HEADLINE NEWS
CHAIR OF HEALTH PANEL
CIPFA is pleased to announce that Peter Shanahan,
Deputy Chief Executive and Chief Finance Officer, University
Hospital Birmingham NHS Trust has been appointed to
the above position.
After graduating in Economics, Peter joined the former
West Midlands Regional Health Authority as a Financial
Management Trainee. Following qualification he held
a number of posts in acute and primary care organisations
before joining KPMG. Returning to the NHS in 1994 he
spent a brief period at a Health Authority before joining
the newly established University Hospital Birmingham
NHS Trust in April 1995. He was appointed Director of
Finance in February 2000 and Deputy Chief Executive
in December 2001.
An Executive Director of the Trust Peter had lead responsibility
for Finance, Procurement, Legal Services, Shared Services
Initiatives and led the development of the first Royal
Centre for Defence Medicine in partnership with the
MoD and local Universities.
In July 2003 Peter assumed a full time role as Deputy
Chief Executive leading the Trust’s successful
Foundation application (as Project Director). On October
1 2004 he returned to be Chief Finance Officer and Deputy
Chief Executive. Since December 2005 he has also been
Project Director for Birmingham’s £550m
PFI scheme which is due to reach financial close imminently.
University Hospital Birmingham is the largest Trust
in the West Midlands and enjoys a high media profile
– being regarded by many as one of the most successful
NHS Trusts in the country. With a turnover of £370M
it has established itself as a leading player in the
South Birmingham economy and has led a number of innovative
regeneration schemes.
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CIPFA NEWS
CODE OF ETHICS
CIPFA has developed a new Standard of Professional
Practice (SoPP) on Ethics as a guide for all members
and students to help to create a degree of uniformity
of professional ethics throughout the organisation.
Find out more and download the code and guide from
www.cipfa.org.uk/conduct/ethics.cfm.
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CONFERENCES/SEMINARS
Children’s Services: Meeting the Financial,
Strategic and Operational Challenges 26 September 2006
– London
This event will provide a rounded view of the latest
developments in children’s services policy and
practices. It will give delegates the opportunity to
take a look at the bigger picture as well as gleaning
practical advice on current technical issues affecting
the workplace.
For more details visit http://secure.cipfa.org.uk/cgi-bin/CIPFA.storefront/EN/product/VS17
Health Finance conference - 6 October, London
The 2006 CIPFA Health Finance Conference theme is ‘Achieving
High Performance Organisations’. As Finance teams
strive to implement the NHS reforms it has been a particularly
difficult year for many NHS organisations. Nevertheless,
many parts of the NHS have been transformed into high
performance organisations. Others continue to pursue
this goal, whilst some appear to have struggled with
the financial and operational challenges.
The CIPFA Health Finance Conference – conveniently
now repackaged into a high profile one day format –
will address key issues that you and your teams currently
face. The CIPFA Health Panel has assembled a programme
of the most senior and influential speakers in and around
the NHS, aimed at helping you obtain the best performance
for your organisation.
To register and receive more details of this event
please go to http://secure.cipfa.org.uk/cgi-bin/CIPFA.storefront/EN/product/VS33
or contact Alexandra Aarons, CIPFA, 3 Robert Street,
London, WC2N 6RL (tel 020 7543 5751; e-mail alexandra.aarons@cipfa.org).
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HEALTH ADVISORY NETWORK
Payment by Results
Update and latest developments
The CIPFA health advisory network recognises the complexities
of the Payment by Results reform and the financial instability
it can create within both commissioner and provider
organizations. We have therefore developed a series
of focused workshops (with a maximum of 15-20 delegates),
to ensure delegates are kept completely up to date with
the latest Department of Health thinking around the
roll out of the payment by results policy into 2007/8
and beyond. Detailed discussions will be held throughout
the day on the financial implications of various aspects
of the policy on individual organizations.
The workshop is aimed at managers from all backgrounds
who want to keep up to date with the PbR policy. The
event will be highly interactive, with places limited
to allow maximum speaker/delegate interaction and facilitated
discussion.
A sample workshop outline is shown below:
- Overview and detailed update of latest PbR policy
developments, including updates and discussion around:
- The secondary uses system
- Non contract activity
- Market forces factor
- Casemix/coding developments
- Rebasing and the financial impact on providers
& commissioners
- The technical guidance in detail - intricacies of
the policy
- The PbR code of conduct and coding assurance framework
- PbR in the future
Note: the detailed content of workshops will vary,
as the PbR policy develops
Workshops will be held in:
Manchester on 20th September 2006
Leeds on 9th November 2006 and
Central London on 12th October and 13th December 2006
For further information please contact
Natalie.Lewis@ipf.co.uk or visit our website at
www.cipfanetworks.net/health/.
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HEALTH PANEL
The Panel has a vacancy for a volunteer with a special
interest in Mental Health Services Finance.
Expressions of interest should be submitted on the
Panel feedback webpage http://www.cipfa.org.uk/panels/health/feedback.cfm
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PUBLIC MANAGEMENT AND POLICY
ASSOCIATION (PMPA)
The forum for today’s public managers
- A forum to hear from and talk to senior public
sector managers about the challenges of public management
- A forum to hear from and talk to leading public
policy academics about developments in public policy
thinking
The Public Management and Policy Association (PMPA)
is a national membership organisation which provides
a forum for public sector managers, academics and those
with an interest in public services to meet and discuss
today’s public policy and management issues. Membership
benefits include priority access to high quality publications
and stimulating lectures and discussions.
PMPA Public lectures:
3 October 2006 Effective Inspection
and Regulation in Education, Training and Children’s
Services – David Bell, Permanent Secretary,
Department for Education and Skills. Chair: Sir Brian
Bender Venue: QAG Conference Centre, 27 Queen Anne's
Gate, London SW1H 9BU
7 November 2006 Delivering Respect:
Why strengthening communities and making public services
more accountable is at the heart of success - Louise
Casey, Anti-Social Behaviour Unit.
6 December 2006 Leading and Measuring
Improvement in Local Government - Colin Moore,
Chief Executive of Redcar & Cleveland Council and
John Wilson, Dean, Teesside Business School, University
of Teesside. Venue: University of Teesside, Middlesborough.
Unless otherwise indicated all PMPA lectures start
at 5.45pm and will be held at CIPFA, 3 Robert Street,
London WC2N 6RL. PMPA events are free to attend, book
online at www.pmpa.co.uk
or email info.pmpa@cipfa.org
for further details.
Other Events
PMPA Annual Conference, 5th December 2006
When will we ever learn: can public sector organisations
learn from their mistakes? Speakers include: Professor
Patrick Dunleavy, Professor of Political Science and
Public Policy at the LSE, who will assess the UK’s
record on public policy mistakes. Lord Laming, who chaired
the Public Inquiry into the circumstances leading to
the death of Victoria Climbie, who will speak on learning
from Public Inquiries. To register your interest in
attending and for further information, contact Rikki
Ellsmore, CIPFA Courses Unit. Tel 020 7543 5746; email
rikki.ellsmore@cipfa.org
PMPA Reports:
The latest PMPA report Public Service Improvement
- The Conditions for Success and the Scottish Experience
by Robert W. Black, Auditor General for Scotland
is now available. (Non-member price £10). Further
details available on the website www.pmpa.co.uk
Membership
Individual Membership is £80 (£75 for CIPFA
and other associate member organisations) and £35
for retired members and full time students. Corporate
rates start at £350 for up to five persons registered
by their employing organisations to receive the benefits
package. Full details are available on the Association's
website www.pmpa.co.uk
or email info.pmpa@cipfa.org
asking for an information pack and sample publications.
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PUBLICATIONS
Practice Based Commissioning – The Essential
Guide to Practical Implementation
This new and timely CIPFA title is an invaluable tool
for all those involved in practice based commissioning
(PBC).
It will be of particular benefit to executives and
non-executives at primary care trusts, professional
executive committee (PEC) members, PBC leads, project
managers and finance managers. Equally, the publication
will be of great use to practice based commissioners
– both practitioners and practice business managers.
This comprehensive guide provides practical advice
on the issues that need to be dealt with and the sub-systems
of the NHS that need to adapt in order to facilitate
successful PBC. It identifies what needs to be considered
in designing, implementing and maintaining local systems
and provides guidance on the foundations that need to
be laid for the further evolution and growth of PBC.
It details the requirements of the key stakeholders,
including practices, PCTs, PECs and SHAs in setting
up practice based commissioning; considers the challenges
in doing this and how to overcome them; and the potential
directions for the strategic development of PBC at a
local and wider health economy level.
In doing this it provides an in depth analysis of the
roles of the key players and stakeholders, the commissioning
models available, their governance and financial management
requirements, and the interaction between partners and
the overall health care agenda.
This publication is a highly effective and accessible
guide and reference for all working within practice
based commissioning.
To purchase a copy visit http://secure.cipfa.org.uk/cgi-bin/CIPFA.storefront/EN/product/HE012
Financing Long Term Illness in the NHS
The successful management of long term health conditions
presents one of the greatest challenges for NHS management
in the 21st century. Life-threatening diseases such
as diabetes, heart failure and respiratory illness are
making heavier and heavier demands on hospital resources
across the western world. Meanwhile, conditions such
as arthritis and lower back injury have a profound impact,
both on health services and - through prolonged absence
from work - on the economy as a whole.
This timely publication on the financing of long term
health conditions addresses two important needs:
- First and foremost, it offers NHS finance professionals,
service managers, commissioners and others a solid
grounding in the financial importance, concepts and
practice of modern chronic disease management. It
includes:
- an introduction to chronic care and the linked
concepts of case management and supported self-care;
- an overview of experience to date, including
a range of case studies; and
- a survey of tools and techniques that support
good chronic disease management, covering modern
technology, end of life care, and policy initiatives
such as expert patient programmes and the GMS
contract.
- In addition, it provides an independent professional
commentary on key financial and accounting issues
arising from the NHS's new focus on long term illness,
and practical signposts through some of the associated
dilemmas. Principal areas covered include the business
case for chronic care, the implications for acute
hospitals, and how chronic disease management can
be squared with payment by results.
To purchase a copy visit http://secure.cipfa.org.uk/cgi-bin/CIPFA.storefront/EN/product/HE009
Future Publications
More details will be published in future editions.
Public Money and Management (PMM)
Public Money & Management is owned and managed
by CIPFA, and is the official journal of the Public
Management and Policy Association which is published
on behalf of CIPFA by Blackwell Publishing.
The October 2006 issue will be on Financial Exclusion.
Details about submitting an article are on the Public
Money & Management section of the CIPFA website
or micky@mickylavender.com
For further information on PMM and details on how to
subscribe, please see www.cipfa.org.uk/pt/pmm
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TIS HEALTH ONLINE
Do you have experience in a foundation trust? Are
you looking for a way to share your expertise and develop
your CPD portfolio? If so, contributing to TIS Health
could be for you.
The editorial board is looking for someone to write
an introduction to foundation trusts for www.tisonline.net,
the online resource for the public sector. The board
welcomes new members, but also accepts contributions
from external authors.
There are a number of benefits for becoming a member,
including free personal access to www.tisonline.net,
the chance to have work published in a respected source,
and the opportunity to meet other practitioners, but
all contributions qualify for CPD.
If you are interested in contributing, please contact
Sarah Jeal on 020 8667 8156 or at sarah.jeal@ipf.co.uk
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OTHER NEWS ENGLAND
COMMUNITY HOSPITALS
The Department of Health has announced a further £750m
in extra funding for the development of community hospitals.
ProCure21 is mentioned in the recent publication as
one method of providing these facilities.
For more information view
www.dh.gov.uk
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DRUG SERVICES
The DH has announced funding for the development of
clinical services for drug users in 45 prisons; 17 of
which will also receive funding to develop an integrated
model of care for substance misusers.
For more details view http://www.dh.gov.uk
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END OF LIFE CARE
A new long-term strategy for improving end of life
care for seriously ill adult patients has been announced
by Health Minister Rosie Winterton.
The new strategy follows on from a successful programme
to train 10,000 district and community nurses in palliative
care, which a King's College report out today found
had greatly improved the palliative care district and
community nurses offered their patients.
Professor Mike Richards, the National Cancer Director,
will work with Professor Ian Philp, the National Director
for Older People, to prepare the comprehensive strategy,
which will look at:
- funding for hospices and specialist palliative
care issues Choice at the end of life
- the need to improve the quality of end of life
care in hospitals and care homes, and
- the need for improved coordination of services
across organisational boundaries.
For more details view www.dh.gov.uk.
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EXTRA CARE HOUSING FUND
The Department of Health has published bidding guidance
to help Local Authorities Social Services Departments
and their partners in preparing a bid for the Extra
Care Housing Fund for 2007 – 2008.
For more details visit http://www.dh.gov.uk
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FOUNDATION TRUSTS
Monitor has published aggregate financial forecasts
for 2006-07 for the 48 NHS foundation trusts authorised
to date, together with annual risk ratings.
48 NHS foundation trusts are forecasting an £18m
surplus, before exceptional charges, for 2006-07.
Monitor also has published the lessons learned from
the recent completion of Wave 2 assessments.
For more details view www.regulator-nhsft.gov.uk
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GOVERNANCE
The Audit Commission has published a report that summarises
the key findings of their auditors' work in 2005 on
the 2004/05 accounts relating to stewardship and governance
issues. It identifies a number of important policy issues
that need to be addressed in order to improve financial
performance, financial reporting and corporate governance
arrangements in health and local government bodies.
For more details visit www.audit-commission.gov.uk
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MENTAL HEALTH SERVICES
More than half of England’s mental health trusts
have seen money diverted away from them to pay for deficits
in other local health services, according to a survey
published by the Sainsbury Centre for Mental Health
(SCMH).
Under Pressure: the finances of mental health trusts,
is the result of a survey of finance directors in England’s
76 NHS mental health trusts. It finds that the vast
majority kept within their budget limits in 2005/06,
but that 75% had to take special measures to break even.
The most common of these was to freeze vacant posts
in local services.
The survey reveals that 63% of trusts have been asked
by commissioners to spend less than they had planned
in 2006/07, on average by 3% of their budgets. The most
common reason for savings to be sought was overspending
in other local NHS bodies, such as primary care trusts
and acute hospitals.
For more details view www.scmh.org.uk
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MINISTERIAL OBJECTIVES
The Secretary of State for Health, Patricia Hewitt
has outlined the key objectives of her ministerial team,
in a letter to the Prime Minister.
The letter details the areas of responsibility each
health minister has been given to deliver the next stage
of health reforms over the next two years.
Patricia Hewitt’s letter is written in response
to Tony Blair’s May 2006 letter, which requested
the Secretary of State to identify the key challenges
faced by the Department of Health, and to propose actions
to tackle these challenges.
For more details view www.dh.gov.uk/assetRoot/04/13/74/54/04137454.pdf
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NHS FINANCE
The Department of Health has published the NHS financial
performance for the first quarter of 2006-07. The data
shows that:
- the NHS as a whole is forecasting a small surplus
for the year - £18m - after application of a
£350 million contingency created by the Strategic
Health Authorities;
- forecast gross deficits for the year total £883
million compared with £1,227 million in 2005-06;
- 120 organisations are forecasting deficits compared
with 174 that returned deficits in 2005-06.
For more details view www.dh.gov.uk
An Audit Commission report to the Secretary of State
for Health, the Rt Hon Patricia Hewitt MP, recommends
major changes in the National Health Service (NHS) financial
management and accounting regime to help improve the
financial performance of the NHS and lessen financial
risks for individual bodies.
The Review of the NHS Financial Management and Accounting
Regime says that the current system has weaknesses and
needs to adapt to the new demands placed on it by the
Department of Health’s reform programme.
Recommendations in the review aim to support the government's
major health reforms and put trusts and primary care
trusts and the NHS overall in a position to operate
on a sound and sustainable financial footing in the
future.
For more details visit at www.audit-commission.gov.uk
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NHS SPENDING
Stark variations in how much the NHS spends locally
on different diseases are revealed in a new King’s
Fund briefing.
Local variations in NHS spending priorities analyses
new Department of Health data from 2003/04 - 2004/05
that shows how much money is being spent by primary
care trusts (PCTs) in England on different diseases.
The briefing reveals that some PCTs spend much more
than others on particular diseases, such as cancer,
mental health and coronary heart disease, even after
differences in the health needs of local populations
and other factors have been taken into account.
The briefing also shows in which areas the extra money
allocated for the NHS in 2004/5 has been spent. The
largest share of spending (over £7 billion - 11
per cent) was devoted to mental health services - twice
as much as spent on cancer care.
The new figures show that spending is reaching the
government’s three clinical priorities of mental
health, coronary heart disease and cancer. They received
the highest share of the total increase in PCT spending
between 2003/4 and 2004/5.
The briefing is available to download from the King’s
Fund website at www.kingsfund.org.uk/resources/briefings
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PATHOLOGY SERVICES
Health Minister Lord Warner has set out plans to reform
pathology services and bring about higher quality, more
efficient, effective and responsive services for patients.
The plans are a response to recommendations set out
in the Report of the Review of NHS Pathology Services
in England, undertaken by Lord Carter of Coles.
Pathology services mainly cover blood tests, but also
include taking other specimens from patients - such
as tissue samples - and post mortem examinations. Pathology
is at the heart of patient care - it is estimated that
70 per cent of all diagnoses involve a pathology investigation
and demand has been rising by 10 per cent a year. Overall,
pathology services cost the NHS around £2.5bn
a year.
Lord Carter's review found that, over time, several
different models of service delivery have evolved within
pathology, from small in-house laboratories to larger
networks which has resulted in fragmentation of services.
The plans to reform pathology services include:
- £1 million funding to support 12 pilot projects
to road-test the recommendations of the review and to
gather improved data on activity, cost and performance
of pathology services; and
- in future, bringing in new providers of pathology
services, especially in regard to routine tests.
For more details visit www.dh.gov.uk
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PAY
The Department of Health has published a pay framework
covering chief executives; executive directors (except
medical directors and directors of public health); and
others with Board level responsibility who report directly
to the chief executive. The framework document includes
details of the dates from which the new arrangements
will apply to different organisations and staff.
For more details view www.dh.gov.uk
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PAYMENT BY RESULTS
The Department of Health has opened the following webpage
to access fact sheets detailing progress of the mental
health project http://www.dh.gov.uk/PolicyAndGuidance
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PRIVATE FINANCE INITIATIVE
Health Minister Andy Burnham has gavin the go-ahead
for six new NHS hospital private finance initiative
(PFI) developments worth close to £1.5 billion.
The new facilities, which include hundreds of single
rooms, will offer more private and personal care to
patients living in areas up and down the country, from
Salford to South Devon.
Up to half of the beds at the new hospitals will be
in single rooms, in a shift away from large, public
wards to more private and personal accommodation.
For more details view www.dh.gov.uk
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SERVICE USERS
The Department of Health has issued guidance aimed
at supporting local health and social care organisations
with the principles and practice of reimbursing and
paying service users for their involvement.
For more details view www.dh.gov.uk
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