Richard Vize Public Policy Media Ltd
LATEST ARTICLES
CV
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. As traditional services are cut, local authorities will need to stitch together disparate, uneven provision from a wide variety and quality of sources. Council staff will be reliant on constantly changing networks that will do much of the work but ultimately carry little of the responsibility. The risks in both assessing and meeting need will be multiplying, while staff will find it harder to influence quality and effectiveness. 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. Treatment delays, understaffing, weak leadership, bullying, data irregularities, missed targets, deteriorating finances, unsafe care, A&E mismanagement and poor governance litter the charge sheets. Read the full article on the Guardian healthcare network ____________________________________________________________________ MoD finally gets grip on procurement 18 February 2014 Two reports by the National Audit Office reveal that the Ministry of Defence, long notorious for runaway overspends on major projects and equipment, is finally getting a grip on its procurement and financial management. The NAO’s review of the MoD’s annual Major Projects Report concluded that in 2012-13 there was a net cost increase of £708 million across the 11 projects the NAO analysed, representing cost growth of 1.4% against planned spending of £49.5 billion. But £754 million of cost increase was accounted for by the new aircraft carriers, which means there is a net decrease of £46 million across the 10 remaining projects. The NAO says the carriers are the only significant cost increase in the last two years. Read the full article at Procurement Insider ____________________________________________________________________ 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. But councils have been running emergency operations centres to co- ordinate thousands of staff working round the clock to identify and help vulnerable residents, evacuate people, find emergency accommodation, pump water, provide chemical toilets, keep roads open, keep roads closed, tell people what is happening, liaise with other services and deliver sandbags. 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. Tell any discussion on public service reform that the public sector needs a new attitude to risk, and you can be sure that your comment will be greeted with vigorous nods. But commissioners and providers need to turn those sentiments into action. If introducing new risks is going to be an acceptable reason for torpedoing reform proposals, then we will remain lumbered with the old risks of running out of money while fitting our patients into services instead of building services round patients. 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 ____________________________________________________________________ Two broadsides target procurement 28 January 2014 Chief procurement officer Bill Crothers has launched a coruscating attack on IT suppliers, while the Institute for Government has dissected commissioning and found it seriously flawed. How should procurement teams react? Perhaps emboldened by the Order of the Bath he received in the New Year Honours, Crothers piled in to some big IT suppliers in a BBC interview “who have had it too good for too long”, accusing them of conducting an abusive relationship with government and indulging in appalling, monopolistic behaviour. His remarks came as the Cabinet Office announced rules – to some extent reaffirming existing arrangements – that government IT contracts will no longer be automatically extended and new contracts should not exceed £100m. Crothers remarks came the last Friday, the day after the Institute for Government launched Beyond Big Contracts, an analysis of the consequences of the coalition’s market-focussed ‘open public services’ drive. Read the full article at Public Procurement Insider ____________________________________________________________________ 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. Monitor has previously reported that an increasing number of foundation trusts are running up deficits. Read the full article on the Guardian healthcare network ____________________________________________________________________ Lamb joins competition reform calls 21 January 2014 Ministers are finally acknowledging the folly of the way competition laws have been imposed on the NHS. Reform is urgently needed. It is not that competition for the provision of NHS services is inherently a bad idea. On the contrary, it can be a useful tool for improving quality and efficiency. The problem is the doctrinaire, unsophisticated way it has been applied. Health minister Norman Lamb has called for the Office of Fair Trading to be excluded from making judgements about whether activity in the NHS is anti- competitive. He is right to do so. The OFT has a purist interpretation of competition which does not work in the context of a cash-limited state healthcare system. Read the full article at Public Procurement Insider ____________________________________________________________________ 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. Hunt’s determination not to mention the health reforms means clinical commissioners have rarely been part of his narrative about improving the NHS. Crucially, his response to the Mid Staffordshire scandal has been to focus on regulation rather than commissioning as the way to avoid future crises. Indeed, commissioners often feel disconnected from the work of the Care Quality Commission in their area. 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. Trusts are turning to sophisticated tools to understand patient flows, identify bottlenecks, see services through patients' eyes and model new ways of working. They cannot afford the financial and safety risks of redesigns based on weak evidence, while clinicians need convincing data, rather than pleas to save money, to change the way they work. 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
January to February 2014
Richard Vize Public Policy Media Ltd
LATEST ARTICLES
CV
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. As traditional services are cut, local authorities will need to stitch together disparate, uneven provision from a wide variety and quality of sources. Council staff will be reliant on constantly changing networks that will do much of the work but ultimately carry little of the responsibility. The risks in both assessing and meeting need will be multiplying, while staff will find it harder to influence quality and effectiveness. 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. Treatment delays, understaffing, weak leadership, bullying, data irregularities, missed targets, deteriorating finances, unsafe care, A&E mismanagement and poor governance litter the charge sheets. Read the full article on the Guardian healthcare network ____________________________________________________________________ MoD finally gets grip on procurement 18 February 2014 Two reports by the National Audit Office reveal that the Ministry of Defence, long notorious for runaway overspends on major projects and equipment, is finally getting a grip on its procurement and financial management. The NAO’s review of the MoD’s annual Major Projects Report concluded that in 2012-13 there was a net cost increase of £708 million across the 11 projects the NAO analysed, representing cost growth of 1.4% against planned spending of £49.5 billion. But £754 million of cost increase was accounted for by the new aircraft carriers, which means there is a net decrease of £46 million across the 10 remaining projects. The NAO says the carriers are the only significant cost increase in the last two years. Read the full article at Procurement Insider ____________________________________________________________________ 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. But councils have been running emergency operations centres to co-ordinate thousands of staff working round the clock to identify and help vulnerable residents, evacuate people, find emergency accommodation, pump water, provide chemical toilets, keep roads open, keep roads closed, tell people what is happening, liaise with other services and deliver sandbags. 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. Tell any discussion on public service reform that the public sector needs a new attitude to risk, and you can be sure that your comment will be greeted with vigorous nods. But commissioners and providers need to turn those sentiments into action. If introducing new risks is going to be an acceptable reason for torpedoing reform proposals, then we will remain lumbered with the old risks of running out of money while fitting our patients into services instead of building services round patients. 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 ____________________________________________________________________ Two broadsides target procurement 28 January 2014 Chief procurement officer Bill Crothers has launched a coruscating attack on IT suppliers, while the Institute for Government has dissected commissioning and found it seriously flawed. How should procurement teams react? Perhaps emboldened by the Order of the Bath he received in the New Year Honours, Crothers piled in to some big IT suppliers in a BBC interview “who have had it too good for too long”, accusing them of conducting an abusive relationship with government and indulging in appalling, monopolistic behaviour. His remarks came as the Cabinet Office announced rules – to some extent reaffirming existing arrangements – that government IT contracts will no longer be automatically extended and new contracts should not exceed £100m. Crothers remarks came the last Friday, the day after the Institute for Government launched Beyond Big Contracts, an analysis of the consequences of the coalition’s market- focussed ‘open public services’ drive. Read the full article at Public Procurement Insider ____________________________________________________________________ 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. Monitor has previously reported that an increasing number of foundation trusts are running up deficits. Read the full article on the Guardian healthcare network ____________________________________________________________________ Lamb joins competition reform calls 21 January 2014 Ministers are finally acknowledging the folly of the way competition laws have been imposed on the NHS. Reform is urgently needed. It is not that competition for the provision of NHS services is inherently a bad idea. On the contrary, it can be a useful tool for improving quality and efficiency. The problem is the doctrinaire, unsophisticated way it has been applied. Health minister Norman Lamb has called for the Office of Fair Trading to be excluded from making judgements about whether activity in the NHS is anti-competitive. He is right to do so. The OFT has a purist interpretation of competition which does not work in the context of a cash-limited state healthcare system. Read the full article at Public Procurement Insider ____________________________________________________________________ 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. Hunt’s determination not to mention the health reforms means clinical commissioners have rarely been part of his narrative about improving the NHS. Crucially, his response to the Mid Staffordshire scandal has been to focus on regulation rather than commissioning as the way to avoid future crises. Indeed, commissioners often feel disconnected from the work of the Care Quality Commission in their area. 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. Trusts are turning to sophisticated tools to understand patient flows, identify bottlenecks, see services through patients' eyes and model new ways of working. They cannot afford the financial and safety risks of redesigns based on weak evidence, while clinicians need convincing data, rather than pleas to save money, to change the way they work. 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