Skip to main content

Healthy lives, healthy people: consultation on the funding and commissioning routes for public health - consultation - 31/03/11

6 replies [Last post]
kevin
kevin's picture
Offline
Joined: 09/03/2009

The public is today invited to have its say on how the new public health service – Public Health England – will look and how the proposed funding arrangements will be implemented, Health Secretary Andrew Lansley has announced. This is a crucial part of the Government’s radical plan to go further and faster in tackling the big public health challenges.

<

Challenging the public to think differently about public health delivery, it seeks views on the following:

  • What activities should be funded from the new ring-fenced public health budget and the appropriate allocations of responsibility for public health activity in the new system.
  • Aspects of how services will be commissioned.
  • How money will be allocated to local authorities, including the design of the new health premium which will reward successes in improving outcomes and incentivise action to reduce health inequalities.

Andrew Lansley said:

“We have set out a vision to ensure that the public health budget will be used as it should be – for preventing ill health and promoting good health.

“We believe the way forward must include a locally led system that puts people’s health and wellbeing at the heart of everything local councils do. This will allow local communities to design services that are tailored for the needs of their populations and ultimately improve their health.

“I want to hear views from the people that this new service will benefit and from those who provide the services we seek to improve; this is your chance to comment on our proposals and to let us know how you think key elements of the service should be designed.”

Professor Dame Sally Davies, Interim Chief Medical Officer said:

“Our public health system needs a protected public health budget to tackle this country’s public health problems.

“I urge all those that are currently involved in public health to feed in their ideas to the Healthy Lives, Healthy People, consultation. We are committed to working with, and listening to, a wide range of stakeholders on the development and implementation of this new public health service, Public Health England.”

Funding and Accountability

The consultation asks questions about the approach that should be taken to allocating public health funds to local authorities, and the design of the health premium which will reward areas for their achievements and incentivise action to reduce health inequalities.

Localism will be at the heart of this new system. Local authorities will have statutory duties to take steps to improve the health of their populations. This will open up opportunities for them to take innovative approaches to public health involving new partners.

Defining Responsibilities

Challenging the public to think differently about public health delivery, this consultation seeks views on proposals about how public health activity is funded and commissioned. In particular, it explores what activity should be funded from the public health budget and the appropriate allocations of responsibility for public health activity in the new system.

<

Notes to editors


1. For further information please contact the DH newsdesk on 020 7210 5221

2. The Consultation, Healthy Lives, Healthy People: Consultation on the funding and commissioning routes for public health, can be downloaded here: http://www.dh.gov.uk/en/Consultations/Liveconsultations/DH_122916

3. To have your say in the consultation visit: http://consultations.dh.gov.uk/healthy-people/funding-and-commissioning The consultation closes on 31 March 2011

http://nds.coi.gov.uk/content/detail.aspx?NewsAreaId=2&ReleaseID=417188&SubjectId=2

http://www.theyworkforyou.com/wms/?id=2010-12-21a.166WS.1

 

<
n/a
kevin
kevin's picture
Offline
Joined: 09/03/2009

HM Government - Healthy Lives, Healthy People - Our Strategy for Public Health in England

This White Paper outlines the governments commitment to protecting the population from serious threats; helping people live longer, healthier and more fulfilling lives; and improving the health of the poorest, fastest.

  The White Paper is available at:

  h<ttp://www.mayden.co.uk/house/apps/doclibrary/documents/pdf/481_Healthy_Lives.pdf<

https://www.londoncareplacements.gov.uk/news/view/hm-government-healthy-...<

n/a
kevin
kevin's picture
Offline
Joined: 09/03/2009
n/a
kevin
kevin's picture
Offline
Joined: 09/03/2009

Proportionate health and social care worker regulation to protect the public

The vast majority of those who work in health and social care are committed individuals with a strong sense of professionalism who aspire to deliver the highest standards. However, where there is poor practice or behaviour that presents a risk to the public, it is vital that swift action is taken, whether by employers, or by national regulatory bodies.

<

The system of professional regulation ensures high standards of practice and reassures the public that their health and social care needs are provided by qualified, properly vetted professionals.

However, the regulatory system is becoming increasingly complex and expensive and requires continual Government intervention to keep it up to date. The Government must move to a proportionate and effective system that imposes the least possible costs and complexity, while maintaining safety and confidence for patients, service users, carers and the wider public.

Health Secretary Andrew Lansley presented ‘Enabling Excellence’ to Parliament this morning. He said:

“Regulation of healthcare workers and social workers makes an important contribution to safeguarding the public, including vulnerable adults and children. But we need an approach to professional regulation that is proportionate and effective.

“The changes we are progressing through the Health and Social Care Bill will give greater independence to those who work in healthcare across the UK and social care in England, to their employers and to the professional regulatory bodies. This will be balanced by more effective accountability in how they exercise that freedom.”

‘Enabling Excellence’ sets out proposals:

  • to devolve power to the regulators, while enhancing accountability and sustaining effective national safeguards where necessary;
  • to constrain the growth and costs of the regulatory system at a time when health and social work professionals are facing pay constraints;
  • for a system of assured voluntary registration as a more proportionate approach to ensuring high standards in the workforce; and
  • to simplify the regulatory structure.

At the moment, most processes - such as registration, investigation and complaints - that regulators need to have are set out in ‘rules’. Every time the rules need to be updated, the Government has to get involved. In most cases, that is an unnecessary use of Government time. Devolving powers to the regulators will give them greater freedom to define their own processes without approval from the Privy Council or Department of Health.

Voluntary assured registration is intended to improve standards and drive up the quality of care without imposing the costs of mandatory regulation. The Council for Healthcare Regulatory Excellence (CHRE) will set the standards for registers and accredit organisations meeting its standards. That way, the public and employers would be able to easily identify whether a worker belongs to a register that sets robust standards for those registered. We intend to incentivise employers to use workers on voluntary registers. For example, this could be a factor taken into account in the Care Quality Commission's proposals for an excellence scheme which it will be consulting on.

The abolition of the General Social Care Council forms part of our wider programme of social care reform which will deliver a more independent model of regulation and strengthen the social work profession. The Council for Healthcare Regulatory Excellence will also become more independent and self-funding. They will review the efficiency of all regulators, with a view to reducing the overall costs of regulation.

The Health Secretary also announced to Parliament today that herbal medicine practitioners will be regulated from April 2012. The four UK health departments have agreed that the Health Professions Council (HPC) should hold a statutory register of practitioners who supply unlicensed herbal medicines to people to enable the supply of herbal medicines to continue after 30 April 2011. This will ensure that practitioners have met specified registration standards. Practitioner regulation will be underpinned by medicines legislation which will provide further safeguards to protect public health.

<

Notes to editors


  1. For media enquiries contact the Department of Health news desk on 020 7210 5221.
  2. ‘Enabling Excellence’ is in the House of Commons Library and is available to download here: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_124359
  3. There are nearly 1.4 million regulated health and social care professionals in the United Kingdom.
  4. In future, local authority commissioners could give preference to providers using workers on voluntary registers. This could be taken into account in the “excellence rating” that the CQC will shortly be consulting on.
  5. Our analysis of the 2009 consultation by the four UK Health Departments which sought views on the possible regulation of practitioners of acupuncture, herbal medicine and traditional Chinese medicine will be published today and available at http://www.dh.gov.uk/en/Consultations/Responsestoconsultations/DH_124337

http://nds.coi.gov.uk/content/detail.aspx?NewsAreaId=2&ReleaseID=418055&...

<
n/a
kevin
kevin's picture
Offline
Joined: 09/03/2009

Andrew Lansley< (Secretary of State, Health; South Cambridgeshire, Conservative)

Safe, respectful and effective care is essential and should be what all users of health and social care services experience.

The vast majority< of those who work in health and social care are committed individuals with a strong sense of professionalism who aspire to deliver the highest standards. However, where there is poor practice or behaviour that presents a risk to the public, it is vital that swift action is taken, whether by employers, or by national regulatory bodies.

Ensuring a strong and effective system for regulating health and social care professionals is one of the cornerstones of our strategy for delivering improved outcomes for people who use health and social care services. The current system of professional regulation helps to ensure this by setting high standards of education, training, conduct and ethics and by taking action to remove unsuitable workers in the rare cases when things go wrong. Regulation of health care workers and social workers therefore makes an important contribution to safeguarding the public, including vulnerable children and adults.

However, the regulatory framework is also complex, expensive and requires continuous Government intervention< to keep it up to date. More generally, reducing regulation is a key priority for the coalition Government. By freeing society from unnecessary laws<, the Government aim to create a better balance of responsibilities between the state, business, civil society and individuals, and to encourage people to take greater personal responsibility for their actions.

While regulation of some professionals is vital to ensure high standards of care, it is only one component of a wider system of safeguards, controls and clinical governance and ultimate responsibility for the provision of high quality services must rest with employers and those contracting with health and social care workers. We believe that the approach to professional regulation must be proportionate and effective, imposing the least cost and complexity consistent with securing safety and confidence for patients, service users, carers and the wider public.

I have today laid before Parliament a Command Paper<, "Enabling Excellence-Autonomy and Accountability for Healthcare Workers, Social Workers< and Social Care Workers" (Cm 8008) setting out the Government's proposals for how the system for regulating health care workers across the United Kingdom and social workers in England should be reformed, to sustain and develop the high professional standards of those practitioners and to continue to assure the safety of those using services and the rest of the public.

The reforms, many of which are being progressed through the Health and Social Care Bill, will give greater independence to those who work in health care across the UK< and social care in England, to their employers, and to the professional regulatory bodies; balanced by more effective accountability in how they exercise that freedom.

We will seek to drive up standards for some groups of unregulated health and social care workers to improve service users' experience through a system of assured voluntary registration. Employers and commissioners will be able to give preference to workers on voluntary registers to ensure that they contract with suitably skilled and qualified workers. In line with the Government's overall social work reform programme, the proposals will also strengthen social work as a profession in England.

"Enabling Excellence-Autonomy and Accountability for Healthcare Workers, Social Workers and Social Care Workers" is available to hon. Members from the Vote Office and to noble Lords from the Printed Paper Office.

http://www.theyworkforyou.com/wms/?id=2011-02-16a.85WS.1<

n/a
kevin
kevin's picture
Offline
Joined: 09/03/2009

Our health depends on it: The Health Select Committee pauses for thought on public health

With the Department of Health likely to publish their response to the consultations on Healthy Lives, Healthy People before their summer recess the Health Select Committee has turned its light onto the public health reforms.<

Initially we welcomed the principles behind these reforms – including the focus on outcomes, the bigger role for local government, and the recognition that the ultimate test is improving the health of the poorest fastest, this government’s code for inequalities. In our submission to the Department on the reforms<, we made more than 40 detailed recommendations, but  the Committee needs to focus on four critical issues.

First, the money and how it’s allocated. The Department has tried to calculate how much the NHS spends on public health in order to make a simple transfer of those amounts to local authorities, who will hold the budget in future. But the more fundamental question remains – is this amount big enough? The government’s own evidence review< sets out a litany of public health challenges that are only set to increase. And the way the money will be allocated means that local authorities can only increase their share  by doing well through the health premium. Allocations will not reflect underlying changes that local authorities can do little – if anything – about. For those authorities with significant population churn (where the young and healthy routinely move on and the poor and unhealthy move in) this is likely to widen the health gap rather than narrow it. And some areas may never be able to break out of a cycle of chronic underfunding.

Second, the balance of accountabilities, incentives and performance support in the new system. The public health outcomes framework is a big step forward, it shows the government has listened and recognised that nudge and information are important. But so too are the places and economic conditions in which we live and the people with whom we live. While the framework recognises this, there are no teeth to it. Current plans do not attempt to define levels of performance against the framework, weakening authorities’ accountability for billions of pounds of taxpayers’ money. Instead the government is putting its faith in the premium and local transparency of this system. Public Health England< will be publishing and comparing results, but doing little else with the information. This isn’t good enough for us – either as national taxpayers or as local citizens.

The third area is the relationship between local authorities and the NHS. We welcome the introduction of health and wellbeing boards. The Bill also introduces important new duties on the NHS Commissioning Board and consortia to tackle inequalities in health, but this is restricted to inequalities in access to, and outcomes from, NHS care. This should be broadened to reflect the fact that the NHS is an economic powerhouse and major employer in local communities, directly affecting the determinants of health by its actions. There are no equivalent duties on local authorities to tackle inequalities – this should go along with the shift of budgets and responsibility for public health. GP consortia also need to be given responsibility for population health, beyond the duty of caring for unregistered patients, if primary care’s role in public health is to be fully recognised.

Fourth, and underpinning all of this, is the information and intelligence that keeps the system working. The Health Select Committee is looking into the role of the regional Public Health Observatories<, bringing their function under Public Health England. While this may save the centre some money it risks creating a less effective local public health intelligence network and significantly higher overall costs as directors of public health each seek to replace the lost capability in their own patches. More fundamental still is the issue of co-terminosity between consortia and local authorities. The freedom to define membership of consortia has unwittingly created huge technical challenges of co-ordinating and supporting the data flows that  inform the decisions of the health and wellbeing boards and others. The Committee needs to press the Department on how it is to tackle these problems.

Overall there is a lack of attention to how the various elements fit together, a consequence of  too little time to get the thinking straight. The guiding philosophy behind the reforms in public health seems to be promoting increasingly devolved and local decisions on public health. But the logic of this would lead to a non-ringfenced budget coupled with strong accountability for performance on the outcomes framework to protect the interests of national taxpayers whose money is being used to finance it. Instead the government proposes a ringfenced static budget that doesn’t properly reflect changing needs, coupled with extraordinarily weak accountability. This seems the worst of both worlds – not really allowing the space for local authorities to innovate or holding them to account for the outcomes that really matter. 

In the next few weeks the Committee will need to be as challenging as it has been on the NHS reforms to help the government get its thinking straight, our future health will depend on it.

Read our consultation response to 'Healthy Lives Healthy People' (358 kb) [pdf]<

http://www.kingsfund.org.uk/blog/public_health.html<

n/a
anonymous (not verified)
anonymous's picture

This is a summary of responses to Healthy Lives, Healthy People: our strategy for public health in England; Healthy lives, Healthy People: consultation on the funding and commissioning routes for public health; Healthy Lives, Healthy People: transparency in outcomes - proposals for a public health outcomes framework; and Review of public health professional regulation.

 

http://www.dh.gov.uk/en/Consultations/Responsestoconsultations/DH_128838<

X