NEWS - MARCH and APRIL 2017
MINISTERIAL RESPONSIBILITY FOR PPI
Letter to Ruth Marsden from Ola Adigun, Ministerial Correspondence, Department of Health
Letter to Ruth Marsden from Ola Adigun, Ministerial Correspondence, Department of Health
CARE HOME, QUALITY ... BEST AND WORST AREAS OF CARE HOME QUALITY IN ENGLAND. STARK VARIATION IN THE QUALITY OF CARE HOMES REVEALED
A stark variation in the quality of care homes at a regional and local authority level across England has been highlighted by new research. The North West is the worst performing region in England when it comes to the proportion of satisfactory care homes, whilst London is the best performing region. In some areas such as Stockport or Salford, older people and their families face little choice of quality care, with 3 in 5 homes rated not good enough. That’s according to new analysis by Independent Age, the older people’s charity.
The key regional findings reveal:
The North West contains seven of the eight worst performing English local authorities on care home quality, with one in three care homes across the region performing poorly.
The new analysis is based on CQC inspections of care homes which rate homes as either ‘Outstanding’, ‘Good’, ‘Requires improvement’ or ‘Inadequate’. The analysis regarded homes rated ‘Requires improvement’ or ‘Inadequate’ as being poor performers.
Performance at local authority level shows even greater variation. Five local authority areas have more than half of homes rated ‘Inadequate’ or ‘Requires improvement’:
In contrast, five local authority areas have less than 5% of homes rated ‘Inadequate’ or ‘Requires improvement’, including three that have no care homes with those ratings:
Commenting on the findings, Simon Bottery, Director of Policy at Independent Age, said:
“No one should be forced to live in an unsatisfactory care home but our analysis shows this is the grim reality in some parts of the country. The market is simply not providing a decent choice for older people and their families but there is little indication that local authorities or the government are giving the problem the attention it deserves. Money is likely to be one cause but not the only one. The government has an opportunity to address this in its upcoming Green Paper on social care but, in the meantime, councils must demonstrate that they understand the reasons for care home failures and are working to resolve them.”
Independent Age believes the drivers for care home quality variation includes factors such as low levels of funding by local authorities, low pay and difficulty recruiting staff, and the lack of a good support mechanism for improving care homes that are struggling. The care homes market is now valued at nearly £16 billion. However, social care is facing a £2.6 billion funding gap by 2019/20.
In order to improve quality in the market, Independent Age makes the following recommendations:
Independent Age offer a free advice guide, ‘How to find the right care home’. The guide looks at what to consider and essential questions like location and cost, what you want from a home and whether a care home is actually the best option. The guide is available to download for free or to order.
Independent Age has developed eight new ‘Care Home Quality Indicators’ to assist local Healthwatch organisations with evaluating the quality of care homes in their area.
A stark variation in the quality of care homes at a regional and local authority level across England has been highlighted by new research. The North West is the worst performing region in England when it comes to the proportion of satisfactory care homes, whilst London is the best performing region. In some areas such as Stockport or Salford, older people and their families face little choice of quality care, with 3 in 5 homes rated not good enough. That’s according to new analysis by Independent Age, the older people’s charity.
The key regional findings reveal:
The North West contains seven of the eight worst performing English local authorities on care home quality, with one in three care homes across the region performing poorly.
- The North West (33.6% of care homes performing poorly), Yorkshire and The Humber (32.2%) and South East (28.2%) are the worst performing regions of England for care home quality.
- London (20.3% of care homes performing poorly), the East of England (20.8%) and the South West (21.1%) are the best performing regions for care home quality.
The new analysis is based on CQC inspections of care homes which rate homes as either ‘Outstanding’, ‘Good’, ‘Requires improvement’ or ‘Inadequate’. The analysis regarded homes rated ‘Requires improvement’ or ‘Inadequate’ as being poor performers.
Performance at local authority level shows even greater variation. Five local authority areas have more than half of homes rated ‘Inadequate’ or ‘Requires improvement’:
- Stockport – 62.9% of homes
- Salford – 61.5%
- Tameside – 54.8%
- Manchester – 51.3%
- Kensington and Chelsea – 50%
In contrast, five local authority areas have less than 5% of homes rated ‘Inadequate’ or ‘Requires improvement’, including three that have no care homes with those ratings:
- Isles of Scilly, Islington and Rutland – 0%
- Richmond upon Thames – 2.3%
- Thurrock – 2.9%
- In Bury, which is in the North West, around 1 in 8 care homes in the local authority are rated ‘Inadequate’ or ‘Requires improvement’.
- But in neighbouring Salford, older and disabled people are faced with far fewer choices of quality care, with 3 in 5 homes in the local authority rated ‘Inadequate’ or ‘Requires improvement’.
Commenting on the findings, Simon Bottery, Director of Policy at Independent Age, said:
“No one should be forced to live in an unsatisfactory care home but our analysis shows this is the grim reality in some parts of the country. The market is simply not providing a decent choice for older people and their families but there is little indication that local authorities or the government are giving the problem the attention it deserves. Money is likely to be one cause but not the only one. The government has an opportunity to address this in its upcoming Green Paper on social care but, in the meantime, councils must demonstrate that they understand the reasons for care home failures and are working to resolve them.”
Independent Age believes the drivers for care home quality variation includes factors such as low levels of funding by local authorities, low pay and difficulty recruiting staff, and the lack of a good support mechanism for improving care homes that are struggling. The care homes market is now valued at nearly £16 billion. However, social care is facing a £2.6 billion funding gap by 2019/20.
In order to improve quality in the market, Independent Age makes the following recommendations:
- The Government must seek to tackle variation in care home quality in their forthcoming Green Paper on social care.
- In areas where there is a failure of quality, the Local Authority needs to understand the drivers for variation in the area and must do more to fulfil their Care Act duty to shape the local care market.
- Drawing on CQC data, Department of Health must understand what drives regional variation and demonstrate leadership on tackling variation in care home quality.
Independent Age offer a free advice guide, ‘How to find the right care home’. The guide looks at what to consider and essential questions like location and cost, what you want from a home and whether a care home is actually the best option. The guide is available to download for free or to order.
Independent Age has developed eight new ‘Care Home Quality Indicators’ to assist local Healthwatch organisations with evaluating the quality of care homes in their area.
FULL TIME GP WORKFORCE DROPS AGAIN
Full-time GP workforce dropped by 445 in three months to December 2016. The full-time equivalent GP workforce fell by a staggering 445 in the three months to December 2016, office NHS data reveal.
In headcount terms, the number of GPs in England fell from 41,865 in September 2016 to 41,475 in December, a drop of 390 - or 0.9%. Full-time equivalent (FTE) data show that the GP workforce fell 445 from 34,495 to 34,050 over the three months to 31 December 2016 - a 1.3% drop.
Excluding Registrars and Locums, there were 28,204 FTE GPs at 31 December 2016, down from 28,530 in September.
The findings published by NHS Digital are the latest blow to the Government's ambition of increasing the GP workforce by 5,000 by 2020/21, and come just a day after the independent Doctors and Dentists review body (DDRB) warned that it is 'unclear' how GP services can be maintained over the coming years given the growing GP workforce crisis.
The figures suggest a growing trend of falling FTE GP numbers, coming after a drop of just under 100 FTE GPs over the 12 months to September 2016.
Analysis found that GP numbers fell fastest in the South London NHS region, where the number of full-time equivalent GPs dropped 77 to 2,190 between September and December 2016 - a 3.4% decline.
In the North East region of England, FTE GP numbers dropped 3.1% - down by 47 to 1,464 over the three-month period. Of 13 NHS regions across England, just two - Wessex and the West Midlands - avoided a drop in the FTE GP workforce, with an increase of five FTE GPs and six FTE GPs respectively. In Kent, FTE GP numbers slipped by 0.9%, while in every other area numbers fell by more than 1%.
Ageing workforceA total of 18% of headcount GPs are aged over 55, the workforce data reveal. However, the age of 7% of GPs is unknown, and if this group is excluded, 19% of the workforce, whose age is known, is 55 or over.
One positive statistic is that 48% of GPs overall are aged under 45. A total of 15% of the headcount workforce are aged 30-34, 17% 35-39 and 16% are aged 40-44.
Partners now make up just 56.9% of the total headcount number of GPs, the figures reveal, with 26.6% of GPs listed as 'salaried/other' GPs, while 13% are registrars. The rest are Locums (3.8%) or retainers (0.4%).
The figures suggest that men and women make up almost equal proportions of the FTE workforce, with 47.2% of FTE GPs male, compared with 46.6% of FTE GPs female.
A DH spokeswoman said: 'GPs are the absolute bedrock of the health service and we remain committed to an extra 5,000 doctors in general practice by 2020.
'We have made important strides over the last year to improve conditions to attract more GPs - such as paying a large amount of GP indemnity costs, cutting red tape, agreeing a new contract with their union to deliver a 1% pay rise, as well as bringing in new schemes to help GPs work more flexibly towards retirement.
'We currently have the highest number of GPs in training than ever before, and we know that it will take time for this to impact on GP workforce numbers. We will also take strong action to make sure the almost 600 practices who have not yet reported their workforce numbers do so.
Full-time GP workforce dropped by 445 in three months to December 2016. The full-time equivalent GP workforce fell by a staggering 445 in the three months to December 2016, office NHS data reveal.
In headcount terms, the number of GPs in England fell from 41,865 in September 2016 to 41,475 in December, a drop of 390 - or 0.9%. Full-time equivalent (FTE) data show that the GP workforce fell 445 from 34,495 to 34,050 over the three months to 31 December 2016 - a 1.3% drop.
Excluding Registrars and Locums, there were 28,204 FTE GPs at 31 December 2016, down from 28,530 in September.
The findings published by NHS Digital are the latest blow to the Government's ambition of increasing the GP workforce by 5,000 by 2020/21, and come just a day after the independent Doctors and Dentists review body (DDRB) warned that it is 'unclear' how GP services can be maintained over the coming years given the growing GP workforce crisis.
The figures suggest a growing trend of falling FTE GP numbers, coming after a drop of just under 100 FTE GPs over the 12 months to September 2016.
Analysis found that GP numbers fell fastest in the South London NHS region, where the number of full-time equivalent GPs dropped 77 to 2,190 between September and December 2016 - a 3.4% decline.
In the North East region of England, FTE GP numbers dropped 3.1% - down by 47 to 1,464 over the three-month period. Of 13 NHS regions across England, just two - Wessex and the West Midlands - avoided a drop in the FTE GP workforce, with an increase of five FTE GPs and six FTE GPs respectively. In Kent, FTE GP numbers slipped by 0.9%, while in every other area numbers fell by more than 1%.
Ageing workforceA total of 18% of headcount GPs are aged over 55, the workforce data reveal. However, the age of 7% of GPs is unknown, and if this group is excluded, 19% of the workforce, whose age is known, is 55 or over.
One positive statistic is that 48% of GPs overall are aged under 45. A total of 15% of the headcount workforce are aged 30-34, 17% 35-39 and 16% are aged 40-44.
Partners now make up just 56.9% of the total headcount number of GPs, the figures reveal, with 26.6% of GPs listed as 'salaried/other' GPs, while 13% are registrars. The rest are Locums (3.8%) or retainers (0.4%).
The figures suggest that men and women make up almost equal proportions of the FTE workforce, with 47.2% of FTE GPs male, compared with 46.6% of FTE GPs female.
A DH spokeswoman said: 'GPs are the absolute bedrock of the health service and we remain committed to an extra 5,000 doctors in general practice by 2020.
'We have made important strides over the last year to improve conditions to attract more GPs - such as paying a large amount of GP indemnity costs, cutting red tape, agreeing a new contract with their union to deliver a 1% pay rise, as well as bringing in new schemes to help GPs work more flexibly towards retirement.
'We currently have the highest number of GPs in training than ever before, and we know that it will take time for this to impact on GP workforce numbers. We will also take strong action to make sure the almost 600 practices who have not yet reported their workforce numbers do so.
CLINICAL COMMISSIONING GROUPS (CCGs) WITH DELEGATED AND JOINT ARRANGEMENTS
List of CCGs currently implementing joint co-commissioning and delegated commissioning arrangements
April 2017 ... 7 pages
List of CCGs currently implementing joint co-commissioning and delegated commissioning arrangements
April 2017 ... 7 pages
COMMUNITY AND LOCAL GOVERNMENT COMMITTEE - ADULT SOCIAL CARE
The £2bn extra earmarked by the Government for social care over the next three years will not be enough, says a committee of MPs.
A report from the community and local government committee finds that inadequate funding very seriously affects the quantity and quality of adult social care provision, impacting on those receiving care, the NHS, care staff, carers and providers.
It urges the Government to urgently review how social care is funded long-term and to address serious threats to the provision of care in England.
The £2bn extra earmarked by the Government for social care over the next three years will not be enough, says a committee of MPs.
A report from the community and local government committee finds that inadequate funding very seriously affects the quantity and quality of adult social care provision, impacting on those receiving care, the NHS, care staff, carers and providers.
It urges the Government to urgently review how social care is funded long-term and to address serious threats to the provision of care in England.
NEW TAX RULES - IMPACT ON LOCUM DOCTORS, AGENCY NURSES AND PRIVATE CONTRACTORS
NHS in 'Mexican standoff' with locums due to new tax rules - 04 April 2017
The NHS is in a “Mexican standoff” with locum doctors, agency nurses and private contractors, with some threatening not to work when new tax rules come into force this week; some locum doctors are demanding uplifts of more than 50 per cent in their pay as NHS Trusts take on responsibility for paying their tax and national insurance from Thursday, under new IR35 regulations from HM Revenue and Customs.
Some Trusts have prepared processes used during last year’s junior doctors’ strike, to respond to any significant staffing shortfalls.
The IR35 Regulations apply to any temporary staff being paid through a personal service company, and could reduce income for temporary staff by more than 20 per cent.
One NHS Finance Director said: “It is akin to a Mexican standoff. Some locums have been asking for between 30 and 50 per cent price uplifts. More than likely we will have to pay this; it is a Hobson’s choice.”
NHS Improvement said it was working with Trusts to resist any demand for higher pay because of the new rules, and added it would work with NHS Trusts to try and tackle the culture that led to locums charging high rates.
Some Trusts have longstanding relationships with locum doctors and agency nurses to maintain staffing in key specialties - such as emergency departments, intensive care and medicine.
An email to a Trust Director at a hospital in the South West said 'three locums were putting pressure on the trust to increase pay by more than 56 per cent'.
The email said: “All three have advised their agency that they will only be working with us if a pay rate of £95 is agreed, meaning the total charge would be £100 per hour. They were all previously on total charge rates between £64 and £69.”
An FT Medical director at a different Trust said: “We have had some locums who have joined our substantive staff, some have agreed the lower rates, but some have said they are taking a two week holiday at the start of April and will see how it plays out before making a decision.”
They added: “Some individuals and agencies are playing games. Locums will play Trusts off against each other and some of these people are quite prepared to travel long distances. The first two weeks in April will be crucial. If the NHS can hold the line, then we might see a change in the market.
“But if one Trust breaks the cap for one doctor in one ward, then it will fail. We need to all hold the line on this.”
At Guy’s and St Thomas’, 35 contractors working on a £16m IT project to update the Trust’s Windows XP System, left the project last month.
A Trust spokesman said they left because of the IR35 Regulations and efforts by the Trust to replace their contracts with permanent staff. He said the Trust was under a legal duty to comply with IR35 rules and provided the contractors with “clarity” about this. “It was then a matter of personal choice if contractors left the Trust as a result of these changes,” he added.
Chris Hopson, Chief Executive of NHS Providers, said: “A number of our members have reported that some contractors are seeking to put pressure on them to pay more, or interpret the rules more generously than they should be. This is a concern as every Trust wants to guarantee safe care at a time of workforce shortages.
“The law is the law. As we have seen with issues - such as agency rates - when the whole sector acts collectively, it can be more effective. There could well be immediate impacts on rotas, which means that NHS Improvement needs to stand ready to support Trusts to overcome these.”
An NHS Improvement spokeswoman said: “We’re absolutely clear that the NHS shouldn’t be picking up the tax liability or costs for individual agency staff – that’s not fair or right for patients and goes against the grain of what we know many nurses and doctors believe in. Any Trusts that see locums increasing costs in this way, should talk to us and we will support them to resist this.”
She said the regulator was offering Trusts direct support, including sourcing staff from other local providers to work shifts. She added: “We are working with Medical Directors and agencies to try and tackle the culture that’s behind locums charging high rates and to bring about longer term improvement.”
Comment
NHS in 'Mexican standoff' with locums due to new tax rules - 04 April 2017
- New tax regulations for off-payroll staff come into force on Thursday
- Some locums and temporary staff are refusing to work at NHS Trusts
- Trusts face “Hobson’s choice” over locums’ pay demands, says finance director
- Medical director says NHS “must hold the line” on pay cap
The NHS is in a “Mexican standoff” with locum doctors, agency nurses and private contractors, with some threatening not to work when new tax rules come into force this week; some locum doctors are demanding uplifts of more than 50 per cent in their pay as NHS Trusts take on responsibility for paying their tax and national insurance from Thursday, under new IR35 regulations from HM Revenue and Customs.
- In one example of the problems facing the NHS, IT contractors walked away from working on a multi-million pound project at Guy’s and St Thomas’ Foundation Trust, rather than accept the new rules.
- At Blackpool Teaching Hospitals FT, 14 locums are refusing to show up for work on Thursday. This was revealed in an email to Trust consultants, appealing for help to fill gaps. One consultant described the situation as a “disaster”. The trust had not responded.
- In other Trusts, substantive staff are being asked to work extra shifts. Trusts have cancelled non-mandatory training time, consultant supporting professional activities time and have suspended secondments so staff can work on wards.
Some Trusts have prepared processes used during last year’s junior doctors’ strike, to respond to any significant staffing shortfalls.
The IR35 Regulations apply to any temporary staff being paid through a personal service company, and could reduce income for temporary staff by more than 20 per cent.
One NHS Finance Director said: “It is akin to a Mexican standoff. Some locums have been asking for between 30 and 50 per cent price uplifts. More than likely we will have to pay this; it is a Hobson’s choice.”
NHS Improvement said it was working with Trusts to resist any demand for higher pay because of the new rules, and added it would work with NHS Trusts to try and tackle the culture that led to locums charging high rates.
Some Trusts have longstanding relationships with locum doctors and agency nurses to maintain staffing in key specialties - such as emergency departments, intensive care and medicine.
An email to a Trust Director at a hospital in the South West said 'three locums were putting pressure on the trust to increase pay by more than 56 per cent'.
The email said: “All three have advised their agency that they will only be working with us if a pay rate of £95 is agreed, meaning the total charge would be £100 per hour. They were all previously on total charge rates between £64 and £69.”
An FT Medical director at a different Trust said: “We have had some locums who have joined our substantive staff, some have agreed the lower rates, but some have said they are taking a two week holiday at the start of April and will see how it plays out before making a decision.”
They added: “Some individuals and agencies are playing games. Locums will play Trusts off against each other and some of these people are quite prepared to travel long distances. The first two weeks in April will be crucial. If the NHS can hold the line, then we might see a change in the market.
“But if one Trust breaks the cap for one doctor in one ward, then it will fail. We need to all hold the line on this.”
At Guy’s and St Thomas’, 35 contractors working on a £16m IT project to update the Trust’s Windows XP System, left the project last month.
A Trust spokesman said they left because of the IR35 Regulations and efforts by the Trust to replace their contracts with permanent staff. He said the Trust was under a legal duty to comply with IR35 rules and provided the contractors with “clarity” about this. “It was then a matter of personal choice if contractors left the Trust as a result of these changes,” he added.
Chris Hopson, Chief Executive of NHS Providers, said: “A number of our members have reported that some contractors are seeking to put pressure on them to pay more, or interpret the rules more generously than they should be. This is a concern as every Trust wants to guarantee safe care at a time of workforce shortages.
“The law is the law. As we have seen with issues - such as agency rates - when the whole sector acts collectively, it can be more effective. There could well be immediate impacts on rotas, which means that NHS Improvement needs to stand ready to support Trusts to overcome these.”
An NHS Improvement spokeswoman said: “We’re absolutely clear that the NHS shouldn’t be picking up the tax liability or costs for individual agency staff – that’s not fair or right for patients and goes against the grain of what we know many nurses and doctors believe in. Any Trusts that see locums increasing costs in this way, should talk to us and we will support them to resist this.”
She said the regulator was offering Trusts direct support, including sourcing staff from other local providers to work shifts. She added: “We are working with Medical Directors and agencies to try and tackle the culture that’s behind locums charging high rates and to bring about longer term improvement.”
Comment
- The issue is somewhat broader than the tax and NI parts of the IR35 Regulations. This does indeed stipulate that a locum or interim member of staff working in an employee type role (covering the role of an employee), should pay the same PAYE and NI as an actual employee. However, what it doesn't do is infer any of the employee rights, such as entitlements to sick pay and annual leave.
The absurdity currently, therefore, is that one will be treated as an employee for tax purposes, but treated as a locum/interim for employee rights purposes.
This cannot be right or fair, whatever ones views are on locums and interims.
INTERNATIONAL GP RECRUITMENT PROGRAMME
NHS England recently published Guidance for Commissioners on the International GP Recruitment Programme.
https://www.england.nhs.uk/gp/gpfv/workforce/international-gp-recruitment
The General Practice Forward View (GPFV) includes a commitment to deliver a major international recruitment drive to attract at least 500 appropriately trained and qualified GPs from overseas by 2020.
Following publication of the GPFV, NHS England’s general practice workforce team has been engaging with our regional and local colleagues, Health Education England and stakeholders including the Royal College of GPs (RCGP) and the British Medical Association (BMA) to agree an approach for delivering the commitment.
The International GP Recruitment Programme will formally commence on April 1 2017. In advance of this, NHS England has provided funding to four international recruitment schemes. These have helped us test approaches and develop plans for the national roll-out of the programme from April 2017.
NHS England has committed to fund the cost of recruiting, relocating and training overseas doctors as part of the programme. The salaries for these GPs will be agreed locally and paid by the practices that employ them
We considered three options for implementation and delivery of the programme:
We assessed each of the options against the following set of criteria:
Stakeholders told us it is important that the schemes are locally led, with general practices involved in the selection process. This approach helps to ensure that successful applicants can start to build connections with practices at an early stage. They can begin to see where they will be living and working from the outset. It was agreed that this approach encourages local buy-in to the scheme and helps ensure that GPs stay after they move to England.
The contracts and support packages for international doctors recruited into general practices will vary across the country to be tailored to the opportunities and needs of the local health system.
It has, therefore, been agreed that the programme will be locally led and delivered with oversight, co-ordination and support by the NHS England general practice workforce team. Each international recruitment project will be expected to satisfy a set of national principles.
Ruth Marsden, HAPIA North
NHS England recently published Guidance for Commissioners on the International GP Recruitment Programme.
https://www.england.nhs.uk/gp/gpfv/workforce/international-gp-recruitment
The General Practice Forward View (GPFV) includes a commitment to deliver a major international recruitment drive to attract at least 500 appropriately trained and qualified GPs from overseas by 2020.
Following publication of the GPFV, NHS England’s general practice workforce team has been engaging with our regional and local colleagues, Health Education England and stakeholders including the Royal College of GPs (RCGP) and the British Medical Association (BMA) to agree an approach for delivering the commitment.
The International GP Recruitment Programme will formally commence on April 1 2017. In advance of this, NHS England has provided funding to four international recruitment schemes. These have helped us test approaches and develop plans for the national roll-out of the programme from April 2017.
NHS England has committed to fund the cost of recruiting, relocating and training overseas doctors as part of the programme. The salaries for these GPs will be agreed locally and paid by the practices that employ them
We considered three options for implementation and delivery of the programme:
- Local leadership and delivery, with funding allocated to local teams or CCGs
- National leadership and delivery
- Local leadership with national support and oversight
We assessed each of the options against the following set of criteria:
- Impact on consistency of approach nationally to meet high standards of recruitment
- Impact on external relationships with other nations
- Impact on establishing relationships between successful applicants and receiving practices and local systems
- Impact on oversight and tracking of recruitment numbers
- Value for money
Stakeholders told us it is important that the schemes are locally led, with general practices involved in the selection process. This approach helps to ensure that successful applicants can start to build connections with practices at an early stage. They can begin to see where they will be living and working from the outset. It was agreed that this approach encourages local buy-in to the scheme and helps ensure that GPs stay after they move to England.
The contracts and support packages for international doctors recruited into general practices will vary across the country to be tailored to the opportunities and needs of the local health system.
It has, therefore, been agreed that the programme will be locally led and delivered with oversight, co-ordination and support by the NHS England general practice workforce team. Each international recruitment project will be expected to satisfy a set of national principles.
Ruth Marsden, HAPIA North
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HEALTH AND CARE IN RURAL AREAS
Public Health England - 47 pages A report by the Local Government Association and Public Health England highlights the challenges for health and care provision in rural communities. Why is this important? . Health in rural communities . . What are the health risks for rural populations? . Questions to consider in developing strategies for rural health . Further information |
HOSPITAL BED CLOSURES - New patient care test for hospital bed closures
06 March 2017
From next month local NHS organisations will have to show that significant hospital bed closures can meet one of three new conditions before NHS England will approve them:
Simon Stevens made the announcement at last week’s Nuffield Trust Summit. The new test joins the four existing tests for hospital reconfiguration put in place in 2010. Under those rules, closures can only go ahead with support from GP commissioners, strengthened public and patient engagement, clear clinical evidence and provided that they are consistent with patient choice.
NHS England Chief Executive, Simon Stevens, will today announce that hospital bed closures arising from proposed major service reconfigurations will in future only be supported where a new test is met that ensures patients will continue to receive high quality care.
From 01 April, local NHS organisations will have to show that significant hospital bed closures subject to the current formal public consultation tests can meet one of three new conditions before NHS England will approve them to go ahead:
Speaking at the Nuffield Trust Health Policy Summit, NHS England Chief Executive Simon Stevens is expected to say:
“Hospitals are facing contradictory pressures. On the one hand, there’s a huge opportunity to take advantage of new
medicines and treatments that increasingly mean you can be looked after without ever needing hospitalisation. So, of
course, there shouldn’t be a reflex reaction opposing each and every change in local hospital services.
But, on the other hand, more older patients inevitably means more emergency admissions, and the pressures on A&E
are being compounded by the sharp rise in patients stuck in beds awaiting home care and care home places. So there
can no longer be an automatic assumption that it’s OK to slash many thousands of extra hospital beds – unless and
until there really are better alternatives in place for patients.
That’s why before major service changes are given the green light, they’ll now need to prove there are still going to be
sufficient hospital beds to provide safe, modern and efficient care locally.”
Hospitals would still have the freedom to flex their number of beds throughout the year, and the responsibility to determine how many beds they can safely staff.
The announcement builds on the four existing tests for reconfiguration put in place in 2010. Under those rules, closures can only go ahead with support from GP commissioners, strengthened public and patient engagement, clear clinical evidence and provided that they are consistent with patient choice.
06 March 2017
From next month local NHS organisations will have to show that significant hospital bed closures can meet one of three new conditions before NHS England will approve them:
- That alternative community provision is in place
- That demand for admissions is being reduced by new treatments or therapies
- That the hospital is improving efficient use of existing beds
Simon Stevens made the announcement at last week’s Nuffield Trust Summit. The new test joins the four existing tests for hospital reconfiguration put in place in 2010. Under those rules, closures can only go ahead with support from GP commissioners, strengthened public and patient engagement, clear clinical evidence and provided that they are consistent with patient choice.
NHS England Chief Executive, Simon Stevens, will today announce that hospital bed closures arising from proposed major service reconfigurations will in future only be supported where a new test is met that ensures patients will continue to receive high quality care.
From 01 April, local NHS organisations will have to show that significant hospital bed closures subject to the current formal public consultation tests can meet one of three new conditions before NHS England will approve them to go ahead:
- Demonstrate that sufficient alternative provision, such as increased GP or community services, is being put in place alongside or ahead of bed closures, and that the new workforce will be there to deliver it; and/or
- Show that specific new treatments or therapies, such as new anti-coagulation drugs used to treat strokes, will reduce specific categories of admissions; or
- Where a hospital has been using beds less efficiently than the national average, that it has a credible plan to improve performance without affecting patient care (for example in line with the Getting it Right First Time programme)
Speaking at the Nuffield Trust Health Policy Summit, NHS England Chief Executive Simon Stevens is expected to say:
“Hospitals are facing contradictory pressures. On the one hand, there’s a huge opportunity to take advantage of new
medicines and treatments that increasingly mean you can be looked after without ever needing hospitalisation. So, of
course, there shouldn’t be a reflex reaction opposing each and every change in local hospital services.
But, on the other hand, more older patients inevitably means more emergency admissions, and the pressures on A&E
are being compounded by the sharp rise in patients stuck in beds awaiting home care and care home places. So there
can no longer be an automatic assumption that it’s OK to slash many thousands of extra hospital beds – unless and
until there really are better alternatives in place for patients.
That’s why before major service changes are given the green light, they’ll now need to prove there are still going to be
sufficient hospital beds to provide safe, modern and efficient care locally.”
Hospitals would still have the freedom to flex their number of beds throughout the year, and the responsibility to determine how many beds they can safely staff.
The announcement builds on the four existing tests for reconfiguration put in place in 2010. Under those rules, closures can only go ahead with support from GP commissioners, strengthened public and patient engagement, clear clinical evidence and provided that they are consistent with patient choice.
DEPARTMENT OF HEALTH NOW RECRUITS MORE
The Department of Health plans to recruit hundreds more civil servants in the next year, while hundreds of others are made redundant.
Ministers have revised up the number of civil servants they expect the Department to recruit during the next 12 months for the second time in as many months.
The Department of Health is due to move out of Richmond House
In January, the Department of Health confirmed 538 civil servants were due to take voluntary redundancy in the coming months, as part of the Department’s plans to cut its running costs by 30 per cent by 2020.
A few weeks later it confirmed it would actually recruit 200 new civil servants, following a Commons health select committee hearing with Health Secretary Jeremy Hunt, and Paul Macnaught the Department's Director of EU and International Issues.
It has now emerged that Richmond House is planning to recruit 340 new staff over the next 12 months – 140 more than initially announced. [Details emerged in a written answer by health minister David Mowat to Labour MP Justin Madders. - see below]
Directorates within the Department of Health were asked to outline their needs for staff, including the requirements for the Department to respond to Brexit-related issues affecting the health service.
The Department of Health declined to comment on the recruitment drive, or explain whether the change in plans to cut staff would affect its ability to meet its savings target by 2020.
In the 2015 Autumn statement, George Osborne redefined the Government’s ring-fence around health spending to exclude the Department of Health and arm’s length bodies, which meant substantial cuts would be required.
A spokeswoman for the Department of Health previously said additional savings via non-staff costs would need to be found, in order to meet the 30 per cent costs reduction by the end of the current Parliament.
The Department is expected to relocate from Whitehall to 39 Victoria Street, and move staff from three separate London offices to one site.
Q: Asked by Justin Madders - (Ellesmere Port and Neston)
Asked on: 02 February 2017
Department of Health: Recruitment
Commons
62929
To ask the Secretary of State for Health, how many civil servants his Department plans to recruit in the next 12 months; and what the cost to the public purse of that recruitment will be.
A:Answered by: David Mowat
Answered on: 10 February 2017
The Department expects to recruit to approximately 340 posts over the next 12 months. All vacancies are advertised on the central Civil Service Jobs website, which does not attract additional costs.
The Department of Health plans to recruit hundreds more civil servants in the next year, while hundreds of others are made redundant.
Ministers have revised up the number of civil servants they expect the Department to recruit during the next 12 months for the second time in as many months.
The Department of Health is due to move out of Richmond House
In January, the Department of Health confirmed 538 civil servants were due to take voluntary redundancy in the coming months, as part of the Department’s plans to cut its running costs by 30 per cent by 2020.
A few weeks later it confirmed it would actually recruit 200 new civil servants, following a Commons health select committee hearing with Health Secretary Jeremy Hunt, and Paul Macnaught the Department's Director of EU and International Issues.
It has now emerged that Richmond House is planning to recruit 340 new staff over the next 12 months – 140 more than initially announced. [Details emerged in a written answer by health minister David Mowat to Labour MP Justin Madders. - see below]
Directorates within the Department of Health were asked to outline their needs for staff, including the requirements for the Department to respond to Brexit-related issues affecting the health service.
The Department of Health declined to comment on the recruitment drive, or explain whether the change in plans to cut staff would affect its ability to meet its savings target by 2020.
In the 2015 Autumn statement, George Osborne redefined the Government’s ring-fence around health spending to exclude the Department of Health and arm’s length bodies, which meant substantial cuts would be required.
A spokeswoman for the Department of Health previously said additional savings via non-staff costs would need to be found, in order to meet the 30 per cent costs reduction by the end of the current Parliament.
The Department is expected to relocate from Whitehall to 39 Victoria Street, and move staff from three separate London offices to one site.
Q: Asked by Justin Madders - (Ellesmere Port and Neston)
Asked on: 02 February 2017
Department of Health: Recruitment
Commons
62929
To ask the Secretary of State for Health, how many civil servants his Department plans to recruit in the next 12 months; and what the cost to the public purse of that recruitment will be.
A:Answered by: David Mowat
Answered on: 10 February 2017
The Department expects to recruit to approximately 340 posts over the next 12 months. All vacancies are advertised on the central Civil Service Jobs website, which does not attract additional costs.