Subject to the Health and Social Care Bill, from 2013-14, clinical commissioning groups will have access to public health advice, information and expertise in relation to the healthcare services that they commission, provided by local public health teams based in local authorities.

The intention is to make it a mandatory requirement for local authorities, from April 2013,  to provide this service to clinical commissioning groups, but the detail of the arrangements will need to be planned locally.

The core offer follows on from the Healthy Lives, Healthy People White Paper consultation on the funding and commissioning routes for public health.

The draft guidance has been sent to Directors of Public Health and Clinical Commisioning Group leads, together with a request for comments to be received by 30 March to help refine the guidance.

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Opponents of the Bill frequently accuse the government of wanting to privatise the NHS. Just in case there’s any doubt, we are not privatising the NHS. This Bill is not about privatising the NHS.

The NHS is, and will always be, a universal service that’s free at the point of need. As we’ve reiterated in the first clause of the Bill itself, NHS services must be free of charge.

The message isn’t getting across and it’s easy to see why. The most vehement opponents of the Bill muddy concerns about competition, implying that there’s some kind of conspiracy to sell off the NHS to the private sector.

This isn’t what we’re doing. Yes, we think there are areas where competition, within the NHS and from the voluntary sector as well as private companies could improve the quality of care. But that’s the same position held by the previous Government and it’s not privatisation.

Charities or social enterprises run by health and care professionals – and indeed, some private sector providers – can sometimes be better placed to offer very specialist support that some patients need.

People treated at the Eastbourne Wound Healing Centre – a company set up by a nurse and an occupational therapist – have often had wounds that haven’t healed over three years. More than eight out of ten of them have their wounds healed in just 6 weeks. It’s one of the best clinics of its kind in the country. Whizz Kidz, a charity and social enterprise, has dramatically improved wheelchair services for disabled children.

We’d like to see more services like this, because it will help us drive up quality and it’s the most effective way we can offer patients some kind of meaningful choice about where and when they’re treated.

But we’ve added some important safeguards. GPs won’t be able to nudge patients towards the organisation that offers the lowest price, for example, because, under the Bill, organisations will compete on quality, not price.

Private companies won’t be able to “cherry pick” the services that are easy to deliver, leaving the NHS picking up the bill for more complex treatment because our legislation is makes pricing fairer and more transparent.

And as I pointed out in last week’s post, the Bill prevents discrimination in favour of private health companies over the NHS – because we don’t want a repeat of the mistakes made with independent sector treatment centres.

I’m happy to discuss competition in the NHS – it’s a legitimate and important area of debate that ignites strong feeling. But let’s leave behind this idea that we’re hell-bent on privatising the NHS. It isn’t true, and it gets in the way of the much more meaningful discussion around the role of competition in the NHS both now and in the future.

Being in government is a risky business

Today, the House of Commons will debate a motion asking for the Department of Health to release its risk register on the reforms.

It’s part of a ongoing argument on whether government departments should have to disclose their risk registers – something that governments of all political persuasions have largely refused to do in the past.

A risk register is not a forecast or a prediction. It’s where civil servants contemplate the most extreme consequences of any major government project. They think the unthinkable to ensure that the unthinkable never happens.

The consequence of this – as for any major government project that’s being properly managed – is a paper trail which details some of the most outlandish and extreme possibilities that civil servants have contemplated. Contemplated, I stress, not forecasted.

As Lord Butler pointed out in the House of Lords last year, if government departments were forced to publish such information, many civil servants would be reluctant to jeopardise a policy they are working on by using language that could be sensationalised or cause embarrassment if made public.

They will simply stop writing the important stuff down – only the most anodyne and vague statements will ever be recorded. And a risk register that’s FOI proofed will be very little use to anyone.

As a minister, I want the civil servants I work with to be frank with me. If I’m asked to make a decision, I want to know that every angle has been covered – and yes, that might mean thinking through the most extreme and unlikely consequences any change in government policy might have.

Anything that inhibits civil servants from doing this will lead to poorer policy- making and poorer risk management.

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At an event held today, showcasing the best ideas for new and existing health smartphone apps, the Health Secretary Andrew Lansley said:

“So many people use apps every day to keep up with their friends, with the news, find out when the next bus will turn up or which train to catch. I want to make using apps to track blood pressure, to find the nearest source of support when you need it and to get practical help in staying healthy the norm.

“Information about your health is a service – just like the GP surgeries, Walk-in Centres and hospitals that millions of people access every week. With more information at their fingertips, patients can truly be in the driving seat.

“Innovation and technology can revolutionise the health service, and we are looking at how the NHS can use these apps for the benefit of patients, including how GPs could offer them for free.”

Maps and apps

The latest innovations in smartphone technology will help patients and the public to find and use NHS services, manage conditions and make better lifestyle choices in a way that is very convenient for them.

This follows a call to find the best new ideas and existing smartphone apps that help people and doctors better manage care, which received nearly 500 entries and more than 12,600 votes and comments.

You can still read all the entries and you can share your thoughts and comments on the maps and apps blog.

The most popular app ideas were to:

• help manage long-term conditions such as diabetes
• help people deal with post-traumatic stress
• track and monitor conditions such as high blood pressure
• help people find NHS services on a map
• get practical information about keeping fit and eating healthily

The competition identified apps with potentially huge value to patients and the NHS that promote better management of long-term conditions or healthy living.

Last month, NHS Choices was visited by 14.5 million people looking for information on health and local services – helping many to get the advice they needed without making an appointment to see their GP. Developing smartphone apps is the next step in giving patients the information and advice they need and want to stay healthy.

Information Strategy

The Government is in the process of developing an Information Strategy to ensure that patients and clinicians have access to meaningful and up-to-date information.

This will give patients more choice, control and responsibility over their health, and clinicians the information to manage how they deliver local services.

The strategy is expected to be published in the spring.

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Improving patient experience is a key aim for the NHS. By asking, monitoring, and acting upon patient feedback, organisations are able to make improvements in the areas that patients say matter most to them.

This framework is significant for healthcare organisations because it provides a common evidence-based list of what matters to patients, and can be used to direct efforts to improve services. For example it can be used to help define what questions to ask patients in surveys and in real time feedback.

Download the patient experience framework

The Framework was agreed by the National Quality Board Patient Experience Sub Group and draws on research published from the King’s Fund and King’s College London. That research suggested it is possible to apply a single generic framework for patient experience to a wide range of health conditions and settings, and recommended that the DH adopts a common framework for this purpose.

This Framework agreed by NQB is based on a modified version of the Picker Institute Principles of Patient-Centred Care.

Applying the framework

Different areas of the framework will be more significant in particular settings for different groups of patients and therefore demographics, equality, and environment will need to be considered when applying the framework.

Healthcare organisations will also need to have regard to the Equality Act 2010 and the three aims of the public sector equality duty:

• the need to eliminate unlawful discrimination, harassment and victimisation
• advance equality of opportunity between people who share a protected characteristic and people who do
• promote good relations between people who share a protected characteristic and those who do not.

The new equality duty replaced three sets of equality duties – for race, disability and gender – and covers the following protected characteristics: age, disability;,gender reassignment, pregnancy and maternity, race, religion or belief, sex and sexual orientation.

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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.

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Read the consultation documents and complete the response form. The consultation runs from 21 February until 15 May 2012.

In February 2011 the Government published the Command Paper Enabling Excellence: Autonomy and Accountability for Healthcare Workers, Social Workers and Social Care Workers.  The paper sets out the Government’s vision for the future of workforce regulation including increasing the independence and accountability of the regulatory bodies.  Following the publication of Enabling Excellence the Council for Healthcare Regulatory Excellence (CHRE) was commissioned to look at whether there was a case for moving to smaller councils for regulatory bodies and the merits of appointing the chairs of the regulators’ governing councils’ rather than electing them from within the governing council.

The CHRE published an interim report, Board size and effectiveness: advice to the Department of Health regarding health professional regulators on these two issues in September 2011.  The advice was that ‘boards with a range of 8-12 members are associated with greater effectiveness’ and advised that ‘the chair should be independently recruited and appointed rather than elected from within the board membership’.

Following the CHRE’s recommendations the Department is proposing to change the legislation for the GMCand the GDC to reduce the size of their governing councils and to enable them to appoint their next chair and this consultation seeks your views on the proposals.  The consultation is largely aimed at the health professions regulatory bodies, their registrants and service users however we would, of course, welcome all views.

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These awards provide the opportunity to undertake a specific health care project, or other educational/development activity that benefits and improves the health outcomes of people from black and minority ethnic communities.

There are two award programmes:

• The Mary Seacole Leadership Awards are up to £12,500 each and provide the opportunity to enhance effective leadership and communication skills.
• The Mary Seacole Development Awards are up to £6,250 each and provide the opportunity to develop leadership skills.

Applications for these awards will close on 1 May 2012. Interviews for all awards will take place on the following dates: 26 June, 4 and 5 July, 17 July and candidates, if shortlisted, will be required to attend.

Application forms

Download the application form for the Mary Seacole Leadership Awards

Download the application form for the Mary Seacole Development Awards

Unsure about applying? Come to a workshop

Workshops for potential applicants will take place on 21 March in London and 22 March in Birmingham.

The aim of these workshops is to provide potential applicants with the opportunity to gain insight into the Mary Seacole Leadership and Development Awards programme, including the application process and an overview of the awardees’ year.

Draft Programme

13.30 Coffee and registration
13.45 Welcome, Introductions, Overview of session
14:00 The Mary Seacole Awards
14.30 Identifying  your area for project development
15:00 Time for free discussion
15.45 Evaluation
16:00 Close

To book a place, email scholarships@rcn.org.uk giving your full name and stating whether you wish to attend the London or Birmingham workshop.  You will then be sent directions to the venue.

The awards are funded by the Department of Health and NHS Employers and awarded in association with Royal College of Midwives, Royal College of Nursing, UNISON, Unite CPHVA.

You do not have to be a member of any of the participating organisations to apply or attend a workshop.

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They discussed the treatment they had all received so far.

A Department of Health spokesperson said: ”It has clearly been a difficult time for them.

“It was a positive conversation and we pledge to work together to ensure women are supported and have good timely information about PiP implants and the Department’s position.”

For the latest advice about PiP breast implants, visit NHS Choices.

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