Richard Vize on CCGs – notes from #reportinghealth

Carol Miers wrote up her notes on the speech by health expert Richard Vize at Help Me Investigate Health’s #reportinghealth event – we’ve reproduced them below with permission:

“GPs tend to be self employed business people, they hate NHS bureaucracy and hate being told what to do, now they are taken away from patient contact, they have to work on committees, they have their business interests compromised, they have become a cog in the bureaucracy and are subject to control from the Department of Health.”

This, added Richard Vize, opens up health reporting because there is now oversight from the Health and Wellbeing board which – given that GPs are vocal – will bring in an area of openness and debate. Continue reading

NHS plans for offender commissioning outlined

As part of the restructuring of the health service, the NHS Commissioning Board (CB) will have national responsibility for healthcare in secure environments.

These include:

  • 120 prisons
  • 16 Secure Children’s Homes
  • 4 Secure Training Centres
  • 12 Immigration Removal Centres
  • Police Custody Suites
  • Courts

Commissioning for Sexual Assault Services will also become the responsibility of the NHS CB.

Whilst the NHS CB has national responsibility for these institutions it will be free to commission services from local providers.

A document on the changes is available here.

Document: who’s responsible for what in health?

Monitoring health bodies - and interventions

If you want to get an overview of the different parties involved in the new health system and their roles – including some new players as well as old players with new responsibilities – a recent report from the National Quality Board‘s (NQB) is worth a look.

Quality in the Health System (PDF) was published to provide context to the establishment of Quality Surveillance Groups, but alongside the guidance there’s lots of very useful context for those getting to grips with the new system. Continue reading

The role of local councils in scrutinising clinical commissioning

A parliamentary written answer from Anna Soubry MP provides some useful information for those interested in the lines of accountability of clinical commissioning groups (CCGs).

In short, this involves consulting with the local authority’s health and wellbeing board, which in turn can report to the NHS Commissioning Board if it is not happy (which can in turn take action). The health and wellbeing board is also accountable itself to the local authority’s scrutiny committee, for which you can find details by adapting this search for your own local council site.

Here’s Anna Soubry’s answer in full: Continue reading

What’s your local CCG doing? A quick guide

Philip John is one of the users of Help Me Investigate looking at his local clinical commissioning group (CCG), for which there isn’t much information (there isn’t even a website).

Here’s why: CCGs are being authorised in four waves, which take place from this month through to March 2013. In addition to those four waves, there are dozens of CCGs which were already operating as ‘pathfinder’ groups – in other words, pilots.

You can find out which wave your CCG is in by searching for it in this document (PDF). Continue reading

The leaked draft NHS reforms risk register

Health Bill Transition Risk Register NC 15 Oct 10 Dept Bd Version v1

A draft version of the risk register that was prepared – but not released – as part of the Health and Social Care Bill has been leaked and is available above.

The leaked document has been widely reported on, with The Guardian noting that it suggests “Emergencies in the NHS could be less well managed under the government’s controversial health reforms”.

Other risks it reports include:

• “Greater costs if new GP-led consortiums make greater use of the private sector. “One example of area where system could be more costly is if GP Consortia makes use of private sector organisations/staff which adds costs to the overall system.”

• “A danger that the new system is set up too quickly, threatening the running of the NHS.

• “A loss of financial control. “Financial control is lost due to the restructuring of budgets distributed between or allocated to organisations within the system [to be clarified],” it said.

• “Unfavourable media coverage. “Public reputation. There is a risk that the transition will be presented in a negative light via the media. Two of the biggest risks which have already surfaced in the media are i) that the reforms will continue to be characterised through the prism of privatisation and ii) financial cuts.”

The Telegraph says

“it lists 43 points ranging from fears for staff morale to problems with transferring responsibilities through workers who are also at risk.

“The document, dated September 2010, was handed to health writer and commentator Roy Lilley after repeated refusals by the Government to publish the register.”

Anything else you can find?

The structure of the NHS – link

One of the initial barriers to investigating health issues is getting your head around the apparent complexity of the UK health system and its jargon. Over at National Health Service History, however, Geoffrey Rivett has put together one of the clearest guides I’ve seen on its various parts and how they connect together, regularly updated to boot (the latest being in November 2011).

The page on A guide to the NHS is worth reading in full for those looking at health issues for the first time, setting out some of the key distinctions (such as that between primary and secondary care), how money flows, and where responsibility sits. Continue reading

Public health spending now and to come – data and documents

NHS public health spending per head 2010-11 mapped to local authorities by local authority index of deprivation

Data visualised by David Buck: NHS public health spending per head 2010-11 mapped to local authorities by local authority index of deprivation

Next year a huge chunk of money for health improvement services will be taken from local NHS bodies (PCTs – primary care trusts) and given to local government (councils) instead.

As a result, as David Buck explains, the Department of Health has had to quickly find out – for the first time – how much money is being spent on public health, so that it knows how much it needs to reallocate – and the result is particularly useful if you’re interested in previous spending or how it might change under the new system. Continue reading

How does the General Medical Council work?

The General Medical Council [GMC] was established by the Medical Act 1858 and is entrusted with regulating the UK’s medical profession. It is also a fee-based Charity [Number 1089278].

Despite its role in investigating alleged misconduct and imposing sanctions on doctors who step out of line, the GMC is not a court. Rather, it is a quasi-judicial body, as established by GMC v BBC 1998.

The distinction is subtle, but significant in respect of which laws apply to the GMC’s actions. Continue reading

Paper trail: Understanding the structure of the NHS pt1

If you’re trying to trace a document trail or identify who is accountable for a particular decision, it’s essential to understand the structure of the health service.

The way the National Health Service is set up in England (Scotland, Wales and Northern Ireland will be dealt with in future posts) can be complex but it is relatively simple once you understand how each department works.

As the structure is now you have the Department of Health (DoH), led by the Secretary of State for Health, who in turn leads DoH ministers. The DoH funds ten strategic Health Authorities (SHAs), who are responsible for 152 Primary Care Trusts (PCTS), which in turn provide hospitals, mental health trusts, ambulance trusts, GP practices, dental practices, pharmacies which will also cover sectors such as primary care service, Foundation trusts, NHS trusts, private companies and charities.

The new proposed structure for April 2013 will look slightly different as the Primary Care Trusts and Strategic Health Authorities will be replaced by NHS Commissioning groups, which are constructed of 200+ Clinical Commissioning Groups (CCGs) that will be led by GPS who will oversee and manage the community, as well as acting as representatives for the boards such as NHS trusts, Foundation trusts, private companies etc.

There will also be a new feature, which will be added to the NHS in England, will be the new group Healthwatch England.

A national body representing the views, opinions of the people who use health and social care services, ot will represent a large network of local Healthwatch groups (taken over by LINK), which will be funded by local authorities.

It is claimed that these Healthwatches will help improve the services from the views of patients and carers during local commissioning decisions, the purpose being to make them run more efficiently, fairly and smoothly.

What is the department of Health’s organogram?

In December 2011 the Department of Health published an ‘organogram’. This is a database system which shows detailed info on the structure and costs of the department of health staff posts i.e. senior posts and costs of junior staff of the organisation as at 5 December 2011.

For example: the senior posts spreadsheet lists a variety of job titles such as private secretary, senior communications manager, executive assistant, Business manager, HR officer, press and media officer, and finance manager.

These all report to the overall professions such as Operational delivery, communications, human resources, informational technology, Policy, Internal audit, Informational Technology, Knowledge and Information manager etc.

Knowing where different roles report to can save you a lot of time in identifying who you need to approach in asking questions.

The junior posts (CSV) are responsible for different functions within the department such as leadership management, Internal audit efficiency strategy officers, Policy research programmes, PR, HR roles, NHS communication etc.

All junior posts report to the senior posts and the Department of Health, which covers money and costs.

Can you add anything? Or are there areas that need expanding or clarifying? Please let us know.