NHS Employers chief executive to take up new role at Leeds Teaching Hospitals Trust, plus the rest of today’s comment and news
4.28pm Graeme McDonald, director of theSociety of Local Authority Chief Executives and Senior Managers (Solace) has spoken out very strongly against the DH’s better care fund announcement:
“The better care fund was a crucial step toward a sustainable, locally integrated health and care system. This announcement puts this at serious risk and will result in further cuts to vital adult social care services.
“These changes undermine the original, localist ambitions of the fund. By setting up a new national programme office, requiring places to submit another round of detailed plans and setting a crude national target, the government has created unnecessary layers of bureaucracy. This will undermine the ability of local areas to jointly develop plans that make the most sense for their place.
“These changes will also reverse progress toward better care for vulnerable, often elderly people. This will mean substantially reduced investment in the community and social care needed to keep people healthy and independent. Further reductions in already stretched adult social care spending and services are now increasingly likely. The better care fund was also supposed to provide the resources needed to implement the government’s new Care Act. As such, these welcome changes could be put at risk.
“Local government and health need a longer term commitment to joint funding not a one year programme. The government is at risk of undermining a policy which is critical to achieving a fair, sustainable health and care system.”
3.58pm Maureen Baker, the chair of the Royal College of General Practitioners, has commented on the government’s better care fund announcement. Here’s what she said:
“Today’s announcement sounds extremely promising, and has the potential to lead to real improvements in the standards of care that GPs can offer their patients.
“This boost to general practice is desperately needed.
“Over the last decade, investment in general practice has been cut back so much that, as patient demand has soared, the service has been left teetering on the brink of collapse.
“As family doctors have increasingly begun to drown under ballooning workloads, waiting times have grown longer and the overwhelming majority of GPs now fear they could miss something serious in a patient.
“The idea that general practice can continue to conduct 90 per cent of patient contacts in the NHS for just 8.5 per cent of the NHS budget is simply unsustainable.
“Today’s initiative shows that the message has finally got through that we cannot continue to let general practice wither on the vine.
“If general practice is allowed to collapse the effects would engulf the rest of the NHS like a tidal wave, with even more pressure being heaped on our already stretched hospitals.”
“This announcement is a major achievement for the College’s high-profile campaign for more funding in general practice, which we felt compelled to launch due to the chronic under-investment in the service.”
2.39pm The Nuffield Trust has also commented on the goverment’s better care fund announcement. Here’s what chief executive Nigel Edwards had to say:
“The better care fund, whilst sound in principle, was built on unrealistic assumptions about the in-year savings that could be achieved by reducing emergency admissions to hospital.
“It’s therefore good to see that the government has listened to the concerns we and others raised about the impact the fund could have on hospital finances in 2015-16, which is looking to be a crunch year for the NHS.
“But we should be under no illusion: the task ahead is not an easy one. The revised plan assumes reductions in emergency admissions of 3.5 per cent, which would require local authorities and the NHS to buck a long-term trend.
“As research to be published this week by the Nuffield Trust will show, emergency admissions rose 1.8 per cent in 2012-13 and 0.4 per cent in 2013-14. So just holding them flat would be a major achievement. What’s more, we know from extensive research that initiatives designed to develop better coordinated care outside hospitals are rarely able to reduce emergency admissions in the short or medium term
“Because this latest change to the better care fund requires local authorities to transfer money back to the NHS if emergency admissions are not reduced, it is likely that they will find themselves on the hook to hand up to £1bn back to the health service in a single year.
“This will come just as local authorities are using money transferred from the NHS to put in place new services for frail older people at risk of being admitted to hospital. It has the potential to be hugely destabilising for local authorities, when they are already under intense financial pressure.
“The government is right to be looking to boost out-of-hospital care to manage demand on the NHS. But extensive evidence shows that this kind of change takes time. Expecting any savings in the short-term is looking increasingly unfeasible.”
1.41pm HSJ’s live Q&A with Sir David Dalton is taking place tomorrow. Click here to share your thoughts on the Dalton review and to put your questions to the chief executive of Salford Royal Foundation Trust.
1.14pm Leadership problems at the Wirral Clinical Commissioning Group are linked to a loss of confidence among general practitioners in the area, a member of the Mid-Mersey Local Medical Committee has claimed.
Ivan Camphor, medical secretary of the group, which represents GPs, told HSJ that the Wirral leadership had upset its members by making “dictatorial” rather than “democratic” decisions when commissioning and axing services.
According to Dr Camphor, the CCG’s chair Phil Jennings and its accountable officer Abhi Mantgani caused the upset by driving through plans to withdraw £1.4m from practices for enhanced services to pay for extended primary care services.
12.58pm Rob Webster, the chief executive of the NHS Confederation has commented on the Department of Health’s plans to enable risk sharing between organisations involved in the better care fund. Here’s what he had to say:
“Transforming services to better meet the needs of people with long term conditions and frail older people is a priority for the NHS and social care. With our Local Government Association partners, we produced a report this week “All together now: making integration happen” that sets out the conditions that will make this happen.
“The NHS Confederation is supportive of the better care fund in principle. It is part of the shared decision making and financial arrangements that will support integrated care. We have been raising concerns about the implementation of the better care fund, based on the experience of our members and the fundamental issue that the fund is repackaged resources, not new money. This places financial risk on NHS organisations during an already tough period.
“These changes better reflect the need to invest in alternatives before taking resources out of hospitals – as expressed by the health select committee this week. However, these changes will not mitigate the intense pressure faced by the NHS and social care, especially if they inadvertently force local authorities to spend less on social care.
“If we are to ensure that the plans are successful then we will need extra resources. Along with the LGA, we have been calling for extra funds to ease transition and longer term financial settlements to provide upfront investment for service change.
“Many of our members will be very concerned about having to resubmit their better care fund plans, particularly at a time when they are also due to be submitting their five year spending plans. Any changes will need to be implemented in a way that is coordinated and reduces the impact felt by front-line teams.
“Ultimately, we must not allow the debate around the future of the better care fund to distract from the wider need to transform how we provide care.”
Mr Royles will leave his post in September after almost four years in the role.
His departure comes at a crucial time for NHS Employers, as negotiations with the British Medical Association continue over making changes to medical consultant and junior doctor contracts.
Relations between trade unions, employers and the government have come under significant strain in recent months following the government’s decision to reject a 1 per cent pay rise for all NHS staff.
Mr Royles also helped steer the organisation through negotiations with unions over changes to the Agenda for Change pay framework which was agreed last year.
11.41am Dean Royles, chief executive of the NHS Employers organisation, is to leave his post in September 2014, to take up a new role as Director of Human Resources and Organisational Development at Leeds Teaching Hospitals Trust. More to follow.
Lucia Gibson was arrested on charges of fraud in 2007 after it was alleged he took out £200 on treatments she did not carry out. She was eventually cleared of all charges.
10.58am Also in The Times, health select committee chair Sarah Wollaston has said that female GPs need to be encouraged to returned to the work after having children.
Dr Wollaston, a former GP, said: “We’ve got a very large female workforce now in general practice, many of whom step out for childcare commitments. Let’s very quickly try to bring those women back into the workforce. It takes four years to train an GP, it takes very short time to get someone back in the workforce who’s been out for three or four years.”
10.53am Nine leading health and care professionals have today written to The Times warning that “unless action is taken, by 2020 maintaining the current level of service provision will require an additional £30 billion for just the NHS – which is as much as the spend each year on defence.”
They call for an “all-party-mandated, independently conducted ‘national conversation’ on the scope, provision and funding of health and social care” which “needs to start now and be completed by the end of next year”.
The signatories include Macmillan Cancer Support chief executive Ciaran Devane and Lord Victor Adebowale, who are both non-executive directors for NHS England.
10.35am A vaccine expert has questioned the scientific rationale for research into the 2009 strain of a pandemic flu virus that could leave the human population defenceless against its re-emergence, The Independent reports (paper only).
Professor Stanley Plotkin, who pioneered development of the rubella vaccine, said the scientist behind the experiment, Professor Yoshihiro Kawaoka, has not been able to answer serious questions on the validity of his research into mutated forms of the 2009 H1N1 pandemic flu virus. Professor Plotkin also said that Professor Kawaoka’s research on H1N1 risks creating a form of pandemic flu virus that would threaten the human population should it escape from his laboratory.
10.34am The Independent reports that diabetes is becoming a “national health emergency” with thousands of new cases diagnosed every week, says a leading charity which warns it could led to a rise in amputations and kidney failure.
More than 280,000 people learn that they have the condition every year according to an audit by Diabetes UK.
10.29am The Telegraph (paper only) reports that mothers with postnatal depression are being failed by the NHS because only 3 per cent of health organisations offer help with the condition, a report has suggested.
The figures from the National Childbirth Trust found 97 per cent of clinical commissioning groups had no mental health strategy for new mothers and 60 per cent said they doid not have plans to put one in place.
10.22am Also in The Telegraph, patients should be denied antibiotics and left to get better without them to wean people off a reliance on the drugs, MPs have said.
In a report today the Commons science and technology committee quote evidence from one doctor who said GPs should be allowed to issue “delayed prescriptions” which can only be used to accedd medicines after a five day wait.
10.13am In The Daily Telegraph, government plans to “name and shame” doctors with poor cancer referral rates will cause huge queues in surgeries, hundreds of GPs warned.
Dr Maureen Baker, head of the Royal College of General Practitioners, said in a letter to the paper today that doctors would have to refer virtually all patients to be on the safe side. A second letter, signed by hundreds of doctors, said the plan was a “bullying tactic” and risked “bankrupting” the NHS.
10.07am Better care fund cash will be used to compensate acute hospitals when local integration initiatives fail to reduce emergency admissions, the Department of Health has announced.
This modification was set out today by the DH and Department for Communities and Local Government following a ministerial pledge last month that an element of “risk sharing” would be incorporated into the initiative.
There have been widespread fears from NHS providers that they would be placed at financial risk if the integration project did not lead to lower hospital admissions.
9.53am Local authorities have been urged to step up their scrutiny of NHS providers, as a survey revealed funding for such checks has dwindled.
The call for strengthening council probes of healthcare services came in new guidance by the Department of Health.
7.00am Good morning. On Wednesday at 9pm we will publish our second list of 50 of the most inspirational women in the sector. Some are in leadership and top executive roles, but many are making a difference on the front line of patient care.