Europhiles need to shout about benefits 20 March 2014 As Nigel Farage and Nick Clegg scrap over the UK's future in the EU, the public sector has already given its verdict. Guardian research unveiled on Tuesday at its Public Leaders' Summit that no single issue is less important. When senior public sector staff were asked their key challenges over the next 12 months, engaging with the EU came last. Only 7% of respondents mentioned it. Does Europe matter at all to local government? In the 1980s and 1990s EU funding was a big local government focus. Areas of high poverty, or where there had been rural or industrial decline – mine closures, for instance – all benefited substantially from EU largess. Read the full article on the Guardian local government network __________________________________________________ Who is blocking change in the NHS? 20 March 2014 In his last days as NHS England chief executive, Sir David Nicholson has warned that the health service is doomed to long-term decline unless it reforms comprehensively and fast. So who is blocking change and what should happen to them? In an interview last week with the Guardian's Denis Campbell, Nicholson argued that it requires "massive change, on a scale we've never seen before, and over a shorter period of time than we've ever seen before in healthcare". He envisages huge centralisation of specialist services and emergency care, alongside substantial expansion of primary and community care and far closer co-operation between clinicians inside and outside hospitals. Read the full article at the Guardian Healthcare Network __________________________________________________ Leadership training in wake of Francis 18 March 2014 Leadership has been identified as the cause of NHS failures and the cornerstone of the solutions. Intolerance of management shortcomings since the Francis Inquiry has led 10 trust chief executives to resign, while thousands of managers and trainees have been undergoing leadership development in pursuit of high quality, compassionate care. In his final report last February into the failings at Mid- Staffordshire NHS Foundation Trust, Robert Francis QC laid bare repeated leadership failures at the root of the collapse in quality in parts of Stafford Hospital. Read the full article in Health Manager (page 15) __________________________________________________ Social care cuts: councils’ guilty secret 17 March 2014 Government underfunding of the reforms enshrined in the Care Bill could finally bring the crisis in social care funding into the open. The reforms, including a cap on what people will have to pay for care and a deferred payment scheme so that people will not have to sell their home, will cost local and central government a great deal of money while failing to meet the expectations generated by this complicated and widely misunderstood legislation. A survey by the County Councils Network has revealed overwhelming concern that the changes are going to increase pressures on social care budgets. Read the full article on the Guardian local government network __________________________________________________ Labour seeks solution to messy problem 7 March 2014 Labour’s independent commission on health policy has made some welcome recommendations on integrated care and system reform, but could create conflict between the NHS and local government. The commission, led by respected GP Sir John Oldham, develops the idea of “whole person care” championed by shadow health secretary Andy Burnham, intended to bring together physical and mental healthcare with social care. It calls for the Payment by Results system to be reformed to stop rewarding episodic care in hospitals, and advocates outcome based commissioning. Read the full article at the BMJ __________________________________________________ Contradictions in Labour’s health plans 7 March 2014 The proposals for Labour's health policy, unveiled this week, open up the prospect of profound changes in the local and national system of leadership of the NHS. The report, One Person, One Team, One System, is the outcome of the party's commission on "whole person care" led by GP Sir John Oldham. Championing integrated health and social care, it is strongly focused on making the system fit round the needs of individuals. It calls for the abolition of the current competition rules and for the loathed Office of Fair Trading to be kept out of the NHS. Read the full article at the Guardian Healthcare Network __________________________________________________ Addenbrooke’s leader’s sight on success 5 March 2014 As a one-time special forces sniper and a former transplant physician, Keith McNeil, chief executive of Addenbrooke's hospital, Cambridge, has little time for leaders who can't make decisions. "If you are in a position where you're supposed to make decisions and you can't, get out of the chair and let someone sit there who will," he says. The report into the Mid-Staffordshire NHS scandal is among several that have identified poor leadership as a cause of service failures. The NHS is now investing tens of millions in leadership training. McNeil calls himself a leader, not a manager. Read the full article at Guardian Society __________________________________________________ Managing a local government startup 28 February 2014 For the staff who survive the repeated culls of the payroll, working in the leaner, riskier local government that is emerging could be an exhilarating time. It will also be stressful and risky. The report Beyond Nudge: to demand management, published by the RSA, highlights the need for councils to reduce reliance on traditional public services and have a more collaborative relationship with local people. The skills that will be needed – such as the ability to rapidly analyse and evaluate information, judge risk and make decisions independently – do not respect professional hierarchies or depend on technical training; the staff able to excel in this new world may well be those who are already working in the community, while those who are internally- and process-focused could struggle. Read the full article on the Guardian local government network __________________________________________________ NHS manager body count mounts 20 February 2014 The NHS management body count is mounting. In the year since Robert Francis QC unveiled his final report following the Mid-Staffordshire scandal, 10 chief executives have resigned over performance issues. Is this a sign of a commitment to the highest standards of leadership, or a system where senior managers are being set up to fail? Seven chief executives have quit from foundation trusts, and three from trusts. At least three more are in difficulties. A trawl through Health Service Journal's coverage of the departures reveals a catalogue of failure. Read the full article on the Guardian healthcare network __________________________________________________ Emergencies will be the toughest test 14 February 2014 For many councils, the floods have swept emergency planning and response to the front of their priorities. Once the cameras and cabinet ministers have left, it will be local authorities who are there for the long haul with residents, while playing a central role in rewriting national and local plans to cope with future disasters. While the media narrative has focused on the Environment Agency, warring cabinet ministers, the emergency services and the increasing involvement of the military, local government's role has largely gone unremarked. Read the full article on the Guardian local government network __________________________________________________ No-one can challenge power of FTs 10 February 2014 The unravelling of the plans by Oxfordshire clinical commissioning group to introduce outcomes-based service contracts shows that while commissioners have the money, providers are still running the system. What will it take to break their power? Oxford health foundation trust and Oxford University hospitals trust's forceful objections to plans for outcomes-based commissioning of adult mental health, maternity and older people's services included the fact that the changes would introduce new financial and clinical risks and affect the local health workforce. But they supported the overall aims, of course. Read the full article on the Guardian healthcare network __________________________________________________ Cuts could force local tax revolution 28 January 2014 The public spending crisis which will follow the general election could be the catalyst for a local government finance revolution. After chancellor George Osborne's budget last March, the Institute for Fiscal Studies warned that tax rises of £9 bn – equivalent to 2p on basic rate income tax – might need to be imposed after the 2015 election to fund the gap in public services. Despite the improved economic prospects the issue of tax rises will return. National politicians are trying to ignore this but local government should seize on it, and propose that a substantial part of the additional revenue should come from local taxation as an alternative to national tax rises. Read the full article on the Guardian local government network __________________________________________________ NHS crisis urgently needs leadership 23 January 2014 The NHS is haemorrhaging its two most valuable resources – money and morale. So who is going to take the tough decisions to prevent a crisis next year? In its latest monitoring report, the King's Fund reveals that financial problems are seeping into every part of the system – trusts, foundation trusts and clinical commissioning groups are all sliding toward deficit in substantial numbers. One in five trusts and one in eight clinical commissioning groups say they are at risk of overspending by the end of this financial year. Read the full article on the Guardian healthcare network __________________________________________________ CCGs start to restructure services 21 January 2014 Clinical commissioners are beginning to demonstrate how they are improving patient services, countering the lack of attention they are getting from politicians. The health reforms were intended to put clinical commissioners at the heart of the drive to improve quality and reconfigure services. But since they took over from primary care trusts in April, clinical commissioners have not fitted in with the political direction being pursued either by health secretary Jeremy Hunt, or the shadow health secretary, Andy Burnham. Read the full article at the BMJ __________________________________________________ Prospects for radical hospital reform 9 January 2014 The picture for the coming year that emerges from senior managers and clinicians is of a hospital sector determined to transform pathways, integrate with social services and use community-based care to slash demand for beds. But their plans risk being overwhelmed by a dysfunctional payment regime and an absence of system leadership. Underpinning everything is the need for recurrent savings of around 5-6 per cent. The overwhelming priority for 2014 is to reform care to avoid financial crisis, without undermining quality. Read the full article at Health Service Journal __________________________________________________ Has patient power been forgotten? 9 January 2014 With increasing numbers of NHS trusts destined to slide into the financial mire this year and next, there is one resource of which hard pushed hospitals enjoy a plentiful but underused supply – patients. They are the best hope for cutting demand and transforming services. "Coproduction" is up there with "integration" and "transformation" in the NHS lexicon of abused words. It is intended to signify clinical staff involving patients in deciding the best course of treatment. As health secretary, Andrew Lansley pitched this as "no decision about me without me". Read the full article on the Guardian healthcare network __________________________________________________