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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NHS announces £120m Research Investment The Department of Health has announced £120m of additional funding as part of an open competition to research ways of improving services provided by the NHS. Each of the research projects that form part of the Collaborations for Leadership in Applied Health Research and Care (CLAHRCs) initiative will be based around partnerships between universities and neighboring NHS organisations and will be overseen by the National Institute of Health Research (NIHR).
First trialed in 2008, the CLAHRCs are intended to help ensure that the findings of research into patient needs are reflected throughout all levels of care provided within the NHS. NHS organisations or providers of NHS services in England wishing to take part in the initiative have been directed to make their submission by Monday 13 May 2013.
Action plan for Improving use of Medicines and Reducing Waste published An action plan intended to deliver improvements in the use of medicines and reduce waste has been published by the Department of Health. The product of a report commissioned by the Department, the scheme suggests that doctors could secure savings of up to £200m through the use of cheaper alternatives to the branded treatments many currently employ. The Action Plan’s recommendations, which have the potential to open up Department of Health procurement to a more diverse range of suppliers, will now be considered by the NHS Commissioning Board, which will assess how best to take them forward.
Sir Bruce Keogh to lead Review of Urgent and Emergency Services in England The NHS Commissioning Board has announced that, the Medical Director of the National Health Service, Sir Bruce Keogh will spearhead a review into the model of urgent and emergency services in England. Sir Bruce will oversee the review’s proposals to improve the way in which care is organised to meet the need of patients. The review’s exact terms of reference are still to be published, however, it is expected to reveal its initial findings in the spring as a basis for a wider consultation.
Update to Supply of Medicines Guidance The Department of Health has published updated guidance on best practice for the supply and distribution of medicines. Developed by a group representing the pharmaceuticals industry, healthcare professionals and government, the updated guidance makes a number of changes to that originally published by the Department in February 2011. Changes outlined in the new guidance include an expectation that pharmacies should receive medicines within 24hrs, provisions for regular communication between manufactures and wholesalers and checks to ensure verification measures imposed by manufactures do not place too great a burden on dispensers.
GP reaction to Contract Changes A recent survey of GPs has highlighted the high level of dissatisfaction felt by many healthcare professions over the Government’s plans to carry out wide ranging changes to the existing GP contract. The survey, conducted for Pulse, found particular concern among GPs concerning the potential for a significant increase in their workload, with many now facing the prospect of having to take on a range of new responsibilities within their existing practices. Of those GPs questioned in the survey, 84% said that their current practice workload was unsustainable and 48% said that it was “dangerously unsustainable.” The survey also revealed that in order to deal with the impending changes to their contracts, more than three quarters of GP partners anticipate having to make cuts to pay and staff, while also reducing the range of services offered to patients.
January 2013
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Health in Politics Andy Burnham outlines Labour’s Health Plans The Shadow Secretary of State for Health has used a speech to the King’s Fund to outline Labour’s “One-Nation” approach to healthcare ahead of the next General Election. Central to the proposals announced by Andy Burnham is a commitment to grant councils greater control over NHS funding up to the tune of £60bn. In his speech, Burnham announced that Labour would seek to deliver what he described as “Whole-Person Care” through the intergration of health and social care services. He went on to explain that Labour would change the “Any qualified provider” status back to the “NHS preferred provider” system and that the rules of the market, as defined within the Health and Social Care Act would be repealed.
Interestingly and in an apparent reversal of his party’s previous policy, Burnham also stated that an incoming Labour Government would not roll back the Coalition’s reforms to the NHS, cautioning that the “NHS has no capacity for further top-down reorganization” and that “any changes must be delivered through the organisations and structures we inherit in 2015.” This commitment was seen as an effort by the Shadow Health Secretary to court health professions, many of whom fear continuing uncertainly generated by further reforms to the NHS if the Government changed as a result of a General Election.
Health in Parliament House of Commons Joint Select Committee, draft Care and Support Bill consultation launched . The Joint Committee on the draft Care and Support Bill, chaired by Paul Burstow MP, is currently conducting pre-legislative scrutiny of the Bill. The Committee is seeking views and comments on carers experiences, via the use of a new online forum. As part of this process, the Committee has identified three key areas of interest, including the responsibilities of local authorities, needs assessments and the safeguarding of adults at risk of abuse and neglect. The consultation will go on to form the basis of the Committee’s recommendations to the Government.
Health Committee publishes Report on Care Quality Commission The Health Select Committee has issued a scathing report commenting on the performance of the Care Quality Commission (CQC), arguing that it has “much to do to earn public confidence” and has not yet “successfully defined its core purpose”. Committee Chair Stephen Dorrell suggested that there was an urgent need for the CQC to “overhaul its governance structures to ensure the Board sets clear objectives for the organisation.” Responding to the Committee’s report, the CQC asserted that it had already “consulted widely on a clear statement of our purpose and role” as part of its own strategic review and that it intended to “tailor the way we regulate different types of organisations based on what has the most impact on driving improvement.”
Health Committee to examine Health Budget Under Spending The Chair of the Health Select Committee has signaled that it intends to launch an investigation into under spending within the NHS. Commenting on the issue, Stephen Dorrell said that a “significant danger” existed of “perverse incentives” being established if the health service continued to be unable carry over unspent funds from one financial year to another. Dorrell’s comments followed the submission of written evidence by the Department of Health to the Committee which revealed that
January 2013
the department had returned nearly £3bn of unspent funds to the Treasury over the past two years. Questioned about the figures provided by the Department, the Deputy Chief Executive of the NHS David Flory explained that a “large part” of the unspent funding was “capital monies associated with particular projects in the department” which hadn’t progressed at the speed anticipated.
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Health Committee calls for action on Value Based Pricing The House of Commons Health Select Committee has criticised the Government over delays in the announcement of key details concerning a new value based pricing regime for new medicines. As part of the Committee’s eighth annual report on NICE and its operations, the Committee charged the government with an unacceptable level of delay since it launched its consultation on value based pricing in December 2010.The Committees’ report also calls for greater transparency over clinical drug trial results, suggesting that a legal and professional obligation should be imposed to ensure that NICE has access to all research related to pharmaceutical products in the UK.
Health Moves and Appointments New Department of Health Social Care Director General named
Government announces Healthcare Export Champion
It has been announced that Croydon Borough Council’s current Chief Executive, Jon Rouse, will replace Shaun Gallagher as Director General for Social Care. Taking up his new post in March, Rouse has previously held a number of posts within the civil service and served as Chief Executive of both the Housing Corporation and Commission for Architecture and the Built Environment.
The Department for Health has announced that Healthcare UK will be launching in the Middle East in February 2013. Established as a vehicle for the promotion of the UK’s healthcare sector overseas, Healthcare UK is a joint venture between the Department of Health, the NHS Commissioning Board and UK Trade and Investment (UKTI).
Report and Publications Royal College of Physicians, Obesity Report
Centre Forum, Delivering Dilnot Report
The Royal College of Physicians has published a report examining the health issues surrounding obesity care in the UK. The report calls for reforms which are needed to address what it describes as an “inadequate” level of care services available to those affected by the condition. The report goes on to observe that obesity rates in the UK are currently among the highest globally and argues that the NHS has yet to adequately respond to health issues associated with the increased incidence of the condition. The report also makes a number of recommendations, including the creation of specialist medical teams to treat the morbidly obese and the appointment of a lead physician to oversee obesity care.
A report by the Centre Forum think tank has examined the way in which the Government might seek to implement the recommendation of the Dilnot Commission on the Funding of Care and Support. The report “Delivering Dilnot” features contributions from former care minister Paul Burstow MP and other high profile figures. It highlights the need for the Government to confront “tough political decisions” in order to deliver the reforms required in order to adapt the UK’s care services to the country’s aging population.
Innovation Scorecard results published The first Innovation Scorecard report published by the NHS Health and Social Care Information Centre (HSCIC) has revealed significant variation in new drug uptake across the UK. The data gathered as part of the report shows that considerable differences exist between the medicines patients in different parts of the UK are able to access. Although these findings have provoked some comment, key industry figures have cautioned that the scorecard needs to cover a much wider range of treatments if it is to develop into a useful long-term tool in addressing current short-falls.
January 2013
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 access to innovative, full-spectrum communication strategies, which draw on the very best experience of our resident Health, Consumer PR, Corporate, Medical Education 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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