HEALTHWATCH AND PUBLIC INVOLVEMENT ASSOCIATION
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NEWS - OCTOBER 2015
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HEALTHWATCH ENGLAND BUSINESS PLAN 2015 - 2016
13 pages

Chief Executive's Forward   .   About Healthwatch   .   Our Relationships   .   What we will do over the year ahead  
​A Business Plan driven by our values   .   Resources and Governance
CQC ASKED TO PLAN FOR 40% CUT IN GOVERNMENT FUNDING
23 October, 2015 

The Care Quality Commission has warned of spending review ‘implications’ for the delivery of its 2016-17 inspection programme, after being asked to model cuts to its Central Government funding of up to 40 per cent.  CQC Chief Executive, David Behan, issued the warning in a paper to its Board Meeting this week, in which he proposed deferring discussion of the inspection plan until after the 25 November spending review.

As reported last month, the CQC is already set to miss its deadline to inspect all adult social care, GPs and out-of-hours services in England by 30 September next year.  However, Mr Behan’s latest Board Report states: “The implications for delivering the [inspection] plan in 2016-17 depend on finalisation of the spending review, CQC receiving a budget allocation for 2016-17, and final agreement on fees for 2016-17.  No decisions have been made on these three important influences so I propose that discussing the programme for 2016-17 is deferred until such time it is clear what the decision is in respect of these three issues.”  The Report adds: “Undoubtedly, with CQC being asked to consider 25% and 40% reduction in ‘grant- in-aid’ there will be implications.”

Grant-in-aid is the funding the CQC receives directly from the Government, with the rest of its budget coming from fees charged to regulated providers.  Last month,   Treasury officials were looking at redefining the ring-fence on NHS spending to apply only to NHS England’s commissioning budgets. This would exclude a number of other Department of Health budgets from the Government commitment to £8bn real terms growth over the Parliament, including those of its other arm’s length bodies. In July the Treasury asked unprotected Whitehall departments to model the impact of 25% and 40% cuts to their budgets.

The CQC paper indicates that DH arm’s length bodies have also been asked to model cut-backs on this scale.  The CQC’s grant in aid is currently £120m, so a 25% reduction would represent a £30m budget cut. A 40% reduction would amount to a £48m cut.  Either scenario would represent a significant reversal of the CQC’s recent financial fortunes.  The CQC’s grant increased by about a third in 2013-14 and by another 50% in 2014-15 to pay for its beefed up inspection regime. The grant did not rise this year.

A CQC spokeswoman said: “All Government Departments have been asked to model scenarios of 25% and 40% of savings from their grant-in-aid by 2019-20 in real terms.  In line with this, the CQC is undertaking an exercise to consider possible implications ahead of the upcoming comprehensive spending review.”

Meanwhile, separately, the CQC today issued a statement admitting it may not hit its deadlines for inspecting adult social care, general practice, out-of-hours primary care and independent health services.

Mr Behan said: “Our productivity is increasing as we recruit more inspectors but we are highlighting this possible risk to delivery now and planning in an open and transparent way as to how we can address this.”  He said it was important that inspectors are “trained, supported, and have the appropriate time to carry out high quality inspections”, and that the CQC would “never compromise on the quality of the work we have to do”.
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6 pages
HEALTH AND SOCIAL CARE IN THE SPENDING REVIEW

​Letter to Rt. Hon. Greg Hands, MP, Chief Secretary to the Treasury, HM TREASURY from Jeremy Taylor, Chief Executive, National Voices
19 October 2015 ...   6 pages

​Signed jointly with National Voices by the following 52 organisations​:  
Access Matters  .  Alzheimer's Society    .   ARMA   .  Arthritis Care  .  Arthritis Research UK   .   Ataxia Black Cancer Care   .   Bladder and Bowel Foundation  .   BLISS   .   BRAP  .   British Heart Foundation   .   British Kidney Patient Association   .   British Liver Trust   .   Cancer52   .   Cancer Research UK   .   Changing Faces   .  Contact a Family   .   Crohn’s and Colitis UK   .   Disability Rights UK   .   Ectodermal Dysplasia Society   .    Endometriosis UK   Forum Link   .   Friends, Families and Travellers   .   GAIN   .   HAPIA   .   I Have IIH Foundation    .    James Whale Fund for Kidney Cancer     .     Lupus UK Marie Curie   .   Mental Health Foundation   .   Migraine Trust   .   Mind   .   MS Society   .       National Ankylosing Spondylitis Society    .    NCB   .  NCPC   NRAS   .   Older People’s Advocacy Alliance   .   Parkinsons UK   .   PiF/SRUK   .   Polycystic Kidney Disease Charity   .   Rethink Mental Illness   .   Shared Lives Plus   .   SHCA   .   Stickler Syndrome Support Group   .   Stroke Association   .   Sue Ryder   .  Together for Short Lives   .   Together UK  .  Transverse Myelitis Society   .   UK CAB   .   Vegan Society
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24 pages
GUIDE FOR LOCAL LEADERS  ...  Health and care quality systems in practice  
September 2015
This guidance has been produced in collaboration with the Centre for Public Scrutiny (CFPS) and Think Local Act Personal (TLAP) to support health and care leaders in navigating the local agencies and organisations responsible for regulating and improving the quality of health and care services.
SOCIAL SERVICES' NEEDS  ...   Dignified care for elderly and disabled at risk due to lack of funding
LGA Media Release, 12 October 2015

Local Government leaders and directors of adult social care have warned that the ability of councils to provide dignified care for people in old age or for those with a disability is at risk unless urgent steps are taken to plug the burgeoning gap in social care funding.
​

In a joint submission to the Government's Spending Review, the Local Government Association (LGA) and the Association of Directors of Adult Social Services (ADASS) say part of the solution would be to use money previously earmarked for delayed Care Act proposals to help close the funding gap. 
However, this still leaves adult social care facing an estimated £1.7 billion funding gap by 2019/20.  The current combined pressures of insufficient funding, growing demand and extra costs mean that adult social care is facing a funding gap that is growing by at least £700 million a year, estimated to reach £2.9 billion by the end of the decade, even before the cost of the National Living Wage is taken into account in full.

The failure to properly fund services for elderly and disabled people is already leaving councils having to severely strip back or axe other key services. It also means there is less money to properly recruit, train and keep the best staff and risks essential residential and home care providers going out of business if councils can't afford to pay the cost of the care being provided.

Councils are left facing impossible decisions about the types of care services they can afford to provide for the elderly and disabled, the submission warns.
See more at:
http://www.local.gov.uk/web/guest/media-releases/-/journal_content/56/10180/7521699/NEWS#sthash.P6nutr99.dpuf
LOCAL AUTHORITIES SEEK GREATER SHARE OF NHS WINTER FUNDING
19 October, 2015 
The Local Government Association is calling for councils to receive more money from the NHS to deal with delayed care transfers this winter. Figures show that councils received less than 6 per cent of ‘resilience’ funding last year.

The LGA wants the Government to give councils £210m of this year’s £700m winter resilience funding, so that their adult social care departments can help the NHS to get older people out of hospital if they are ready to leave.

Research by the Association of Directors of Adult Social Services (ADASS) showed local authorities received just 5.9 per cent, or £41m, of the £400m 2014-15 “winter resilience fund” in 2014-15 even though a third of hospital beds were occupied by elderly people who could go home or into a care home with the right support.

At the beginning of the financial year the £700m funding was shared out between clinical commissioning groups for them to decide how best to spend it.

NHS figures show 145,067 bed days over the last 12 months were used by patients who should have been discharged, but these were not due to delayed transfers.

In 2014-15, 30 per cent of delayed discharges were attributed to a lack of ongoing social care, up from 25 per cent the previous year.
PPV/LAY ROLE OPPORTUNITIES IN SPECIALISED COMMISSIONING, NHS ENGLAND (to CRG PPV Members)
​Letter to Ruth Marsden, Chair
19 October 2015
CHAIR OF NHS CONFEDERATION
Stephen Dorrell has been appointed Chair of the NHS Confederation .

​Former Conservative MP, Mr Dorrell was Health Secretary from 1995 to 1997 in John Major’s Government, and served as the Chair of the Commons Health Committee from 2010 to 2014.  He stepped down as an MP ahead of the General Election earlier this year, after 36 years in Parliament.
NEW NHS ENGLAND APPOINTMENTS
NHS England has appointed:
  • Jonathan Fielden to lead on specialised services  
  • Arvind Madan to lead its work primary care.
  • Cally Palmer, Chief Executive of the Royal Marsden Foundation Trust,  as National Director of Cancer Services.
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PROPOSAL FOR THE ENGLISH REVALIDATION IMPLEMENTATION BOARD
By: Malcolm Alexander, Chair, HAPIA
October 2015 ... 5 pages
CHOICE OF DISPENSER
As part of on-going work to address the direction of prescriptions, NHS England has this week written to all General Practices and Pharmacies to ask for their help in ensuring that all patients are aware of their right to choose freely where they have their medicines dispensed ... and can exercise this right without influence.

Action where choice is being influenced

NHS England states that we all have a duty to ensure patients’ rights under the NHS Constitution are met, and NHS England take very seriously any attempt to undermine this. Action will be taken against individuals and Contractors to protect patients’ rights.

If Contractors or Pharmacy teams are aware of a situation, where the right of patients to choose where their prescriptions are dispensed is being influenced, they should raise this first with their Local Pharmaceutical Committee (LPC). If the situation cannot be resolved, it should be escalated to NHS England - via the local office or by emailing england.primarycareops@nhs.net, including ‘Prescription Direction’ in the subject heading.
PUBLIC HEALTH AND OBESITY IN ENGLAND - The New Infrastructure Examined
05 October 2015 by imelda.mcdermott@manchester.ac.uk


​As part of the Health and Social Care Act 2012 (Secretary of State 2012) significant changes to the public health system were introduced. Such changes included:
  • The creation of a new national public health service, Public Health England (PHE);
  • A restored emphasis on the role of general practice in health improvement (DH 2010);
  • The transfer of public health responsibilities from Primary Care Trusts (PCTs) to Local Authorities;
  • The creation of Health and Wellbeing Boards (HWBs) as Committees of each unitary and upper-tier Local Authority, where key leaders from the health and care system work together to improve the health and wellbeing of their local population and reduce health inequalities.
As a result of the new arrangements, responsibility for commissioning and delivering public health activities are now split between a number of organisations, including: local authorities, general practice, PHE, NHS England (NHSE) (formally called the NHS Commissioning Board), and voluntary organisations. This potentially means a more complex commissioning and service delivery environment for public health than previously (DH 2011a, DH 2011b).

The PHOENIX project aims to examine the impact of structural changes to the health and care system in England on the functioning of the public health system, and on the approaches taken to improving the public’s health.
TOP TORY CLAIMS HALF OF NHS BEDS ARE FACING THE AXE, FUELLING FEARS OF HEALTH PRIVATISATION
The Mirror - 08 October 2015
GP LAW - HOW IT WORKS  ...   http://www.gplaw.co.uk
This website provides a free of charge guide to the legal rights and obligations of General Practitioners working in the NHS in England. ​The site is written by David Lock QC, of Landmark Chambers.  David Lock is nationally recognised as a leading practitioner in the law relating to the National Health Service.  David is regularly instructed by GP practices, Clinical Commissioning Groups and NHS England to advise on the law relating to NHS functions and to appear in court on their behalf.  He has appeared in many of the leading cases in this area of law.
David is quoted in the 2013 Chambers and Partners Directory as being "Highly respected for his broad public law expertise, David Lock QC receives particular plaudits for his expertise in matters at the intersection of public law and healthcare law".  
He is a non-executive director of Heart of Birmingham NHS Foundation Trust, Chair of Innovation Birmingham Limited and is an Honorary Professor of Law at the University of Birmingham. He has served as a Government Minister and has many years experience of advising NHS bodies and GP practices.

Registration to access the GP Law Chapters is free of charge.  We reserve the right to charge in due course but registered users will not be charged without at least 30 days notice.  Please register in order to see the full contents of the site.
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WORKING WITH PATIENTS AND COMMUNITIES - THE KEY TO IMPROVING SERVICES
Thursday, 01 October 2015 in London - the venue will be confirmed shortly
  • Copy of Email
  • The Agenda
  • Website  
This event in London on 01 October brings together commissioners, provider organisations and leaders of patient participation groups to share examples of projects that go beyond rhetoric and put patients at the heart of the local health system. ​
ARCHIVED SITES ...
NATIONAL ASSOCIATION OF LINKS MEMBERS - NALM
ACHCEW - Assoc. of CHCs in England and Wales
NATIONAL ASSOCIATION OF PATIENTS' FORUMS - NAPF
HEALTHWATCH DEVELOPMENT ... 2011 - 2012
REVALIDATION OF DOCTORS IN ENGLAND
PREVENTING FUTURE DEATHS
HEALTHWATCH AND PUBLIC INVOLVEMENT ASSOCIATION
   Formerly: National Association of LINks Members (NALM)
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CONTACT US ...
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