Northern cities must lead HS2 debate 27 September 2013 The HS2 lobby should get the cities and towns that would benefit most from it to lead the campaign to get it built. Depending on the route, the beneficiaries include Birmingham, Manchester, Sheffield, Derby and Leeds. Sir David Higgins, the newly appointed chairman of the HS2 rail link, said yesterday that it is essential the £50bn scheme has cross-party backing. His remarks followed shadow chancellor Ed Balls' intimation that Labour might withdraw support if the costs climb. By threatening to withdraw Labour consent, Balls sees an opportunity to tout Labour's message that it can be trusted with taxpayers' money while kyboshing one of Chancellor George Osborne's flagship projects. The uncertainty is fuelled by the extraordinarily long and complex procedure for getting the route agreed, punctuated by court and parliamentary battles. Read the full article on the Guardian local government network __________________________________________________ Primary care crisis is driving change 20 September 2013 Primary care is about to be seized by a degree of turbulence and change that will make the acute sector look ordered and calm. The pressures for change are coming from every direction: the short-term crisis in A&E, the long-term need to move care out of hospitals, the need to improve access to GPs while reducing their workload, the tightening economics of general practice and the need to improve clinical quality. Looming over all this is the determination of Jeremy Hunt, the health secretary, to claim the government has "sorted out primary care". His speech to the King's Fund last week made plain his game: having decided that the Labour's 2004 GP contract is the source of problems ranging from poor care of older people to A&E pressures, he is going to rewrite it by next April, sweeping away bureaucracy and securing a "dramatic simplification" of targets and incentives. Read the full article on the Guardian healthcare network __________________________________________________ Labour is stuck in policy black hole 13 September 2013 Labour Leader Ed Miliband has talked in broad terms about the need for a Labour government to "get on with devolving power away from Westminster to English local authorities and the people, without the need for mayoral referendums or such-like". However, as in other policy areas – where we had had to put up with the usual platitudes trotted out by opposition parties – we still don't know the party would actually do. Intriguingly, Miliband opens up the prospect of Labour introducing mayors without local consultation, but beyond that morsel we don't know what he means by devolution. Read the full article on the Guardian local government network __________________________________________________ Playing politics with the top NHS job 3 September 2013 Applications for the post of NHS England chief executive close this week. The winning candidate will be made or broken by their ability to negotiate the politics of health policy. While choosing the successor to Sir David Nicholson is nominally in the hands of NHS England chair Sir Malcolm Grant, in reality he will be sidelined from the process. Health secretary Jeremy Hunt will be in control, and Downing Street will be all over it. In terms of the Conservatives' electoral chances, this appointment is as important as the governor of the Bank of England. Like the Bank of England position, this is a role with an international profile, which will be filled after an international search. But the central role of politics in the job is a complicating factor when looking for candidates overseas. Read the full article on the Guardian healthcare network __________________________________________________ Councils risk hypocrisy on NHS cuts 30 August 2013 Councils are becoming increasingly aggressive in their opposition to hospital trust moves, such as changing an accident and emergency unit into a more modest urgent care centre. In the high court, Lewisham council won a major victory, blocking changes to their local hospital that were part of a plan to save the imploding South London Healthcare Trust. In west London, Ealing is objecting to changes to A&E services, while down the M4 Windsor and Maidenhead is fighting a plan to move a minor injuries unit to Bracknell and close a birth unit. Trafford council has voted unanimously to fight the closure of the A&E unit at Trafford general hospital, which at peak times see seven patients an hour according to the Department of Health, and expand services nearby. Read the full article on the Guardian local government network __________________________________________________ GPs must give telehealth a chance 27 August 2013 The greatest benefits from telehealth are yet to come – as a catalyst for service integration and patient empowerment. But these will only be realised if doctors stop looking for opportunities to reject it. The development of telehealth has been dogged by politicisation of the issue and the way the conclusions of the "whole system demonstrator" programme were interpreted and debated. Health secretary Jeremy Hunt is firmly committed to telehealth. The day after the publication last November of the first NHS Mandate, identifying its priorities for the coming years, he confirmed that seven pathfinders run by the NHS and councils would be signing contracts to provide access to telehealth for 100,000 people this year. Read the full article on the Guardian healthcare network __________________________________________________ Building a dementia friendly world 8 August 2013 The idea of dementia-friendly communities brilliantly encapsulates what a progressive care system could deliver, both for those who need support and for the taxpayer. The concept is simple: to improve the quality of life for people with dementia and help them to become active members of the community. Making it happen involves bringing together every part of a community – health services, social care, transport, local businesses, charities and voluntary groups, the police, the fire brigade and local people. Clinical commissioning groups (CCGs) are at the heart of the dementia-friendly drive, and their approach demonstrates how healthcare can and should extend well beyond the borders of the NHS. Read the full article on the Guardian healthcare network __________________________________________________ Civil service has a great deal to learn 2 August 2013 The cabinet office behavioural insights team – the "nudge unit" – has set up a training programme called Policy School. Responding to criticism that much civil service training is lecture-based, fast-track civil servants are given four days to design a policy that requires little investment, saves money and improves services. One of the first groups through the system was asked to design a programme to improve the health and lives of older people in a London borough. The results were less than impressive. This well-meaning stab at improving the policy-making quality of civil servants highlights the serious flaws that endure in the training and development of senior public servants. Despite many years of sporadic effort to open up civil service recruitment, it still fails in the essential test of learning from the outside talent it attracts. Read the full article on the Guardian local government network __________________________________________________ Confusion reigns over urgent care 25 July 2013 Who is in charge? Hidden among the predictable dissection of urgent and emergency care woes in the health select committee report, published on Wednesday, are serious concerns about whether the myriad of new NHS bodies are capable of sorting the problems out. Few people would look at the new NHS structure – which bears more than a passing resemblance to the piping diagram for a gas works – and conclude that what the NHS needs is yet more organisations. But that was indeed what NHS England decided when faced with growing problems in A&E. Ignoring the primacy of clinical commissioning groups, it imposed urgent care boards across the country, under the auspices of its local area teams, charged with rapidly producing plans to sort out A&E. But it then seemed to lose its nerve. Read the full article on the Guardian healthcare network __________________________________________________ Gove’s flawed solution for Doncaster 19 July 2013 The education secretary's decision to strip Doncaster council of its children's services is a turning point in relations between central and local government in the leadership of child protection. On Tuesday, Michael Gove ordered that all the council's children's services apart from education be run by an independent trust for at least five years. This means that, from next April, the secretary of state will be responsible for the safety of Doncaster children. The decision follows the recommendations of a government commissioned review led by professor Julian Le Grand. It is, as the report acknowledges, a major development in children's services. Read the full article on the Guardian local government network __________________________________________________ When will Hunt fall through the ice? 11 July 2013 So far, Jeremy Hunt has been skating over the NHS ice with the practised ease of an impressive communicator. When will he fall through? In the wake of the Francis inquiry, the health secretary has shrewdly positioned himself as the patients' champion against the vested interests of the healthcare system. He moves quickly to condemn failure, even if, as in the case of the Care Quality Commission's recent convulsions over the Morecambe Bay maternity failures, he is not in possession of all the facts. (The unravelling of the Grant Thornton report into the CQC's supposed cover-up means there is now the prospect of an investigation into the investigation into the investigation into the investigation. Read the full article on the Guardian healthcare network __________________________________________________ Cockell takes the fight to ministers 5 July 2013 Calibrating a Cockell is a delicate science. Cockells are not instruments given to wild swings between boundless joy and rage, but nuanced fluctuations between cautious optimism and irritation. And on Tuesday it was clear Local Government Association leader Sir Merrick Cockell, opening its annual conference in Manchester, was very irritated. The result? The best speech he has given as LGA leader. In measured but firm, often edgy tones he took the fight to both the government and the opposition. He threw at them not demands for more money or a wishlist for a localist Utopia but hard-edged, practical policies to allow councils to help local businesses grow and to redesign public services for a future short of cash but enriched by technological and community resources. Read the full article on the Guardian local government network __________________________________________________ Meet the new public health masters 4 July 2013 How is public health run now? Under the Health and Social Care Act 2012 most public health functions carried out by primary care trusts moved to 152 local authorities—unitary, metropolitan, and county councils and London boroughs. These authorities are responsible for promoting population health and reducing inequalities. Councils now run a diverse range of programmes such as smoking cessation, drug and alcohol services, obesity prevention, and prevention and treatment of violence. The 2012 act created an executive agency, Public Health England, which is part of the Department of Health rather than NHS England. Its responsibilities include health protection, providing information and data, and developing the workforce. Read the full article at the British Medical Journal __________________________________________________