Website of the Department of Health

Consultation on improving community and health services

A major consultation will give citizens the opportunity to give their views on the future of community health and care.

Responses to Your health, your care, your say: Improving Community Health and Care Services will help shape the Government's White Paper on community health and care services, due out later this year.

It will examine issues such as:

The initiative began with a 'listening' event with stakeholders in London, the aim of which was to examine the proposed consultation process.

• Summary of the first listening event

Boards' key role in accelerated commissioning schedule

The accelerated introduction of practice-based commissioning (PBC) will require PCT non-executive directors to play a key role in ensuring implementation runs smoothly.

The Department of Health expects PCTs to make the necessary arrangements to enable all practices to be involved in PBC, should they wish, by December 2006, which is two years ahead of schedule.

PBC enables practices to be more closely involved in improving services for patients and new research for the Department of Health shows 70 per cent of practices believe it will bring benefits.

Under PBC, practices will be able to keep up to 100 per cent of the savings they make from commissioning services to invest in improving the range and quality of services they offer to patients.

Although practices, which have been able to take on indicative budgets since April, will take on commissioning responsibilities based on the health needs of their local population, PCTs, working on behalf of practice groups, will be responsible for placing and managing contracts.

Several documents designed to ensure PBC goes smoothly are already available. These include Making Practice Based Commissioning a Reality: Technical Guidance, published by the department.

Designed for PCTs, SHAs, practice managers and GPs, it covers the key aspects of:

Practice Based Commissioning: A Preliminary Toolkit for PCTs also sets out the roles and responsibilities of PCTs, while other guides are also available from the NHS Confederation, National Association for Primary Care, the NHS Confederation and the NHS Alliance.

• DH guidance and links to the other PBC resources

Health legislation timetable

The Department of Health is currently running a series of key consultations that will help shape the development of future health and social care legislation. The latest timetable for 'live' consultations is:

• More on the latest live and closed consultations

The Government has also outlined the next steps for its reform of mental health legislation by publishing its response to recommendations made by the pre-legislative scrutiny committee on mental health.

The Mental Health Bill will provide improved safeguards for patients and a better legal framework for the small minority of people who need to be treated against their will.

• Full response

Trusts urged to implement reforms

Non-executive directors at underperforming trusts must prioritise implementing system reforms aimed at improving patient choice and the quality of care.

This was one the key messages delivered by health secretary Patricia Hewitt at the NHS Confederation conference in June.

In one of a series of high-profile speeches since her appointment, Ms Hewitt also spoke of her determination that NHS administrators and staff should build on the progress that has already been made five years into The NHS Plan.

Ms Hewitt said: 'We are in the middle of the longest and most sustained period of investment in the history of the NHS. Spending has doubled since 1997 and will have reached £90 billion a year by 2008.

'By that time, we will have tackled the historic under-investment in the NHS and we will have eliminated many of its main symptoms. So whilst of course growth will continue, the unprecedented increases of recent years will no longer be necessary.

'And I know you're worried about delivering the huge agenda of the next five years. But, quite apart from the funding increases already committed for the next three years, a potential pot of gold is already in your hands. There are major productivity gains to be had from the extra investment that is already coming into the system.'

She picked out three major challenges for the NHS in the near future:

Ms Hewitt said: 'We need payment by results - not only because it underpins patient choice, but because it will create very sharp incentives to under-performing parts of our service to change their ways or give way to others who can do better.

'We need the independent sector and the growing number of NHS Foundation Trusts to stimulate even more innovation.'

And in another speech to NHS human resources (HR) staff, Ms Hewitt also urged trusts to prioritise reducing waiting times and outlined the transformation that the NHS is going through. During the speech in June, Ms Hewitt also announced the second wave of ISTCs.

Highlighting key issues such as tougher hygiene standards, increased patient choice and improved safety and quality, she told the HR in the NHS conference: 'I want to be absolutely clear with you that I will not be proposing yet another wholesale re-organisation of the system. We don't need it. But we do have to make sure that our organisations are fit for purpose. So we'll be looking for organic evolution in our SHAs and PCTs, to cut administrative costs and keep improving performance.'

• Speeches index

NHS Foundation Trusts can order bulletin

The Non-Exec Bulletin aims to cover stories of interest to NHS Foundation Trust board members as well as non-executives across the rest of the NHS.

However, because terms and conditions of service for NHS Foundation Trust members may differ from those of other NHS boards, details in some bulletin items may not apply to some readers.

NHS Appointments Commission chief executive Roger Moore said: 'The commission promotes good governance of the NHS so much of the content is of direct relevance to all board members.

'We welcome ideas for content of the bulletin and feedback from the whole readership.'

Chairs of NHS Foundation Trusts receive the Non-Exec Bulletin direct but members' names are not held on the mailing list.

NHS Foundation Trusts can obtain copies of the bulletin for board members by contacting the Recruitment Service Centre on 0870 240 3801.

The bulletin is also available online at:

• Non-exec bulletin

Report on the work of the NHS Appointment Commission's disability advisory group

Networking and building partnerships were the focus of the Disability Advisory Group's activities during 2004-05.

The group provided significant input to the commissioner for public appointment's short-life working group on disability. This working group made a series of recommendations aimed at increasing the number of disabled people on the boards of public bodies.

These ranged from improving disabled people's awareness of public appointment opportunities to ensuring that the process was as smooth as possible for disabled people wishing to be considered for an appointment.

The advisory group was able to make a positive contribution to this important work by feeding in many of the recommendations made during its audit of the Appointment Commission's processes and was able to highlight examples of good practice adopted by the commission.

A good working relationship has also been forged with the Disability Rights Commission. The advisory group has met twice with the commission's chair and officer colleagues to exchange information on activities and discuss areas of mutual interest.

The group has remained active in highlighting to ministers and MPs the potential benefits barrier, where income-related benefits may be affected by taking up renumerated public appointments.

It has also has been working closely with the Department of Work and Pensions and the Cabinet Office to produce a leaflet which gives potential applicants more and better information about the possible impact of a public appointment on their benefits.

Finally, the group is pleased that so much progress has been made in the steady increase in the number of disabled people appointed to local NHS boards: at 1 April 2005, 7.71 per cent of all those appointed had declared that they are disabled, of whom 4.73 per cent are chairs.

For more information e-mail:

• ruth.whitlam@apcomm.nhs.uk (opens new window)

Non-execs have their say

The 2005 survey of chairs and non-executives, designed to measure satisfaction with NHS Appointments Commission recruitment services, is underway.

The findings will help to improve and develop these and other services provided by the commission as it broadens its role across government.

Involving a sample of chairs and all non-executives across the country, the anonymous survey is being carried out by the independent market research company Continental Research.

Commission chairman Sir William Wells thanked everyone who was taking part.

'We are pleased to be receiving non-executives' frank and constructive views on all aspects of what we do. We will take seriously all the outcomes in planning the future direction of the commission,' he said.

The survey will be complete in September and a report on the findings will be published in the autumn edition of Non-Exec Bulletin and will also feature on the commission's website.

Local induction programmes for newly-appointed NHS non-executive directors

NHS non-executive directors are appointed and remunerated on a part-time basis for a commitment of relatively few hours per month. 

It might therefore be thought wasteful to expend too many resources on local induction programmes. 

Perhaps a 'get to know you' session, a trip to representative units and an information pack would do, particularly as the NHS Appointment Commission's national induction programme is now embedded within the NHS. Not if the experience of Jai Tout, Chair of South Essex Partnership NHS Trust is anything to go by. She believes that no investment of time, energy and resources in full induction of non-executive directors has ever been wasted.

Jai has written a paper on the development of the south Essex local induction programme and has produced a useful checklist.

Since the role of the non-executive director involves a range of board responsibilities Jai has identified a number of themes which she believes should inform the induction programme. 

High on her list is the distinct and compelling ethos of the NHS organisation and its focus in the community.  But her other themes include: the links between the NHS organisation the wider NHS and the local community; the structure and systems within which the non-executive will have to operate; board appraisal; the organisation's governance arrangements; the change agenda and its impact on the local organisation; and the non-executive role in the guardianship of NHS resources and assets.

In order to tailor programmes of local induction to local relevance, Jai shares the elements which structure the south Essex induction programme. 

Basic information is consistent, accessible in various formats and available in a way that enables the new non-executive to dip in and out. Non-executives are made aware not only of the time commitment for the role but also the time commitment required for induction. 

The south Essex induction programme affords an early opportunity for each individual to become acquainted with as wide a group of trust personnel as possible, while also linking to trust partners and stakeholders. Whilst the south Essex model does include some 'classroom' presentations of information and instruction, there are elements delivered away from the classroom in order to accelerate learning, planning and mutual understanding. 

All new non-executives receive both national and local induction but Jai also facilitates a continual learning process within the boardroom, in chair and non-executive directors meetings and when attending relevant conferences.  She also meets regularly with each newly-appointed non-executive director to monitor progress and identify any further individual development requirements. Together they will set individual objectives for the current year leading to review and appraisal.  

Jai has found that however qualified, skilled and/or experienced a new non-executive director may be, they cannot be expected to be immediately aware of all NHS boardroom requirements and NHS governance implications. A full understanding of the complex nature of the organisation and the individual task requires an extended period of induction.  A substantial, though well considered, investment of resources will greatly benefit the trust both in boardroom excellence and in avoiding expensive turnover of ineffective or frustrated non-executive directors.

• Full text of the paper on South Essex Partnership NHS Trust's non-executive director local induction programme and the supporting checklist (opens new window)

Launch of safer healthcare website

A one-stop-shop for knowledge and innovation for safer healthcare is now available online.

The National Patient Safety Agency (NPSA) has launched a website dedicated to patient safety, providing healthcare professionals with direct access to knowledge and innovation for safer healthcare.

The site provides tools, advice and research on best practice in patient safety.

It is a joint project between the NPSA, the British Medical Journal and the Institute for Healthcare Improvement, a not-for-profit healthcare organisation based in the USA.

Articles cover a wide range of patient safety topics, including safety culture, medication practice, patient identification and discharging patients.

• saferhealthcare (opens new window)

Future work on patient safety

The NPSA is also inviting NHS staff to make suggestions for future work on patient safety - the closing date for feedback is 31 October.

• Prioritising the work of the NPSA (opens new window)