CIPFA NEWS
CONFERENCES/SEMINARS
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 contact Alexandra Aarons, CIPFA, 3 Robert Street,
London, WC2N 6RL (tel 020 7543 5751; e-mail alexandra.aarons@cipfa.org).
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FINANCIAL MANAGEMENT
A copy of the CIPFA response to the Audit Commission
discussion paper World Class Financial Management is
available at www.cipfa.org.uk/pt/pt_details_r.cfm?news_id=27663
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HEALTH ADVISORY NETWORK
Payment by Results
The CIPFA Health Advisory Network has developed a series
of focused workshops that will run throughout 2006 that
will 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.
This practical one day workshop will provide attendees
with a detailed update on the latest developments under
the payment by results reforms policy and focus on key
financial challenges arising from the revised tariff
and the 2006/07 technical guidance. Delegates will have
the opportunity to set their own PbR priorities for
discussion during the day and to discuss practical issues
arising within their own organisations.
The next workshops in this series will run on:
- 20 September Manchester
- 12 October Central London
Workshop outline:
- The 06/07 rebasing exercise and the financial impact
on providers & commissioners
- 2006/07 national tariff (& technical guidance)
- The PbR code of conduct and managing PbR risks
- Developments in coding – version 4 HRGs &
beyond
- The Secondary Uses System (SUS) and it’s
capabilities
- Developing local action plans to identify areas
of financial risk
- Looking beyond transition
Note: the content of the workshops may vary slightly
as the PbR policy develops.
This workshop is primarily aimed at commissioning and
information staff but will also be of interest to those
who wish to gain a greater understanding of the complexities
of the (continually) evolving PbR reform.
The event will be highly interactive, with places limited
to allow maximum speaker/delegate interaction, group
exercises and facilitated discussion.
If you would like further details about this workshop
or would like to find out more about the CIPFA Health
Advisory network, please visit our website at http://www.cipfanetworks.net/health/
or email liz.simmonds@ipf.co.uk
Attendance on this workshop can count towards CIPFA's
CPD Scheme as laid out in CIPFA CPD Guidelines.
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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:
28 June 2006
Managing in a Political Environment - Cheryl
Miller, Chief Executive, East Sussex County Council
and Richard Penn, former Chief Executive of Bradford
City Council.
Chair: Sir Simon Milton, Leader, Westminster City Council
3 October 2006
Effective Inspection and Regulation in Education,
Training and Children’s Services –
David Bell, Permanent Secretary, Department for Education
and Skills.
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.
7 February 2007
The Civil Service The Way Forward – Sir
Gus O’Donnell
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.
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
PMPA/SFI/CfPS Roundtable Discussion:
How Best to Hold Local Government to Account: The Scrutiny
Debate
PMPA hosted an extremely successful roundtable at the
end of March 2006. The roundtable was developed with
partner organizations: the Centre for Public Scrutiny
(CfPS) and the Solace Foundation Imprint (SFI). The
roundtable brought together people working in and around
local authority scrutiny to reflect and share experiences.
The opportunity was timely. At least three government
department’s ¬ OPDM, the Department of Health
and the Home Office - are thinking about the value and
potential of the local authority scrutiny function.
How might it be reinforced as part of a local public
accountability landscape which prompts local people
to engage with problems, connect with local councillors
and use their council to build solutions? David Walker
has produced a substantial report on the roundtable
which can be downloaded on the PMPA website: www.pmpa.co.uk
PMPA at CIPFA Annual Conference
Find out more about the PMPA by visiting stand number
107 at the CIPFA Annual Conference & Exhibition
2006, 13-15 June, Harrogate International Centre.
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 – Practical
Steps to 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 2006 issues will cover Managing Knowledge Across
Organizational and Professional Boundaries within Public
Services (April); and Terrorism and Public Management
(June). 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.cfm
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PUBLIC SERVANTS OF THE YEAR
AWARD
WINNERS ANNOUNCED
The winners of the 2006 Public Servants of the Year
Awards were announced on 17 May at an awards ceremony
held at the prestigious Grosvenor House Hotel on London's
Park Lane. Sir Trevor McDonald OBE and Felicity Barr
hosted the glittering occasion. Sir Gus O'Donell, Cabinet
Secretary and Head of the Home Civil Service was the
guest speaker.
Details of the winners and their achievements can be
found on www.publicservants.org.uk
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TIS HEALTH ONLINE
If you work in Scotland and you’re wondering
how to develop your CPD portfolio, TIS Health could
be the answer. We are looking for people who work in
NHS finance to contribute to our website. No previous
experience is necessary, just enthusiasm and a willingness
to participate.
You can be part-qualified, newly qualified or an experienced
practitioner, and can contribute as much or as little
as you want. We are looking for people to review our
content and write drafts on specific topics to make
sure arrangements in Scotland are covered on the website.
Any work you do will qualify for your CPD scheme and
we will provide evidence for your portfolio. Contributing
also allows you to explore areas of interest, develop
your professional skills and meet with other practitioners.
You’ll also have complimentary access to TISonline
for the duration of their membership.
If you are interested in any of the above vacancies,
please contact Sarah Jeal on 020 8667 8156 or at sarah.jeal@ipf.co.uk
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OTHER NEWS
ENGLAND
AUDIT
Sir John Bourn, the head of the National Audit Office,
has reported to Parliament on the cancellation of the
Paddington Health Campus scheme in June 2005 at a cost
of £15 million.
The scheme was a complex and ambitious attempt to build
a world-class healthcare facility and ultimately proved
to be beyond the capacity of the scheme partners to
deliver. There were three main reasons for this. The
first was the number and scale of the risks and the
lack of a single body in charge of the scheme. The second
was the way in which the partners organised and carried
through the scheme. The third was the lack of active
strategic support for the campus vision.
The 2000 Outline Business Case estimated the gross
capital construction cost to be approximately £300
million (£411 million at 2005 prices), with completion
of the hospitals due by 2006. By the time the scheme
was cancelled in 2005, projected costs had risen to
£894 million and the expected completion date
had slipped to 2013.
The National Audit Office considers that the North
West London Strategic Health Authority should either
have required the campus partners to draw up a new Outline
Business Case in early 2003 or cancelled the scheme
at that stage. In late 2002, external construction consultants
confirmed that the estimated capital construction costs
had more than doubled and Westminster City Council confirmed
that the scheme could not fit on the land available.
The report concludes that the failure of the Two NHS
Trusts – St Mary’s NHS Trust and the Royal
Brompton and Harefield NHS Trust - to merge at the start
of the process was a key factor in the failure of the
scheme. Their diverging clinical and financial interests
were exposed as the scheme wore on, exacerbated by developments
in NHS policy.
For the full report view www.nao.gov.uk
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BED MANAGEMENT
The number of NHS beds has fallen by a third over the
past 20 years as a result of improvements in care, including
better joint working with social services, the NHS Confederation
has claimed.
In a report this week, the confederation dismissed
the assumption that bed count was a measure of care
quality and called for a debate over the share of future
NHS investment that should go into hospitals.
The report said joint working between health and social
care, through initiatives such as intermediate care
and sitting services, had created added capacity in
the community.
'Why we need fewer hospital beds' is available from
www.nhsconfed.org
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CHARITIES
The Department of Health has finally revealed which
charities have been successful in this year’s
section 64 funding applications, almost six months after
the decision was expected.
New care services minister Ivan Lewis apologised for
the delay, which was caused by a departmental review
of all budgets.
The amount allotted to the programme, which supports
health and social care projects, fell 3.5 per cent,
from £17.85 million to £17.2 million.
Organisations receiving major awards include Drugscope,
which received £300,000, Carers UK, which gets
£195,000 and National Centre for Independent Living
which benefits from £130,000.
For more details visit www.dh.gov.uk
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CHOICE
The Audit Commission has published a report that analyses
whether greater individual choice can help improve local
public services and to help local bodies understand
when and why a policy of increasing individual choice
can be implemented fairly and cost-effectively. The
report sets out a means of analysing some of the costs
and benefits of providing choice in local public services.
For more details view www.audit-commission.gov.uk
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COMMISSIONING
The Minister of State for NHS Reform, Lord Warner,
announced the review into commissioning arrangements
for specialised services on 19 October 2005. The review
is aimed at helping the NHS to plan provision for some
of the most rare conditions and expensive treatments.
The Review Group, headed by Scotland’s former
Chief Medical Officer Professor Sir David Carter, investigates
how the NHS commissions specialised services and makes
proposals for improvement. Specialised services are
those services where the planning population is greater
than a million; they range from bone marrow and kidney
transplants to secure forensic mental health services.
The primary purpose of this review is to propose improvements
to commissioning arrangements for specialised services
in England. The review recommends changes to structure,
organisation and powers that will ensure the commissioning
process is robust and fair, is understood by all, engages
patients and offers optimal value for money. Realisation
of the full potential of the system reforms will depend
critically on providing commissioners of the future
with the essential levers and tools for success.
This is an independent review and should not be considered
as Departmental guidance. The Department will be considering
how to address the review’s recommendations in
the forthcoming commissioning framework to be published
by the Department in summer 2006.
For more details view www.dh.gov.uk
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CONNECTING FOR HEALTH
The National Audit Office has reported to Parliament
the results of its examination of the National Programme
for IT in the NHS.
The Programme’s scope, vision and complexity
are wider and more extensive than any ongoing or planned
healthcare IT programme in the world and it represents
the largest single IT investment in the UK to date.
It is designed to deliver important financial, patient
safety and service benefits.
According to the report by head of the NAO Sir John
Bourn, the main implementation phase of the Programme
and the realisation of benefits are mainly a matter
for the future and it will therefore be some time before
it is possible fully to assess the value for money of
the Programme, as this will depend on the progress made
in developing and using the systems it is intended to
provide. It is therefore important for taxpayers and
patients that this investment pays off, and for the
Programme to be well managed and open to public scrutiny.
Accordingly, the NAO has examined the progress to date
in delivering the systems against the original plans
and the costs of the Programme; the steps taken by the
Department, NHS Connecting for Health and the NHS to
deliver the Programme; how the IT systems have been
procured; and how the NHS is preparing to use the systems
delivered.
The NAO found that the Department and NHS Connecting
for Health have made substantial progress with the Programme.
Successful implementation of the Programme nevertheless
continues to present significant challenges for the
Department, NHS Connecting for Health and the NHS, especially
in three key areas:
- Ensuring that the IT suppliers continue to deliver
systems that meet the needs of the NHS, and to agreed
timescales without further slippage.
- Ensuring that NHS organisations can and do fully
play their part in implementing the Programme’s
systems.
- Winning the support of NHS staff and the public
in making the best use of the systems to improve services.
For more details visit www.nao.org.uk
Plans to speed up implementation of the electronic
patient record, have been announced by Health Minister
Lord Warner.
Speaking at the BMA's Local Medical Committee Conference,
Lord Warner spoke about a number of initiatives to gear
up progress on the electronic patient record - known
as the NHS Care Records Service.
The first of these will be setting a date in early
2007 to begin pilots for the uploading of patient information
onto the summary care record. This will enable the transfer
of patient records when people change GPs. After a short
period of consultation, a firm date will be published.
Another initiative is the establishment of a new taskforce
to develop a detailed implementation plan for speeding
up delivery of the electronic medical record. It will
be chaired by a layperson and involve a cross-section
of clinical representatives.
Charged with producing a detailed action plan by the
end of this year, the taskforce will also be asked to
draw on the work already done in this area by the Veterans'
Administration in the US. This organisation already
has a fully operational electronic patient record system,
and the Health Minister will be consulting the profession
imminently on this.
Deputy Chief Medical Officer, Professor Martin Marshall
will be involved with the taskforce and working with
the current National Clinical Leads, will take on a
fuller role in assisting with clinical engagement on
introducing an electronic patient record.
Lord Warner also announced the development of a public
information campaign to explain the patient benefits
and implications of moving to electronic patient records.
This will build on the work already done with the profession,
and on the information guarantee. A further announcement
will be made in due course.
For more details visit www.dh.gov.uk
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DENTISTRY
NHS dental practices and their patients will benefit
from a programme of capital investment of £100million
over two years announced by health minister Rosie Winterton,
designed to improve and modernise dental practices across
the country.
The capital investment, announced in her speech to
the British Dental Association conference, will:
- support dentists in modernising premises and equipment
to improve services for patients, and
- allow PCTs to give greater financial support to
help dentists establish practices or to upgrade existing
ones.
The £100 million of capital investment will be
made available to the NHS, through SHAs, over the next
two years to take forward infrastructure improvements
for NHS primary dental care services. This builds on
the £80 million capital investment already going
towards modernising dental education establishments
and supporting the 25 per cent expansion in dental training
places.
For more details view www.dh.gov.uk
Circular AL (DOS) 1/20 informs NHS employers of the
changes with effect from 1 April 2006 in the national
pay, allowances and conditions of service of dental
public health staff including those appointed to Director
of Public Health posts in PCTs.
For more details view www.dh.gov.uk
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DEPARTMENT OF HEALTH REPORT
- Waiting times for operations and A&E shorter
than ever
- NHS deficits down over £100m in six months
- Government to publish quarterly NHS finances figures
in drive to balance the books
The quality of NHS care is continuing to improve, with
maximum waits for operations down to six months and
more than nine out of ten A&E patients seen within
four hours, reports acting chief executive of the NHS,
Sir Ian Carruthers, in his first six-month report, which
also reveals that NHS finances are starting to stabilise.
Official NHS figures show that the NHS overspend has
fallen by around £110 million over the last six
months to just over £512 million.
The NHS deficit represents less than one per cent
(0.8 per cent) of the annual NHS budget, with more than
two thirds of this sum accounted for by about one-tenth
of all NHS organisations.
The NHS has improved access to services by reducing
maximum waiting times. The maximum waiting time for
inpatient admissions is down to six months. For outpatient
appointments, the maximum waiting time has fallen to
13 weeks, and 98 per cent of A&E patients are now
seen within four hours. Cancer patients are being treated
faster than ever before, with nine out of ten patients
treated within 2 months of an urgent GP referral.
For more details visit www.dh.gov.uk
Commenting on the figures published in the Chief Executive's
report to the NHS which reveals the net NHS deficit
has more than doubled from last year to £512m,
King's Fund chief executive Niall Dickson said
"These figures mask the true scale of financial
problems in the health service. The gross deficit has
increased throughout the NHS to £1.27 billion
and has been reduced to a net of £512 million
only by using increased surpluses from other parts of
the service. In fact, more NHS organisations are in
deficit than predicted, while the net deficits for primary
care trusts and hospitals are worse than last year.
"It is especially worrying that Trusts have known
for months that they have been running an overspend
- yet even though they have been under enormous pressure
they haven't managed to tackle this. Some will certainly
need more time but the requirement to manage a budget
that already assumes efficiency savings as well as rising
cost pressures such as pay deals, new drugs and other
technological costs will also add to the challenge."
Niall Dickson added: "The health service faces
significant challenges over the next year and the issues
are for both local management and the government to
sort out. At a national level we have already had too
many changes pushed through too quickly - the priority
now must be to sort out the financial muddle and concentrate
on a small number of key areas such as improving productivity
and efficiency. Short-term fixes will not help the service
in the long-term and are likely to only lead to further
rounds of job losses and service cuts.
"But it important to keep all this in perspective.
There are serious questions about how some of the extra
money going into the health service has been used up
- not least in large pay awards - but it has also led
to real achievements in reduced waiting times, better
cancer services and treatment of coronary heart disease."
For more details visit www.kingsfund.org.uk
The publication of the Chief Executive’s Report
to the NHS shows how far the Department of Health has
moved in the direction of reform. In recent years the
focus of such reports has been on higher spending and
extra capacity. This year the emphasis is on reform,
productivity and value for money. However recent reports
have indicated some delays to the programme. This should
be the cause of great concern. The key task for the
Department of Health is to implement its reform programme
before funding slows after April 2008 otherwise deficits
will worsen.
For more details visit www.reform.co.uk
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EFFICIENCY
The NHS could improve patient care and save more than
£700m a year in the process by improving efficiency,
according to Health Minister Andy Burnham .
Launching the NHS Institute for Innovation and Improvement,
he published its first report detailing the savings
that could be made by addressing areas such as:
- reducing avoidable emergency hospital admissions;
- increasing the number of operations carried out
as day cases;
- cutting patients' length of stay in hospital;
- slashing agency staff costs; and
- reducing the number of wasted bed days.
The report contains recommendations for acute trusts
and Primary Care Trusts (PCTs) on how to improve patient
care and increase efficiency.
The NHS Institute for Innovation and Improvement's report,
Delivering Quality and Value: Focus on Productivity
and Efficiency can be found at www.institute.nhs.uk/productivity
The NAO has launched a toolkit, which provides practical
guidance on assessing an organisation's current approach
to achieving efficiency. It helps identify opportunities
for improvements and develop actionable recommendations.
It is designed around a broad interpretation of what
'efficiency' means and is also relevant to some aspects
of effectiveness - e.g. spending money on the right
things.
For more details visit www.nao.org.uk
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FRAUD
The Audit Commission's National Fraud Initiative (NFI),
the country's largest public sector fraud detection exercise,
has sharply increased its success by detecting frauds
and overpayments of £111 million.
For more details view www.audit-commission.gov.uk
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GENERAL PRACTICE
The Department of Health has advised that it does not
support payments to GPs as ‘inducements’ to
refer patients to any particular provider, for example
an ISTC.
A letter from Lord Warner to the Guardian on this subject
is at www.dh.gov.uk
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HEALTH POLICY
The leader of the UK’s hospital consultants has
called for a halt to Government health policies that have
failed to improve patient care and cost the NHS billions.
Dr Paul Miller, chairman of the BMA’s consultants
committee, will criticise the Government for wasting
NHS money on costly private finance deals, independent
sector treatment centres and needless management consultants.
In a speech to senior hospital doctors attending the
annual consultants’ conference, Dr Miller will
say: “Care is suffering, jobs are disappearing,
patients and staff are paying the price. If a patient
gets worse instead of better with treatment, then it’s
time to figure out whether the diagnosis or the treatment
is wrong. Something is going very badly wrong with these
health policies. It is time to call a halt. Examine
what is not working and why.”
NHS deficits are the fault of poorly-designed policies
and political interference, says Dr Miller: “The
deficits are clustered in a few areas and are caused
by local service management and strategic planning failure,
often caused by political interference with proper local
service planning. But most particularly they are caused
by bad policies and shocking incompetence inflicted
on the whole service from the top, from Whitehall. And
a large part of that is an excessive keenness and liking
for expensive management consultants.”
The Government’s private finance initiative (PFI)
and contracts with independent sector treatment centres
(ISTC) also come under fire. Dr Miller refers to £130million
wasted on three controversial PFI projects*1 alone and
money ploughed into ISTCs where the extra capacity was
neither used nor needed.
Dr Miller will issue the Government with a prescription
for curing the NHS. He will call on the Secretary of
State for Health to:
- Integrate existing ISTCs with NHS patient services
and not to sign off any more contracts for further
ISTCs.
- Have no more reorganisation of the NHS. It accomplishes
nothing and costs hundreds of millions of pounds each
time.
- Stop interfering for political reasons in the sensible,
local planning of services.
- Bring in no more external management consultants
to tell NHS clinicians and managers how to run their
services.
- Stop thinking that there is lots of money to save
by getting care moved out of hospitals. There are
benefits to giving more care in the community, but
it is not a cheap option.
- Let staff get on with the jobs for which they were
actually trained.
- Have the NHS run by an independent body, depoliticise
it.
- Invest in clinical engagement – hospital consultants
working in partnership with managers to plan and run
local health services.
For more details visit www.bma.org.uk
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HOSPICE CARE
Children’s hospices will be able to deliver improved
care to children who most need it as a result of £27
million worth of funding announced by the Department
of Health.
Health secretary Patricia Hewitt announced the funding
which will be spread over the next three years and will
allow hospices to provide help for families at home,
planned and emergency respite care and where necessary
end of life care in hospices.
The funding will begin this financial year and help
expand the role hospices play in the administering of
children’s palliative care.
Between 2000 and 2004, almost 15,000 children and
young people died in England and a quarter of those
young people would have needed palliative care.
Hewitt will work with the Association of Children’s
Hospices to distribute the new funding.
For more details visit www.childhospice.org.uk
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INVESTMENT GUIDANCE
The DH has made available a Route Map in two different
formats – life-cycle of an investment and five-case
model. Each item of guidance provided in these formats
has an accompanying synopsis, and where it has been
superseded by new guidance this is identified. The "specialist
areas" index links to other useful sources of information,
including that which is relevant to LIFT, IM&T and
Estates; and there is an A to Z index of all guidance
included in the Route Map.
For more details visit www.dh.gov.uk
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MENTAL HEALTH SERVICES
The DH has issued a policy briefing outlining the key
findings from a one-off survey of Strategic Health Authorities
carried out by the Department of Health in December
2005. The survey was undertaken to establish whether
NHS organisations had maintained their agreed investment
levels during 2005/6.
Circular LAC (2006)13 provides guidance on the administration
and conditions attached to the Mental Health Supported
Capital Expenditure (Revenue) (MHSCE(R) 2006/07. Councils
proposals for its use should be developed with PCTs
and other relevant agencies taking account of user and
carer interests.
For more details view www.dh.gov.uk
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NHS FINANCE
There was a deficit across the NHS as a whole in 2004-05
for the first time since 1999-00. Latest figures also
show the deficit has worsened for 2005-06. Compared
to 2003-04, the number of NHS bodies with deficits increased,
and more of these deficits were significant in size,
according to Financial Management in the NHS, a joint
study by the National Audit Office and the Audit Commission.
The overspend for 2004-05 was £251 million compared
to an underspend of £65 million in 2003-04. Some
171 NHS bodies (28 per cent) incurred a deficit, compared
to 106 (18 per cent) in the previous year. Of these,
143 had a significant deficit (over 0.5 per cent of
their income). This is an increase on 2003-04, when
76 NHS bodies incurred a significant deficit.
The aggregate deficit across the NHS in 2004-05 was
relatively small in the context of overall expenditure,
and 72 per cent of NHS bodies achieved break-even or
surplus. But clearly without action some organisations
with significant deficits will have difficulty meeting
financial commitments. In 2004-05, a small number of
NHS bodies considered deferring payment of key creditors.
The report states this is a cause for concern because
the steps which an NHS body needs to take to restore
financial balance may affect service delivery as it
diverts resources and management attention way from
normal operational and strategic priorities.
For more details visit at www.nao.gov.uk
and www.audit-commission.gov.uk
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PAYMENT BY RESULTS
The Department of Health is inviting feedback on the
procedure classification on which they are based (OPCS
4.3) and the arrangements for handling specialised services
under Payment by Results. A questionnaire is available
for download and should be returned to the DH by 30
June 2006.
For more details view www.dh.gov.uk
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PRACTICE BASED COMMISSIONING
(June)
The Audit Commission has published key areas to focus
on for success and key questions for primary care trusts'
boards to consider. The booklet is the first in a series
of products that the Commission intends to produce on
practice based commissioning to support and monitor
implementation. Drawing on evidence from those primary
care trusts (PCTs) which are furthest ahead, it identifies
the key areas that PCTs and practices should be focusing
on in the early stages of implementation and sets the
scene for a fuller national report on practice based
commissioning, to be published in early 2007.
For more details visit www.audit-commission.gov.uk
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SHARED SERVICES
IPF has published a paper providing an overview of
the major issues associated with sharing services in
the context of the Efficiency Review and Transformational
Government. It explains some of the potential benefits,
highlights areas where problems may occur and provides
guidance on implementing a shared services solution.
For more details visit www.ipf.com
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SOCIAL FUND
A Government scheme meant to help those most in need
is increasing levels of poverty for some, according
to a new report funded and published by the Joseph Rowntree
Foundation. The Social Fund: Current role and future
direction, drawing on group discussions with benefit
recipients and taxpayers, calls for immediate reforms
to the scheme and concludes that a radical review is
needed.
The Social Fund is meant to help people on a low income,
predominately those on means-tested benefits, with necessary
or emergency expenses that could not otherwise be met.
It provides financial support in the form of grants
or repayable interest-free loans.
According to the report, however, the Social Fund
has sometimes failed those most in need. The overwhelming
experience of participants was that the Social Fund
was not helping them meet their needs as applications
were refused or only a partial award was granted. There
was confusion about how grants and loans were awarded,
with a successful outcome often attributed simply to
luck. Many felt decisions took too long. Even though
the Social Fund was an option for many, some used other
more expensive forms of credit because there was a guarantee
of an immediate response when needed.
When people ran out of money, coping tactics included
not paying utility bills, going without meals or heating,
taking out commercial loans, borrowing money from family
or friends, and selling saved up for possessions such
as TVs or cars.
For more details visit www.jrf.org.uk
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SCOTLAND
NHS ACTIVITY
This winter saw a dramatic reduction in the number
of NHS operations cancelled at the last minute, according
to new statistics released by the Department of Health.
Figures for the number of operations cancelled during
the period from January to March this year show that
there were more than 4000 fewer operations cancelled
at the last minute than in the same period last year.
The number was also significantly down on other previous
years.
This decrease in cancelled operations shows that,
even against a backdrop of winter pressures and the
financial challenges of a smaller number of NHS organisations,
the NHS is giving patients more certainty about their
treatment as well as the fastest access to care.
The figures show that almost 99 per cent of operations
- around 1.5 million - were carried out as scheduled
across 2005/2006.
The latest NHS waiting times statistics for the beginning
of 2006 are the 'best ever', according to Health Minister
Andy Kerr.
They show the number of outpatients and inpatients/day
cases with a guarantee waiting more than 18 weeks was
at its lowest ever level.
They also show that at the March 31 census the six
month target for all patients was maintained.
For more details view www.scotland.gov.uk
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