LATEST
ARTICLES
What if the media come for you?
27 June 2013
So what will you do if you are the next NHS organisation to be
engulfed in a crisis? The current febrile run of accusation and
rebuttal around the failure of Morecambe Bay's maternity
service and its oversight is by no means a unique example of
how the public, politicians and the media react when the health
service gets it wrong.
There is a strong punitive element in the reaction to a crisis – a
requirement to identify and punish individuals deemed to be at
fault – and it is extraordinarily difficult for managers to explain
the context in which they are working or the pressures they are
under.
Read the full article on the Guardian healthcare network
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The unsparing truth about death
21 June 2013
Local government has endured many league tables over the
years, revealing performance on everything from litter to benefit
payments. Now it has a league table of death.
Public Health England's new Longer Lives website paints in
vivid red the toll of premature mortality – before 75 years –
council by council.
Read the full article on the Guardian local government network
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Community budgets grind slowly
on
14 June 2013
Even by the lamentable standards of Whitehall pilots and
initiatives on local government, the community budget
programme is frustrating in its sloth and lack of ambition. But
there is hope.
The four pilots are not actually intended to make it work - they
are supposed to be proving the concept. It is now proved, so
let's get moving.
As Local Government Association leader Sir Merrick Cockell
told a communities and local government select committee
hearing on the budgets: "Now is the time to move from an
acceptance that it is validated to delivery; there is no reason to
hold back."
Read the full article on the Guardian local government network
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Picking up the pieces of surgery
review
13 June 2013
The Independent Reconfiguration Panel's demolition of
proposals for reconfiguring children's heart services has set the
benchmark for all future service reviews.
The panel told the health secretary, Jeremy Hunt, that the
review of children's heart services had failed in its objective of
recommending a safe, sustainable and accessible way forward.
Read the full article on the Guardian healthcare network
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Nicholson: passion and
centralism
10 June 2013
Sir David Nicholson’s last speech to the annual NHS
Confederation conference as the leader of the service reflected
all the traits of his seven years in control.
His passion, commitment, and drive were undeniable, but he
failed to acknowledge mistakes which had undermined patient
care, gave little time to the role of local clinical commissioners,
and saw centralised direction as the overriding driver of
change.
Read the full article at the British Medical Journal
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A look into local government's
abyss
7 June 2013
The public accounts committee's dissection of the funding cuts
to local government exposes flaws and ignorance in ministerial
thinking which have been apparent to councils for many
months.
Take, for example, the failure of government to analyse how
cuts in one service may affect demand on another. Cuts to
social care are undoubtedly contributing to the current crisis in
some A&E departments because social workers are unable to
provide the support to allow many older people to be
discharged from hospital promptly.
Read the full article on the Guardian local government network
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Will there be NHS cultural
revolution?
5 June 2013
The NHS in England is awash with promises of change. In the
wake of health reforms and the Francis inquiry into the Mid-
Staffordshire scandal – which examined the failure of the
system to identify and act upon poor standards of care that
may have led to hundreds of deaths between 2005 and 2009 –
staff have been bombarded with vows of clinical leadership, an
end to bullying and a renewed focus on patients. But will NHS
managers really take this on board?
Read the full article at the Guardian
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Hunt’s political games batter NHS
30 May 2013
Eight weeks after their implementation, Andrew Lansley's
reforms have already been battered by his successor. The
politicians are just as in charge of the NHS as ever, while
clinical commissioners are being marginalised.
The reason is that Jeremy Hunt is already focused on the
campaign for the next general election, a fact he does little to
hide from his advisers. His policies are driven by political point
scoring and gestures.
Read the full article on the Guardian healthcare network
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Can councils help defeat
extremism?
24 May 2013
As the country comes to terms with the first terrorist killing in
Britain since the 7/7 bombings, local government will again be
at the frontline of keeping communities together. But what
should it do?
Councils are faced with two priorities: dealing with immediate
problems such as the risk of further violence, and then the
more complex issues of keeping communities together and
tackling radicalisation.
Read the full article on the Guardian local government network
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Ofsted exposes faultline in
education
17 May 2013
A sharply worded attack on regulator Ofsted by the senior
managers' organisation Solace has again exposed fault lines
on local government's role in education.
On Tuesday, Ofsted unveiled its new inspection framework for
local authorities' school improvement services. Solace claimed
that in doing so the regulator "harks back to a bygone era" of
council control over schools that "simply no longer exists".
Read the full article on the Guardian local government network
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Long, difficult road to integrated
care
17 May 2013
There is a great deal to welcome in the announcement from
health minister Norman Lamb that there will be a big push to
integrate health and social care, but the road ahead is longer,
more difficult and considerably more costly than the
government recognises.
The plans provide an ambition around which all care services
can unite, and there is a strong commitment to identifying and
overcoming the barriers, through the work of at least three
waves of large-scale pioneer areas backed up by a dedicated
central team.
Read the full article on the Guardian healthcare network
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Councils hold the key to youth
jobless
3 May 2013
One of the few pieces of economic good news is the way
employment has held up as the economy has flat-lined. But the
latest jobless figures revealed that 979,000 16- to 24-year-olds
are out of work. Across the country local government is
scrambling to get young people into training and jobs. They are
having some success, but they could do so much more if the
government would co-operate.
The strength of the best local government programmes is that
they are finely tuned to the needs of both local employers and
young people.
Read the full article on the Guardian local government network
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Cuts and inertia could crush the
NHS
2 May 2013
The NHS is in danger of being crushed between a funding cut
and political inertia over the need to reconfigure services.
While the outcome of the chancellor's spending review will no
doubt contain some financial sophistry to maintain the fiction
that health spending is growing in real terms, in reality NHS
spending is going to be cut as money leaches out to social
care. Whatever George Osborne says on 26 June, the cuts will
catch up with the NHS after the general election.
Read the full article on the Guardian healthcare network
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Commissioners grapple with role
25 April 2013
At the first conference of NHS Clinical Commissioners — an
independent group launched by the NHS Alliance, NHS
Confederation, and National Association of Primary Care —
introspection was refreshingly absent. While there were
concerns about workload and the risk of conflicts of interest as
commissioners invest in primary care, the focus was very much
on the big picture of their new role.
Read the full article at the British Medical Journal
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The localist flirtation is over
19 April 2013
Anyone needing to be convinced that the coalition's flirtation
with localism is over only has to look at the last couple of
weeks. As well as trying to secure unwarranted changes to
planning rules, the government is imposing ministerial control
over council publishing and has admitted it has abandoned any
monitoring of Whitehall departments' progress towards
localising powers.
Read the full article on the Guardian local government network
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What can CCGs learn from PCTs?
18 April 2013
Next week the NHS Confederation, supported by NHS Clinical
Commissioners, is launching Reflections on a Decade of
Commissioning, which looks at the experiences, difficulties and
achievements of primary care trusts and analyses what it all
means for the new regime. (Disclosure: I wrote the report).
The most powerful message is that the success or failure of a
clinical commissioning group will in many ways be determined
by how well it engages with both the public and its member
practices.
Read the full article on the Guardian healthcare network
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Public health is big local chance
5 April 2013
Amid the cuts and redundancies, local government's new
responsibility for public health is a great opportunity.
While public health is hardly new territory for councils – more
than 80 public health directors were joint appointments
between councils and primary care trusts – formal assumption
of the powers is momentous.
Read the full article on the Guardian local government network
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Leeds suspension is taste of the
future
4 April 2013
The suspension of children's heart surgery at Leeds general
infirmary and the subsequent battle to restart operations is a
foretaste of what will become a familiar chain of events in the
NHS post Mid-Staffordshire.
In his final report, Robert Francis QC is unequivocal on the
requirement for services to meet fundamental standards to be
set out in the NHS constitution. Expressions such as "no
tolerance of non-compliance" and "rigorous policing" make
clear that managers or clinicians hoping to make do could lay
their organisation – and possibly themselves – open to
prosecution if death or serious harm results.
Read the full article on the Guardian healthcare network
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Goodbye to PCTS - good
riddance?
2 April 2013
Did primary care trusts improve healthcare? It took just 13
years for them to be created, merged, clustered, and
abolished. During that time they were responsible for about
80% of the NHS budget in England.
The original 303 PCTs across England began taking over from
district health authorities and primary care groups in 2000. In
2006 they were merged to form 152 organisations and
instructed to begin withdrawing from running community
services-known in the artless syntax of Whitehall as
"separating out their provider arm"-to focus on commissioning.
Read the full article in the British Medical Journal
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Public Policy Media
Richard Vize