Wednesday 22 February 2012
Variations to the NHS Standard Contracts
The variations to the NHS Standard Contracts for 2010/11 and 2011/12 are now available.
The NHS Standard Contract should be used by commissioners when commissioning acute, mental health and learning disability, community or ambulance Services.
These variations will bring these contracts in line with the requirements of the 2012/13 NHS Operating Framework. Department of Health
Better care for patients
Examples from around the country highlight that during the first year of emerging clinical commissioning groups redesigning services, patients are starting to experience improvements in quality of care. NHS Networks
Introducing the national dementia CQIN
In a video blog Professor Alistair Burns – National Clinical Director for Dementia, introduces the National Commissioning for quality and innovation (CQIN) plan. The CQIN will be introduced in April with the aim of improving areas of dementia care in hospital. Department of Health
Government 'not trusted on NHS'
GPs 'to prescribe health apps'
Changing the prescription for regulating pharmacies
New organisational models for delivering health and social care
This briefing paper pulls together information on the development of employee ownership and social enterprises in health and social care. It is aimed at commissioners who may be interested in stimulating the creation of new forms of organisation as an alternative to direct service provision or conventional outsourcing, and staff who may be interested in setting up some form of employee ownership and/or social enterprise.
Plain packaging: commercial expression, anti-smoking extremism and the risks of hyper-regulation
This report discusses the efficacy of plain packaging for tobacco products and the consequences that a plain packaging policy might have on counterfeit products and the economy.
The NHS bill is wrong to target managers for cuts
The health service must retain experienced leaders able to work with doctors, nurses and other clinicians to provide the best possible care
Paying for new drugs and treatments and meeting the demands of an ageing population requires that the NHS finds £20bn of efficiency savings by 2015. Never has the need for effective leadership and management of resources in the health service been more apparent.
It is all the more worrying, therefore, that the government's NHS reforms involve deep cuts in management posts. Even in advance of the controversial health and social care bill becoming law, the number of health authorities and primary care trusts has been reduced, resulting in the exit of many experienced NHS leaders. Thousands more will leave in the coming months, as these organisations prepare for their abolition in a year's time to be replaced by the new NHS Commissioning Board.
The loss of managers creates a real risk that financial control will be lost and quality of care and patient safety will suffer. This is partly because of the departure of experienced individuals through retirement, redundancy or simply disillusionment with top-down reforms many consider unnecessary; and it is partly the result of far-reaching changes to the organisation of the NHS that are already well advanced. These changes have distracted managers from the core business of improving patient care when this should be the priority.
Analysis carried out by the King's Fund health thinktank in 2011 found that there was no evidence that the NHS is over-managed. The proportion of managers in the NHS workforce is not excessive compared with other sectors of the economy, and NHS funding has grown much more rapidly than the number of managers in the last decade. With an annual budget of £100bn and a workforce of over 1 million, the NHS must retain experienced leaders able to work with doctors, nurses and other clinicians to provide the best possible care.
Our analysis of the evidence led us to argue that while the NHS is not over-managed, it is certainly over-administered. This is because of the policy of successive governments to increase the regulation of standards and performance and to bring about improvements in care through the use of "targets and terror". NHS organisations have employed more staff to deal with the demands of greater regulation and tighter performance management, and their numbers can only be cut if politicians are serious in their stated intention to reduce central control of the NHS.
Equally important has been the emphasis placed in the English NHS on the use of choice and competition to improve patient care. The separation of commissioner and provider roles and the use of contracts have undoubtedly contributed to the increase in management costs through the appointment of staff to deal with transactions in the NHS market.
The NHS in the rest of the UK has been able to avoid many of these costs by relying on planning rather than competition. The current reforms will add to the complexities of the English NHS, as the use of competition is extended and more independent providers are encouraged to offer care to NHS patients. The challenge here is that the government's cuts in management costs have been targeted mainly at NHS commissioners, meaning they are unfairly constrained compared with providers who decide for themselves how much of their budgets to spend on management support.
Commissioning has been the weak link in successive NHS reforms over the past 20 years and the limits placed on spending by commissioners will do nothing to avoid history repeating itself. Populist appeals to reduce bureaucracy and put resources directly into patient care may attract favourable headlines, but they risk undermining the effective implementation of the very policies on which the government's successful stewardship of the NHS depends.
A service as big and complex as the NHS cannot be run on the cheap. A reasonable proportion of the budget must be used to employ skilled staff to manage budgets and people, and to provide strategic leadership. Now is the time for ministers to start praising managers, rather than seeking to bury them.
• Professor Chris Ham is chief executive of the King's Fund The Guardian
Doctors told to prescribe smartphone apps to patients
The Daily TelegraphDoctor faces disciplinary hearing for daring to question NHS reforms
RCN launches two new publications
Going Upstream: Nursing’s Contribution to Public Health. Prevent, Promote and Protect. RCN Guidance for Nurses looks at nursing’s contribution to public health.
It aims to help RCN members and other health professionals, particularly service planners and commissioners of health services, tasked with finding cost effective solutions to the problems caused by unhealthy lifestyles and behaviours.
The RCN has also launched a publication on inflammatory bowel disease. Inflammatory Bowel Disease Nursing. Results of an Audit Exploring the Roles, Responsibilities and Activity of Nurses with Specialist/Advanced Roles provides the results of the first national audit of inflammatory bowel disease (IBD) nursing roles