What if the media come for you? 27 June 2013 So what will you do if you are the next NHS organisation to be engulfed in a crisis? The current febrile run of accusation and rebuttal around the failure of Morecambe Bay's maternity service and its oversight is by no means a unique example of how the public, politicians and the media react when the health service gets it wrong. There is a strong punitive element in the reaction to a crisis – a requirement to identify and punish individuals deemed to be at fault – and it is extraordinarily difficult for managers to explain the context in which they are working or the pressures they are under. Read the full article on the Guardian healthcare network __________________________________________________ The unsparing truth about death 21 June 2013 Local government has endured many league tables over the years, revealing performance on everything from litter to benefit payments. Now it has a league table of death. Public Health England's new Longer Lives website paints in vivid red the toll of premature mortality – before 75 years – council by council. Read the full article on the Guardian local government network __________________________________________________ Community budgets grind slowly on 14 June 2013 Even by the lamentable standards of Whitehall pilots and initiatives on local government, the community budget programme is frustrating in its sloth and lack of ambition. But there is hope. The four pilots are not actually intended to make it work - they are supposed to be proving the concept. It is now proved, so let's get moving. As Local Government Association leader Sir Merrick Cockell told a communities and local government select committee hearing on the budgets: "Now is the time to move from an acceptance that it is validated to delivery; there is no reason to hold back." Read the full article on the Guardian local government network __________________________________________________ Picking up the pieces of surgery review 13 June 2013 The Independent Reconfiguration Panel's demolition of proposals for reconfiguring children's heart services has set the benchmark for all future service reviews. The panel told the health secretary, Jeremy Hunt, that the review of children's heart services had failed in its objective of recommending a safe, sustainable and accessible way forward. Read the full article on the Guardian healthcare network __________________________________________________ Nicholson: passion and centralism 10 June 2013 Sir David Nicholson’s last speech to the annual NHS Confederation conference as the leader of the service reflected all the traits of his seven years in control. His passion, commitment, and drive were undeniable, but he failed to acknowledge mistakes which had undermined patient care, gave little time to the role of local clinical commissioners, and saw centralised direction as the overriding driver of change. Read the full article at the British Medical Journal __________________________________________________ A look into local government's abyss 7 June 2013 The public accounts committee's dissection of the funding cuts to local government exposes flaws and ignorance in ministerial thinking which have been apparent to councils for many months. Take, for example, the failure of government to analyse how cuts in one service may affect demand on another. Cuts to social care are undoubtedly contributing to the current crisis in some A&E departments because social workers are unable to provide the support to allow many older people to be discharged from hospital promptly. Read the full article on the Guardian local government network __________________________________________________ Will there be NHS cultural revolution? 5 June 2013 The NHS in England is awash with promises of change. In the wake of health reforms and the Francis inquiry into the Mid- Staffordshire scandal – which examined the failure of the system to identify and act upon poor standards of care that may have led to hundreds of deaths between 2005 and 2009 – staff have been bombarded with vows of clinical leadership, an end to bullying and a renewed focus on patients. But will NHS managers really take this on board? Read the full article at the Guardian __________________________________________________ Hunt’s political games batter NHS 30 May 2013 Eight weeks after their implementation, Andrew Lansley's reforms have already been battered by his successor. The politicians are just as in charge of the NHS as ever, while clinical commissioners are being marginalised. The reason is that Jeremy Hunt is already focused on the campaign for the next general election, a fact he does little to hide from his advisers. His policies are driven by political point scoring and gestures. Read the full article on the Guardian healthcare network __________________________________________________ Can councils help defeat extremism? 24 May 2013 As the country comes to terms with the first terrorist killing in Britain since the 7/7 bombings, local government will again be at the frontline of keeping communities together. But what should it do? Councils are faced with two priorities: dealing with immediate problems such as the risk of further violence, and then the more complex issues of keeping communities together and tackling radicalisation. Read the full article on the Guardian local government network __________________________________________________ Ofsted exposes faultline in education 17 May 2013 A sharply worded attack on regulator Ofsted by the senior managers' organisation Solace has again exposed fault lines on local government's role in education. On Tuesday, Ofsted unveiled its new inspection framework for local authorities' school improvement services. Solace claimed that in doing so the regulator "harks back to a bygone era" of council control over schools that "simply no longer exists". Read the full article on the Guardian local government network __________________________________________________ Long, difficult road to integrated care 17 May 2013 There is a great deal to welcome in the announcement from health minister Norman Lamb that there will be a big push to integrate health and social care, but the road ahead is longer, more difficult and considerably more costly than the government recognises. The plans provide an ambition around which all care services can unite, and there is a strong commitment to identifying and overcoming the barriers, through the work of at least three waves of large-scale pioneer areas backed up by a dedicated central team. Read the full article on the Guardian healthcare network __________________________________________________ Councils hold the key to youth jobless 3 May 2013 One of the few pieces of economic good news is the way employment has held up as the economy has flat-lined. But the latest jobless figures revealed that 979,000 16- to 24-year-olds are out of work. Across the country local government is scrambling to get young people into training and jobs. They are having some success, but they could do so much more if the government would co-operate. The strength of the best local government programmes is that they are finely tuned to the needs of both local employers and young people. Read the full article on the Guardian local government network __________________________________________________ Cuts and inertia could crush the NHS 2 May 2013 The NHS is in danger of being crushed between a funding cut and political inertia over the need to reconfigure services. While the outcome of the chancellor's spending review will no doubt contain some financial sophistry to maintain the fiction that health spending is growing in real terms, in reality NHS spending is going to be cut as money leaches out to social care. Whatever George Osborne says on 26 June, the cuts will catch up with the NHS after the general election. Read the full article on the Guardian healthcare network __________________________________________________ Commissioners grapple with role 25 April 2013 At the first conference of NHS Clinical Commissioners — an independent group launched by the NHS Alliance, NHS Confederation, and National Association of Primary Care — introspection was refreshingly absent. While there were concerns about workload and the risk of conflicts of interest as commissioners invest in primary care, the focus was very much on the big picture of their new role. Read the full article at the British Medical Journal __________________________________________________ The localist flirtation is over 19 April 2013 Anyone needing to be convinced that the coalition's flirtation with localism is over only has to look at the last couple of weeks. As well as trying to secure unwarranted changes to planning rules, the government is imposing ministerial control over council publishing and has admitted it has abandoned any monitoring of Whitehall departments' progress towards localising powers. Read the full article on the Guardian local government network __________________________________________________ What can CCGs learn from PCTs? 18 April 2013 Next week the NHS Confederation, supported by NHS Clinical Commissioners, is launching Reflections on a Decade of Commissioning, which looks at the experiences, difficulties and achievements of primary care trusts and analyses what it all means for the new regime. (Disclosure: I wrote the report). The most powerful message is that the success or failure of a clinical commissioning group will in many ways be determined by how well it engages with both the public and its member practices. Read the full article on the Guardian healthcare network __________________________________________________ Public health is big local chance 5 April 2013 Amid the cuts and redundancies, local government's new responsibility for public health is a great opportunity. While public health is hardly new territory for councils – more than 80 public health directors were joint appointments between councils and primary care trusts – formal assumption of the powers is momentous. Read the full article on the Guardian local government network __________________________________________________ Leeds suspension is taste of the future 4 April 2013 The suspension of children's heart surgery at Leeds general infirmary and the subsequent battle to restart operations is a foretaste of what will become a familiar chain of events in the NHS post Mid-Staffordshire. In his final report, Robert Francis QC is unequivocal on the requirement for services to meet fundamental standards to be set out in the NHS constitution. Expressions such as "no tolerance of non-compliance" and "rigorous policing" make clear that managers or clinicians hoping to make do could lay their organisation – and possibly themselves – open to prosecution if death or serious harm results. Read the full article on the Guardian healthcare network __________________________________________________ Goodbye to PCTS - good riddance? 2 April 2013 Did primary care trusts improve healthcare? It took just 13 years for them to be created, merged, clustered, and abolished. During that time they were responsible for about 80% of the NHS budget in England. The original 303 PCTs across England began taking over from district health authorities and primary care groups in 2000. In 2006 they were merged to form 152 organisations and instructed to begin withdrawing from running community services-known in the artless syntax of Whitehall as "separating out their provider arm"-to focus on commissioning. Read the full article in the British Medical Journal __________________________________________________