The first eight sites to introduce integrated health and social care personal budgets have been revealed, plus the rest of today’s news and comment
5.10pm Here’s a quick recap of the top news stories from HSJ today:
- A shortage in the supply of senior NHS managers will not prevent the Care Quality Commission from taking action against trusts who employ ‘unfit’ directors, Sir Mike Richards has told HSJ
- HSJ’s exclusive map shows which CCGs will be co-commissioning general practice from next month, and at which level of involvement
- North Staffordshire Clinical Commissioning Group has become the first CCG in the country to restrict access to NHS funded hearing aids
- NHS unions have officially ended their pay dispute with the government by accepting a 1 per cent pay rise and committing to future talks on reform of Agenda for Change
4.25pm Just a reminder that the entry deadline for the Patient Safety Awards has now been extended to 13 March. Enter now for a chance to showcase your project in front of NHS leaders.
The Patient Safety Awards recognise and reward outstanding practice within the NHS and independent healthcare organisations.
Now in their seventh year, the awards have joined forces with the Patient Safety Congress.
There are various categories you can enter. They are:
- Best New Product, Innovation or Service
- Cancer Care
- Changing Culture
- Clinical Leadership
- Dementia Care
- Education and Training in Patient Safety
- End of Life Care
- Hall of Fame
- Improving Safety and Quality in Primary Care
- Improving Safety in Medicines Management
- Managing Long Term Conditions
- Mental Health
- Musculoskeletal Care
- Patient Safety in Care of Older People
- Quality of Care Award
- Technology and IT to Improve Patient Safety
- Trust of the Year
The awards will be announced at the Patient Safety Congress in Birmingham on 6-7 July.
If you have any queries regarding your entry or not sure which category is right for you then don’t worry, help is at hand. Call Flavio on 020 3033 2350 or email flavio.rispo@EMAP.com
4.20pm There have been some interesting reader comments our story today that North Staffordshire Clinical Commissioning Group has become the first in the country to restrict access to NHS funded hearing aids.
One reader described the move as “short termist”. They added: “What impact and cost will not being able to hear properly (for that cohort of patients) have on the NHS in terms of increased levels of depression, isolation, accidents etc? I guess more than the £200k saved.”
Another reader said it “looks like a progressive crank down of the range of services the NHS is either willing or can afford to provide”.
3.35pm Healthcare unions have today called off industrial action in England and have agreed to a pay proposal made by the government in January.
The decision was made at the NHS Staff Council, in which meetings between health unions and employers take place on pay terms and conditions.
The unions’ decision follows weeks of balloting of their members. HSJ reported last week that members of Unite, the largest healthcare union, voted to accept the government’s latest pay offer, while NHS managers have turned down the proposals, describing them as “divisive”.
Responding to the decision, NHS Employers chief executive Danny Mortimer said: “This will be a huge relief for NHS organisations and for the thousands of patients and staff who were disrupted by industrial action.
“Employers do understand the anxieties of staff and urgently want to discuss sustainable ways to move away from pay restraint.
“This end to industrial action means we are now in a position to start those crucial discussions.
“Any solution will need to support better, safer and more responsive services to patients and more efficient use of NHS resources.”
2.47pm The Daily Telegraph reports on a controversial calculator introduced by the NHS that can compare a person’s “heart age” with their biological age and can predict when they would be likely to have a heart attack or stroke.
1.56pm Here’s some more detail about how the first eight sites will be integrating health and social care personal budgets:
Barnsley - partners will be working together to develop the [integrated personal care] model to support people with complex diabetes. This new approach will help people who have lots of contact with services, especially acute services, to take more control of their own health and wellbeing.
Cheshire West and Cheshire - the focus will be on people with learning disabilities, including those who have mental health problems or autism. The programme will focus on people who have high support needs, are in institutional settings or at risk of being placed in these settings, and/or are children and young people aged 14 and with complex/learning disability needs. Working together, the local NHS, council, voluntary sector and families will ensure more people with learning disabilities in Cheshire can be supported to live more independently in the community.
Luton - through the development of the IPC model, people with dementia will be offered more choices about their care with the goal of being able to stay independent for longer. Local leaders estimate enhanced personalised care plans will be in place for 60 per cent of dementia sufferers, with local support and treatment services better aligned to the needs of individuals and their carers.
Stockton on Tees - organisations will work with older people with long-term conditions. Their aim is to develop a model for the management of long-term conditions for the older people. Effective promotion of self-management will be at the heart of their new care model.
Tower Hamlets - partners aim to expand the offer of personal health budgets to include: people with long-term conditions, particularly adults and children with more complex health needs including significant mental health problems; and people eligible for jointly funded continuing healthcare, for whom providing a seamless service aligned with the local authority is important.
Hampshire - partners will work with children and young people in transition (14-25 years old) with complex needs such as learning disability, mental health problems and physical conditions, as well as adults with a learning disability, including those in, or at risk of entering, an institutional setting.
Portsmouth - this area will be supporting older people with multiple long-term conditions who are most at risk of avoidable hospital admissions. Pooled health and social care budgets and the increased use of personal health budgets will enable Portsmouth to continue to breakdown organisational barriers between health and social care and provide more joined up personalised care for older people.
South West Consortium - partners in this large consortium will be working to improve care for people with a range of multiple long-term conditions; including mental health issues; learning disabilities and children with complex needs. The focus will be on embedding the culture change needed to deliver personalised care using personalised care plans, and an emphasis on crisis prevention.
1.34pm NHS England and the Local Government Association have named the first eight sites to introduce integrated health and social care personal budgets.
The successful sites are:
- Cheshire West and Cheshire
- Stockton on Tees
- Tower Hamlets
- South West Consortium
The first wave of the integrated personal commissioning (IPC) programme is due to go live on 1 April.
It will affect about 10,000 people who fit within four groups of high need individuals – older people with long term conditions, children with disabilities and their families, people with learning disabilities, and people living with serious mental illness.
NHS England chief executive Simon Stevens said: “Our aim in this radical initiative is to end fragmented like-it-or-lump-it health and social care, by giving high-need individuals the power for the first time to decide on the blend of support they themselves want.
“Integrated personal commissioning gives families the chance to make a reality of person-level health and social care integration, as the NHS moves beyond just asking “what’s the matter with you?” to “what matters to you?”.
The Local Government Association’s community wellbeing board chair Izzi Seccombe said: “Councils have made great strides in introducing personal budgets for people, who through personalised care and support are able to live independently.
“People are best placed to decide what support they need to enable them to live full and independent lives. Through our work with the integrated personal care programme, councils will be able to join up health and social care budgets, offer support to help people navigate the system and have their voice heard and give the best information and advice.
“As co-sponsor of the programme, the LGA will now be working with the demonstrator areas to see how this works in practice and share any valuable lessons with all health and care commissioners.”
1.20pm A shortage in the supply of senior NHS managers will not prevent the Care Quality Commission from taking action against trusts with ‘unfit’ directors, Sir Mike Richards has told HSJ.
The CQC chief inspector of hospitals also outlined the process for dealing with complaints under the new fit and proper person test regulations and the approach the regulator would take in judging individual cases.
The regulator received several referrals from campaigners and whistleblowers in January, seen by HSJ, together naming more than 20 current and former NHS chief executives, medical directors and senior board level executives as being allegedly unfit for their roles.
1.15pm Ed Balls has warned that the Conservatives’ spending plans could result in NHS charges, The Guardian reports.
The plans would lead to £70bn of cuts to public spending in the next parliament, Labour has said, which is more than double the amount stated by chancellor of the exchequer George Osborne.
“This is the implication of the choice that George Osborne made last December, and which he is now trying to brush under the carpet,” the shadow chancellor said.
“If he is to deliver on his autumn statement plans for a £23bn overall budget surplus, as he says, through a budget with no fiscal loosening, while promising unfunded tax cuts in the next parliament, then he is going to have to deliver these colossal cuts.
“The evidence is clear: countries which reduce public spending at the pace George Osborne intends have found they have had no alternative but to cut health spending.”
12.45pm Over a quarter of clinical commissioning groups have links to a private company involved in healthcare, according a study carried out by the trade union Unite.
Unite analysed the registered interests of 3,392 CCG board members. The trade union has said this is the most extensive research of these interests undertaken.
It found that 27 per cent of board members (932) had a link to a private company involved in healthcare. This figure includes 513 Company Directors, 140 business owners, 105 external work, 17 partners, 15 chairs, 10 company secretaries, 5 chief executives, 1 trustee, 1 financial officer and 125 others including consultants.
The study also found that 12 per cent of board members (409) are shareholders in such companies, through either businesses they own or external private companies, including providers of out of hours services.
Unite general secretary Len McCluskey said handing budgest to CCGs “created a monster” where “personal financial interests run amok”.
Chair of the doctors’ section of Unite Ron Singer said:“The Health and Social Care Act forced GPs into a business model that the vast majority did not want.
“Most GPs want to spend their time caring for their patients not tendering out services and being part of a bidding war.
“The government’s health act has created opportunities for exploitation by some CCG board members.
“At the same time some GPs have decided to become CCG members as a way to defend NHS services from privatisation and fragmentation.
He said the Act is “disaster” that is “fit for the dustbin of history”.
12.24pm The Guardian has visited a GP practice in Glossop that is experiencing a high level of demand.
It reports that nationally the number of consultations across England has risen from 304m in 2008-09 to 372m in 2014-15.
12.03pm The Patients Association has also criticised the Parliamentary and Health Service Ombudsman for “[continuing] to let down families”.
A statement issued by the organisation on Suday said it “[continues] to raise concern that the PHSO which should be a catalyst for change is failing to challenge poor practice and bring about change in the NHS confirmed yet again in the Kirkup report into the failings of Morceambe Bay published this week.
It called for “radical change and reform” of the PHSO, adding that “the public deserve nothing less” that a “truly independent, transparent and honest Ombudsman”.
“This is the organisation that sits at the critical apex of the NHS Complaints system and sets the culture for the whole of the NHS system. If the tone and culture is wrong at this level – the dishonesty and poor practice will continue to scar the NHS and patients and their families will continue to suffer,” the statement continued.
“Families feel bewildered, traumatised and let down by the failings of the Ombudsman.”
Patients Association chief executive Katherine Murphy said: “Sadly yet another report this week demonstrating false assurances and yet again too many missed opportunities by the Parliamentary Health Service Ombudsman – it makes for very distressing and sad reading
When will the lessons be learnt so the public can have confidence and trust in a safe NHS which is treasured by so many?”
11.54am Patient safety campaigner James Titcombe has written an open letter to the Commons Public Administration Select Committee chair Bernard Jenkin calling for “urgent action” to be taken to “change the culture of the [Parliamentary and Health Service Ombudsman]”. He wrote: “It is hard to see how this can be achieved without a change of leadership and direction.”
Mr Titcombe’s campaigning following the death of his baby son Josia as a result of failings at University Hospitals of Morecambe Bay Foundation Trust in October 2008 helped to bring about the Kirkup inquiry into care failings at the trust, which published its report last week.
The inquiry found that “failures at almost every level of the NHS” combined to create a “lethal mix” which caused the avoidable deaths of at least 11 babies and one mother.
Mr Titcombe’s letter references HSJ exclusive story from last Friday, that the capability of the PHSO to investigate complaints and obtain evidence has been seriously questioned in light of the Kirkup inquiry.
Concerns were raised after the inquiry’s conclusions contradicted a PHSO investigation last year on the question of whether Morecambe Bay midwives colluded over evidence to an inquest.
The Kirkup inquiry said there was “clear evidence of distortion of the truth” by midwives, describing how they were given a crib sheet of “model answers” before the inquest into the death of Joshua Titcombe, who died as a result of failings at Morecambe Bay in October 2008.
This came a year after ombudsman Dame Julie Mellor said she found no proof that the midwives colluded over evidence. She said she saw no evidence of “professional wrongdoing” by midwives ahead of the inquest taking place.
11.24am North Staffordshire Clinical Commissioning Group has become the first CCG in the country to restrict access to NHS funded hearing aids.
The decision by the West Midlands group will take effect from September and affect approximately 500 new patients a year, saving around £200,000 in the first full year.
However, it was condemned by the charity Action on Hearing Loss, which accused the CCG of forcing its plans “through the backdoor”.
11.17am More than half of all CCG chief officers and chief finance officers were paid salaries above official guidance rates they were “strongly encouraged” to follow by NHS England prior to their establishment, according to a survey by the research organisation E-reward.co.uk.
The survey analysed remuneration data from over 2,500 individuals working in 208 CCGs.
It found that 56 per cent of all chief officers and chief finance officers received salaries above recommended rates. 43 per cent of chief officers in CCGs with the largest populations (over 500,000 people) were paid salaries above the £120,000 to £130,000 recommended level.
A greater proportion of chief finance officers (over 60 per cent) earned more than the suggested ranges.
The survey identified few differences in gender pay levels. Both male and female lead directors had a median salary of £122,500. There were also no significant differences between the median levels paid to those working as chief finance officers or chief operating officers.
Based on the research, the median pay levels for various CCG senior positions are as follows:
- Accountable officers - £127,500
- Chief officers - £122,500
- Chief financial officers - £102,500
- Chief operations officers -£97,500
- Nursing directors - £82,500
Steve Glenn, E-reward.co.uk’s head of executive remuneration research, said: “Whether the initial high-end positioning of salaries suggests that CCGs foresee recruitment and retention battles ahead remains to be seen but early indications are that there is already quite a bit of activity in the labour market for CCG executives even though it is only a couple of years since their establishment”.
10.46am NHS England has decided which clinical commissioning groups will take on full delegated responsibility for general practice in their area from April, and which will begin the lower level of “joint commissioning” these services.
Our map shows the 64 groups that are confirmed to take on full delegated responsibility (in green) and 87 which will begin “joint commissioning” (in yellow). The situation for a further one group (in black) is yet to be confirmed, and the remainder of CCGs (in grey) will not take on any additional formal primary care co-commissioning responsibility.
10.34am In an open email, Sussex Partnership Foundation Trust chief executive Lisa Rodrigues outlines why chief executives should set an example and sign up for NHS Change Day 2015.
10.27am This year’s NHS Change Day on 11 March promises to be the biggest, and the most wide reaching and action packed yet. Shreshtha Trivedi reports.
10.13am Here’s another story you might have missed last week - a number of trusts are taking legal advice about the potential to challenge Monitor and NHS England’s decision to withhold their commissioning for quality and innovation payments.
The move follows the pricing authorities’ decision to withdraw the payments – worth up to 2.5 per cent of contract income – from those providers that rejected the latest tariff offer and opted instead to remain on 2014-15 prices next year.
Monitor and NHS England last Friday confirmed that 30 of the 241 NHS providers rejected the “voluntary” tariff offer. They said in a statement that since these providers “would not be contributing proportionately to the shared NHS-wide 2015-16 efficiency goals through the tariff deflator, they will instead be ineligible for discretionary payments, including CQUIN, next year”.
However, numerous senior sources have told HSJ some of the trusts that rejected the offer have sought lawyers’ advice on whether CQUIN payments can be withheld from them.
10.02am Some important news from the end of last week - a clinical commissioning group has warned that its deficit could hit an enormous £40m by the end of the financial year, which would be the largest recorded by any group so far.
Bedfordshire CCG’s chief operating officer John Rooke has also announced his departure - although a CCG spokeswoman told HSJ this was not related to the deficit.
7.00am Good morning. In our Comment section, Mencap’s Jan Tregelles writes that for NHS Change Day, NHS England chief executive Simon Stevens, who has pledged to drive through change in the NHS for people with a learning disability, must make good on his promise.