Strategic partner updates for July 2013

Thu,25 July 2013
News

Health and Social Care update from our work as Strategic Partner to the Department of Health, NHS England and Public Health England

Disability Rights UK continue to focus on taking user-driven commissioning into the NHS (including a ‘right to peer support’ with substantial roles for ULOs). 

This month’s update includes news and insights on the new health and social care reforms, Care Bill, NHS Call to Action, community capacity development, Care Quality Commission, health and housing and the vulnerable older people’s plan for example. It will be important reading for everyone who thinks that social care service users, patients and their families and friends should have a much greater role in social care and the NHS. If you would like to discuss anything in greater depth, do get in touch with Strategic Partnership Manager Bernd Sass. Bernd.sass@disabilityrightsuk.org . He is looking forward to your views and contributions. For the update see disabilityrightsuk.org/healthandsocialcare.htm

The Strategic Partners (SPs) last met on 16 July 2013:

  1. Disability Rights UK, Shaping Our Lives and Change will add to the work of Regional Voices and build on their existing resources to inform members and networks about the health and social care reforms, for example http://disabilityrightsuk.org/policy-campaigns/health-and-social-care-reforms/health-and-social-care-reforms-glance The King’s Fund has produced a video taking a wide systems perspective http://www.kingsfund.org.uk/projects/nhs-65/alternative-guide-new-nhs-england . We aim to illustrate what the new system offers to individual disabled people and how they can have our voices heard.
  2. A forthcoming report by NAVCA and Regional Voices will focus on social value and promote it in the public sector.
  3. The Strategic Partners (SPs) will revisit the Secretary of State’s priorities and as far as possible align their workplans with them. A list of top layer themes needs to be produced to start.
  4. The SPs will create the foundations for a proper audit of Joint Strategic Needs Assessments. Access to and use of NHS data from the Health and Social Care Information Centre will be explored, eg on protected characteristics, and a method for the audit set out. Short briefings will then be explored with good examples of the role of voluntary sector organisations (incl ULOs).
  5. The SPs will launch an Information Portal in the autumn led by UK Health Forum.
  6. Four topics were discussed: Under ‘Housing and Health/Healthy Places’ plans were made for a learning event to address the ageing population and their care needs, improve openness and mutuality (where residents take on business processes like handyman services) and produce a briefing. ‘Premature Mortality’ was considered a pejorative term – ‘living longer’ considered better; there should be an emphasis on positive, asset-based approaches such as experience-led commissioning, investing in young people and preferred communications that also reach learning disabled people who still die much earlier. ‘Integration’ may be better described as ‘coordination’ based on the needs of particular groups – e.g. transitions from YP to adult services, integrated assessments and voluntary sector’s role in that – some people fall from the net and don’t get any services, never mind integrated services. Regional Voices will look at an empowerment tool that will make clearer what people ought to be getting along the lines of the ‘Disabled Children Charter’ as an excellent example of a rights based approach. Brokerage is crucial to this end. ‘Building Community Capacity’ builds on Care and Support White Paper which called for "local health and care commissioners to identify how the skills and networks in a community can make an important contribution to the health and wellbeing of local people... This will promote care and support which keeps people active and connected to their communities. It will mean that care and support draws on community networks where possible, rather than segregating people in formal services. The Think Local Act Personal Initiative has set out ‘Making it real’ – a set of standards on what good care and support look like: www.thinklocalactpersonal.org.uk . The SPs agreed to cross-reference our shared (user-led) vision and mission with TLAP’s five priorities.
  7. The Urgent and Emergency Care Review was introduced, and it was emphasised that it was not people who increasingly opted for A&E services but uptake is due to ageing society – 40% falls on long-term conditions. Disability Rights thinks the system needs to build on evidence according to which people’s ability to make choices (with personal health budgets for example) has led to fewer referrals for unplanned care. It was acknowledged that the evidence base is really important – there won’t be any changes without this being very clear ….
  8. The Care Quality Commission is keen to make a new start with their current consultation on they might go about ratings. Consultation runs until 12 August http://www.cqc.org.uk/sites/default/files/media/documents/20130616_regulatory_impact_assessment_for_a_new_start_consultation_final.pdf  - easy read version here: http://www.cqc.org.uk/sites/default/files/media/documents/consultation_annexelow_res_final_easy_read.pdf

Some SPs may be focusing on giving meaning to the terms used to establish whether a service is safe, caring, responsive, effective, well led.

  1. A refresh of the Equality and Diversity Council (EDC) and Equality Delivery System (EDS) was announced by linking together health inequalities and equality agendas – bringing them into the mainstream of NHS England, and a new NHS constitution is about to be launched.

General updates

NHS Constitution – short survey on rights

The NHS Constitution establishes the principles and values of the NHS in England. It sets out rights to which patients, public and staff are entitled, and pledges which the NHS is committed to achieve, together with responsibilities which the public, patients and staff owe to one another to ensure that the NHS operates fairly and effectively.

The NHS Constitution Team at the Department of Health is exploring how the NHS Constitution can be given greater impact, with a specific focus on ensuring patients are able to get their rights. To help them with this work, they are interested in finding out from you which of the rights set out in the NHS Constitution are most important to you. The survey also conveys full information on these rights, and Disability Rights UK will explore the findings with the Department of Health and contribute to related resoruces.

The Department of Health will be running this short survey for four weeks, finishing on 16 August www.surveymonkey.com/s/HP7FSQS

Creating a vulnerable older people’s plan – your views

The health secretary Jeremy Hunt is seeking your views on a set of proposals that together will form a vulnerable older people’s plan. The proposals are about how to make improvements in primary care and urgent and emergency care and how to get NHS and social care services to work together more effectively for the benefit of patients – in and out of hospital. There are six proposals which will also help refresh the Mandate for 2014/15 by which the SoS holds NHS England to account:

1. Better early diagnosis and support to stay healthy

2. A named accountable clinician

3. Improved GP access

4. Consistent and safe out of hours services

5. Enhanced choice and control for patients and users of services

6. Better information sharing between health and social care services

Combined, these proposals seek to establish a more holistic approach to care and treatment, cutting across the traditional boundaries between clinical and community services, including: A stronger role for general practice at the heart of out-of-hospital services, building on the established relationships and values of the GP. The ‘named accountable clinicians’ will play a crucial, proactive role in the quality and coordination of a vulnerable person’s care. They could be GPs or other appropriately qualified members of a practice team and will have knowledge of that person’s medical history, needs and care pathway. They will also be the common point of reference for guidance on the treatment and services needed to keep them healthier for longer. Whilst not always administering care directly, they will have overall responsibility delivering the best quality care, in the right place, at the right time.

Integrated care in and out of hospital is the goal, allied to the need to make hospital stays as short and beneficial as possible. This can only be achieved by ensuring availability and ease of access to services elsewhere. That is why the Department of Health want to capture as wide a range of views as possible.

Refreshing the Mandate

A final plan, shaped in part by your input, will be published in October and reflected in the refreshed Mandate to NHS England for 2014/15. The Mandate is intended to drive forward better integrated and coordinated out-of-hospital care. Additional proposals to be consulted on include commitments to transform patient care and safety (following the Francis Inquiry Report) and parity of esteem for mental and physical health. More generally speaking, the Mandate sets the government’s ambitions for the NHS as well as the funding available to achieve the kind of care people need and expect – please share your views: www.gov.uk/government/consultations/refreshing-the-nhs-mandate  

Ways of expressing your views

The Department of Health website http://betterhealthandcare.readandcomment.com/ invites you to share your views on the proposals via an online questionnaire. There will also be engagement events across the country from July to September, and the feedback from these events will be used to further refine the policy proposals. 

NHS England’s ‘ways of working’ with CCGs launched

NHS England and the independent collective voice of clinical commissioning groups, NHS Clinical Commissioners, have coproduced ways of working that support CCGs and NHS England. The ways of working flow from NHS England’s vision and purpose and are integral to the way NHS England works:  http://www.england.nhs.uk/about/our-vision-and-purpose/ways-of-working/  

People with learning disabilities still face unacceptable inequalities in healthcare

Far more needs to be done across health and care services to improve the treatment that people with learning disabilities receive, Care and Support Minister, Norman Lamb has made clear. Two new publications from the Department of Health, the responses to the Confidential Inquiry into premature deaths of people with learning disabilities and the Six Lives Progress Report on Healthcare for People with Learning Disabilities, show that whilst some improvements have been made, people with learning disabilities are still experiencing poor care, and face unacceptable inequalities in health and social care, including premature mortality rates.  

In response, the National Clinical Director for Learning Disability has been asked to look at the feasibility of developing best practice guidelines for the treatment of people with learning disabilities: www.gov.uk/government/news/people-with-learning-disabilities-still-face-unacceptable-inequalities-in-healthcare  If you have any comments on that document, please get back to us at Bernd.Sass@disabilityrightsuk.org , and we will advocate on your behalf.

New fairer capped funding system to help everyone plan for the cost of care

Proposals will protect people’s savings and homes from unlimited care costs and allow them to financially plan for the first time. Plans to help people better prepare for the cost of their future care needs have been published alongside details of how the new fairer funding system will protect homes and savings: www.gov.uk/government/news/new-fairer-capped-funding-system-to-help-everyone-plan-for-the-cost-of-care

Caring for our future: implementing funding reform

The DH is seeking views on the practical details of how the changes to the funding system should happen and be organised locally, in particular on:

  • how the capped costs system should work
  • how deferred payments should be administered
  • how we can help people make informed choices about their care and support

The reforms to care funding are one part of a wider programme that will put individuals’ wellbeing at the heart of care and support services, and put them more in control of their lives.

Detailed analysis of these reforms and the problems they address is available in the ‘Universal Deferred Payments Impact Assessment’ and ‘Funding Reform Impact Assessment’ published with the Care Bill. For more information, go to: www.gov.uk/government/consultations/caring-for-our-future-implementing-funding-reform

NHS Friends and Family Test
The Friends and Family Test is at the heart of patient and public involvement in the NHS. Prior to discharge, people are being asked whether they would recommend the service to friends and family. The results of the NHS Friends and Family Test (FFT) for all acute hospital inpatient and accident and emergency departments will be published by NHS England on 30 July 2013.  This will be the first occasion that FFT results will be made available at a national level.  As the data is classed as an ‘experimental Official Statistic’ and governed by strict publication protocols, NHS England is not able to share the results of the national FFT picture prior to publication: www.england.nhs.uk/ourwork/pe/fft/

The NHS belongs to the people: a call to action

NHS England has set out a call to action to staff, public and politicians to help the NHS meet future demand and tackle the funding gap through ‘honest and realistic’ debate. NHS England has called on the public, NHS staff and politicians to have an open and honest debate about the future shape of the NHS to meet rising demand, introduce new technology and meet the expectations of its patients. This is set against a backdrop of flat funding which, if services continue to be delivered in the same way as now, will result in a funding gap which could grow to £30bn between 2013/14 to 2020/21.

A new publication, ‘The NHS belongs to the people: a call to action’ sets out the challenges facing the NHS, including more people living longer with more complex conditions, increasing costs whilst funding remains flat and rising expectation of the quality of care.  The document says clearly that the NHS must change to meet these demands and make the most of new medicines and technology and that it will not contemplate reducing or charging for core services: www.england.nhs.uk/wp-content/uploads/2013/07/nhs-belongs.pdf.

Commission on the Future of Health & Social Care in England The King’s Fund has launched a new commission to look at whether the post-war settlement, which established separate systems for health and social care, remains fit for purpose today. The Commission has been tasked with looking at the significant changes that have taken place, social, demographic and technological, since the NHS was established in 1948, whilst also taking into account the current challenges facing our health and care system, in order to make a judgement on whether or not the current separate models will be able to cope with the future health and care needs of the people of England. The Commission will be looking to gather evidence on the sustainability of the current NHS and social care models and ensure that questions relating to funding are addressed, whilst also analysing how best to meet the changing needs of patients over the coming decades. To this end, the Commission will issue a call for evidence and commission research and papers to inform its thinking. For Disability Rights UK the future of the NHS and social care depends largely on the extent to which service users, patients and people with support needs are empowered, informed and supported to make their own decisions on the care and support that is most beneficial to them. Better health outcomes, more independent living and productivity gains can go hand in hand, as the recent evaluation of personal health budgets has shown: personal health budget holders had fewer referrals for unplanned care than previously.

The King’s Fund’s Commission will produce an interim report in early 2014 and a final report by September 2014, with the aim of influencing the manifesto calls of the main parties at the 2015 General Election. For more information and a briefing about the Commission see here.

2014 GSK IMPACT Awards - funding, training and national recognition for health charities

GSK’s IMPACT Awards, run in partnership with The King’s Fund, are designed to reward charities that are doing excellent work to improve people’s health. Organisations must be at least three years old, working in a health-related field in the UK, with income between £25,000 and £2 million. Up to 20 awards will be made ranging from £3,000 to £40,000 plus free training valued at £4,000. Organisations will also have a film made, receive help with press and publicity and be given a set of promotional materials. Judges include Professor Steve Field and the Chairmen of The King’s Fund and GSK: www.kingsfund.org.uk/gskimpactawards . Closing date is 20 September 2013.