These are a great opportunity to share and embed best practice across all LINks in the run up to local Healthwatch. They are ideal for LINks members who wish to gain more confidence and enhance their skills, as well as those who are new to LINks and want to make a difference to local health and social care services, improve local patient experiences and outcomes, give a voice to those who are seldom heard and hold commissioners and providers to account.

The three-hour events will focus on how people can develop their skills as leaders, carry out enter and view visits, represent the views of local people, engage with diverse local communities and influence decision makers. They are free to attend, travel expenses will be paid and lunch will be provided.

The events will be delivered in partnership by Disability Rights UK [http://www.disabilityalliance.org/disabilityrightsuk.htm], NAVCA [http://www.navca.org.uk], the Race Equality Foundation [http://www.raceequalityfoundation.org.uk/] and Regional Voices [http://www.regionalvoices.net/].

As places are limited to 2 per LINk, we ask that bookings are agreed in advance through LINks Chairs. People can sign up now to attend the first of a series of events, which will explore the role of leadership in the context of LINks, help you reflect upon your own leadership challenges, identify solutions and enhance your leadership skills and confidence.

The sessions will be delivered in 14 locations across the country.  Dates and locations for these along with how to book will be available on this web page from 1st February 2012.

Throughout the document the role of the voluntary sector as a crucial partner is highlighted- in identifying and acting on local priorities.  More formal draft guidance will come out in January (it will remain draft until the Health and Social Care Bill gains Royal Assent)- when the Department of Health intends to consult on the guidelines.  So if you have any thoughts about the guidance- or around voluntary sector involvement with JSNAs- leave a comment below, or contact your nearest regional Health and Social Care Network.

Other support for the developing Health and Wellbeing Boards includes the National Learning Network for health and wellbeing boards.  It may be of interest to voluntary organisations to know what is going on in your area by joining the online “community of practice” by registering at: http://www.communities.idea.gov.uk/login.do.

Read the Regional Voices briefing for more information about Health and Wellbeing Boards

1. Performance on finance and service quality – retaining financial stability, progress on waiting times, reducing hospital acquired infection and reducing mixed sex accommodation

2.  Changes to service provider requirements to meet the quality and productivity challenge

3. To complete the transition to the new health and care system, harnessing the power of clinical commissioning, transforming the way services are provided and the local environment so that patients and the community can be heard in the planning of services

4.  Ensuring that elderly and vulnerable people receive dignified and compassionate care in every part of the NHS, learning the lessons from Mid-Staffs, changing the culture, behaviour and clinical practices as required, and listening to patients, their families and carers about their experience of the NHS to make care better.

The Operating Framework spells out to the NHS how to respond to each of these 4 areas, with a strong focus on the quality of leadership required in management.

It also provides detail on the delegation of commissioning responsibility to Clinical Commissioning Groups (CCGs), with increasing momentum on delegating the power to commission services provided to them by PCT clusters.

Read National Voices briefing on implications of the Operating Framework for patients, service users and the sector.

It details five main changes are that are coming in around public health:
1.    Local authorities will lead on public health, to shape services for local needs (health and wellbeing boards will be key to this)
2.    Public Health England (PHE) will support integrated public health from April 2013
3.    An integrated PH outcomes framework is being developed, focused on health outcomes
4.    Make PH a clear priority across government- a cross-government committee is being formed.
5.    Commitment to reduce health inequalities as a priority across the system.

The voluntary sector gets one clear mention in the overview- that local authorities will be thinking about how they use existing networks of community groups and third sector providers (and pharmacies), and also be developing new relationships to promote health and wellbeing).

Nationally, PHE will bring together 18 different bodies together (includes the Health Protection Agency, the National Treatment Agencies, the public health observatories, cancer registries, some Department of Health and strategic health authority functions) and will be twice as big as the Department of Health.  It will be an executive agency, more independent from the Department of Health than originally proposed.

At the DH Strategic Partners meeting this week we were told that:

• across the system, from national to local, there needs to be a sustained partnership with the VCS in order to improve population health
• they want a collaborative approach to evidence gathering, an open and cross-sectoral approach to policy and delivery, and a recognition of the social market- with more collaboration between providers and commissioners.

Next steps and opportunities to influence: more detailed plans about the future of public health, and its transition to local authorities and PHE, will be published in the Autumn.  In the meantime, early implementing health and wellbeing boards are being set up across the country- and it will be useful for the voluntary sector to work with these boards, to feed in the needs and priorities of the communities that we serve.  Nationally, Regional Voices is working with the Early Implementers Network, to ensure that the importance of the voluntary sector in reducing health inequalities is embedded in the system.

What Regional Voices thinks:

• We welcome a clear commitment to the reduction of health inequalities and reference to the Marmot Review in the Government response.
• We are concerned that not all health and wellbeing boards that are being set up are engaging with the voluntary sector in a systematic way. Our overriding principle is that a tokenistic place offered on a Board is of little value to either statutory health providers or Third Sector organisations.  Any engagement must be meaningful and be underpinned by the existence and accountability to a much wider and recognised Third Sector network which will inform and support any direct representation and act as an advisory panel.
• It is not yet obvious how the voluntary sector will link with Public Health England, and we will look for further opportunities to engage with them as they develop.

What do you think?
What are your experiences of the developing Health and Wellbeing Boards in your local area?  We’re interested in capturing different models that are developing for engaging the voluntary sector and the people we work with.  What are your thoughts on benefits to the voluntary sector from engaging with Public Health England?

Let us know your thoughts by commenting below, and/or linking in with your regional health and social care network, so we can raise your issues with the Department of Health.

The Future Forum has recently met and determined 4 new areas to consider and develop recommendations:
(1) Public health in the NHS
(2) Education and training
(3) Integration-towards person centred care, in terms of health and social care, adult and children’s services, primary and secondary care service and mental health.
(4) Information-to help people make choices and to promote accountability.

Some useful feedback from Steve Field (Future Forum Chair) was that a lot of the comments the Future Forum heard from the voluntary sector were too much focused on the voluntary sector itself, rather than the people it supports.

Find out more:
Nuffield Trust and Kings Fund Paper on integration
Regional Voices’ submission to the Future Forum listening exercise- what the sector said.

Next steps and opportunities to influence: the Future Forum has yet to decide how it wants to approach this next” engagement phase”, which is likely to be 8-10 weeks long. It would like the voluntary sector to help shape thinking, to get patient voice and the needs of disadvantaged communities at the forefront of developments.  They want radical ideas to challenge current thinking.  The shape of this “engagement” has yet to be determined- Regional Voices will share messages the voluntary sector share with us, across England, as the process gets up and running.

What Regional Voices thinks:
We welcome that this independent body of experts is continuing to gather views about how the Health and Social Care Bill can be improved.  We particularly welcome more concentrated thought on how policy and spending can be integrated across the whole system and how that impacts on the holistic care of individuals. The information strand will be important to influence from the point of view of people who need support to access information.  It will also be important for how services (including voluntary sector services) are signposted by NHS gatekeepers.

What do you think?
What “integrations” in the system would most benefit the people you work with?  What would be the key messages you’d like the Future Forum to hear about regarding accessibility of information for your service users?  What messages did you give the Future Forum in the listening exercise that you don’t feel were “heard”?  Do you have any thought about how to make this next stage of engagement with the Future Forum effective?

Let us know your thoughts by commenting below, and/or linking in with your regional health and social care network, so we can raise your issues with the Department of Health.

• the cost of care and support, as a partnership between individuals and the state
• how individuals can plan for the future and to protect their assets (homes) against the cost of care
• how public funding should be used to meet care and support needs

The Commission initially looked at the problems in the current system:

• Demand for social care is on the increase
• Public spending is under pressure
• The system isn’t currently understood and information and advice are poor
• Those with some assets (above 14k) have to contribute the largest proportion of their assets- up to 86%, which instils fear for what happens when the funds run out, and is a disincentive to planning for the future
• Not many people are planning for their care costs, and there are no real mechanisms to support planning
• The current means test creates a huge cliff edge, that anyone with more than £23k has to pay for 100% of their care and support, until their assets are worth only £23k

Proposals:

A cap to prevent anyone paying more than £35k towards the cost of care.

Reform the means test to remove the cliff edge.  Currently there is a huge cliff edge at 23k.  Dilnot says this is the worst means test of all he’s seen.  The reformed means test would become more tapered up to 100k.

This combination of proposals would mean that no one would need to spend more than 30% of their assets on social care. This will eventually apply to both domiciliary care and residential care, aiming to reduce perverse incentives to move into residential care.

Younger adults: For adults of working age with care and support needs, similar principles apply, however the Commission felt that younger adults are less likely to have saved for social care needs and thus should be supported in full by the state.  It is proposed that older adults (in 40s and 50s) are more likely to have some assets and thus, if above the means tested threshold to be expected to contribute to their own care and support needs.

Living costs: People in residential care would be expected to contribute to general living costs, as they would at home (although they are likely to be more expensive in residential home)  The Commission recommended the maximum contribution should be between £7 and £10k per year.

Improvements for carers: recommendations about improved support for carers, including more timely assessments and better quality advice.

Eligibility: as a minimum, people with a “substantial” or “critical” care need under the fair access to care criteria will be eligible for support with the costs of care, that is a national eligilibity threshold and that assessments for care should be portable across the country.

Alignment: Better integration between health and social care.

Cost of proposals: Out of the total £697bn public spend, £27bn is spent on social care and disability benefits.  These proposals would cost the state a further £1.7bn.

Promoting more financial planning products particularly equity release schemes and deferred payment routes.

Comments from the sector on the Dilnot report

Next steps and opportunities to influence: the Social Care White Paper is due in the spring.  It will include issues around quality, the Law Commission Review and finance reform under their vision for social care. Regional Voices will be coordinating consultation events around the country and both regional responses and a national response to the White Paper to ensure the voice of the voluntary sector and the people we work with influences the developing care and support system.

What Regional Voices thinks

• Regional Voices welcomes the main proposals in the Dilnot Report, that it aims to close the gap in the costs in care between the richest and the poorest and to ensure that no-one is left out.
• It also welcomes the aim of making the care and support system more understandable to the public- and hopes that the Government will accept the recommendations. Social care has previously been quite a political football and thus the system is in serious need of change.
• However, it will depend on the quality of services that will be available that will determine the ultimate fairness of the care and support system.

What do you think?

Do you think the proposals in the Dilnot refor will make the funding of care and support fairer?  Do you have specific examples of service users who will benefit from these proposals ?(and thus add weight to the argument to funding them?) Do you see any gaps for voluntary sector beneficiaries that we need to warn about?

Let us know your thoughts by commenting below, and/or linking in with your regional health and social care network, so we can raise your issues with the Department of Health.

Diagram showing voluntary sector role in PPI

Background on the NHS Commissioning Board:
The NCB will hold approximately £20 b, of the £80 bn clinical commissioning budget, as well as being responsible for authorising the clinical commissioning consortia. In shadow form the Board will be created- between Oct 11 and Oct 12 and is likely to have around 3000 staff.  As it sets up its governance structures, the Department of Health want the voluntary sector’s thoughts about how to promote effective engagement with patients and the public, possibly through a lay adviser structure and/or through a stakeholder reference panel for the board of directors.
Read more about proposed developments for the NCB.

Next steps and opportunities to influence: the NCB is being formed over the next 18 months, and there will be further conversations with the DH Strategic Partners and the wider sector about how to embed PPI into the system.  Regional Voices is keen to feed thoughts from the wider voluntary sector into this process.

What Regional Voices thinks:

• We need to be careful not to lose previous lessons from effective mechanisms for engaging public and patient voice in health and social care architecture.
• Effective engagement, with well supported, democratically accountable representatives isn’t free- however it will support the right commissioning decisions to take place.

What do you think?
How do you think the voluntary sector can support more effective public and patient involvement in the developing systems?  Are there any pitfalls to avoid or useful experiences you think the NCB should build on in developing its governance structures?

If you have any please let us know, either using the comments space below or by contacting your regional health and social care network, to promote discussions.

The GP Commissioning – Third Sector & Big Society – Commission is led by Voluntary Sector North West on behalf of Regional Voices, the national forum of regional voluntary and community sector networks and a Strategic Partner of the Department of Health.

Third Sector membership of the forum is made up of nominations from NHS Strategic Partners and North West Based organisations including RADAR, Mental Health Helplines, the Lesbian & Gay Foundation, Sefton CVS and NCVO.  The Department of Health is represented on the Board, along with the NW NHS lead on Commissioning Support, Joe Rafferty.  Influential think tank, the Kings Fund, has also joined the group.

The meeting will focus on identifying the barriers and support needs of both the third sector and GP Commissioning Consortia (GPCCs), through case studies demonstrating organisations already delivering real health benefits in communities. These will be used to identify where services and interventions may need to be developed in the commissioning support process, to ensure the sector’s potential to deliver health services is maximised. 

Paul Burstow

Paul Burstow, Health Minister, said he was pleased to see organisations working together to make sure the best services are available for local patients:

“It is great to see the enthusiasm of the third sector in working with GP consortia and the wider NHS to design the best care for patients. It’s the actions that these organisations take together on the ground that will make a difference to patients in personalising services for their communities.

“As part of the ongoing listening exercise, the Prime Minister and Health Secretary met with leaders from the voluntary sector. There are so many wonderful examples of innovative services delivered by the voluntary sector, such as Primary Care Advice Liaison (PCAL) provided by Wirral CAB and Advocacy in Wirral. We want to see the voluntary sector given the opportunity to get involved in all elements of health and social care, not just playing a supporting role.”

Richard Caulfield

Richard Caulfield, Chief Executive of VSNW, said that despite the ‘pause’ in the Health and Social Care Bill, it was vital that the issues around GP Commissioning were explored at the earliest possible stage:

“A huge number of third sector organisations are already delivering health benefits funded from within the health system across the country.  Many are looking to deliver more but are struggling to come to terms with what GP commissioning will mean for them.  Planning in the sector is proving incredibly difficult in the current environment, and organisations are struggling to make sense of how GP commissioning will evolve.

“We will explore the issues in depth to ensure that the third sector and the new commissioners are equipped to meet the needs of communities by working effectively together, and to ensure the systems and structures developed are fit for purpose. By bringing together a range of partners, we will be able to make considered recommendations to government, the NHS and the wider third sector to help move forward in a manner that delivers for our communities.”

Joe Rafferty, Commissioning Support Lead for NHS NW, said the group’s work was of national importance:

“NHS NW has worked well with VSNW over recent years to identify how we maximize the use of the third sector.  In our discussions on how to maximize opportunities for the third sector in the NHS reforms we agreed to develop a work stream to address the issues of commissioning support.  We believe through our work and its dissemination we will be able to positively contribute to the development of effective commissioning support services across the country.”

Notes to editors
Case study from Wirral CAB is available and Richard Caulfield can be interviewed – please contact Hannah Horton on 07760 752986 for further information.

Dates and Locations

If you would like to attend one of these meetings, please follow the instructions below- a booking form is attached.  The relevant regional network will contact you to confirm attendance and send any specific joining instructions. 

Event Overview

NHS Future Forum members will attend each meeting in order to listen to participants’ views around the developing Health and Social Care Bill. Particularly around “Choice and Competition” and “Accountability and Patients”. 

Each meeting will be attended by approximately 25-35 voluntary sector leaders, particularly those working with patients, service users and carers from throughout each region. In order to gather as many voices as possible from across the sector, we request that all attendees liaise with their members and networks prior to the meeting to obtain views and feedback on the questions raised. 

Who are the events for?

These events are aimed primarily at the voluntary and community sector with an interest in any aspect of public health and health inequalities eg lifestyles, early years, environment, mental wellbeing, education and skills and healthy aging. 

We anticipate that demand for places will be high so we reserve the right to restrict the numbers of delegates attending from any single organisation.

If you are not able to participate in these events, find out how you can get involved in the wider listening exercise: http://healthandcare.dh.gov.uk/category/conversations/listening-exercise-conversations/

 For further details contact the relevant regional organisation- see table above or Jo Whaley on 07769168388 or jo.whaley@regionalvoices.org

The events will give you the opportunity to learn more about the proposed changes in the White Paper as well as attending workshops to discuss issues in depth.

Dates

Event Overview

These events will help voluntary and community sector, service user, carer and patient organisations understand how the White Paper will impact on their work and the opportunities it presents.  They will:

• Be the first stage in engaging with the voluntary and community sector in relation to public health
• Raise awareness of the changes proposed in the White Paper and help you to develop an informed response to the consultations
• Inform delegates about how the public health landscape is changing locally, in the region and across England
• Identify some of the cross cutting issues of particular relevance to the voluntary and community sector
• Be an opportunity to promote the role of the voluntary and community sector in the new public health landscape

The events are being hosted by Regional Voices with the London event being jointly hosted with Faith Action.  All events are being held in partnership with the Department of Health and other local partners where appropriate.

Who are the events for?

• These events are aimed primarily at the voluntary and community sector with an interest in any aspect of public health and health inequalities eg lifestyles, early years, environment, mental wellbeing, education and skills, healthy aging
• Delegates from local authorities and NHS organisations are welcome to attend but places are limited and will be allocated on a first come first served basis.
• We anticipate that demand for places will be high so we reserve the right to restrict the numbers of delegates attending from any single organisation.

How to book

Click on the regional event you wish to attend in the table above to download the specific publicity for that event and a booking form.  (Booking forms for the London, South East and West Midlands events will be available shortly.

For further details contact Emma Easton:

T: 0113 394 2304        E: emma.easton@regionalvoices.org