HEADLINE NEWS
PAYMENT BY RESULTS
CIPFA sponsored a study visit to Germany to compare and contrast
their equivalent Payment by Results policy. With radical changes
to tariff structure and major shifts in market forces factors
late last year and now a twelve month delay in its application
to all but Elective Services, "Payment by Results"
in England has not had a smooth take off. Colin Dunn and Suzanne
Tracey looked for lessons from Germany who are also implementing
a DRG based system for funding hospitals. In particular the
aim of the visit was to look at financial risks of implementing
such systems and how these are being managed.
The full report is available at www.cipfa.org.uk/panels/health/
CIPFA NEWS
CIPFA COUNCIL
Jaki Meekings, Director of Specialist Commissioning South
Strategic Health Authorities, and David Poynton, Finance Director,
Harrogate & District NHS Foundation Trust, have both been
re-elected as Health representatives on the Council. The results
are available at www.cipfa.org.uk/council/election05_06.cfm
PANEL MEMBERSHIP
Vacancies have arisen on the Panel which meets quarterly,
usually at CIPFA HQ in London. The Panel is responsible for
all of the Institute's policy and technical work on the health
sector and reports to CIPFA's Public Finance and Management
Board. It is responsible for the development of: the Institute's
responses to exposure drafts and consultation papers; the
Institute's policies on current issues of concern; and guidance
and advice on finance and policy issues affecting the health
sector. Expressions of interest should be submitted via the
feedback page at www.cipfa.org.uk/panels/health/feedback.cfm.
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CONFERENCES/SEMINARS
Health Conference 2005
This annual event will be held in Bournemouth on the 6 and
7 October. More details will be provided as soon as they become
available.
To register and receive more details of events please contact
Alexandra Aarons, CIPFA, 3 Robert Street, London, WC2N 6RL
(tel 020 7543 5751; e-mail alexandra.aarons
@cipfa.org). Further details can also be found on the
CIPFA website: www.cipfa.org.uk/shop
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CIPFA HEALTH ADVISORY NETWORK
Payment by Results – Update and latest developments
14 June, Manchester; 15 June, Central London; 29 June,
Leeds; 30 June, Central London
Over the next three years NHS Trusts, NHS Foundation Trusts
and Primary Care Trusts will be adjusting to the full impact
of transition to tariff based payments. The CIPFA Health Advisory
Network is running a series of one-day workshops that will
provide delegates with a detailed and practical update of
Department of Health thinking around the revised ‘staged’
transition period, tariff sharing, market forces factor, PbR
‘code of conduct’ and many other key policy areas.
Managing financial risk during the transition period will
also be a key element of the workshop, together with discussing
how benefits arising under PbR can be maximized across the
whole of the health economy.
Commissioning Developments – setting the right
balance of primary and secondary care
28 June, Central London; 7 July, Central London
Proactive commissioning is central to the success and financial
stability of health economies. PCT and practice-based commissioners
are expected to make sizeable reductions in acute hospital
admissions, and achieve material financial savings, through
better management of chronic conditions and greater use of
non-acute care.
However, creating a primary care led NHS has proved to be
more complex in practice than in theory. What is going to
be different this time? And what is our vision of the acute
hospital of the future?
As well as providing an up to date summary of key commissioning
developments, this one-day workshop will explore how the NHS
can use the tools at its disposal to encourage the successful
management of long-term illness. We will assess the financial
risks within the Department of Health strategy, and identify
some hidden costs. We will also consider apparent contradictions
between financial policies (especially payment by results)
and building good primary care, and how they can be resolved.
Effective commissioning – minimising risk
14 July, Central London; 21 July, Central London
Five years ago, the NHS plan gave us a vision for a new health
service based on greater patient choice and local involvement.
The current programme of NHS reforms is about moving that
vision towards reality.
This workshop will mainly focus on Payment by Results, but
also take a closer look at some of the other key reforms and
their ‘joint’ impact on financial and overall
organisation stability. We will examine and discuss the main
causes of financial and other risks that are now being faces
by many organisations and how these risks might be minimized.
If you would like further details about any of the above
workshops or would like to find out more about the CIPFA Health
Advisory network, please visit our website at www.ipf.co.uk/healthcare
or email michelle.weatherspoon@ipf.co.uk
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FINANCIAL MANAGEMENT
Strong and effective financial management is key to well-managed
and sustainable public services.
The CIPFA Financial Management Model (FM Model) is a web-based
self-assessment tool that examines financial management in
the public services. It tests how an organisation measures
up against 42 good practice statements and places that organisation
into a spectrum of three 'styles'- Enabling Transformation,
Supporting Performance and Securing Stewardship - to build
a picture of how finances are working and identify areas for
improvement. A key feature is the ability to survey opinion
throughout the organisation.
The FM Model sits on a secure website that lets users score
and evidence the good practice statements, revisit, collate
and report on their scores and target questions at key people
to test views and opinions. It offers organisations the opportunity
to:
- Manage strategic risk through self-assessment;
- Identify strengths and areas for improvement;
- Prioritise improvement;
- Be better prepared for inspections and audit;
- Review and track its progress over time;
- Benchmark performance against other comparable organisations
For more information visit www.cipfa.org.uk/shop
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PUBLIC MONEY AND MANAGEMENT ASSOCIATION
(PMPA)
The Public Management and Policy Association (PMPA) is a
national membership organisation, managed by CIPFA, dedicated
to helping managers, policy makers and academics keep in touch
with and understand the wider cross-cutting developments in
public policy making that affect the governance, general and
financial management of the public services. In addition to
excellent networking and personal development opportunities
across the public services, the benefits package includes:
- Priority booking for PMPA lectures
- Subscription to Public Money and Management
- Up to three PMPA reports each year
- The PMPA quarterly Review
PMPA lectures in 2005 include:
21 June - Colin Talbot: The Future of the Civil Service
Chair: David Walker. Venue: Robert Street, London.
22 September - David Hunter: The Fall and Rise of
the NHS
Chair: Michael Clarke. Venue: Health Services Management Centre,
University of Birmingham.
8 Dec - Various Speakers. PMPA Annual Conference
Register your interest with Rikki Ellsmore, email rikki.ellsmore@cipfa.org
Venue: Institute of Public Finance, Queen Anne's Gate, London.
The latest PMPA publication ‘The Future of Local Government’
authored by Sir Jeremy Beecham- is now available.
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
Financing of Chronic Disease Management The
Panel has commissioned guidance on the Financing of Chronic
Disease Management, which is due to be published in June.
The guidance will examine clinical and policy issues and financial
mechanisms for promoting good practice with a number of case
studies. The guidance will examine clinical and policy issues
and financial mechanisms for promoting good practice with
a number of case studies.
Practice Based Commissioning
The Panel has also commissioned guidance on the practical
steps to implementation that is due to be published autumn
2005.
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.
Public Money & Management has a multidisciplinary and
international audience. It publishes articles which contribute
new knowledge as a basis for policy or management improvements,
or which reflect on evidence from public service management
and finance in order to suggest topics for research. Readers
include: officials in all types of public service organizations;
academics; consultants and advisers working with the public
services; politicians; journalists; and students on both academic
and professional courses.
In response to a steady rise in sales and submissions, Public
Money & Management increased its frequency in 2004 from
quarterly to five issues per year. The number of pages in
the volume was also increased: from 256 pp. a year to 320
pp. Future issues in 2005 will be published in June, August,
and October. Articles for consideration by the editors should
be sent to micky@mickylavender.com
Public Money & Management has a strong reputation: citations
have increased steadily in the UK and abroad and its articles
were prominent in submissions by academics to the Research
Assessment Exercise of 2001. Blackwell Publishing's recent
survey of readers has also strongly endorsed Public Money
& Management's position as a bridge of academic and practitioner
interests.
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 REPORTING AND ACCOUNTABILITY
AWARDS
Cambridgeshire & Peterborough Mental Health Partnership
NHS Trust is one of the finalists in the category of local
organisations with an annual turnover of £50m or more.
All entries have been judged according to five criteria:
appropriateness for particular audiences; clarity; timeliness;
innovation; and success in achieving response from the public
and other stakeholders. The judging process has been overseen
by a distinguished panel of judges chaired by John Speed,
Director of Human Resources, Informatics and Telecommunications
at the European Court of Auditors.
The winners will be announced at a ceremony taking place
on Tuesday 14 June 2005 at the Manchester International Convention
Centre. Guardian journalist David Walker and Rodger
Hughes, PricewaterhouseCoopers’ Managing Partner –
Clients and Markets, will present the awards, which will be
followed by a reception in the G-MEX to mark the start of
the CIPFA Annual Conference 2005.
For more details visit www.cipfa.org.uk/press_show.cfm?news_id=23900
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TIS HEALTH ONLINE
Are you looking for a rewarding way to earn CPD credits?
The TIS Health editorial board is currently looking for health
finance practitioners to produce information for the website,
including the following topics:
- Patient Choice
- Priorities and Planning Framework
- Foundation Trusts
- Information for Scotland
- National programme for IT
- Counter-fraud
- Care Trusts
The website acts as a portal or ‘one stop shop’
for all NHS finance practitioners to access and share best
practice and improve performance. All contributions count
towards CPD credits, and meetings offer members an opportunity
to meet other health practitioners. Travel and subsistence
costs are met by IPF, and members are entitled to complimentary
access to www.tisonline.net
for the duration of their membership.
If you are interested in contributing, or would like free
trial access to the site, please contact Sarah Ellison on
020 7340 1203 or at sarah.ellison@ipf.co.uk.
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OTHER NEWS
ENGLAND
AGENCY STAFF
The cost of employing agency staff in NHS hospitals failed
to rise for the first time in recent memory, as agency spending
reported by NHS Trusts and Primary Care Trusts in the UK actually
decreased by 1% in 2003-2004 according to Laing and Buisson's
new NHS Trusts & Primary Care Trusts Financial Information
2005 data product.
For more details visit www.laingbuisson.co.uk/PressReleaseList.htm
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AUDIT COMMISSION
The Commission has published ‘Approach to service inspections’
which sets out their policy and practice framework for service
inspections of local authorities, housing associations and
other bodies.
For more details visit www.audit-commission.gov.uk.
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FOUNDATION TRUSTS
In April Monitor published the financial reporting guidance
for NHS foundation trusts following full consultation with
stakeholders. The major changes are as follows
- The presumption of going concern has been removed
- The requirements of FRS3 in relation to activities that
have been acquired, are continuing or have been discontinued,
must be followed
- There is no requirement to index fixed assets, instead
FRS15 must be applied
- There is a requirement to include disclosure of protected
and unprotected assets; and
- An analysis of income is required, which is consistent
with that required by the Compliance Framework.
For more details visit www.regulator-nhsft.gov.uk/publications
The CIPFA response to the above consultation document can
be found at www.cipfa.org.uk/panels/health/responses_health.cfm
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KINGS FUND
The Government must press ahead with reforming the National
Health Service and resist the temptation to hold back on a
radical vision for health during its third term according
to the King's Fund chief executive Niall Dickson.
For more details visit www.kingsfund.org.uk
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MODERNISATION FUNDS
A letter and spreadsheet are now available which outline
the new financial arrangements following the changes to the
Modernisation Agency. They detail the allocations to be made
to every PCT and SHA.
For more details visit www.dh.gov.uk/PublicationsAndStatistics/Bulletins
NHS FUNDING
The Institute for the Study of Civil Society has published
a briefing note, The NHS: Has the Additional Funding Worked?
on the following policy areas:
- Expenditure
- Productivity
- Waiting Lists
- Cancellations
- Hospital acquired infections
- Cancer
- Circulatory disease
- Stroke
For more details visit www.civitas.org.uk/pubs/NHSBriefingApr05.php
NHS LIFT MAKING A POSITIVE IMPACT
The NHS Local Improvement Finance Trust (NHS LIFT) initiative
is an effective way to improve primary care premises, finds
a National Audit Office (NAO) report.
NHS LIFT began in 2000 as a way to modernise primary care
premises and to bring investment to the areas of greatest
need. The initiative initially focused on inner city areas
with the greatest health inequalities, where there were disproportionately
high numbers of substandard premises.
The NAO report looks at the first six schemes completed under
LIFT in:
- Ashton, Leigh and Wigan
- Barnsley
- Barking and Havering
- East Lancashire
- East London and the City
- Sandwell
The report acknowledges that there is more to do, but concludes
that LIFT schemes are an effective way to improve, and forge
links between, primary and social care. In bringing different
services under one roof, the initiative will support the management
of chronic diseases, shifting services away from secondary
care and towards communities. Improving premises, the report
suggests, will also support the recruitment and retention
of GPs.
For the full report visit www.nao.org.uk/pn/05-06/050628.htm
NHS PLAN
The Chief Executives report describes activity in the NHS
over the past year and since publication of The NHS Plan.
It is accompanied by a statistical supplement.
For more details visit www.dh.gov.uk/PublicationsAndStatistics
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QUEEN’S SPEECH
The Government has included the following commitments in
respect of health and social services:
- to continue to reform the National Health Service in
a way that maintains its founding principles.
- to introduce more choice and diversity in healthcare
provision and to continue to improve the quality of health
services and hospital hygiene.
- legislation to restrict smoking in enclosed public places
and workplaces will also be introduced.
- a Bill will be brought forward to support patients who
wish to seek redress should they experience problems with
their healthcare
- to continue its reform of the welfare state, in order
to reduce poverty further, offer greater equality, and match
rights with responsibilities
- a Bill will be introduced to establish a barring and
vetting scheme, and other measures to provide better protection
for children and vulnerable adults
- legislation will be introduced to safeguard the welfare
of children in circumstances of parental separation and
to improve the process of inter-country adoption
- legislation to provide a new framework for the provision
of compulsory treatment of those with mental disorders
- Legislation will be introduced to streamline regulatory
structures and make it simpler to remove outdated or unnecessary
legislation.
For more details visit www.number-10.gov.uk/output/Page7488.asp
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SHARED SERVICES
Richard Douglas, NHS Director of Finance, has published details
of the setting up of the joint venture NHS Shared Business
Services Ltd, constitution of the Board, distribution of profit,
and the Department's opinion on the value for money offered
by the joint venture to the NHS.
For more details visit www.dh.gov.uk/PublicationsAndStatistics/LettersAndCirculars
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SOCIAL CARE
Social care services could lose out to health under the Department
of Health’s grant distributions to voluntary sector
groups this year, social care organisations have warned.
Learning difficulties charity the Association of Real Change
and 20 other groups have written to Sir Nigel Crisp, permanent
secretary of the Department of Health, expressing concern
that the section 64 grant priority areas for 2006-7 showed
a “distinct shift” away from social care towards
health and mental health issues.
The section 64 general scheme of grants is designed to “strengthen
and develop” the partnership between the DH and voluntary
and community sector.
The organisations called for the priorities to be amended
in the light of the adult green paper and “additional”
priorities to allow scope for innovation.
While the Department of Health does not set a sum for individual
grants, the total budget for 2005-6 was around £17 million,
with an average of £38,000 a year for an individual
grant.
For more details visit www.communitycare.co.uk
A cross-party group of MPs, chaired by Labour backbencher
David Hinchliffe, wants the structural division between health
and social care to end to improve the services for those with
long-term care needs.
A committee of cross-party MPs has called on the next government
to integrate health and social care in a single community
care provider in order to end inconsistencies in long-term
care funding.
The call is in a Commons health committee report, NHS Continuing
Care, sixth report of 2004-05, published in April.
The committee, chaired by Labour backbencher David Hinchliffe,
concluded the arrangements for funding long-term care are
too complex, and a lack of coherent guidance has contributed
to widespread variation in practice around the country.
Its report argues the “confusion, inconsistency and
opacity” stems from the barriers between health and
social care, and recommends these be removed.
The report recommends the government integrate the parallel
funding systems for NHS continuing care and nursing care for
those who do not qualify for fully funded continuing care.
And it argues this single funding system should include incentives
to reward high-quality care and promote rehabilitation and
independence.
It says the long-standing problems of inconsistency and inequity
should be tackled by establishing a single set of eligibility
criteria for continuing care in a bid to end the postcode
lottery in access to funding.
These criteria should take into account physical, psychological
and mental health needs, and be supported by a standard assessment
methodology.
For the full report visit www.publications.parliament.uk/pa/cm/cmhealth.htm
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WALES
STRATEGIC PLAN
A 10-year government strategy has been launched by Welsh
minister, Dr Brian Gibbons, outlining what the public sector
must do next to improve health and social care in Wales.
Timetable for strategy:
- By September 2005: each health and social care community
to have in place an updated 'delayed transfers of care plan',
setting targets for reduced delays;
- By March 2006: a methodology to be developed for researching,
auditing and evaluating progress in health and social care
in order to spread best practice;
- The Welsh Local Government Association to set up a dedicated
improvement team for social services that will link with
the new National Leadership and Innovation Agency for Healthcare,
which is aimed at building leadership.
There will be greater government investment in prevention,
screening, community-based assessment, carer support, rehabilitation
and intermediate care, as well as domiciliary and respite
care, and supported housing and home-based technology services.
More funding is also to be provided to ensure health, social
care and voluntary sector staff have the skills to deliver
this new agenda.
The vision for 2015 will be delivered through a series of
strategic frameworks, of which Designed for Life is the first.
Each framework will last for three years and will be reviewed
and assessed against targets in key policy areas.
For more details visit www.wales.gov.uk/subihealth/content/keypubs/pdf/designed-life-e.pdf
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