January 2012
UK HEALTH MONITOR Policy and NHS Developments Francis Report Published The status of healthcare management as a profession needs to be enhanced in order to bridge the gap between managers and clinicians, according to the report produced by Robert Francis QC. In his review into the care failings at Mid Staffordshire Foundation Trust, Mr Francis noted that the “tenure” of trust chief executives is “shockingly short” and the pool of candidates for such posts is “often small”, claiming that clinicians are reluctant to put themselves forward for senior leadership roles.
Ultimately his report claimed that the experience of Stafford shows “there is no system of accountability for leaders or managers of healthcare providers that is uniformly fair to the individuals concerned and that satisfies the public”.
The report concluded that enhancement of the status of healthcare management and leadership as a profession is dramatically needed and proposes the creation of a “physical” staff college that would enable all aspiring leaders to attend training and go through a “common and shared experience” that could lead to some form of accreditation, as this would enhance the eligibility of candidates for leadership roles. Mr Francis stopped short of proposing regulation of all NHS managers in his report, instead proposing that the regulator, Monitor have the power to disqualify board level directors if they fall below a fit and proper persons test, in line with a shared code of conduct. However, he says the creation of an independent professional regulator should be kept under consideration if it is thought appropriate in future to extend a regulatory system to a “wider range of managers and leaders”. The proportionality of such a step could be better assessed after reviewing the experience of a licensing provision for director.
David Nicholson highlights need for 'more' Community Focused Care
Duncan Selbie comments on meeting Local Public Health Challenges
The head of the newly created NHS Commissioning Board has described hospitals as “bad places for old, frail people” and argued that there is a need for a greater emphasis on locally provided care. Speaking to the Independent newspaper, Sir David Nicholson argued that the emphasis hospitals placed on treating patients quickly made them unsuitable for those requiring longterm care. He went on to add that there was a need for “alternatives” and predicted that some hospitals would be “shifting services out into the community”.
Public Health England Chief Executive, Duncan Selbie has used his post for the Department of Health blog to discuss the task of meeting local public health challenges. Although conceding that “no ‘one size fits all’ approach exists across the NHS, he identifies a number of areas in which common approaches should be adopted across the organisation.
Nicholson’s comments provoked considerable reaction, with a number of care groups welcoming his calls for a greater emphasis to be placed on care provided outside of hospitals. Responding to his remarks, the Alzheimer's’ Society agreed with Nicholson’s comments saying that “Supporting the 800,000 people with dementia in the UK to live well in the community needs to be established as a top priority for the new NHS Commissioning Board”.
January 2013
Highlighting the need for local government to “recognise their new responsibilities for improving the health of their populations”, Selbie argues that there is particular need for local government to foster stronger links with Public Health England across the country. He also goes on to identify bodies in the voluntary sector, such as Age UK and community sector bodies as vital partners for Public Health England going forward. His comments echo those made in an article for the Guardian newspaper in November 2012, in which he asserted that Public Health England needed to adopt a form of “radical localism” in order to fulfill its objective of “local action led by local government.”
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