: Agree a 10-year funding settlement for the NHS/(the ‘decade-deal’)
We need change for many reasons. Often we default to the money. In order to take money
off the table and allow local leaders the room to plan and for the future, political parties
should promise to ring-fence and protect NHS funding for the next 10 years as a minimum
commitment. This means making a public pledge to deliver a real-term increase in NHS
funding over the next decade, in line with increasing needs and demands.

1.26pm Rob Webster read out a poem from a 14-year old patient:

1.22pm Rob Webster: “The needs of our population have moved on. Society has changed.The NHS is no longer geared up to meet their needs. An episodic service for patients is anathema for those with long term conditions, older people and children. The idea of being discharged for many patients is simply no longer relevant.

“Scandals have rocked staff morale and we face daily media headlines that were
unimaginable a decade ago.

“And we cannot afford to deliver the service in the way it is configured now - I am a simple
soul. If you take 25% out of something, it can’t be the same thing.

“This is the Burning Platform that we find ourselves on. One that has been discussed and
debated at length by the commentariat, think tanks and national bodies.

“If we stay here and fail to make the necessary changes, then the consequences are pretty
dire. A mismatch between NHS Care and society. Longer waits, rationing, failing
organisations, a loss of public support, decline and decay. This can’t be allowed to happen.”

1.20pm Follow the speech live via web cast here:

1.15pm Rob Webster opens his speech by paying tribute to Kate Granger, holding a sign saying “Hello my name is…”

1.12pm Opening the NHS Confederation conference, Sir Andrew Cash, deputy chair of the confederation,welcomes delegates with a message that money is tight and demand is rising.

1pm: Commenting on the government’s decision not to include the draft Law Commission bill, Regulation of health and social care professionals, in the Queen’s speech, Nursing and Midwifery Council chief executive and registrar, Jackie Smith said: “I am hugely disappointed that the government has not included this revolutionary bill in its final session of parliament.

“Both the NMC and the public it protects now continue to be left, indefinitely, with a framework that does not best serve to protect the public. 

“We will now take time to digest this disappointing news and work with the Department of Health on how we can now move forward and ensure the NMC is able to fulfil its ambition of becoming a more efficient and effective regulator.”

12.30pm: Today’s Queen’s Speech - setting out the government’s plans for legislation for the coming 12 months - confirms that the possibility of law to reform the role of professional health and care regulators has been dropped. HSJ reported on this yesterday.

However, it has confirmed the government is planning legislation to change rules on public sector redundancy payments.

A government briefing says of its proposed Small Business, Enterprise and Employment Bill: “Measures will be taken to stop the revolving door of big redundancy pay-outs for highly paid public servants.

“Measures will be brought forward to limit excessive redundancy payments across the public sector.” It said it would “stop highly paid public sector employees keeping redundancy payments when they come back to the same part of the public sector within a short period of time.”

It relates to suggestions made late last year by the health secretary, in response to media coverage of large payouts for those made redundancy under the government’s NHS reforms. Many have later returned to jobs in the NHS, after taking payouts, the government has admitted.

HSJ’s HR barometer, in partnership with NHS Employers, asked more than 100 HR directors and managers how likely it was that staff on the Agenda for Change pay framework would have their pay progression stopped in the next year.

Thirty per cent said it was very likely or likely staff in their organisation would have their pay increments withheld during the next 12 months. A further 39 per cent said they were slightly likely to withhold increments.

10.40am The Guardian reports that mothers should wait at least 18 months after giving birth before having another child in case their next baby arrives dangerously early, experts have warned.

Research by US academics suggests that women who give birth again within 18 months are much more likely to have a very premature child.

However, the Royal College of Obstetricians and Gynaecologists, which represents NHS maternity doctors, said women should leave it only a year before becoming a mother again.

10.35am The NHS will become “unsustainable” unless politicians urgently work out how to modernise and fund the service so that it can cope with sharply rising pressures, hospital bosses warn today and reported by The Guardian.

In a letter to the paper 71 NHS leaders urge the three main parties to start producing solutions to help the NHS survive or risk it ceasing to be a universal service that is free at the point of need.

Senior managers responding to HSJ’s HR barometer have revealed plans to recruit staff from overseas due to UK shortages.

The survey reveals the impact on HR departments of the Francis report into the Mid Staffordshire scandal and the subsequent focus on patient safety.

10.25am The Times reports that whistleblowers will be deterred from coming forward after an NHS inspector who highlighted key failures lost her employment tribunal, campaigners have warned.

Amanda Pollard told a public inquiry into the Mid Staffordshire scandal in 2011 that the Care Quality Commission, where she worked, prioritised paperwork over looking for poor standards of care.

An employment tribunal has rejected Mrs Pollard’s claim for unfair dismissal, even though it acknowledged she was making public interest disclosures. The tribunal ruled that while she suffered because of her revelations there was no campaign against her.

Mr Francis led the public inquiry into the scandal of poor care at Mid Staffordshire Foundation Trust, the report of which was published last year and was widely viewed as a watershed moment in the NHS’s approach to care quality.

The government’s response to his inquiry included a major overhaul of the CQC’s approach to inspection.

Mr Francis’ appointment as a CQC non-executive director was announced today.

10.07am Weston Area Health Trust has announced it is looking for a partner trust within the NHS to acquire it or merge with it.

The trust is only looking for a partner within the NHS and within a 50 mile radius. The selected bidder is expected to be announced in the autumn.

Nick Wood, chief executive of Weston Area Health Trust, said: “Previously, an ‘NHS only’ route was not an option, but that’s now changed. Due to the fantastic commitment of all our staff, significant improvements across the trust have put us in a much stronger position than we were 18 months ago when the procurement process first began.

“Weston is the smallest acute trust in the country. Work conducted with NHS North Somerset over the last five years clearly demonstrates that the trust cannot satisfy the requirements to become a Foundation Trust or find an option that is financially and clinically sustainable as a stand-alone organisation.”

10.00am The NHS Confederation’s annual conference begins at midday and HSJ Live will be there covering events as they happen.

The Twitter hashtag for the event is #confed2014 and you can follow our reporters @nickrenkom, @judithwelikala, @shaunlintern and @whazell for further updates.

9.55am The Times reports that coughs, colds and minor infections can cause rapid deterioration in patients with early Alzheimer’s disease, according to dementia expert Professor Holmes.

Professor Holmes’ data suggests that Alzheimer’s patients whose immune systems consistently showed signs of infection had a four-fold greater decline in memory tests during a six-month period compared with patients who had the lowest levels of infections.

9.50am The Daily Mail reports that hospitals are being put under unprecedented pressure as record numbers of people live to 100 or more, experts have warned.

The number is expected to reach half a million in Britain by 2006, according to a ten year study by King’s College London academics.

7.00am Welcome to HSJ Live. The majority of HR directors plan to ramp up the recruitment of nurses this year as many admit their organisations lack the staff to meet demand. Senior managers responding to HSJ’s HR barometer have revealed plans to recruit staff from overseas due to UK shortages.