PA Health Newsletter March 2013

January March2012 2013

UK HEALTH MONITOR Policy and NHS Developments Review into Training of Healthcare Assistants Launched The Department of Health has announced the launch of a review into the training of healthcare assistants. The review will examine how the training and support available can be strengthened to ensure they are able to provide essential services to the highest standards, thereby enhancing the quality of care for patients.

Led by The Times journalist, Camilla Cavendish, the review will report back to Government at the end of May. Under Cavendish’s leadership, the review will also examine how recruitment can be improved with the aim of placing the right people, with the right values and behaviours, in the right settings.

Commenting on the launch of the review, Secretary of State for Health Jeremy Hunt said that it was his aspiration that “everyone receiving treatment and support across the health and care sector… [should] get the most safe, effective and

compassionate care.” The Health Secretary went on to add that there was a vital need to “make sure that the staff tasked with carrying out some of the most personal and fundamental jobs have the skills, values and behaviours needed to provide this.”

Department of Health Responds to Mid Staffs Public Inquiry Report The Department of Health Permanent Secretary, Una O’Brien has responded to the findings of the Mid Staffordshire NHS Foundation Trust Public Inquiry, stating that the Department will place a renewed focus on listening to the concerns of patients.

Regulations for Health and Wellbeing Boards Published Regulations governing the administration of new Health and Wellbeing Boards, responsible for bringing together all local commissioning stakeholders across the NHS, social care and public health, have been published by the Government. The new regulations are intended to grant local authorities greater flexibility and freedom in directing the work of the Boards' so that they have a stronger governance framework and are able to respond to local circumstances and needs appropriately.

Reflecting on Robert Francis’s recommendations, O’Brien said that the Department would “take action on the recommendations from Robert Francis” and was “committed to a renewed focus on putting patients at the centre of everything we do.” She went on to add that the Department would endeavour to “listen to patients and truly understand their experience of illness, care and recovery.” It was also revealed that the Department would be responding to the Francis report in more detail later in March.

As a result of the changes, Health and Well-being Boards will be free to establish sub-committees and delegate functions to them.

Meanwhile voting restrictions have been lifted so that non-elected members are able to vote alongside nominated elected representatives. Finally, political proportionality requirements have also been lifted so that the final decision over the political proportionality of the Board's membership can be left to local determination.

February 2013

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Commissioning Board Permitted to Extract GP Data

The NHS Commissioning Board has been successful in securing the ability to extract data from GP practices. The initiative is intended to allow the Board to extract data on demographics, diseases, events and referrals from GP systems each month. It will also enable it to “compare data between practices” and provide individual GP practices with suggestions on “where improvements can be made”.

The data provided will be sent to the Health and Social Care Information Centre, where it will be stripped of individual identifications before being sent on to the Board. However, it has been ruled that in order to access the data the Board will be expected to clearly define the purpose of the extraction and then involve important groups, such as the BMA and RCGP in discussions about what is needed and how it should be used.

Department of Health, Children’s Health Pledge The Department of Health has pledged to make wide-ranging improvements to the health of children and young people. The pledge represents a key part of the Government’s response to the Children and Young People’s Health Outcomes Forum.

Organisations involved in the provision of health care services for this demographic will be encouraged to sign up to the pledge, with a number of bodies, including the Care Quality Commission, Local Government Association and Public Health England, having already done so. As part of its own support for the pledge, the Department of Health is seeking to encourage the sharing of data between the NHS and Local Authorities, as well as ensuring that children and young people are given the opportunity to comment on the quality of the care they receive.

Commenting on the initiative, Health Minister Dr Daniel Poulter MP, asserted that the Government’s pledge “demonstrates how all parts of the system will play their part and work together to improve children’s health.”

Community Services Competition to be Increased The Government are seeking to make community services subject to increased competition through the introduction of guidance that will be enacted through new secondary legislation under the Health and Social Care Act. The new proposals are to be developed by the NHS Commissioning Board, which will seek to establish how commissioners should apply competition to the provision of local services.

The final recommendations will be published by the NHS Commissioning Board as part of the ‘Choice and Competition Framework, which is expected to set out where competition on prices would be considered appropriate and clarify which services should be open to local tenders.

The move has caused an angry reaction by many NHS professionals who claim the Government has gone back on earlier promises made and is trying to sneak increased competition in through the back door. The Government has sought to downplay these suggestions, with Health Minister Lord Howe arguing that there “is no Government policy to privatise all NHS services.” Howe went on to add that the changes were “about ensuring that when services are tendered for… the rules that are applied to the process are fair to all concerned.”

Government Announces Reforms to Long Term Care As part of its Mid-Term Review, the Coalition Government has announced a range of measures which will reform elderly care costs and tackle the escalating cost of caring for the UK’s increasingly ageing population. The reforms follow the publication of the Dilnot Commission’s report which provided recommendations to the Government on long-term care funding and sustainability. The package of measures announced includes a cap on care costs at £75,000, with the Government undertaking to pay care costs incurred by individuals over this level from 2017. Also announced as part of the measures is a new means test threshold of £123,000, which will mean in future, people will no longer need to be down to their last £23,000 before they get help with residential care costs.

The Government has also under taken to take forward a number of other reforms proposed by the Dilnot Commission including the provision of free care to those who turn 18 with eligible care needs, a lower cap for those of working age who develop care needs before retirement age and measures to ensure that those unable to afford their care are given the right to defer paying for this during their lifetime.

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Describing the reforms announced by his Department as a “watershed moment for our country”, the Health Secretary Jeremy Hunt argued that the “issue of social care has been ducked by successive governments” and that this had led to “an unfair system that has seen people selling their homes and losing nearly everything they’ve worked for to pay for their care.”

Concluding, the Health Secretary said that the reforms to long term care would grant “everyone the protection they want in their old age and save the family home.”

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Health in Parliament Review of Liverpool Care Pathway to be Launched Controversial end-of-life regimes, such as the withholding of food and drink from terminally ill patients, will be reviewed as part of an independent inquiry into the Liverpool Care Pathway (LCP), being led by the crossbench peer Baroness Julia Neuberger. The review will hear evidence from patients, families and health professionals before reporting to ministers and the NHS Commissioning Board in the summer.

Commenting on the review, care minister Norman Lamb asserted that it was “vital for relatives to have complete confidence in the care that their loved ones are receiving.” He went on to state that the Department of Health was eager to “ It is vital for relatives to have complete confidence in the care that their loved ones are receiving. This is why we want to hear from people with experience of the Liverpool Care Pathway”.

Sir David Nicholson to be Quizzed on NHS Procurement It has been reported that Sir David Nicholson will be called to give evidence to the House of Commons Public Account Committee regarding the interim agreement between the ITC services provider CSC and the Department of Health.

Under the agreement, the first ten trusts to commit to taking CSC’s Lorenzo electronic patient record system by the end of March, would be granted a signing-on bonus of £1m for implementation expenses. This would be in addition to up to £4m that will be available for deployment and training costs.

The Public Accounts Committee session is expected to take place on Monday 18 March and will see Sir David questioned about the end of the National Programme for IT in the NHS and the incentive payments allocated to Trusts that purchase the system.

Health Moves and Appointments Commission on Human Medicines Chair Confirmed The Department for Health has confirmed Professor Stuart Ralston as the new Chair of the Commission on Human Medicines (CHM). The Commission advises on matters relating to the safety, quality and efficiency of medicines as well as the collection information relating to adverse drug reactions.

Commenting on the appointment, Health Minister Lord Howe described Stuart Ralston as “ideally placed to take on the role as Chair of the CHM as a result of his previous role as a member of CHM and experience in clinical medicine, clinical trials and biomedical science.” He went on to add that he expected Ralston to “lead the CHM at a time where advances in molecular biology and genomics are being used to tailor drugs to patients more effectively and where techniques such as nanotechnology are being used to develop more sophisticated ways of delivering drugs.”

February 2013

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Department of Health Website to Move It has been announced that the Department of Health website will move to the new single website for Government in March 2013. A majority of Departmental websites have already moved to the Government’s new online hub at GOV.UK, which seeks to bring together Government information and guidance from Directgov and Business Link into one place.

Public Health England Regional Director Appointed The Chief Executive of Public Health England, Duncan Selbie has announced that Dr Jenny Harries has been appointed as the body’s Regional Director for the South of England. Prior to taking up her new post, Jenny Harries worked as Joint Director of Public Health for Norfolk County Council and NHS Norfolk and Waveney.

Public Health England Organisational Structure

Department of Health Quality and Strategy Director Appointed

Public Health England has finalised its organisational structure in advance of taking on its new range of responsibilities on Monday 1 April. As part of this process, appointments to Public Health England’s National Executive have also now been completed.

Former King’s Fund director of policy Anna Dixon has been appointed as the Department of Health’s Director of Quality and Strategy. Having previously worked within the Department of Health strategy unit, in her new role, Dr Dixon will report to Richard Douglas, Director General of Strategy, Finance and NHS.

Sir Thomas Blundell to remain as Chair of Biotech Research Council Sir Thomas Blundell has been reappointed to a second term as chair of the UK's Biotechnology and Biological Sciences Research Council (BBSRC). Sir Thomas was originally appointed to the role in July 2009 and will now serve a further two years more than his original four-year term, with his reappointment lasting until June 30, 2015.

Reports and Publications Care Quality Commission, Mental Health Act Annual Report In its annual report on the Mental Health Act, the Care Quality Commission has argued that mental health services must improve the care they provide to patients. The report revealed that 15 per cent of people receiving care under the Act are not being involved in the decisions made about their care.

The Commission also found that a significant number of patients had little or no information regarding their discharge from care, facilities, including what they might have to do in order to demonstrate that they were ready to be discharged.

Another key finding of the Commission’s report was the increasing pressure under which mental health services are currently operating, especially in regards to the provision of Approved Mental Health Professionals who contribute to decisions about the detention of patients under the Act. The Commission also expressed concerns about the culture of “control and containment” enforced over detained patients, arguing that these kinds of rules could become institutionalised and carried the risk of stripping patients of their autonomy and dignity.

Commenting on the report, CQC Chief Executive David Behan argued that “People who need treatment in hospital for their mental health should have care and support to help them recover.” He went on to add that the CQC was “concerned that some hospitals have allowed cultures to develop where control

February 2013

and containment are prioritised over treatment and care.”

Concluding, he revealed that the CQC would be making “mental health a high priority this year and the information gained through our Mental Health Act visits and from other strategic partners will direct our inspection work.”

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NHS Constitution Consultation Responses Published

Mobile Health Worker Report

The Government has published a report providing an overview of responses to its consultation on the NHS Constitution. The report focuses only on the changes to the guiding ‘Principles of the NHS Constitution’ and does not address any other changes to the constitution. These changes incorporate most of the amendments to the principles proposed in the consultation document, as well as some minor additional changes to reflect consultation feedback and ensure that the principles are consistent with relevant legislation. It has also been announced that regulations to change these principles will be laid before Parliament shortly.

The Department of Health’s Mobile Health Worker Project has published a report that seeks to outline the benefits of mobile technology for health staff and patients. The project examined the introduction of mobile devices at 11 NHS pilot sites, with the aim of understanding the requirements of mobile working and to consider whether increased productivity and efficiency could be achieved by making changes to working processes.

The report suggests that significant increases in productivity could be achieved through the adoption of mobile technology, with medical personal also being able to spend far greater time with patients following deployment of mobile devices.

NHS Confederation Health and Wellbeing Boards Report A new report for the NHS Confederation has recommended that Health and Wellbeing Boards should take advantage of the experience and connections of established providers of health and care-related services, as well as be more open to innovative contributions from new providers in order to successful improve the health outcomes of their communities.

The report also recommends that Health and Wellbeing Boards should tailor their engagement programmes to local priorities, employing different tools and models at different times, rather than sticking rigidly to one structure or process.

The report, ‘Stronger together: how health and wellbeing boards can work effectively with local providers’, argues that health and wellbeing boards are unlikely to produce a comprehensive Joint Strategic Needs Assessment (JSNA) or successfully deliver a Joint Health and Wellbeing Strategy (JHWS) unless they involve and engage local providers, many of which already have strong relationships with service users and considerable institutional knowledge.

Commenting on the report, the interim director of policy at the NHS Confederation, Jon Webber said that “Local communities, their health needs and priorities vary widely across England, and

Kings Fund Quarterly Report raises concerns over Social Care The Kings Fund’s quarterly monitoring report has highlighted concern over the quality of health and social care from nearly half of directors who thought that the quality of services they commissioned had worsened in the past year. The report also found significant dissatisfaction within the NHS as a whole over the provision of care and concerns over how the organisation would meet the Nicholson Challenge to find £20 billion in productivity improvements before 2015.

Responding to the Report, Labour’s Shadow Health Secretary, Andy Burnham described the findings as “clear evidence that England’s health and care system is heading in the wrong direction.” He went on to add that “The report backs up Labour’s recent warnings of a growing crisis in emergency care” and that the Government needed to “urgently wake up to these warnings and ensure there are enough staff on the ground across the NHS to provide safe care.”

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the services which best meet these needs will vary as much, so it’s obvious that no ‘one size fits all’ approach for health and wellbeing boards to engage effectively with local providers will suffice.”

About us This Health Monitor has been produced by Edelman’s UK Health Public Affairs and Market Access Team. A specialist team of political consultants, skilled in health policy, political advocacy, stakeholder relations, regulatory affairs and reputation management. Working as part of a global award winning integrated communications agency, Edelman’s Health Public Affairs and Market Access Team is uniquely positioned to offer clients truly innovative, full-spectrum communication strategies, which draw on the very best experience of our resident Health, Consumer PR, Corporate, Bioscience and Digital Health Teams – spanning disciplines and geographical locations where necessary.

For more information or an informal conversation about your organizational requirements, please contact: Camilla Horwood Head of Health Public Affairs and Market Access UK Tel: 0203 0470 2072, Email: camilla.horwood@edelman.com

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