Strike called off after pay offer put forward, plus the rest of today’s news and comment

Live logo

6.00pm Michael White has posted an update beneath his column.

“I come back online to report that since filing this morning, Alan Milburn has popped up on Radio 4 Wato to warn that Labour risks a re-run of 1992 this May by seeming to be a conservative party over the need for continuing NHS reform and hostile to private sector involvement.

“Not very coded. Alan Johnson, another ex-health secretary, was more discreet. But the message to Ed Mil was the same and reinforced by pollster saying that the ‘NHS in peril’ language works with the core Labour vote, less so with floaters Miliband needs.

“Liz Kendall was interviewed, always a tempting test to use it to show off. She didn’t. While sticking to her reformist agenda, she said ” Ed this ” and “Andy that.” very loyal”

5.47pm Jeremy Hunt has responded to the staff strike suspension.

He said: “This is good news for patients, and I welcome the unions calling off strike action. We have consistently said that we wouldn’t agree a pay deal that risked frontline jobs and therefore patient safety. This offer achieves that – the NHS paybill will not increase next year, while we reward hardworking staff.”

5.46pm The Royal College of Psychiatrists has welcomed Labour’s 10 year plan.

Professor Sir Simon Wessely, President of the Royal College of Psychiatrists said: “We welcome Labour’s strategy set out today in their 10 year plan for health and social care.

“Psychiatry has always recognised the crucial importance of integrating physical and mental health care, primary and secondary care, and health and social care. This is vital  if we are to provide the best possible care for people with mental health problems, and we hope that a consensus can be reached across the political parties to work towards this.

“We particularly welcome the strong focus on early intervention and improving child and adolescent mental health, and we urge whoever forms the next Government to ensure that evidence-based policies- such as parenting programmes- are introduced.”   

Unions will now consult members over the offer, which follows several meetings with Department of Health officials and health secretary Jeremy Hunt.

HSJ understands the offer is for a consolidated, or pensionable, 1 per cent pay rise for all staff up to band 8B on the Agenda for Change pay framework with an additional £200 consolidated payment for lower paid staff on pay points 3-8.

5.40pm NHS Employers is “delighted” that the strike has been called off.

Chief executive Danny Mortimer said: “We are delighted that the strike has been called off. It is the right decision for patients and puts us all in a better position to start talking about long-term solutions.

“Unfortunately, many patients will have already have been disrupted where it was necessary to safely reschedule their non-urgent appointments.

“If the unions proceed to fully accept the proposed pay agreement it will demonstrate a commitment and signal the start of a period of negotiations to deliver long term pay reform in the NHS. This needs to ensure that the pay system helps the NHS to provide better, safer and more responsive services to patients and lead to a more efficient use of NHS resources.”

5.36pm UNISON’s head of health and the unions’ lead negotiator, Christina McAnea, has commented on the suspension of the staff strike.

She said: “The two strike days staged by health workers last year have moved the government to negotiate with the unions.

“This isn’t a great offer but it addresses some of the key concerns unions have about low pay in the NHS. In the interest of patients’ safety unions will now consult members. 

“It will be up to members to decide whether to accept or reject the proposals. If they choose to reject them we will move to further industrial action.”

5.02pm The BBC is reporting that the planned strike by NHS staff this Thursday has been suspended while further talks are held over pay, Unison says.

5.00pm NHS England will continue to commission specialist renal and morbid obesity services in 2015-16 after concerns were raised by organisations including NHS Clinical Commissioners who said patients could be put at risk if the services were transferred this April.

It said it will keep under review whether to transfer responsibility to clinical commissioning groups, but any changes would not happen before April 2016.

Director of commissioning specialised services Richard Jeavons said: “We all want what is best for patients, and we have listened extremely carefully to their views and those of CCGs. For the time being we will continue to directly commission these services, which will give us head room to work through the proposals in more detail and address the issues that have been raised with us.”

NHS England has launched a consultation into how it will prioritise which specialised services and treatments to invest in.

It directly commissions around 145 specialised services. It is now going to decide which of these it will continue to fund.

The consultation will last for 90 days.

The NHS England board voted to extend the length of the consultation at their last board meeting in December.

Mr Jeavons said: “We want to ensure patients have access to the very best innovative, evidence-based treatments and services that are being developed all the time. We need to get the most out of every pound for the benefit of patients. They asked us to consult on the principles and process behind making these decisions, which is exactly what we are doing.”

This process is looking at the specialist treatments and services that will be routinely available for groups of patients on the NHS. Clinicians, on behalf of their patients, will continue to be able to make a request (an Individual Funding Request) to NHS England for treatment that is not routinely available.

NHS England is also seeking views on which specialised services should be prioritised for ‘service reviews’ as part of a rolling programme of reviewing how each specialised service is delivered. NHS England is writing to all providers of specialised services, Clinical Reference Groups and associated patient groups seeking their views on where to concentrate efforts over next 12 – 24 months. 

4.25pm In the HSJ editor column Alastair McLellan writes that Labour’s plan for the NHS is “relatively brave in content and tone”.

He adds: “The easy wins of ‘more doctors and nurses’ are there, but the plan focuses on the less glamorous aspects of health and social care. Effective home support is prioritised and hospital admission is rejected as an appropriate response to the challenges of an aging population.”

Speaking at a press conference this afternoon, Mr Burnham said it “made sense” to have a single regulatory regime for both FTs and non-FTs, but added that he had not made a “firm decision” on whether to merge the two organisations.

His comments followed the publication this morning of Labour’s 10 year plan for the NHS, which promised to consult on “how to release even larger savings” from the new organisations created by the coalition government’s health reorganisation, including “by addressing potential duplication of responsibilities and further reducing bureaucracy”.

3.25pm At The King’s Fund this morning Andy Burnham was asked about Ed Miliband’s refusal to confirm if he would give Burnham the health secretary role under a Labour-led government.

Bunrham replied: “I hope my passion for what I’m doing comes over… I’ve given this great thought over many years, I’ve reflected  on the things that have been happening in health over recent times, I’ve thought about the challenges of the future. This is our mission if you like, I really believe passionately in putting the NHS on the right basis for the 21st century. Of course I want to see these plans through, I’ve put a lot of thinking and myself into them, it’s been a long process. You can’t come up with a plan like this overnight, you have to really think it through. Before the last election I was planning a National Care Service, and then I changed my thinking to say, well, no, this has to be one system, so my thinking has evolved.

“What you’ve heard today is probably the product of 10 to 15 years work from when I first joined the health select committee. I’ve thought this through at every level, I’d obviously like to see it through but ultimately, whoever’s in Ed Miliband’s cabinet is a decision for Ed. But I hope I’ve given him a plan which really sets the NHS up for the future.”

3.20pm Jeremy Taylor, chief executive of National Voices, has called for Labour to “flesh out” their vision for the NHS.

He said: “We welcome the Labour 10 year plan which offers a powerful vision and direction for improving health, wellbeing and care. Since Andy Burnham first set out his vision of whole person care it is clear that much thought has gone into developing it, not least as a result of the Oldham Commission. 

“More work is needed to flesh out the vision, however. Issues include: Labour’s vision of citizen and service user involvement seems underdeveloped; new rights for patients and carers in the NHS Constitution - while welcome - don’t answer the question how to give the Constitution teeth; it remains unclear whether Labour supports personal budgets in creating people-powered health; there is a tension between the policy of the NHS as preferred provider and a powerful role for local voluntary organisations and it is not clear that Labour has fully risen to the funding challenges set out in the recent Five Year Forward View.

“Getting this right means working closely with people who use services, voluntary organisations and health and care professionals. National Voices looks forward to continuing to work with Labour’s health team on these and other issues. The other parties also need to set out their plans.”

3.15pm NHS Clinical Commissioners’ Amanda Doyle said, of Labour’s 10 year plan, “It is right to put the patient at the centre of the NHS and look at caring for the whole person. It is right also that we look for long term solutions to integrate NHS and social care services to ensure they are sustainable and responsive to the needs of the local population, so we are reassured that Labour have listened to our members calls to trust in the local systems that are already delivering for their patients and sees a future for CCGs.”

“Andy Burnham is also right when he says in the plans that “integrating health and care services cannot be imposed by top-down edict and timetables. It must be driven at a local level and designed around local needs”. CCGs, led by local clinicians who are embedded in their local communities, are already embracing the opportunity to work in partnership to join up care for patients. It is vital that we allow CCGs to continue to do this and to give those existing local partnerships the space and support to grow and mature”

Steve Kell said: “The commitment to implement the Five Year Forward View is a welcome recognition that one size does not fit all, and the approach Andy Burnham has set out allows local health and care systems to work together to find the right local solutions. Our members will be pleased to hear him commit to no disruptive reorganisation of the NHS, which is fundamental to the Five Year Forward View”

“We would now call on Labour to enable a truly equal partnership across health and care that draws together the clinical legitimacy that CCGs bring, with the democratic legitimacy of local authorities both accountable to the public, which could be the key to delivering the plan Andy Burnham has set out.”  

3.10pm Nuffield Trust chief executive, Nigel Edwards, has described Labour’s plan as “credible”.

He said: “Labour’s plan presents a credible explanation of their understanding of the issues facing health and social care. It would be helpful to have the same from the other political parties at this stage in the electoral cycle.

“The party is right to focus on a wider vision of care, a long-term shift towards care out of hospital, and the need for more funding to achieve that. This is in line with much of the thinking currently being adopted by health and social care professionals, as set out in the Five Year Forward View.

“However, while more support outside hospital could improve people’s lives, Labour needs to be more careful about assuming they will deliver short-term savings.

“In many countries politicians are stepping back from detailed operational management of complex health services. But Labour’s proposals still feel somewhat top-down. It is not clear why politicians should be in charge of specifying the numbers of staff to be recruited, or when patients need to see their GPs.

“This is a concern because nationally driven performance management can be just as disruptive as structural reorganisation.

“Meanwhile, it would be helpful to have more detail about how a Labour Government would bring funding together across the NHS and local authorities, and whether social care as a whole will be more generous.”

Mr Robinson will join the Nottinghamshire acute trust from Sheffield Health and Social Care Foundation Trust, where he has been finance director for two years.

He has previously worked for a range of trusts and primary care trusts.

Mr Robinson replaces Margaret Ashworth, who has been interim chief finance officer since June.

3.05pm The British Property Federation is urging all political parties to commit to providing a healthcare estate “fit for the 21st century”.

In response to Labour’s plan Melanie Leech, chief executive of the British Property Federation, said: “Better quality primary and elderly care facilities will hugely reduce the burden on hospitals and A&E departments which, as we are all aware, are suffering from over-crowding and lack of resources. The property industry stands poised to invest in these sectors and to help government and medical professionals to deliver 21st century healthcare. What is needed is for politicians of all parties to recognise that we face a growing crisis in our  healthcare estate, and to set out a strategic approach to meeting this challenge.

“It is all very well pledging to deliver thousands more GPs and nurses, but it is essential that they work in premises that are fit for purpose. If we can unlock investment in the retirement homes sector, this will also help efficiency, as fewer elderly will have to be admitted into hospitals and can instead be cared for in more appropriate settings.”

3.00pm Here is the full text of Labour’s 10 year plan for the NHS attached.

3.00pm While the Health Foundation finds Labour’s NHS plan “appealing” more detail is needed on “how the proposals would be implemented and funded”, it says.

Jennifer Dixon, chief executive of the Health Foundation, said: “Although Labour’s announcement today seems appealing, there needs to be more detail on how the proposals would be implemented and funded.  What has been set out would aim to end a historic divide between the NHS and social care systems. However, there would be significant challenges: first in blending one system which is free at the point of use with another that is subject to means-testing; and second yet another upheaval to administrative structures in the NHS which distracts from the issue of real reform in care to patients, especially given the financial squeeze. No more structural reorganisation should be the first element of any party’s policy on the NHS.”

Anita Charlesworth, chief economist at the Health Foundation, added: “Our analysis suggests that £8bn is likely to be the minimum amount needed to maintain the quality and range of services over the next Parliament. The incoming government will also need to provide additional resources in the form of a ‘transformation’ fund to provide the financial assistance necessary to underpin the changes called for in the Five year forward view. Also they will need to establish a public and political consensus on the longer-term funding levels of the NHS.”

2.55pm The King’s Fund chief executive Chris Ham has said that while Andy Burnham was “at pains to stress his plans would not result in another structural reorganisation” it is “not clear how change on this scale can be achieved without some changes to commissioning structures in particular”.

He said: “Andy Burnham has set out an ambitious and wide-ranging vision for the NHS and social care. It throws down the gauntlet to the other parties to set out their plans ahead of the General Election.

“Burnham is right to put integrated care at the heart of this vision. This echoes the prescription for a single budget and single commissioner for health and social care set out by the Barker Commission. His emphasis on mental health was also very welcome.

“While he was at pains to stress his plans would not result in another structural reorganisation, it is not clear how change on this scale could be achieved without some changes to commissioning structures in particular. As our own research shows, although health and wellbeing boards are making good progress in some areas, the jury is still out on whether they can take on responsibility for commissioning on this scale.

“While many will welcome the commitment to repeal some aspects of the Health and Social Care Act, it is not clear how far Labour intends to go in dismantling the architecture it established. It also remains to be seen how easily his commitment to roll back competition in the NHS can be squared with EU competition law.

“The elephant in the room is how this will be paid for. Labour has not yet committed to finding the additional £8bn identified in the Five Year Forward View as being needed to close the NHS funding gap by 2020. While Burnham’s plans to improve social care and increase the pay of care workers are very welcome, they will come with a hefty price tag which Labour will need to balance with its commitment to reduce the deficit.

“The challenge for the Labour Party is to demonstrate how it will provide the funding to implement such a positive vision of the future.”

2.50pm The NHS Confederation is “reassured” that Labour’s plan for the NHS is not “prescriptive” and does not call for another “reorganisation”.

Director of policy, Johnny Marshall, said: “Our members across the health system tell us they are tired of top-down edicts and need the space and freedom to deliver care for their populations. We are reassured Labour’s plan is not prescriptive and does not call for yet another reorganisation of NHS structures. It is important that the progress made by clinical commissioning groups is built on and not lost. 

“Many of Labour’s plans such as the focus on prevention, parity for physical and mental health and providing care closer to home is in line with the NHS Confederation’s thinking, set out in the 2015 Challenge Manifesto. 

“On integration, local leaders are already making progress on delivering better coordinated services for patients. Labour’s plan rightly looks at how best to support local leaders across health and social care working together. This approach must be replicated by all political parties and crucially by whoever forms the next Government in May. 

“On new models of care, care must be transformed around the needs of people, patients and communities. The only people who can determine the right provision locally are local leaders of health and social care in partnership with the public. To ensure patients have access to the highest possible quality of service available, commissioners need the freedom to work with a whole range of providers of care, including the profit and not for profit sector.

“On funding, it is right Labour are looking at health and social care budgets together. We need to be careful that by doing this, underfunded social care does not have a negative impact on patient care. All political parties need to make clear how they will ensure both the NHS and social care are sufficiently funded. With at least £8bn extra required for the health service and £20bn of efficiencies each year, an honest debate is required to give the public a better understanding of the choices we face on the future models of care across health and social care.”

2.45pm The Royal College of GPs says it supports better integration but only if all political parties “recognise that general practice must remain at the heart of any models of care that are introduced”, in response to Labour’s 10 year plan.

Chair Maureen Baker said: “It is good to see that the Labour Party have acknowledged the resource and workforce pressures facing general practice and their pledge of 8,000 more GPs by 2020 - something the RCGP has long called for - is very welcome.

“We also welcome that Labour have recognised that there are a variety of models of integrated care and these must be developed around the needs of local populations. Better integration is something that the College supports, but only if done properly, and only if all political parties recognise that general practice must remain at the heart of any new models of care that are introduced.

“The GP workforce in England is currently straining under the increasing pressure of a growing and ageing population, with more and more patients presenting with multiple and long term conditions. Family doctors and their teams currently make 372m patient consultations every year - a rise of 58m in the last five years – yet the share of the NHS budget that general practice receives has dropped to a record-low 8.3 per cent.

“Whilst more GPs are desperately needed, it is essential that this is backed up with the supplementary resources needed for us to be able to deliver excellent care to our patients when they need it.

“We recognise that GP access is extremely important but prioritising it over everything else by introducing targets can mean that other services suffer and patients often end up worse off. Before any targets are imposed on our already struggling workforce, we must first ensure that general practice receives a much greater share of the NHS budget and that ambitions to boost GP numbers are realised.

“General practice is the cornerstone of the NHS – we keep the health service sustainable and safe for our patients. The RCGP looks forward to working with all political parties to discuss how general practice can be properly funded to provide excellent patient care closer to home, out of hospitals, where they want and need it most.”

The 18 page plan unveiled today says a future Labour government would “set out a strategy and timetable to deliver a waiting time standard of 28 days for access to talking therapies, for both adults and children”.

This goes further than the coalition government’s existing plans, which will come into effect in April and aim to ensure 75 per cent of people referred for talking therapies will start their treatment within six weeks and 95 per cent within 18 weeks.

2.10pm Here are some more interesting comments from HSJ readers in response to Labour’s 10 year plan:

“This will work if the politicians stay out of it at local level. Get all of the funding for hospital and home care into a National Health and Care Service -this will then put an end to competition for care resources with rubbish collection and street cleaning, and whilst we are about it put an end to means testing for home care.”

“The 5000 care workers to be employed by the NHS, presumably free to users, is a good idea. But it represents 1 or 2 per cent of the total of care workers, the rest of whom are available on a means-tested cost. You would need an assessment to determine which tiny portion of care would be provided by the NHS employees. Why not think big? There is no real reason why long-term care for people with disabilities in their own homes or in Care Homes should be provided by largely untrained employees of private companies while the rest is within a still publicly provided NHS. A case for real integration, not tinkering on the edges.”

1.35pm A “crisis” in the NHS cannot be fixed without tackling the “growing crisis” in social care, the chief executive of the Royal College of Nursing has said in response to Labour’s 10 year plan.

Peter Carter said: “Incentivising care outside of hospitals is a significant and positive move, because the care system needs to be better at keeping people well and managing their conditions – rather than relying on hospitals when problems have become acute.

“Whoever is running the NHS after the general election will need to get to grips with the serious task of plugging the gap in the workforce, without being over-reliant on nurses from overseas. We need to be training more nurses now to be able to cope with rising demand both in health and social care.

“There are two fundamentals which have to be grasped by all parties – the need for resources to meet rising demand, and the need for long term planning. Without both, the NHS could continue to lurch from reorganisation to reorganisation, and from crisis to crisis.

“Nurses and patients will be looking to all parties to back up their promises with deliverable plans and resources without using the NHS as a political football.”

1.15pm Former Labour health minister Alan Milburn has just been interviewed on the BBC’s World at One.

He said there is a “risk that Labour’s position on the NHS becomes an emblem of the party showing an unwillingness to lead into a difficult reform agenda.”

He added: “I think the biggest risk for Labour on health is we could look like we are sticking to our comfort zone but aren’t prepared to go into territory that the public know any government would need to go into.”

“You’ve got a pale imitation of the 1992 election campaign – it could have the same outcome. It would be a fatal mistake for Labour to look like it is a party ready to increase resources into the NHS but not to reform it.”

1.05pm The closer integration of health and social care services set out in Labour’s proposals for the NHShas been welcomed by the chief executive of the Chartered Society for Physiotherapy, Karen Middleton.

She said: “There is much to welcome in Labour’s proposals, specifically around the closer integration of health and social care services.

“This will move us towards a system built around the needs of individuals that keeps more people out of hospital and living independently at home.

“It is good that Andy Burnham recognised physiotherapists and occupational therapists are the ‘person-centred professionals’ who would come to the fore when delivering this in the future.

“We hope this translates into workforce training places and not just more doctors and nurses, as the plan published today suggests.

“The rehabilitation workforce will be essential to meet the demands of a rising population and more people living with at least one long-term condition in a cost-effective way.

“That reality must be reflected in any proposals on integration so we look forward to more detail from Labour on this.”

Addressing the proposals regarding ‘homecare workers’, she added:

“Support workers are a key part of that rehabilitation workforce so it is good to see their role highlighted today.

“But to use their full potential, their pay must be addressed as low wages for that group have traditionally led to high staff turnover and therefore inconsistent and unsettled services.

“Staff must be paid fairly to encourage them to stay in their roles and provide continuity of care for their service users.”

1.00pm The chief executive of the Bath and North East Somerset Council and spokeswoman for the Society of Local Authority Chief Executives, Jo Farrar, has responded to Labour’s 10 year plan for the NHS.

She said: “We need to secure a cross party consensus about how we create a radically different future for our health and social care services. That future should be locally based, democratically accountable and fully integrated.

“There has been a historic imbalance in spending on health and social care. Ring-fencing health spending in this Parliament has been achieved only by significantly cutting local government budgets. This makes no sense, hitting social care and other critical services that keep people happy, healthy and out of hospital. Any political party setting out a credible long term vision for health and care needs to set out how they will tackle this imbalance. Westminster, Whitehall and local councils all need to engage honestly with communities and each other to improve public services where we live.”

12.20pm In Michael White’s latest column he writes that he is not convinced so far by either David Cameron or Ed Miliband as they try to “neutralise each other’s pre-campaign election messages” - Miliband’s a “fairly familiar six point healthcare plan” and Cameron’s “a token hit on benefit claimants to help ‘reduce the deficit’ and fund those elusive Tory tax cuts”. 

Unveiling its ten year plan for the NHS today, Labour said it would enter into a new ‘compact’ with the 1.3m NHS staff to “lift morale and improve patient care.”

This would include appointing a new “NHS staff champion” responsible for improving workplace culture and reducing bullying, work-related stress and sickness absence.

The Labour leader gave an exclusive interview to HSJ last night ahead of the launch of his party’s pivotal 10 year plan for the NHS today. The interview comes at a time of high political interest in the health service. It is 100 days out from May’s general election, after which Mr Miliband is the current favourite to become prime minister, and with NHS rated by voters as the most important issue.

Mr Miliband outlined key details of his plans including:

  • stating that implementation of his “national vision of integrated health and social care” will be “evolutionary”;
  • endorsing the “NHS preferred provider” policy but also stating there “will be circumstances in which the private sector has a supporting role”;
  • insisting the decision whether to meet NHS England’s £8bn funding requirement for the next parliament is a “matter for us [when] in government”; and
  • endorsing Andy Burnham as doing a “brilliant job [with] a really important vision” but declining to confirm he would be health secretary in a Labour led government.

The party’s 10 year plan for health and care, released this morning, confirms its intention to repeal the Health Act 2012 at the start of the next parliament, and to replace the NHS’s competition framework with an “NHS preferred provider” framework.

This, it says, would include scrapping the roles of Monitor and the Competition and Markets Authority as “economic regulators enforcing competition within the NHS” and the “Section 75 regulations” that placed competition rules on a statutory footing.

The announcement forms part of the party’s 10 year plan for health and care, published today.

The plan does not state which organisations it would target, but the focus may raise doubts about the long term future of national arm’s length bodies created by the legislation, such as the NHS Trust Development Authority and NHS England. Other potential targets for savings could include NHS commissioning support units, or clinical commissioning groups.



Mr Stevens raised the possibility that reforms to care models across different parts of the country could “expand the family of what can serve as a foundation trust”.

He also emphasised that the FT model was not “past its sell-by date”.



11.26am The year of care tariff will apply for those with ‘complex needs’, such as frail older people. Over ten years this will be developed for ‘larger segments of the population’.

They hope this will give the accountable provider ‘much stronger incentive’ to invest in prevention and ‘driving out the culture of care visits limited to 15 minutes’.

11.25am Labour will introudce a ‘new compact’ with NHS staff to ‘support those who care for us’ and ‘ensure that all patients are treated with the highest levels of dignity and respect’.

11.10am There is further detail on Labour’s 10 year plan.

Here are some interesting extracts:

On the sale of land that is ‘surplus to requirements’ - ‘Where the NHS owns assets or estate no longer employed for health service purposes, Ministers should actively seek to achieve value for the taxpayer and consider disposal in order to release resources for the frontline. There are at least £7.5bn worth of sites currently deemed as ‘surplus to requirements’ by the Department of Health yet still owned by the NHS.’

Attempt to reduce ‘bureaucracy’ by removing ‘duplication of responsibilities’ - ”We will consult with the sector on how to release even larger savings from the new set of organisations created by the reorganisation, including by addressing potential duplication of responsibilities and further reducing bureaucracy.’


10.45am Sir John Oldham is now speaking at The King’s Fund.

10.32am “We will end the scandal of neglecting mental health by prioritising investment in young people and ensuring teachers are trained to spot problems early.

“We will hire more doctors and by saving resources on privatisation and competition, we will end the scandal of patients having to wait days, even weeks, for a GP appointment.

“We will use the resources we raise to hire 5,000 care-workers - a new arm of the NHS - to help elderly people stay healthy at home.

“And because we will be putting in place one system of health and social care we will end the scandal of care visits restricted to 15 minutes.”

10.30am Miliband’s speech is attached. Here are some more extracts:

“Let me tell you what I have learnt most talking to people in the NHS. The most important principle is that the success of what goes on inside a hospital depends on what goes on outside in the community.

“When people can’t get to see their GP they end up in A&E, adding to the problems there. When problems with mental health aren’t spotted early at school or work, they build up and people end up in hospital.

“And most importantly of all, when elderly people can’t get the care they need at home, they are more likely to struggle, grow ill or have a fall.

“In each and every case, failing to act early is worse for the person involved and it costs more for the NHS too. So the most important principle of 21st century healthcare is that people get the care at the right time, in the right place.”

10.26am Miliband sets out how NHS funding will be raised:

“We will raise a billion pounds from tax avoidance, including by the hedge funds. We will raise extra revenue from the tobacco companies.

“And we will use the proceeds of a Mansion tax on properties worth over £2 million.

“And we will use that money for a plan to train and hire more doctors, nurses, care-workers and midwives – so that they all have the one thing that patients need most: an NHS with time to care.”

10.25am Ed Miliband has delivered a speech this morning on Labour’s ‘10 year plan’ at the Life Centre in Sale.

He said: “The central idea is this: that we must both invest in the NHS so it has time to care and join up services at every stage from home to hospital, so you can get the care you need, where you need it.”

10.15am Schemes in which mental health nurses work with police on patrol and in call centres have seen a drop in the number of people with mental health problems being detained under the Mental Health Act, according to a briefing published today by the NHS Confederation’s Mental Health Network and the Association of Chief Police Officers.

In some areas this reduction has been up to 50 per cent. 

10.10am The Telegraph reports that over-the counter hay fever tablets, sleeping pills or asthma drugs significantly raise the risk of developing dementia, a study has shown.

Taking a daily dose of pills like Benadryl, Piriton and Nytol, for at least three years, can increase the chance of getting Alzheimer’s disease by more than 60 per cent.

Researchers at the University of Washington said pensioners taking over-the-counter drugs should tell their doctors and stop taking medication immediately if it is not needed.

9.50am New mortality data indicates that 15 trusts have been categorised as having a ‘lower than expected’ mortality ratio according to a new report published by the Health and Social Care Information Centre.

The report also shows that nine trusts have been categorised as having a ‘higher than expected’ mortality ratio.

The fifteen trusts with a ‘lower than expected’ SHMI for the period July 2013 – June 2014 were:

  • Barts Health Trust
  • Cambridge University Hospitals Foundation Trust
  • Chelsea and Westminster Hospital Foundation Trust
  • Guy’s and St Thomas’ Foundation Trust
  • Homerton University Hospital Foundation Trust
  • Imperial College Healthcare Trust
  • Kingston Hospital Foundation Trust
  • London North West Healthcare Trust
  • North Middlesex University Hospital Trust
  • Royal Free London Foundation Trust
  • Royal Surrey County Hospital Foundation Trust
  • St George’s Healthcare Trust
  • The Hillingdon Hospitals Foundation Trust
  • The Whittington Hospital Trust
  • University College London Hospitals Foundation Trust

The nine trusts with a ‘higher than expected’ SHMI for the period July 2013 – June 2014 were:

  • Aintree University Hospital Foundation Trust
  • Blackpool Teaching Hospitals Foundation Trust
  • City Hospitals Sunderland Foundation Trust
  • East and North Hertfordshire Trust
  • Medway Foundation Trust
  • North Tees and Hartlepool Foundation Trust
  • Southport and Ormskirk Hospital Trust
  • South Tyneside Foundation Trust
  • Tameside Hospital Foundation Trust

9.45am Andy Burnham will be speaking at The King’s Fund today, with more detail on Labour’s 10 year plan. He is due to speak at 10.50am and HSJ reporters @whazell and @jamesillman will be tweeting. Keep following HSJ Live for updates.

9.40am HSJ’s story on Labour’s 10 year plan for the NHS as gathered some heated reader debate:

“Another reorganisation on the cards then. No real new money and the misguided view that by just putting money into the same budget lines all the NHS and social care pressures will be released. This is nonsense and naive at best.Health and wellbeing boards are talk shops and full of elected members - most of which have no mandate to do this, nor (most importantly) the competency to oversee this work. If this is the solution and Labour get elected - we really are doomed.”

“Would someone with some clout please tell all of these politicians that making targets/ pledges on new numbers of staff to employ is just counterproductive. All we do is spend time chasing the target- put the education system into a tail spin and miss the point of re-designing care around the patient. More staff would be great - but make it the right type at the right time - not just to fit a newspaper headline to show how much you as a politician value the NHS and it’s staff……So depressing and the campaign has not really started yet.”

“NHS providers as the preferred option does represent a better opportunity for joined up care, although Health & Wellbeing Boards as the driver isn’t exactly reassuring. Three years on from the H&SC Act and we are finally seeing some forward vision - even if it is only to repeal some ill-thought through strands of policy.” 

“A 10 year arm wrestling contest between local authorities and GPs on the deck of the Titanic.”

9.30am Kent News reports that Chris Bown has been apppointed interim chief executive at East Kent University Hospitals Foundation Trust.

Current chief executive Stuart Bain announced he was retiring last year. He will step down from his role in March.

Chris Bown was previously chief executive at Poole Hospital Foundation Trust.


9.20am Jeremy Hunt has tweeted about Labour’s economic policies

9.05am John Oldham is giving a speech at The King’s Fund this morning.

Here are two interesting extracts:

“The principle of co-management is also why we believe the legal ownership of records should reside with the citizen, not the Secretary of State, as now. This also helps people from different organisations to work co-operatively, ensuring the flows of information necessary for care to happen. Information governance is important but should be the servant not the master.”

“The commissioning plan for this cohort of the population and these arrangements we suggested should be driven by a whole system leadership invested in Health and Wellbeing Boards, or analogous arrangements. Existing commissioners would remain the accountable organisation;  these Local Authorities and CCGs would be responsible for enacting the plan, and required to do so. Not structural change, but behaviour and relationship change.”

9.00am Much of Labour’s plans for integrating patient care are underpinned by principles set out in a report by former Department of Health director Sir John Oldham. 

The report, One person, one team, one system, sets out reforms to payment systems to incentive better integration between different care providers such as rewarding organisations on outcomes. 

You can read the report here.

8.55am Here is HSJ’s story on the Labour 10 year plan for the NHS.

The key point is that Labour want health and wellbeing boards to be accountable for new “year of care” budgets which would cover the “health and social care needs” of those at the “greatest risk of hospitalisation”.

8.55am Here are some extracts from shadow health secretary Andy Burnham’s interview on the BBC’s Today programme this morning:

He said the country needs to “rethink” the way we care for older people, who are often “trapped” in hospital beds and subject to “flying 15-minute visits” by social care workers on home visits. “We need to support people with dementia and autism as well as those with cancer,” he said.

He also said the Labour Party is planning to “re-set” the NHS in England as the “National Health and Social Care Service”.

8.50am The Daily Telegraph’s coverage of Labour’s 10-year NHS plan leads on the announcement that the terminally ill should be allowed to spend their final days at home with their family.

Labour will today unveil its ‘fleshed-out’ plans to protect the NHS.

Should the party win office, 5,000 new homecare workers would help bring elderly patients back home from hospital sooner, the party’s leadership will say.

Leader Ed Miliband and shadow health secretary, Andy Burnham, will also reveal a new promise to end the culture of 15-minute care visits which fail vulnerable pensioners.

8.42am The BBC focuses on Labour’s pledge to provide longer home care visits by social workers.

Ed Miliband said there was an “iron curtain” between social care and the NHS.

8.40am The Guardian has covered Labour’s 10 year plan for the NHS describing it as a “pivotal election pledge” and focusing on the party’s promise to bring in 36,000 more staff and repeal privatisation laws.

Labour said the number of days patients were left in hospital because they could not be discharged was at a record high in the past year.

7.00am Good morning and welcome to HSJ Live. We begin the day with the news that Labour plans “a new arm of the NHS” in the form of 5,000 “home care workers”, it has announced.

A briefing ahead of speeches by Labour leader Ed Miliband and shadow health secretary Andy Burnham today said the new staff would be employed “within the NHS” and focus on “those with the greatest needs, including the terminally ill so they can stay with their family at the end of life, and those who are leaving hospital who need extra help if they are to move back into their homes”.

Speaking at the King’s Fund this morning, Mr Burnham is due to unveil a “10 year plan” for the NHS. Follow HSJ Live for unparalleled coverage.