EQUITY & EXCELLENCE

ADASS DISABILITIES OCTOBER, 2010NETWORK

OVERVIEW

In July 2010 the Coalition published ‘Liberating the NHS’ and a number of supporting papers, laying out its vision for the future of the National Health Service. This sets out a range of significant reforms to place patients and clinicians at the heart of the NHS and to produce £20 bn in efficiency savings in the next four years.

There are significant implications for Local Authorities and Social Care. Community based models of care remain central with a continuing shift from acute hospitals to one that is built around community management of long term conditions and improving public health outcomes.

ORGANISATIONAL CHANGES

• Commissioning responsibility for health services will be passed to GPs who will have to join up to form consortia.

• A new national NHS Commissioning Board will be established (from April 2011 in shadow form). The Board will set commissioning guidelines, champion patient involvement and support the development of GP consortia.

• New statutory ‘health and wellbeing boards’ will be established, at cabinet/director level, within local authorities. They will take the strategic lead for promoting integrated commissioning of local NHS, social care and health improvement services.

Organisational Changes

• A national Public Health Service (PHS) will be established with responsibility for health protection aspects of public health, Locally, Directors of Public Health will be jointly appointed between the PHS and the local authority, with responsibility for health improvement and their locality’s proportion of a ring- fenced public health budget

• Local Authorities will be responsible for commissioning local HealthWatch, which will provide a voice and means for local people to shape health and care services. Local Involvement Networks (LINKs) will become the local HealthWatch

• The Department of Health will become less involved in the day to day running of health services, and placing a greater focus on its role in relation to public health and adults’ social care services.

Joined Up Commissioning

• A Consortia take on responsibility for NHS commissioning, Local Authorities need to establish what will be the local approach to integrated commissioning and how this will affect existing integrated commissioning and pooled budget arrangements.

• Where Consortia areas and NHS commissioning arrangements do not correspond to Local Authority boundaries there will be added demands on developing and sustaining partnership working.

• Local Authorities are ideally positioned to consider areas of collaboration and efficiencies both with GP’s and across borough boundaries. Adequate levels of delegated authority will be needed for this function effectively.

Health Improvement and Prevention Activity

• Health and Wellbeing boards, with robust governance arrangements, will be critical for establishing local accountability and ensuring the needs of the most vulnerable are met

• Incentives for commissioners and providers will need to be developed to encourage the redesign of systems and services to improve outcomes.

• Local Authorities should drive the change programme locally. Early identification of key focal points for partnership working will be preclude PCTs and GP’s seeing the changes as purely a Health issue.

Equity & excellence: liberating the NHS-White Paper-12 July

• Power & responsibility for commissioning NHS services to GP consortia

• Creation of a NHS Commissioning Board• PCTs to be abolished by 2013• PCTs’ responsibilities for public health to be

transferred to local authorities• DOH will establish a commission on the funding

of long term care and support to report within a year

• Creation of ‘Healthwatch England’ with LINks becoming the local healthwatch’s