LATEST
ARTICLES
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
__________________________________________________
Public Policy Media
Richard Vize