HEADLINE NEWS
NHS Charities
A brief review of the statutory requirements and the
available guidance for NHS charities on writing their
trustee annual report and producing the charity accounts.
has been produced by Nigel Davies, Deputy Head of Accountancy
Policy, Charity Commission and is available at www.cipfa.org.uk/pt/briefings.cfm
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CIPFA NEWS
CONFERENCES/SEMINARS
CIPFA Annual Conference and Exhibition 2006
Harrogate International Centre - 13 - 15 June 2006
The programme for our 2006 Annual Conference is near
to finalisation. Confirmed speakers include:
- Sir Michael Barber, former No. 10 advisor
- Steve Bundred, Audit Commission
- Niall Dickson, Kings Fund
- Lord Roy Hattersley
- Peter Housden, Department for Communities and Local
Government
- Simon Jenkins, author and journalist
- Mary Keegan, Head of Government Accountancy Services
- Sir Michael Lyons, Chair, Lyons Inquiry into Local
Government
- John Oughton, Office of Government Commerce
- Professor Colin Talbot, Chair of Public Policy
& Management, Manchester Business School
- David Walker, US Comptroller General
- Dr Tony Wright MP, Chair of the House of Commons
Public Administration Select Committee
To request a copy of the full conference programme
and booking form (available from March) contact margot.gallie@cipfa.org,
alternatively visit www.cipfaconference.org.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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FINANCIAL REPORTING
CIPFA monitors developments in financial reporting
and auditing standards, paying particular attention
to those that are relevant to the public benefit sector.
The Accounting and Auditing Standards Panel website
features a newly redesigned page which provides a round
up of recent consultations, drafts and final standards.
More details are available at www.cipfa.org.uk/panels/accounting/newstandards.cfm
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GOVERNANCE
CIPFA and IPF, its management support services company,
has launched a website that brings together the CIPFA
Group’s work, and the work of others, on governance
in the public sector.
The website can be found at: www.CIPFAgovernance.net.
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HEALTH ADVISORY NETWORK
Financial recovery for primary
care trusts
The financial position of the NHS deteriorated
rapidly during 2005/06, with accounts not yet finalised
it looks likely that the overall NHS deficit will be
in excess of £700m for the year.
Those of us who work in the NHS are fully
aware that it isn’t just secondary care providers
that are suffering from financial instability. Many
PCTs are also experiencing deficits, some of them substantial.
Provider budgets are being squeezed, prescribing costs
are mounting, and a combination of targets and tariffs
has left commissioning budgets increasingly exposed.
Yet ‘turnaround’ interventions are still
predominately focussed on hospitals.
It is anticipated that 2006-07 will be
an even more financially challenging year for primary
care trusts, with the announcement (just 2 months before
the end of the financial year), that they are to receive
only 50% of the additional allocation required to purchase
activity levels under payment by results. This change
in policy alone is expected to leave huge ‘black
holes’ in PCT finances.
Practice based commissioning, service
redesign and proactive demand management are being promoted
as the keys to PCT financial recovery; yet they also
carry risks…
The CIPFA health advisory network will be running an
interactive workshop on 28 June 2006 in Central London
that will discuss and explore the radical approaches
being taken by some PCTs to try and restore financial
stability.
Workshop objectives:
- To identify and prioritise the major short-term
financial challenges faced by PCTs, and the warning
signs of deterioration
- To identify some of the levers that can be used
to change a ‘deficit’ mind set, with a
particular focus on practice-based commissioning
- To review the impact of PCT reconfiguration and
the ‘healthcare outside hospitals’ white
paper
- To understand the relationship between service
redesign, efficiency and the use of resources
- To highlight areas where the national tariff offers
a lever for improvement and efficiency gain
This workshop will be led by Noel Plumridge, Health
Service Journal columnist and author of CIPFA guides
to the Payment by Results system and to the finances
of long term illness.
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 www.ipf.co.uk/healthcare
or email Davina.Joseph@ipf.co.uk
A certificate of attendance is issued after all our
health network workshops, which can count toward your
CPD.
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HEALTH PANEL
The Panel last met on 25 April when the following
topics were considered included:
- The NHS Financial situation
- Financial Management in the NHS
- White Paper ‘Our health, our care, our say’
- A presentation on Education and Training in the
NHS
- Health Commission consultation Paper ‘Assessment
for Improvement’
- DH Draft Simplification Plan
- A progress report on work programme
- The next meeting of the Panel is planned for 18
July and comments/views are always welcome.
For more details visit www.cipfa.org.uk/panels/health
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PUBLIC MANAGEMENT AND POLICY
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:
28 June
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
5 October
Effective Inspection and Regulation in Education,
Training and Children’s Services –
David Bell, Permanent Secretary, Department for Education
and Skills.
*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 organisations: 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
departments’ ¬ 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
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/
Future Publications
More details will be published in future editions.
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PUBLIC REPORTING AND ACCOUNTABILITY
AWARDS
Finalists to be announced
The judging panel of the CIPFA/PricewaterhouseCoopers
PRA awards recently met to decide the finalists and
winners of the 2006 awards. We are in the process of
informing all those who have been shortlisted. All finalists
will be announced on the website, next week.
The winners will be announced at the ceremony, which,
for the first time, will be integrated into CIPFA’s
annual conference programme and will be followed by
the inaugural CIPFA/PricewaterhouseCoopers Accountability
Lecture given by Dr Tony Wright, MP, chair of the House
of Commons Public Administration Select committee.
For more details view www.cipfa.org.uk/awards/accountability.
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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 last week 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 at www.publicservants.org.uk.
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SUSTAINABILITY
CIPFA has launched a Sustainability microsite to raise
awareness amongst members about the development of the
topic area. The site will communicate current developments
and relevant information to members.
For more details visit www.cipfa.org.uk/pt/sustainability/index.cfm
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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
CHILDREN'S FUND
A £960 million initiative to improve services
for children and families at risk of social exclusion
has failed to put long-term strategies in place, according
to a government-backed evaluation.
The Children’s Fund, which runs until 2008, was
described as a “lost opportunity to build a more
sustainable strategy for prevention” by the study
published by the Department for Education and Skills.
It found agencies in some areas worked in isolation
from local authorities and other services “with
the consequent risk that learning could be lost”.
The active involvement of NHS partners was “extremely
variable”, it added.
The evaluation also found that agencies funded under
the initiative, which began in 2000, had paid “little
attention” to changing mainstream services to
make them work in more inclusive ways.
However, the report did have some praise for the fund,
saying it had “filled an important gap”
in provision for children not covered by Sure Start
or Connexions.
The evaluation is available from www.dfes.gov.uk
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CONSULTANT CONTRACTS
The new contract for senior hospital doctors in England
has cost a great deal more than anticipated and as yet
there is little evidence to show it is benefiting patients,
according to a new report from the King’s Fund.
‘Assessing the new consultant contract - A something
for something deal?’ is the first independent
report on the impact of the consultant contract in England,
based on a case study of five NHS trusts in London and
interviews with key national figures.
The new consultant contract, implemented in 2003, has
seen large increases in consultant pay and pensions,
but the study found little evidence so far to show consultants'
working practices have changed. It concludes that a
combination of rushed implementation, a serious underestimate
of existing consultant workloads and a lack of national
guidance has made it difficult for hospitals to use
the contract to bring about improvements for patients.
The report highlights evidence from the Department
of Health showing the contract cost £90 million
more to implement than was planned. Consultants’
pay has increased substantially over the last four years
with starting salaries rising by 36 per cent since 2001
(from £50,810 in 2001 to £69,298 in 2005).
The increased costs have put considerable pressure on
hospital budgets and have contributed to the size of
deficits faced by some trusts, according to the report.
But the report does identify potential advantages from
the new contract. It welcomes greater transparency about
the hours consultants work in the NHS and the duties
they undertake. It also supports the increased recognition
of the amount of work carried out by consultants in
the NHS.
For more details view www.kingsfund.org.uk
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DEPARTMENT OF HEALTH
The DH has published its Departmental report for 2006
which provides Parliament and the public with an account
of how the Department of Health has spent the resources
allocated to it, as well as its future spending plans.
It also describes their policies and programmes and
gives a breakdown of spending within these programmes.
The DH has also published a letter that builds on January's
"The NHS in England: the operating framework for
2006/07". It amplifies arrangements detailed in
that publication, and details the specific business
and financial rules which must operate this year. It
ensures that DH and the NHS continue to drive, and where
possible accelerate the Government's programme of healthcare
reform.
For more details visit www.dh.gov.uk
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NHS FINANCE
A pressure group of nearly 1,000 doctors has been
ruffling the feathers of NHS stalwarts by calling for
a rethink of the way health services are funded. In
letters to the three main political parties, the group
called Doctors for Reform (DfR) argues the time has
come to move away from an entirely tax-funded system.
It claims that the public supports its view, quoting
a poll by the think-tank Reform, showing that two-thirds
of the public feel that the service cannot meet the
demands made on it, no matter how much is spent on it.
But DfR has an uphill struggle to convince the majority
of its fellow healthcare professionals of its arguments.
The group has been condemned as 'dangerous mavericks'
by the health service union Unison and has not swayed
the BMA.
Doctors for Reform was set up two years ago and, in
that time, its membership has swelled from 500 to 949.
For more details view www.reform.co.uk
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NHS REFORM
The NHS must improve productivity, reduce variations
in performance, routinely measure health outcomes and
introduce more sophisticated incentive systems if it
is cope with lower growth in funding over the next five
years.
These are four of the biggest challenges facing the
NHS, according to a high-level summit held at Leeds
Castle in Kent and organised by the King’s Fund.
It was attended by senior officials, NHS managers, health
economists, doctors and leading policy analysts.
Experts at the summit discussed the implications for
the health service of a slow down in funding - widely
expected next year - at a time when the NHS is facing
financial problems and charged with making a success
of reforms to make improvements in performance.
The next comprehensive spending review in 2007 is
likely to announce real increases of between 3.0 to
4.4 per cent per year for the NHS up to 2011/12. Although
this is around half the annual amount the NHS has received
every year since 2000, spending on health care will
have reached nearly 10 per cent by 2008. This is up
to the European average spend on health care.
Improving productivity was identified as a key task
for the NHS. And evidence discussed at the summit suggested
that substantial improvements could be made if healthcare
organisations seriously tackled longstanding and unexplained
variations in hospital and clinical performance across
the country.
The summit said the NHS should start as soon as possible
to measure the impact of its services on the health
of patients. This was seen as essential to provide the
information to help improve performance and productivity,
make a reality of patient choice, and to give primary
care trusts and GP practices the data they need to improve
the purchase of care.
Ensuring that the NHS and its staff were given incentives
to innovate and improve performance was also essential.
But the summit agreed more work was required to understand
what motivates organisations and in particular staff.
Financial incentives, such as Payment by Results, will
play a part but there was a pressing need to investigate
other non-financial motivational factors.
For more details view www.kingsfund.org.uk
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OUT OF HOURS CARE
There were shortcomings in the process of setting
up new arrangements to provide out-of-hours primary
medical care in 2004, although there is no evidence
that patient safety was compromised, the National Audit
Office reported today. The Primary Care Trusts (PCTs)
who took over responsibility for organising out-of-hours
services from GPs lacked knowledge and experience in
this area. However, most patients say that they are
receiving a good service, with six out of ten rating
it as excellent or good.
The report finds that, after some initial problems,
the service is beginning to reach a satisfactory standard,
but that no providers are meeting all the required levels
of performance and few are achieving the required levels
for speed of response. The report also finds that the
actual costs of providing out-of-hours care under the
new system are considerably more than the specific Department
of Health allocation made to support these services
and that there is scope to reduce costs without compromising
quality.
For more details view www.nao.org.uk
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PRIMARY CARE TRUSTS
Health Secretary Patricia Hewitt has announced a reorganisation
of Primary Care Trusts (PCTs) in England.
The number of PCTs will be reduced from 303 to 152
and the new organisations will be able to commission
the very best services for their local people, that
are shaped around the needs of patients and deliver
the very best value for money for taxpayers.
This announcement is the final part of the Commissioning
a Patient-Led NHS consultation, which ended on 22nd
March. Local public consultations were held by the 28
existing Strategic Health Authorities and the decisions
are based on the results of those consultations.
The new PCTs will be more closely aligned with Local
Authority boundaries and patients will benefit from
more joined-up working with the NHS and social services
covering the same areas. More than 70% of PCTs will
mirror Local Authority boundaries meaning that patients
will have all of their needs looked at and avoid unnecessary
duplication.
Maps of the old PCT and the new PCT boundaries are
available from www.dh.gov.uk
The Secretary of State has also agreed that no uplift
would be made to the allowances and locum payments paid
to PEC chairs and members for 2005/06.
More details are available at www.dh.gov.uk
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