Public sector needs to find voice on cuts 27 June 2014 There is a growing consensus that it is time the finance profession found its voice on public spending. Politicians say cuts can be pain-free, but the public are confused about the true financial position and what it means for local services. Informed, impartial professionals are urgently needed to join the debate. To address this need, CIPFA is holding a series of roundtable debates across the country to give public sector finance managers a platform to speak about public spending policy and practice, and to help the institute develop its own policies. Read the full article in Public Finance __________________________________________________ Hunt’s safety league table misses target 26 June 2014 The superficial appeal of health secretary Jeremy Hunt's new safety league table obscures deeper questions about how to create a safety culture throughout the NHS. As part of the government's Sign Up to Safety campaign, the NHS Choices website now carries a measure of "open and honest reporting" of patient safety incidents. Open and honest reporting is of course essential to developing a safety culture, but it is questionable whether this particular measure is focusing on the right issue. Read the full article on the Guardian Healthcare Network __________________________________________________ Miliband betrays weak localist vision 20 June 2014 Local government reform should be inseparable from the economic and social issues it is intended to tackle and the Institute for Public Policy Research's (IPPR) Condition of Britain report, released on 19 June, puts a persuasive case for empowering local government. Judging by Ed Miliband's speech at the launch, however, it is far from clear whether he will take much notice. The report was supposed to be a major staging post in the development of Labour's manifesto. Read the full article on the Guardian Local Government Network __________________________________________________ Will the NHS really allow people power? 12 June 2014 The NHS will soon be in the grip of unprecedented people power. Will there be knowledge and responsibility to go with it? Two events are beginning to define the role of popular sentiment and personal consent in the NHS – the crescendo of opposition to Care.data, and the determination of NHS England chief executive Simon Stevens that public opinion should be given significant weight in determining service configurations. The failure to involve the public in building the concept of Care.data collided with public suspicion of big government, big business and big data to form a critical mass of insurmountable opposition. Read the full article at the Guardian Healthcare Network __________________________________________________ Unpalatable truth on service integration 6 June 2014 The reality of trying to redesign public services is actually much harder than anyone wants to admit. Ministers peddle platitudes about the integration of health and social care and say services should be built around those who use them, but what happens when you try to do this? Councils in 25 areas across England have been finding out. They have been participating in the government-backed Local Vision programme which encourages those working to improve local areas – such as NHS trusts, probation services and businesses – to come together in an attempt to solve problems that often seem intractable. Read the full article on the Guardian Local Government Network __________________________________________________ Does evidence on integration stack up? 3 June 2014 The case for integrating care has been compelling. It seems obvious that health and social care services should be working more closely together to provide better care, meet rising demand, and cut costs in wasted or duplicated efforts. It is the much needed shift in care provision that people have been talking about for 20 years. But evidence that integration works is hard to find. Does it justify the time and money being spent? Integrated care is an imprecise term. It is often used to describe the coordination of existing services, perhaps extending to pooling budgets or sharing staff. Read the full article in the BMJ __________________________________________________ How NHS might escape funding crisis 29 May 2014 This week two visions are being offered for how the NHS can find its way out of the funding and quality crises. One is a myth, the other might make a difference. The myth is, of course, being peddled by a politician. This week it's the turn of health secretary Jeremy Hunt (again). In an HSJ interview he claimed that safety and technology are all that are needed to get the NHS through more years of deficit reduction. Eradicating mistakes while installing new kit appears to be the way forward. Of course safe care saves money, but it is specious to suggest the potential savings are anything like the size required. Read the full article at the Guardian Healthcare Network __________________________________________________ Winners still have chances despite cuts 23 May 2014 This is a good year to be winning control of your local council. Party groups that have seized control in the elections have a great deal more to do than simply administer cuts. Even slashing spending provides political opportunities. That is not to trivialise the reality of the cuts – particularly in northern councils, which are suffering the most – but there are still options. While it is true many councils are reaching the limit of anything that could be called an efficiency saving, there are certainly more opportunities to be found for reshaping services through collaboration with other councils and other parts of the public sector. Read the full article on the Guardian Local Government Network __________________________________________________ Parties promote visions for primary care 15 May 2014 The focus of the NHS and politicians is finally shifting to where the transformation in healthcare needs to take place – primary care services. Who should commission them, how much money they should get and what they should do are all being debated. It is striking that one of Simon Stevens' first actions as NHS England chief executive has been to tackle the paralysis in primary care development, by acceding to clinical commissioning group calls for a much bigger role in developing primary care. Read the full article at the Guardian Healthcare Network __________________________________________________ Why Better Care Fund belief is faltering 9 May 2014 The Better Care Fund is under scrutiny, and with it, local government's role in the health and care system. Until a few weeks ago, integration was seen as the best hope for improving care quality while coping with rising demand in an age of austerity. Now that belief is faltering. In March a study by York University of 38 schemes around the world pooling health and social care resources – including 13 in England – found none had secured a sustained reduction in hospital use. Read the full article on the Guardian Local Government Network __________________________________________________ Health learns to work with local politics 8 May 2014 Local government matters to hospitals as never before in NHS history. Councils oversee services vital to hospitals’ success, share their money, play a central role in setting local health policy and scrutinise hospitals’ performance and plans. The legislation introducing the NHS reforms underpins much of the current relationship. Working together is tough. Both sides are short of money while many NHS staff are baffled by local politics. “The relationship between the NHS and local government is as close as it has ever been,” says Carolyn Downs, chief executive of the Local Government Association. Read the full article at Health Service Journal __________________________________________________ Stevens offers hospital closure escape 1 May 2014 In his first appearance at the health select committee, NHS England chief executive Simon Stevens revealed important departures from orthodox thinking about the future of the health service, while repeatedly championing local autonomy in deciding the best way to deliver care. During more than two hours of questioning, Stevens revealed deep scepticism about the effectiveness of integration schemes being planned as part of the Better Care Fund. He highlighted research published last month by York University, which found that not one of 38 integration schemes in eight countries – including 13 projects in England – secured a sustained, long- term reduction in hospital admissions. Read the full article at the Guardian Healthcare Network __________________________________________________ Who can step in when councils implode? 25 April 2014 When a council hits serious difficulties the response is drawn out, muddled and overseen by central government. A better answer is urgently needed before a growing numbers of councils slip into financial crisis. Problems with children's services in Birmingham and Doncaster and the political travails of Tower Hamlets all stretch back many years. Governments and local politicians have come and gone while long-term solutions and new beginnings have proved elusive. Read the full article on the Guardian Local Government Network __________________________________________________ NHS funding hopes are a delusion 15 April 2014 There is a dangerous delusion taking hold of some parts of the NHS – that if the service shouts loudly enough, and often enough, that it needs more money, it will get what it wants. It won't. Clinicians and managers will have to work out the solutions themselves. As the finances of a growing number of trusts slide out of control, the prospects for the NHS in 2015 are increasingly being debated in capital letters, the word CRISIS being brandished like a Daily Mail headline. Realising the rhetoric stakes were getting higher, the Royal College of General Practitioners overreached themselves with the preposterous claim that GP practices were at risk of "extinction". Read the full article at the Guardian Healthcare Network __________________________________________________ Heseltine not Miliband is localist radical 10 April 2014 Labour leader Ed Miliband's proposals for empowering cities are far from the revolution he pretends. The real revolutionary is still Tory grandee and former deputy prime minister Lord Heseltine. In his speech in Birmingham on Tuesday, Miliband billed his plans for local government as the biggest shift of power and money to towns and cities "in living memory". In reality, he is offering just another few steps down the well-trodden track of councils bidding for central government largesse. This approach can be traced back at least as far as the City Challenge programme launched by then environment secretary Michael Heseltine in 1990, which brought together local government and the private sector in bids for economic and environmental projects. Read the full article on the Guardian Local Government Network __________________________________________________ Stevens sets out a radical NHS vision 3 April 2014 In his first speech as NHS England chief executive, Simon Stevens prepared the ground for radical change in the way health service staff think and work. Speaking at Shotley Bridge hospital in County Durham, where he began his NHS career as a trainee manager 26 years ago, Stevens encouraged staff to "think like a patient, act like a taxpayer" as he gave the first indications of what he would – and would not – be doing. He will not be getting into a trial of strength with the health secretary, Jeremy Hunt. He stressed the need for the national leadership of the NHS to work "in coherent and purposeful partnership", and in highlighting that the NHS England board is operationally independent, he implicitly recognised the legitimacy of political influence on its objectives. Read the full article at the Guardian Healthcare Network __________________________________________________