Proportion of women holding senior leadership positions in the NHS has increased slightly over the past year, plus the rest of today’s news and comment.

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Kate Barker, who chairs the King’s Fund’s commission on the future of health and social care, was speaking today at the Local Government Association annual conference in Bournemouth.

She was asked whether it would be difficult for health and social care to be sufficiently funded without increased taxation or national insurance.

Ms Barker said it was “really hard to see how you’d get the money you’d need” in any other ways.

4.50pm Our readers have some interesting thoughts on the expansion of the personal health budgets policy:

“While personal budgets may have had some success in social care, they have been part of a regime for the user where if the personally chosen care bought with the budget does not work, no more funding is generally made available. This contrasts with NHS pilots where mainstream NHS services remain available free at the point of use, should the personal services fail. Presumably, politicians will be brave enough to cap such double funding?”

“Many of us have been waiting to see how Mr Stevens works round to furthering the private sector agenda he has brought with him from his sojourn at UnitedHealth – and here it is. Exactly how carving random lumps out of the already pitifully limited budgets for social care and community health care to give to individuals to spend with the assistance of a self-interested voluntary sector and the local Yellow Pages is a mystery. If there is not enough money to offer a decent level of services to everyone now, how is the same amount of money going to generate any more care if spent by individuals steering a difficult route between grasping private companies seeking to rip them off?”

“Classifying the voluntary sector as self serving and the Third Sector as the yellow pages are cheap and misguided comments which add nothing to what should be a positive debate - describing anything different as privatisation is equally unilluminating.”

4.00pm HSJ reporter Judith Welikala is tweeting from the Local Government Association conference. Here are some highlights:

“Stevens says he knows that times are tight for local govt and the NHS and ‘yes that is creating tensions’”

“Stevens says he won’t duck the controversy over the better care fund, and admits the current situation is no one’s first choice”

“Stevens says the NHS at the early stage of recognising that the change in health needs will mean change in the style of services.”

2.25pm In our leader column for this week HSJ editor Alastair McLellan argues that while progress has been made in the number of females occupying leadership positions in healthcare, there is still some way to go in the treatment of female leaders when things go wrong.

2.15pm Similarly, the Chartered Society of Physiotherapy says pilot scheme results from personal health budget trials are “encouraging”, but is keen to see more detail as to how the policy will work.

Professor Karen Middleton, chief executive of the Chartered Society of Physiotherapy, said: “Personal budgets can give people control over how they manage their condition and enable them to continue leading full, independent lives.

“That is a principle we support and results from pilot schemes involving physiotherapists have been encouraging.

“Where people are properly supported by health and social care professionals in making their decisions, it can have a very good impact on quality of life.

“How the policy is implemented will be critical, however, so we look forward to seeing more detail.

“And personal budgets shouldn’t be used to mask shortfalls in funding or poor access to services - and the reality is that only by addressing those issues can personalisation achieve its real potential.

“For example, self-referral to physiotherapy empowers people to take control of their condition but is not widely available.

“Personal budgets are a step towards putting patients at the centre of everything we do, but remain just one part of the solution.”

2.12pm The National Association of Primary Care has welcomed Simon Stevens’ announcement on Personal Health Budgets “in principal”. 

Dr Nav Chana, NAPC’s vice chairman and GP,said: “NAPC welcomes approaches that focus on personalisation with an emphasis on health and social care integration. We see this as a key component of improving population health outcomes, something NAPC has championed. Key to this will be defining value of approach bases on outcomes that matter to people rather than those that are traditionally measured”.

Dr James Kingsland, NAPC President OBE, said: “New approaches to integrating care and utilising NHS resources in different ways must be supported by a strong evidence base and well defined metrics to assess the value of these approaches. Increasing ambition requires heightened accountability to ensure that both the ‘thoughts’ of the patient and the ‘actions’ of the tax payer are both fully realised.  Dr Kingsland added “ Speculative approaches to new ways of providing care may be very dangerous in current fiscal climate.”

1.02pm HSJ’s list of the most inspirational women in healthcare leadership for 2014 will be revealed tonight at 8pm. The full list will be published here.

Cambridgeshire and Peterborough CCG has agreed to delay the go-live date for the restructure of its older peoples services, part of a contract deal worth £800m, from January to April 2015.

The decision follows a consultation on the plans.

A CCG statement said: “In order to ensure patient safety during the transition, the CCG’s governing body has agreed to move the start date for the new integrated older people’s healthcare and adult community services contract from January to April 2015.

A report by umbrella body Homeless Link shows that the proportion of homeless people in England with a physical and mental health problem is at least twice that of the general population.

Of the 2,500 homeless people included in the survey, 41 per cent reported having a long-term physical health problem. This compares with 28 per cent among the general population.

12.27pm The debate over the use of A&E waiting times statistics has continued in Prime Minister’s Questions today.

Ed Miliband asked David Cameron to correct the record on A&E waiting times. Mr Cameron had said that waiting times had more than halved. This measure referred to the time between when the patient arrives in A&E and initial assessment.

A House of Commons blog found that the “total time in A&E had risen”.

10.50am The proportion of women holding senior leadership positions in the NHS has increased slightly over the past year, with an additional 206 women now sitting on clinical commissioning group governing bodies and provider boards.

Exclusive analysis by HSJ found that 39 per cent of executive and non-executive positions were held by women, compared with 37 per cent at the same time last year.

NHS acute, mental health and community providers saw a 30 per cent increase in the number of female finance directors, a 7 per cent increase in female medical directors and an 9 per cent increase in female trust chairs.

Mr Stevens, addressing the Local Government Association annual conference in Bournemouth, will describe the move as a “radical new option” for councils and clinical commissioning groups to adopt.

Areas will be invited to bid to pilot the initiative in 2015-16. In an interview with the Guardian Mr Stevens said 5 million people could have combined health and care personal budgets by 2018. He added this would involve “billions” of pounds of NHS and local government funding.

Details of the CQC’s “significantly flawed” recruitment process, which ran from January to December 2012, were laid out in an internal report, presented to its audit committee in March and obtained by HSJ under the Freedom of Information Act.

It revealed that the watchdog, which inspects thousands of health and social care organisations each year, employed 134 applicants in 2012 who “failed some or all of its recruitment activities”. Of that group 121 are still in post, the CQC told HSJ.

10.24am Rising numbers of elderly and obese organ donors are forcing surgeons to give patients two unhealthy kidneys instead of one good one, or use livers packed with fat “like foie gras”, the NHS transplant chief has said, reports The Times.

Despite record numbers of transplants doctors are having to turn to organs that have suffered “wear and tear” in older, fatter patients said Professor James Neuberger of NHS Blood and Transplant.

More than a third of organ donors are now over 60, twice as many as a decade ago.

10.20am The Times reports that deaths from overheating could triple to 7,000 a year because many of Britain’s hospitals, care homes and houses are not designed to cope with global warming, according to the government’s climate change advisory body.

10.16am The Times splashes with the uncovering of a tax avoidance scheme involving 1,600 people who tried to shelter £1.2bn, including doctors.

The Liberty tax strategy has been investigated by HMRC and is due to be challenged in court in March next year.

10.00am NHS England chief executive Simon Stevens is due to make his announcement on the extension of personal budgets at the LGA conference at 3pm today.

9.55am HSJ reporter Judith Welikala is at the Local Government Association’s annual conference today where she is tweeting updates.

Follow @judithwelikala for the latest news from the conference.

9.20am: The NHS England chief executive Simon Stevens will today announce a large extension of the use of combined health and social care personal budgets.

He will describe it as a “radical new option” which councils and clinical commissioning groups will be able to choose to pilot in the near future or to offer in future. In an interview with the Guardian he said the personal budgets could extend to 5 million people by 2018.

Mr Stevens will make the announcement at the Local Government Association conference in Bournemouth today. HSJ’s Judith Welikala will cover the event live.

Information provided by NHS England on the programme, called Integrated Personal Commissioning (IPC), states:

“Four groups of high-need individuals are likely to be included in the first wave from next April 2015, although councils, voluntary organisations, and NHS clinical commissioning groups may also propose others. These are:

  • people with long term conditions, including frail elderly people at risk of care home admission
  • children with complex needs
  • people with learning disabilities, and
  • people with severe and enduring mental health problems.

“Under the new IPC programme, a combined NHS and social care funding endowment will be created based on each individual’s annual care needs. This will blend funds contributed from local authorities and NHS commissioners (CCGs and NHS England). Individuals enrolled in the programme will be able to decide how much personal control to assume over how services are commissioned and arranged on their behalf.

“NHS England will now work with partners in local government, CCGs, patient groups and the voluntary sector to develop an IPC Prospectus which will be published at the end of July. This will formally invite local expressions of interest in jointly developing and participating in the IPC programme from April 2015.

“NHS England will provide technical support to develop projects, and fund independent evaluation. Wider scale rollout of successful projects is envisaged from 2016-17.”

Read full NHS England information

7.00am Good morning. Leadership is the important ingredient that will make the NHS the best healthcare service in the world, but great leaders are rare and their qualities come as naturally to them as breathing, says senior programme lead for inclusion at the NHS Leadership Academy, Yvonne Coghill.