Latest reaction and comment in response to wide ranging HSJ interview with shadow health secretary
4.59pm Amanda Doyle, co-chair of NHSCC said “CCGs are currently statutory NHS organisations, led by local clinicians who are part of the fabric of local healthcare and the local community. In our recent publication Leading Local Partnerships we have demonstrated how CCGs are effecting change and improving services for patients and it is vital that we allow CCGs to continue to do this.
“To make CCGs advisory to Health and Wellbeing boards moves statutory responsibility and gives leadership of NHS commissioning to local councils. This removes the influence of local doctors over how local health services are delivered and is absolutely a reorganisation of the NHS.”
Steve Kell, co-chair of NHSCC, added: “These proposals would represent a significant change in both the structure and the funding of the NHS, and we cannot see how they can be implemented without another re-organisation. They present a huge risk of losing the clinical leadership we have seen develop through clinical commissioning. This local clinical leadership has been key for the NHS in a time of increasing demand and financial challenge, and it must not be put at risk.
“It would be totally wrong to put the NHS through another reorganisation with the distraction that would cause to the essential work needed to meet increasing patient and population needs.
“The NHS faces a significant challenge and we support NHS England’s Five Year Forward View which emphasises the need for joint working, prevention and service improvement, but rejects any reorganisation of the NHS.”
4.57pm NHS Clinical Commissioners has reacted to our interview with Andy Burnham on the future of CCGs. They said they “supported the move towards integrated working, but rejected proposals to move responsibility for NHS commissioning to local government under the auspices of Health and Wellbeing Boards.
“These proposals risk losing essential clinical leadership and constitute a reorganisation of the NHS,” they added.
3.51pm Some breaking news: the NHS is to face a second day of strike action as unions continue their dispute with the government over NHS pay.
Unions will stage a four hour walk out from 7am until 11am on Monday 24 November followed by work to rule for the rest of that week until Sunday 30 November.
A total of 11 trade unions will take part in the strike including Unison which has 250,000 health members in England; the Royal College of Midwives; Unite, GMB and Managers in Partnership.
Christina McAnea, chair of the NHS trade unions staff side, said: “The next set of industrial action will be even stronger as more unions are joining in.
“Health workers care for patients and their families every day of the year often when they are at their most vulnerable or distressed. The NHS depends on the goodwill and commitment of the workforce and this is now at breaking point.
“The government has made no attempt to resolve this dispute and staff have been left with no alternative but to take more industrial action. Jeremy Hunt needs to realise that this dispute is not going away. All we are asking for is fair pay.”
The industrial action follows health secretary Jeremy Hunt’s decision earlier this year to reject the independent pay review body’s recommendation of a 1 per cent pay increase for all NHS staff.
Instead, the government imposed a two year deal in which employees eligible for incremental pay rises under Agenda for Change receive no separate cost of living rise, while employees not eligible for an increment receive a non-consolidated, non-pensionable, 1 per cent pay rise.
The government has offered the unions a deal to give staff a consolidated pay rise if unions agreed to a freeze on increments in 2015-16.
3.18pm Here’s what NHS Confederation chief executive Rob Webster has to say on the authorisations:
“There’s been a jam in the FT pipeline for 16 months now and no trusts have been authorised at all during this period. Monitor’s decision to authorise Bridgewater Community Healthcare Trust, Derbyshire Community Health Services Trust and Royal United Hospital Bath Trust as FTs is great news and I congratulate the staff and leadership at the trusts for succeeding at what has no doubt been a demanding task. We’re keen for more NHS organisations to attain the same freedoms these trusts now have and hope the backlog built up over the last few years can be reduced as quickly as possible.
“For the first time, a standalone community services trust has become an FT and this demonstrates the important role for community services in the NHS. Community healthcare is enabling people to stay healthy across the NHS, giving them the power to live independently and avoid crises that lead to unplanned hospital admissions.
“The 2015 Challenge Manifesto of 21 national health and care organisation sets out a powerful vision for reshaping care around the needs of people today, emphasising the importance of proactive, readily accessible community-based services. To do this, NHS organisations need to plan for a sustainable future and we continue to call on the government to clarify urgently how it will support the more than 90 NHS trusts still seeking FT status, including those that have little realistic prospect of meeting Monitor’s sustainability tests for FT status.”
3.14pm Three NHS providers have been authorised as foundation trusts – the first time the status has been conferred in more than a year.
Monitor announced today that it had awarded the status to Bridgewater Community Healthcare Trust in the North West, Derbyshire Community Health Services Trust and Royal United Hospital Bath Trust, effective from 1 November.
Bridgewater and Derbyshire are the first two providers in the community sector to become FTs.
Chris Hopson, chief executive of the Foundation Trust Network, welcomed the authorisations as a sign “the FT pipeline is well and truly flowing and delivering its objectives”.
2.02pm Peter Shand of The Whitehouse Consultancy detects a change in Andy Burnham’s tone when discussing the role of the private sector:
— Peter Shand (@Whitehouse_Hlth) October 30, 2014
1.29pm Here’s what Harry Smith of MHP Health had to say about Mr Burnham’s NICE suggestions:
NICE TAs aren’t implemented across all the country already, what makes Labour think it would be any different for clinical guidelines?
— Harry Smith (@hofs88) October 30, 2014
12.29pm Some breaking news from Monitor: three NHS providers have been authorised at foundation trusts.
Bridgewater Community Healthcare Trust in the north west of England, Derbyshire Community Health Services Trust and Royal United Hospital Bath Trust have been authorised, effective from 1 November 2014.
It is the first time authorisation has been granted since July 2013, and Bridgewater and Derbyshire become the first trusts in the community sector to get the status.
More to follow
12.18pm Here’s Mike Birtwistle of Incisive Health on the interview:
My reaction to @Jamesillman story: making guidelines mandatory is a good ambition but significant cost & local autonomy implications
— Mike Birtwistle (@MBirty) October 30, 2014
12.00pm Here’s the HSJ editor’s view on the Burnham interview. Alastair McLellan writes:
“In his lengthy interview with HSJ, Mr Burnham makes it very clear that he is still in listening mode – wanting to know how the service believes he can best achieve his desired outcome of ‘whole person care’. But he is beginning to colour in-between the lines of his proposals for NHS organisations to become ‘preferred providers’ and for health and wellbeing boards becoming the pre-eminent commissioning power within a health economy.
“Mr Burnham claims the difference with the current administration is that Labour would be working with the grain of what the NHS and social care system wants to deliver. HSJ suspects he will have to continue to work hard to suggest his ‘evolutionary’ approach will not create confusion or, perhaps as a result, morph into a full blown reorganisation.”
11.47am There’s already been a lot of reaction on Twitter to our exclusive interview with Andy Burnham. Here’s what Jeremy Taylor, chief executive of National Voices had to say:
— Jeremy Taylor (@JeremyTaylorNV) October 30, 2014
11.23am A Labour government would use pay restraint and make “difficult choices” about the wages of NHS frontline staff if the party wins the election next year, Andy Burnham has said.
The shadow health secretary told HSJ he wanted a deal for staff that was “right and fair” and which reflected rises in living costs and other pressures, such as increases in professional fees for nurses.
11.20am Private health providers could play a significant role in providing NHS services under a Labour government, the shadow health secretary has suggested.
In an exclusive interview with HSJ, the Andy Burnham gave his most detailed account of how his flagship policy that the NHS being the “preferred provider” for state run services would work.
Mr Burnham, who first floated the model in 2009 while health secretary under the last Labour government, said the “simplest way to put it” was that the “first chance” would be given to the NHS.
11.08am Clinical commissioning groups could be morphed into the operational arms of the health and wellbeing boards, which will take on the role of “signing off” health plans, Andy Burnham has suggested.
The shadow health secretary said CCGs could function “more as an executive to the health and wellbeing board’s non-executive” role in an interview, giving the greatest detail to date about how commissioners could operate under his ambitious plans to integrate health with social care services.
10.53am A Labour government could reduce variation in access to drugs and procedures by making it mandatory for commissioners to follow national clinical guidelines, Andy Burnham has revealed.
In an exclusive interview with HSJ, the shadow health secretary also gave his most detailed account of how he would deliver his ambitious NHS and social care reform proposals.
He revealed new details of his plans on staff pay, NHS funding, his “NHS preferred provider” policy, and changed roles for health and wellbeing boards and clinical commissioning groups.
10.45am Also in The Guardian, the Ebola epidemic in west Africa may have reached a turning point, according to the director of the Wellcome Trust, which is funding an unprecedented series of fast tracking trials of vaccines and drugs against the disease.
Writing in the paper, Jeremy Farrar said that while there are bleak months ahead, “it is finally becoming possible to see some light”.
Farrar’s comments come as the World Health Organisation confirmed that the number of Ebola cases in Liberia has started to decline, with fewer burials and some empty beds.
10.37am Browsing through this morning’s papers, The Guardian reports that scientists have grown miniature human stomachs from stem cells as a way of studying gastric diseases, such as ulcers and stomach cancer, and creating tissue in the future to repati patients’ stomachs.
The mini stomachs are grown in petri dishes from stem cells. Fully formed they are the size of a pea and shaped like a rugby ball. They are hollow with an interior lining that is folded into glands and pits like a real stomach.
9.52am HSJ’s David Williams has analysed the government’s plans to extend the reach of joint commissioning before the better care fund has been tested. David writes:
“It is interesting that the government has chosen to make today’s announcement about the better care fund a part of its response to the NHS Five Year Forward View – as that document was distinctly lukewarm about the project.
“The forward view, led by NHS England and published last week, suggested that the fund should not be expanded without a full evaluation of its impact next year. It also praised many better care fund style integration schemes, before going on to say “some [of these examples] may even cut costs” – a cautious turn of phrase given that this is just the sort of thing that ministers are now confidently telling us will save half a billion pounds next year.”
David argues that the experimental nature of joint commissioning innovations, recruitment challenges, and uncertainty about how the marginal tariff rate will impact on the amount of money saved, mean there is still reasons to be sceptical about the better care fund.
9.29am Ministers want to extend NHS joint commissioning with councils to public health and children’s services, after being convinced by the better care fund planning process that the model will reap service improvements and financial benefits,HSJ has been told.
It comes as the government announces today that health and wellbeing boards across England believe they will save more than £500m in 2015-16 because of the fund. Half of this is planned to come from a 3 per cent year on year reduction in the number of emergency admissions.
HSJ has learned that Department of Health ministers believe the joint commissioning model should be applied to children’s services, which are currently commissioned by the NHS and councils with involvement from the Department of Education. Public health, which has primarily been the responsibility of local authorities since April 2013, should also increasingly be jointly commissioned with clinical commissioning groups, the DH believes.
7.00am Good morning and welcome to HSJ Live. We kick things off with an opinion piece from Mike Birtwistle and Ben Nunn of Incisive Health, arguing that polls have exposed the limits of party conference pledges alone as platform for communicating policies.
The authors argue that all the major parties have a way to go before they convince the public and media and have a decisive breakthrough.