01.06.14
A new era – or more of the same?
Source: National Health Executive May/Jun 2014
Welcome to this larger-than-usual edition of National Health Executive, with even more features, analysis, news, views and interviews than usual.
With thousands of NHS managers, directors and clinicians soon to meet up in Liverpool for the annual NHS Confederation conference, we’ve got a preview of the show, including information about the exhibitors, speakers, venue and the events you should be sure not to miss. Our guide begins on page 31.
As our last edition was going to press, Simon Stevens was about to take over as NHS England chief executive. Now, a few weeks into the job, Stevens is settling in. He handled Health Select Committee questioning as well as can be expected, while sounding sceptical on some of the grander claims made for integration projects and service reconfigurations. He has questioned the widespread view about the changes needed in the acute sector (centralisation of specialist services, downgrading or closure of many district general hospitals) – an argument made in this very edition by 2020health.org on page 22, among others. He has invited CCGs to get involved in ‘co-commissioning’ of primary care, apparently assured that concerns over local conflicts of interest will be avoided by NHS England oversight. The arguments made by NHS Clinical Commissioners on this are compelling – but governance is going to have to be water-tight. Stevens has also signalled a symbolic break with the past by clamping down on officials’ expense claims.
Stevens is a clear believer in the power of multiple providers. His first speech referenced the “innovation value of new providers”, and of course the new competition and commissioning landscape is only going to see more private and third sector involvement in the NHS. Concerns remain over whether the NHS has enough commercial-minded people with the experience and ability to manage the growing number of such contracts, which have to depend on quality targets being hit.
Stevens has said of the Better Care Fund that it “needs to deal with the realities in order to be successful”. The whole principle behind the fund remains unpopular for many in the acute sector in particular, where it is often seen as a way of transferring money from health into local government (I am simplifying, but that’s often the undertone). In this edition of NHE, Simon Morioka and Claire Kennedy urge the BCF’s critics to look at the full facts before jumping to conclusions – see page 17. Some bids have apparently been of questionable quality, and newspaper stories claiming the fund had been postponed attracted attention, particularly because of Cabinet Office doubts about it. The official line was that the delay only related to the publication date of some case studies of the best bids, while the target dates for the fund itself remain in place.
More on this in the next edition of NHE, no doubt.
Adam Hewitt
Editor
(Image: Owen Humphreys & PA Wire)