NHS England is set to target “shockingly low” diagnosis rates of dementia in England in a move that could see tens of thousands more people diagnosed and treated each year. Health Secretary Jeremy Hunt recently announced the drive to completely overhaul dementia diagnosis as the Prime Minister’s Challenge on Dementia reaches its first year.

Monitor and NHS England call for views on how the NHS payment system can do more for patients

Monitor and NHS England are working to reform the way NHS services are paid for. They aim to develop and design a new payment system which will deliver the best possible care for patients. For nearly a decade hospitals have been paid through the Payment by Results system. They are now inviting views on how the NHS payment system can be reformed to do more for patients.

National partners make commitment to join up health and social care

NHS England as a key partner in the National Collaboration for Integrated Care and Support has signed up to first ever system-wide ‘shared commitment’ to help local areas integrate services. The agreement, set out in the ‘Integrated care and support: our shared commitment’ framework document on integration, will tackle national barriers and enable and encourage locally-led, integrated services to flourish.

Be clear on cancer – looking ahead 2013-14

Public Health England is running a series of campaigns  to raise awareness of the symptoms of cancer.  These campaigns may have an impact on numbers presenting with relevant symptoms and on demand for a range of NHS services including an increase of 10% for chest x-rays and CT scans over the campaign period. For further information please contact David Halsall. CCG clinical leaders and NHS chief executives will wish to ensure plans are in place to prepare for the campaigns. If you have any queries about the forthcoming campaigns, please contact Hilary Walker.

Consultations and evaluations

£10m to improve discharge arrangements for homeless people

The Department of Health has launched an application process for voluntary sector bids working in partnership with NHS and local authorities to improve discharge arrangements for homeless patients that can improve health outcomes, reduce ‘revolving door’ admissions and save NHS money. The funding will ensure better services are in place so that no patient is discharged without their housing and medical support needs planned. The deadline for voluntary sector organisations to apply for the fund is 8 July 2013.

Leadership pilots

Eight leadership pilots running across the country have been finding new ways for partners in health and care systems to tackle problems and find workable solutions. Supported by a team from local government and health, applications are being sought from another 22 Health and Wellbeing Boards. CGC clinical leaders, NHS and local authority chief executives who wish to submit an application to John Jarvis should do so by 2 June 2013.

Patients First Programme Three Year Evaluation, Invitation to Tender

The Foundation of Nurse Studies would like to understand more about the longer term value of this programme and its impact on practice. To this end, we are seeking an external evaluator to undertake an evaluation of the first three years of the Patients First Programme (November 2009 – October 2012) involving forty nurse-led teams invitation to tender. The total budget for this evaluation is £20,000 and the closing date for applications is 10 June 2013.

Publications

Guide to the Healthcare System in England

This guide was published on 10 May 2013. It builds on previous guidance issued, bringing together in one place a concise explanation of how existing and new NHS organisations are working closely together to deliver improved care for patients. The roles and responsibilities of each partner in the healthcare system are outlined in a way that is a useful companion piece to the NHS Constitution.

NHS Improving Quality publishes strategic intent

NHS Improving Quality has published a strategic intent document, which outlines the aims and values of the organisation. Set up on 1 April 2013, NHS Improving Quality works to improve health outcomes across England by providing improvement and change expertise. The strategic intent details how the organisation will deliver 10 key improvement programmes based around the priority areas set out in the NHS Outcomes Framework 2013/14, as well as four programmes to develop capability and capacity within the healthcare system.

OK to Ask about clinical research: international clinical trials day

On 20 May the National Institute for Health Research launches “It’s OK to ask” a national campaign to encourage patients to ask their doctor/consultant about opportunities to take part in clinical research. See a related video message from the Chief Medical Officer. CCG clinical leaders will wish to prepare for the clinical trials day on 20 May and consider how to channel patient interest in research in their local area.

Conferences and events

The Bristol NHS Values Summit, 17 May 2013

The Equality and Health Inequalities team within NHS England is hosting the Bristol NHS Values Summit on Friday 17 May 2013. The event will bring leaders from across health and social care together with staff, patients and local community representatives to share insights into how people’s differences can affect their experiences, quality of care and health outcomes. To attend please get in touch.

Quality Accounts Wednesday 5 June 2013, London

Simon Bennett, Quality Framework Team, NHS England will give the opening address at this conference which will provide an important update on strengthening quality accounts in response to the Francis recommendations following the Mid Staffordshire Public Inquiry. CCG clinical leaders and NHS chief executives can register at the link above or contact Kerry for further information. A 20% discount is available by quoting ref: hcuk20nhsnews when booking.

Patient Experience Feedback, Tuesday 11 June, London

With an address by Neil Churchill Director of Patient Experience, NHS England this conference focuses on implementing the patient experience feedback recommendations from the Francis Inquiry Report into Mid Staffordshire NHS Foundation Trust, including developing real time systems. Please register at the link above or contact Kerry for further information. A 20% discount is available by quoting ref: hcuk20nhsnews when booking.

Extra Notes

All communications requiring the attention of NHS commissioning organisations must include a publications gateway reference number. In order to streamline the number of communications issued by NHS England, these will continue to be sent via ‘NHS news’ every Thursday.

Unless otherwise stated, guidance referred to in the bulletin has not been commissioned or endorsed by NHS England – it is evidence that organisations and professionals may find helpful in improving practice. The National Institute for Health and Care Excellence is the provider of accredited evidence and guidance, which can be found on the Institute’s website www.nice.org.uk

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You can view separate recordings of each agenda item below:

Parts one and two

Part three

Parts four and five

Parts six and seven

Part eight

Parts eight to eleven

You can view the agenda and board papers below.

• Agenda – public meeting 3 May 2013
• Minutes of the NHS England public meeting 12 April 2013
  • Corporate governance item
• Item 4 – Prioritising patients in every decision we make
  • The insight dashboard – an overview
• Item 5 - A single patient focus for NHS England: developing and embedding our vision and purpose
• Item 7 – HR update
• Item 8 - Assuring NHS 111 operational delivery
• Item 9 - Feedback from Board committees and sub-committees
  • Report of the CCG authorisation committee

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The announcement of the drive to completely overhaul dementia diagnosis was made today by Health Secretary Jeremy Hunt as the Prime Minister’s Challenge on Dementia reaches its first year.

The plans aim to see two-thirds of people with dementia identified and given appropriate support by 2015, an increase from 37 per cent in 2010 and the current average of around 45 per cent.

Dr Martin McShane, Director NHS England said: “NHS England recognises that dementia is a national priority and is committed to working with Clinical Commissioning Groups and Health and Wellbeing Boards to achieve transformation in the quality of care and support for people with dementia , and for their carers.

“We know that a diagnosis is the first step to accessing appropriate care and support.

“We are delighted that Clinical Commissioning Groups across the country have taken the first steps in addressing the national ambition; with new information provided by NHS England to support them to understand the scale of the challenge at a local level and the opportunities for individuals and their carers when that diagnosis and support is achieved.

“We relish the opportunity to share best practice and effective ways of meeting the needs of people with dementia once diagnosed with our colleagues in Clinical Commissioning Groups and Health and Wellbeing Boards.”

There are currently 670,000 people with dementia in England but 350,000 of those people remain undiagnosed and without access to support.

With the number of sufferers set to double in the next 30 years and costs expected to rise to £19 billion, improved diagnosis will be key if the system is to cope effectively with the predicted surge in numbers.

The focus will also see a correction to the existing postcode lottery on diagnosis rates. Although the average diagnosis rate across England is now at around 45 per cent, up from 42 per cent in 2010/11, this still leaves more than half of people undiagnosed.

Hitting the two-thirds ambition will see an extra 160,000 people diagnosed in 2015 compared with the number identified this year. This will bring them the benefits and reassurance of help and support with the condition.

Health Secretary Jeremy Hunt said: “For too long diagnosis rates have been shockingly low and leaving too many people living in the dark suffering with this terrible condition undiagnosed, unable to get the help they need and deserve.

“I am pleased that NHS England has set a clear direction and sent a message to the NHS that we must do more. I fully support every GP, doctor and health worker who accepts this challenge.”

To read more on the Dementia Progress Report, go to the Department of Health website.  See also UK to use G8 to target global effort on dementia and the The Prime Minister’s Challenge on Dementia: Annual report of progress.

For further information, please e-mail the NHS England media team at  nhscb.media@nhs.net or call 07768 901293.

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• Welcome from Barbara Hakin

1. Commissioning Assembly news – Integrated care pioneers
2. CCG Development Framework 2013/14
3. CCG Assurance Framework 2013/14 proposals published
4. Timely diagnosis of dementia and post diagnostic support
5. NHS111 update
6. NHS support plan launched to help hospital and A&E departments keep waiting times in check
7. CCG set up: Guide to good handling of complaints
8. Quality Premium 2013/14 guidance for CCGs
9. Enabling data flows for commissioning
10. GP systems of choice (GPSoC) administration of Schedule A on the Tracking Database
11. Important changes to national immunisation programme
12. How can the NHS payment system delivers more for patients? – Joint Monitor/NHS England discussion paper
13. Sustainable Development Strategy consultation – closes 31 May 2013
14. Joint Monitor /NHS England review of emergency admissions marginal rate – call for evidence
15. Scheme to improve homeless discharge – call for bids
16. Dedicated web pages launched for 74 specialised services Clinical Reference Groups (CRGs)
17. NHS England releases update to national Cancer Drugs Fund list
18. NHS England welcomes publishing of medicines optimisation
19. Health and wellbeing leadership: delivering improved outcomes for local communities
20. Implementing a ban on age discrimination in the NHS: free learning event for commissioners
21. Commissioning Show 2013 – 12-13 June 2013, Excel, London

• Letters to CCGs
• About this bulletin

Gateway reference number: 00110

Download the Bulletin for CCGs: Issue 34, 14 May 2013 (PDF, 143KB)

Welcome from Barbara Hakin

Dame Barbara Hakin
Interim Chief Operating Officer and Deputy Chief Executive

Welcome to the latest edition of the CCG Bulletin. In this week’s bulletin we outline a number of strategic issues that you will be considering in your own CCG.

Today sees the launch of Integrated Care Pioneers, a national initiative, which will focus on the role of integration in the health and social care system. Together we recognise that integration is key to improving experience of patients and delivering value and for many of you considering the role integration can play for your patients you will want to be up to date with this new development.

Many of you have been involved in the shaping and refining of the interim CCG Assurance Framework 2013/14 and I am eager to develop this document further with as many stakeholders as possible through a series of engagement events. More information about this can be found in the bulletin.

At the end of last week we published the A&E Improvement Plan setting out a tripartite agreement between NHS England, Monitor and the NHS Trust Development Authority (NHS TDA) which will see local urgent care boards established which will ensure system recovery and improvement plans are in place for each A&E department. As lead commissioners, CCGs should support their providers to ensure that each A&E department, that is not within the NHS Constitution threshold, can recover its position at the earliest possible time. This will require the development of local recovery and improvement plans centred on each A&E department. I have asked each Area Director to facilitate the preparation of these plans by CCGs for each A&E department on their patch.

We hope you will find the inclusion of a number of operational issues in this week’s bulletin helpful. These include issues relating to day to day commissioning, such as the current position on A&E, through to practical information that may help your organisation run effectively such as data flows. This section provides helpful pointers to information that you may wish to action within your own organisation.

Towards the end of the bulletin you will find a number of opportunities to get involved in work related to clinical commissioning. These range from consultations to events and you may like to consider your involvement in any of these.

The bulletin also highlights correspondence that has been sent to CCGs since the last bulletin at the end of April 2013.

Dame Barbara Hakin
Interim Chief Operating Officer and Deputy Chief Executive

1.    Commissioning Assembly news

Integrated care pioneers

A collaboration of national organisations, including NHS England, Local Government Association, Monitor and the Department of Health, have come together to help make integrated care and support happen across the country.

As part of the initiative CCGs will be particularly interested in the opportunity for health economies to bid to become integration “pioneers” running large-scale experiments in integrated care.  Those areas awarded pioneer status will be offered support and advice to help overcome barriers to care.

The collaboration has published three key documents as part of this initiative:

• ‘Integrated Care and Support – Our Shared Commitment’ ( which sets out clear “statements of commitment” by the national partners to support localities and what we expect in return from local areas. This will be a sustained collaboration to remove national barriers, develop national enablers and support local efforts, with a view to making integrated care and support the norm over the coming years;
• a definition (referred to as the Narrative) of what good, integrated care and support looks and feels like from the perspective of the individual, co-developed for us by National Voices and aligned with the Making it Real initiative supported by Think Local, Act Personal (TLAP); and
• a letter and supporting note inviting expressions of interest from CCGs, local authorities, health and wellbeing boards and providers areas to become pioneers in integrated care and support, to receive intensive support from the national partners and contribute to accelerating learning at scale and pace for dissemination, promotion and adoption across England. Expressions of interest should be submitted by the end of June 2013.

The NHS Commissioning Assembly Integration Working Group has played a key role in the development of this work, including review of the key documents. As we now move into the implementation phase the Working Group will be focussing on how these guiding principles could be turned into reality at local level.  This will include expanding engagement with CCGs and other key stakeholders.

• Find out more and download the documents

2.    CCG Development Framework 2013/14

Many of you will have already been involved with shaping our early thinking of NHS England’s CCG Development Framework for 13/14 and beyond, and the initial proposals for supporting CCGs to agree their development plans. We are keen to understand the current approaches in place between CCGs and Area Teams explore the wider development offer to CCGs to achieve their ambition to become great clinical commissioners.

We would like CCGs to help shape the thinking around the organisational health component of the assurance framework, including what a safe threshold for assurance should look like at the end of 2013/14.

To steer this work and ensure that it delivers what CCGs require, we would like to invite you to “save the date” for the first of a series of free events to examine:

• the current landscape of CCG development;
• what a great CCG looks like?;
• the current and future development offers to CCGs; and
• the organisational health assurance process.

To ensure that we can have the most effective conversation we would like to two representatives from every CCG, one clinical and one non-clinical to the events to enable us to co-produce the work and address these key issues, perhaps your CCG chair and accountable officer. NHS England will be represented by colleagues from the National CCG Development Team, Area Teams and Regions.

The events will be held in five locations across the country to facilitate attendance and encourage as much participation as possible. Please hold the date that is most convenient for you.

• 20 June – London
• 9 July – Northampton
• 10 July – Reading
• 16 July – York
• 17 July – Manchester

We are keen to work with you to understand the specific needs of CCGs now, and how we can work together to ensure your organisation realises its full potential.

The events are all free and further details on venues, timings and registration will be issued shortly, along with a final event programme and information.

3.    CCG Assurance Framework 2013/14 proposals published

On 7 May NHS England published proposals for the CCG Assurance Framework 2013/14. These draft proposals cover the interim arrangements for assurance in Q1 and Q2, and an outline of what elements of assurance will be covered on an annual basis.

The proposed CCG Assurance Framework has been developed with colleagues from CCGs and NHS England. The draft was tested with members of the NHS Commissioning Assembly, through Rapid Reference Groups, prior to publication last week.

We are now keen to draw on the views of commissioners and beyond in developing the framework further, ensuring it delivers for us all.  We want to know how these proposals can be refined and developed further to allow the final document, published in the autumn, to be a truly co-produced piece of work. Nationally this work will be led by a CCG leader and Area Director.  We will want to work with all interested parties in local areas to hear views.  More details on how you can put your views forward and arrangements for local engagement will follow shortly and we are very keen that we gather as much feedback as possible on the current proposals over the coming months.

If you have any queries, please email england.ccgassurance@nhs.net.

• Find out more

4.    Timely diagnosis of dementia and post diagnostic support

Dementia is a major and growing challenge for both health and social care. It is increasingly recognised that care and support can be improved for people with dementia, their families and carers. CCGs have taken the first steps to improving diagnosis and care for people with dementia by setting out an ambition for the proportion of people diagnosed as having dementia and receiving care and support by March 2015. The ambitions range from 40 percent to above 70 percent. This level of variation indicates an opportunity for NHS England to support those CCGs with a lower level of ambition by sharing best practice and the experience and lessons from those with a greater ambition in order to aim for an overall national ambition of two thirds of people with dementia receiving a diagnosis and care by March 2015. We have had fascinating feedback from the NHS Commissioning Assembly Rapid Reference Group on the nature of the barriers that will need to be overcome.

To help achieve this NHS England has created a suite of tools to enable individual GPs, practices and CCGs to improve diagnosis, care and support for people with dementia and their families. We will be seeking to support CCGs and practices to meet the challenges presented by the increasing prevalence of dementia and engaging in dialogue to understand the barriers and how to help spread best practice.

• Dementia Prevalence Calculator and supporting suite of tools

5.    NHS111 update

The NHS Commissioning Assembly has established a working group to focus on 111.  Jointly chaired by Dr Peter Melton, CCG Chief Clinical Officer and John McIvor, Area Team Director. The group is considering how it best supports three phases of work related to 111, ‘roll- out’, ‘review’ and ‘the future’.

Updates on this on-going work will be provided in future CCG bulletins.

6.    NHS support plan launched to help hospital and A&E departments keep waiting times in check

Plans to strengthen performance in urgent and emergency care are being put in place across the country to help hospital A&E departments meet demand and tackle waiting time pressures.

NHS England has joined with the NHS Trust Development Authority (NHS TDA) and Monitor, which are responsible for provider regulation, to ensure coordinated action to ease the immediate pressures.

At the same time, a review will take place to understand the causes of problems, which differ around the country.

We have already had detailed feedback from the NHS Commissioning Assembly Rapid Reference Group on the potential factors which has helped to inform our analysis.

• Find out more

7.    CCG set up: Guide to good handling of complaints

During transition many CCGs asked for support and advice on handling complaints.  In response NHS England has worked in partnership with the Health Service Ombudsman, and with input from CCGs, to develop a Guide to good handling of complaints.

This final part of support to CCGs as they set up, has now concluded and NHS England has this week published a guide to support CCGs to develop good processes for handling of – and responding to – complaints. Ensuring good handling of complaints – and learning from them – are ways in which CCGs can improve quality for their patients.

All NHS organisations, including CCGs, need to comply with the 2009 complaints regulations. ‘Guide to good handling of complaints for CCGs’ provides advice and top tips to CCGs on responding to complaints about the services they commission on behalf of their populations, or about the exercise of any of their own functions. It is intended as a helpful guide to good practice and will help CCGs to ensure they comply with the legal requirements of the 2009 complaints regulations. The document also highlights the importance of monitoring trends and learning from complaints and makes suggestions for CCGs on how to do this.

• Download the Guide from the CCG Resources page of the NHS England website.

8.    Quality Premium 2013/14 guidance for CCGs

Please be aware that an error has been found in the Quality Premium guidance for CCGs. A key section implies measures are focused on adults. However, this is incorrect and should include all ages.

The change details are as follows:

Domain 2 enhancing quality of life for people with long term conditions and Domain 3 Helping people to recover from episodes of ill health or following injury is a composite measure of emergency admissions.

On page 7 the elements of the composite measure for Avoidable Emergency Admissions in relation to:

• unplanned hospitalisation for chronic ambulatory care sensitive conditions and
• emergency admissions for acute conditions that should not usually require hospital admission

make reference to these measures being focussed on adults. This is incorrect. Paragraph 9 of the technical guidance (page 19) makes clear that, although these items were originally restricted to adults only in the NHS Outcomes Framework, all ages are included for Quality Premium purposes.

CCGs should therefore be aware that for the purposes of the quality premium, performance will be assessed on the basis of progress for all age groups.

The guidance will be amended to reflect this.

9.    Enabling data flows for commissioning

Following Dame Fiona Caldicott’s review into information governance (IG), ‘Information: to share or not to share’, we are reviewing the necessary actions to improve IG arrangements in the new health and social care landscape.

This work will enable better and more transparent sharing of information in the interest of patients. As part of this, we need to ensure we have a lawful basis for disclosure of data for commissioning and the separation of direct and indirect care uses of data is important for this.

NHS England recently secured a 3-month Section 251 (s251) extension until 30 June 2013 to support the flow of Secondary Uses Service (SUS) data from Health and Social Care Information Centre (HSCIC) to commissioning support units (CSUs) and CCGs. A decision from the Confidentiality Advisory Committee (CAG) regarding the outcome of a further application to support SUS and other data flows is expected shortly. If successful, we anticipate, the approval will be subject to a number of conditions that will need to be implemented within a short timeframe.

We recognise that the past couple of months have been difficult as we try to re-align data flows to new organisations and appreciate the patience and professionalism that has been shown by CCGs whilst the necessary approvals are sought.

To offer further support, a series of four workshops are planned for the first two weeks of June in the North, the Midlands and London. These working sessions will provide a view of the changes necessary to comply with the s251 support and opportunities for questions of NHS England and the HSCIC IG and Data Services delivery teams.

Dates and venues for the workshops are:

• 5 June – London (for London area)
• 7 June – London (for South)
• 11 June – Leicester (Midlands and East)
• 14 June – Leeds (North)

• If you have any questions, please email england.dataworkshops@nhs.net

10. GP systems of choice (GPSoC) administration of Schedule A on the Tracking Database

In line with the NHS restructure, various responsibilities associated with the administration and ordering of GPSoC services has transferred from PCTs to CCGs. It is understood that the CCGs would typically defer some of these responsibilities to the commissioning support units (CSUs).

One of the responsibilities is the administration of Schedule A on the Tracking Database which is the central tool the NHS uses to order GPSoC services. Staff who were formerly working for a  PCT, who formerly undertook this task, have had their access downgraded to read only since PCTs have disbanded.

Therefore we have requested staff who require Tracking Database full access to contact the Exeter Help Desk at Exeter.helpdesk@nhs.net completing the Access Request Form. As part of this process the Help Desk need to verify the request by contacting the Accountable Officer at the CCG to verify the request.

Please contact the Exeter.helpdesk@nhs.net with the e-mail address of an Accountable Officer at the CCG who can verify such requests.

• Useful FAQs related to CCG and CSU responsibilities are available here

11. Important changes to national immunisation programme

A number of important changes to the national immunisation programme will be introduced this year to protect against flu, meningitis C, shingles and diarrhoea.

A letter sent to CCGs and GPs via Area Teams on 30 April 2013 outlined the changes, including more detail on the introduction of a rotavirus vaccination for babies, which will be implemented following a series of recommendations by the Joint Committee on Vaccination and Immunisation (JCVI) to improve the overall level of protection against preventable diseases.

From 1 June 2013 there will be changes to the schedule for administering the meningitis C vaccine as the second priming dose currently given at four months will be replaced by a booster given in adolescence. A second letter announcing these changes sent on 7 May 2013 can be viewed here.

The new rotavirus vaccination programme will start from July this year for children under four months old. In addition a new shingles vaccine will be introduced for people aged 70 years with a catch-up programme for those aged up to, and including, 79.

There are also plans to extend the flu immunisation programme to include all two year olds, which is the first step of the phased introduction for all children aged two to 16 years old over the next couple of years.

Further letters will be sent about the changes in England in relation to shingles and childhood flu programmes prior to their implementation.

It has also been announced that the temporary programme of pertussis (whooping cough) vaccination for pregnant women, which has been in place since October 2012, will continue into 2013/14.

These changes follow the publishing of an update to the detailed agreement between the Department of Health and NHS England on the delivery of certain public health functions, which will drive improvements in the health of England’s population.

12. How can the NHS payment system delivers more for patients? – Joint Monitor/NHS England discussion paper

Monitor and NHS England, working in partnership, need your help to ensure that the future NHS payment system delivers affordable, quality care and better outcomes for patients.

This discussion paper sets out early thinking on designing a comprehensive payment system for NHS services for the long term.

We are particularly interested in hearing your views about:

• the objectives of the NHS payment system:
  • how can we best support innovation in patterns of care?
  • how can we positively influence provider and commissioner behaviours?
  • how can we support sustainable, risk managed improvements in quality of care?
• how can the payment system be best designed to include different payment approaches for the different types of patient needs and care?
• how can we strengthen the foundations of the current payment system in the meantime?

This paper also sets out our approach for the first jointly produced 2014/15 National Tariff document.

There will be additional opportunities to share your views on this important area over the coming months at which we encourage your attendance and contribution.

• We welcome your comments on the discussion paper by 19 July 2013
• Find out more

13. Sustainable Development Strategy consultation – closes 31 May 2013

A major consultation to help shape the future of an environmentally, financially and socially sustainable health system is currently under way and is seeking input from anyone involved in healthcare.

Run by the Sustainable Development Unit the consultation is to help shape the ‘Sustainable Development Strategy for the Health, Public Health and Social Care System 2014-2020’ which will be launched in January 2014. The team are particularly keen to receive input from CCGs because of their core role in commissioning health services.

You can support the consultation in a number of ways:

• Complete the online response form at www.sdu.nhs.uk/sds. Organisational and an individual responses welcomed.
• Raise awareness of the consultation through your own networks via your regular communication channels. Refer people to www.sdu.nhs.uk/sds.
• Use the consultation as an opportunity to engage with your stakeholders. You will find a suite of supporting materials on the website including presentations, videos and exercises.

14. Joint Monitor /NHS England review of emergency admissions marginal rate – call for evidence

We are gathering evidence to support short and longer term improvements to the payment system. This includes a call for evidence to inform the thinking on a review of the 30 percent marginal rate rule for emergency admissions.

The purpose of the review is to:

• explore what has happened as a result of the introduction of the marginal rate;
• assess what impact it has had including whether it has helped to control the numbers of avoidable emergency admissions; and
• identify whether the approach could be improved.

Our intention is to build a solid base of evidence from a range of stakeholders. We are particularly interested in hearing from commissioners on a range of issues set out in the call for evidence.

• Please provide submissions to emergencycare@monitor.gov.uk by 5pm on 10 June 2013.
• Find out more on Monitor’s website under ‘Related Publications’ (page right)

15. Scheme to improve homeless discharge – call for bids

Department of Health working with NHS England has launched an application process for voluntary sector bids working in partnership with NHS and local authorities to improve discharge arrangements for homeless patients – to improve health outcomes, reduce ‘revolving door’ admissions and save NHS money.

Homeless people visit A&E six times, and are admitted four times, more than those with a home – with 70 percent discharged back onto the street – estimated to cost NHS £85m/year.

The funding will ensure better services are in place so that no patient is discharged without their housing and medical support needs planned.

16. Dedicated web pages launched for 74 specialised services Clinical Reference Groups (CRGs)

NHS England has launched a series of web pages dedicated to each of the 74 specialised services Clinical Reference Groups (CRGs).

CRGs cover the full range of specialised services and are responsible for providing NHS England with clinical advice regarding these directly commissioned services. The CRGs are made up of clinicians, commissioners, Public Health experts and patients and carers. They are responsible for the delivery of key ‘products’ such as service specifications and commissioning policies, which enable NHS England to commission services from specialist providers through the contracting arrangements overseen by its Area Teams.

17. NHS England releases update to national Cancer Drugs Fund list

NHS England has released an update to the national Cancer Drugs Fund list, further increasing access for patients to an additional three new cancer drugs. The additions to the list have been made following a review of trial data from the drugs by the Chemotherapy Clinical Reference Group (CRG).

18. NHS England welcomes publishing of medicines optimisation

NHS England is supporting the Royal Pharmaceutical Society’s call for health professionals and patients to work together to ensure better use of medicines.

A guide, called Medicines Optimisation: helping patients make the most of medicines, has been published by the Society which provides frontline professionals with four guiding principles to make sure that the right patients get the right choice of medication, at the right time.

This has been developed through collaboration between patients, health professionals, lay representatives and patient groups, so importantly it focuses on patient outcomes rather than processes.

The four principles are to aim to understand the patient’s experience, ensure evidence based choice of medicines, make medicines optimisation part of routine practice and ensure medicines use is as safe as possible.

In their foreword to the guide, Sir Bruce Keogh (Medical Director), Jane Cummings (Director of Nursing) and Dr Keith Ridge (Chief Pharmaceutical Officer) from NHS England encourage everyone to adopt these principles whether prescribing, dispensing, administering or taking medicines.

The report has been endorsed not only by NHS England but also the Academy of Medical Royal Colleges, the Royal College of General Practitioners, the Royal College of Nursing and the Association of the British Pharmaceutical Industry.

• More information can also be found on the Royal Pharmaceutical Society’s website.

19. Health and wellbeing leadership: delivering improved outcomes for local communities

CCGs are invited to attend one of two learning events to hear about and share experiences of work with health and wellbeing partners to improve outcomes for local communities.

NHS England and the Local Government Association (LGA) are hosting two events for Health and Wellbeing leaders, as part of the health and wellbeing system improvement programme.

CCGs have signalled that developing good collaborative relationships across the commissioning landscape is an essential element to improving outcomes; and that ensuring the effective leadership of health and wellbeing boards is crucial to deliver joint challenges for system transformation.

The full day events – one in Leeds and one in London – will bring together representatives of health and wellbeing boards including CCGs, local authorities, public health, NHS England and Healthwatch, to share perspectives on how local health and wellbeing leaders can work together to deliver shared ambitions to improve outcomes for local populations. Attending the sessions will be a valuable opportunity for CCGs to hear local and national perspectives, and participate in workshops and discussions with colleagues and partners.

The events are taking place on:

• Tuesday 25 June in London
• Wednesday 26 June in Leeds

•  For more information about the events visit or to book a place, contact marie.coffey@local.gov.uk.

20. Implementing a ban on age discrimination in the NHS: free learning event for commissioners

From October 2012, all public bodies including CCGs have a duty to eliminate unlawful age discrimination.

The Equality and Human Rights Commission, Age UK and Department of Health are running a free learning event on 6 June 2013, 10.30am – 4.00pm in London.

The event will tell you all you need to know about the ban on age discrimination in goods and services. It will also look at how to take a good practice approach to drive improvements in services, in particular for older people.

You will have the opportunity to hear from a range of high profile speakers including strategic policy makers, as well as participating in workshops looking at the practical approaches to implementing the ban.

• Register your place online

21. Commissioning Show 2013 – 12-13 June 2013, Excel, London

This national event for clinical commissioning is aimed at CCGs, CSU, Area Teams, GPs and practice managers to acquire first hand advice and practical training in business and finance management, provision of care, commissioning support, long term conditions and productivity through technology.

Speakers include NHS England’s Chairman, Professor Malcolm Grant along with Rosamond Roughton, Interim National Director: Commissioning Development, who is speaking on ‘From authorisation to transformation – the new focus for CCGs and the commissioning system in 2013’.

• Find out more on the event website and register for your complimentary pass

Letters to CCGs

NHS England has issued the following letters to CCGs since the last bulletin:

• Letter from Dame Barbara Hakin dated 30 April 2013 re: Important changes to the national immunisation programme in 2013-14, and introduction of rotavirus vaccination for babies at two and three months (Gateway reference: 00047)
• Letter from Dame Barbara Hakin dated 7 May 2013 re: Changes to the schedule for meningococcal serogroup C conjugate vaccine (Gateway reference: 00061)
• Letter from Dame Barbara Hakin dated 7 May 2013 re: CCG Assurance Framework 2013/14 (Gateway reference: 00072)
• Letter from Dame Barbara Hakin dated 9 May 2013 re: A&E Improvement Plan (Gateway reference: 00062)
• Letter from Dame Barbara Hakin date 10 May 2013 re: Continuation of temporary programme of pertussis (whooping cough) vaccination of pregnant women (Gateway reference: 00077)

Online

Access the bulletin at www.england.nhs.uk/category/publications/ccg-bulletin/.

Subscribe

Please do forward this bulletin to colleagues and encourage them to sign up online at www.england.nhs.uk/category/publications/ccg-bulletin/.

Submissions

If you have an idea for a future issue, please email england.ccgbulletin@nhs.net.

Future communications to CCGs

We have had feedback from a number of CCGs about preferred methods for communications. We will be putting in place a more systematic methodology to reach all CCGs directly. If you have any comments you would like to make on this, or indeed on the bulletin, please email england.ccgbulletin@nhs.net.

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The event, which is being held in Bristol, will enable leaders from health and social care and staff, patients and local community representatives to share insights into how people’s differences can affect their experiences, quality of care and health outcomes.

Prof Steve Field, NHS England’s Deputy Medical Director, Health Inequalities, said: ‘These summits will help us understand key and emerging issues and will raise awareness of quality care for all.

‘We are committed to strengthening opportunities for all to participate in challenging strategic conversations and to influence positive change by embedding the values of the NHS Constitution’.

Further information on the Bristol event is available in the programme brochure

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“People don’t want health care or social care, they just want the best care. This is a vital step in creating a truly joined-up system that puts people first. Unless we change the way we work, the NHS and care system is heading for a crisis. This national commitment to working together is an important moment in ensuring we have a system which is fit for the future.”

For health, care and support to be ‘integrated’, it must be person-centred, coordinated, and tailored to the needs and preferences of the individual, their carer and family. It means moving away from episodic care to a more holistic approach to health, care and support needs, that puts the needs and experience of people at the centre of how services are organised and delivered.

Where local areas have succeeded in integrating health, care and support services, too often it has been despite of the national system rather than because of it. This is why NHS England has joined a range of national partner organisations to tackle national barriers and enable and encourage locally-led, integrated services to flourish.

Integrated Care and Support: Our Shared Commitment

The national partners have co-produced ‘Integrated care and support: our shared commitment’, a framework document on integration, which has been published today.

The document, signed by all the partners, sets out how local areas can use existing structures such as Health and Wellbeing Boards to bring together local authorities, the NHS, care and support providers, education, housing services, public health and others to make further steps towards integration.

A Narrative for Person-Centred Coordinated Care

National Voices, a national coalition of health and care charities, has developed a person-centred ‘narrative’ on integration (also available as an easy read version). This is an agreed definition of what we mean by ‘integrated’ care. It provides a guide to the sort of things that integrated care will achieve, such as better planning, more personal involvement of the person using services, and free access to good information. It also provides some clarity over what local areas should be aiming to achieve practically, in their efforts to integrate services.

It is written not just for the experts, but for patients, people, families and carers. It shows them what they have a right to expect, so they can then demand the most helpful care and support.

As a national partner we have adopted this definition of what good integrated care and support looks and feels like for people, and we are asking local areas to sign up to using it too.

Pioneers

Together the national partners are asking local areas to express an interest in becoming ‘pioneers’ to act as exemplars, demonstrating the use of ambitious and innovative approaches to efficiently deliver integrated care.

We are looking for pioneers that will work across the whole of their local health, public health and care and support systems, and alongside other local authority departments as necessary, to achieve and demonstrate the scale of change that is required.

The national partners will provide tailored support to pioneers. In return, we expect them to be at the forefront of sharing and promoting what they’ve learned for wider adoption across the country.

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Hospitals are currently paid through the Payment by Results system, which has been in operation for nearly a decade and has delivered benefits. However feedback from the health sector is that the current system is not sufficiently patient focused, not always based on good quality information, and can act as a barrier to delivering integrated care.

While NHS medical services are free at the point of use for the patient, the system is taxpayer funded. It must deliver more and better health care for the foreseeable future within the level of funding available.

The transfer of responsibility for the design and oversight of the NHS payment system to Monitor and NHS England offers a good opportunity to look at how the system works today and how it can develop in the future.

The two organisations are publishing a discussion paper, which asks for views on the future of the payment system, and a call for evidence on the way hospitals are reimbursed for some emergency admissions. The discussion paper also sets out possible improvements and presents early thinking on setting objectives and designing the NHS payment system.

Adrian Masters, Managing Director of Sector Development, Monitor said: “We believe the way NHS services are paid for can help deliver the best possible care for patients, for example by encouraging more integrated care, as well as helping the NHS deliver better value for the taxpayer.

“This is an opportunity for us to make a real difference to NHS services and we want to work with the sector to achieve this.”

Paul Baumann, Chief Financial Officer, NHS England said: “We are keen to use this opportunity to develop and design a new payment system that does more for patients. We are asking people to contribute by answering the four questions set out in the document.  

“Changes to this system will not happen overnight, and it is important we get this right. As part of this engagement we are gathering evidence to support short and longer term improvements to the payment system.

“There will be minimal change to the 2014/15 National Tariff in order to provide continuity and help providers with their planning. However in the long-term Monitor and NHS England are looking at more widespread changes from 2015/16 onwards.

Further information:

1. The Health and Social Care Act 2012 gave Monitor and NHS England joint responsibility for the NHS payment system with NHS England specifying the services to be priced and Monitor designing and applying the methodology for pricing them.
2. The two organisations will publish the prices annually in the National Tariff.
3. The joint discussion paper on the payment system sets out the 2014/15 National Tariff timetable.
4. A link to a summary of Monitor and NHS England’s early work on designing a comprehensive payment system for NHS services can be found on the Monitor website

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Plans to strengthen performance in urgent and emergency care are being put in place across the country to help hospital A&E departments meet demand and tackle waiting time pressures.

NHS England has joined with the NHS Trust Development Authority (NTDA) and Monitor, which are responsible for provider regulation, to ensure coordinated action to ease the immediate pressures.

At the same time, a review will take place to understand the causes of problems, which differ around the country.

A&E departments have seen a rise in the number of patients they are seeing in recent years, with an extra 4 million people a year using emergency services compared with 2004.

Although 90 per cent of A&E patients are seen within four hours – and last week the NHS met its 95 per cent standard overall – concern has been growing about the underlying trend of more patients waiting longer.

The maximum four-hour wait in A&E remains a key NHS commitment to the public, set out in the NHS Constitution.

Detailed data published on first hospitals in Keogh Review

Detailed data about the first four of the 14 hospitals involved in the Keogh Review into mortality rates have been made public.

Professor Sir Bruce Keogh’s national review team has analysed information from across the NHS about all of the 14 hospital trusts who were identified in February as having had higher-than-expected mortality rates for more than two years.

This data has been used to develop the key lines of inquiry that are being explored by the regional Rapid Responsive Review teams, which began their site visits this week.

Interim CCG Assurance Framework published

The Interim CCG Assurance Framework for 2013/14 published today will help NHS England, patients and the public identify how well Clinical Commissioning Groups are performing in their role as the commissioners of local health services.

CCGs are accountable to their local populations and to NHS England for planning and delivering comprehensive and high quality care that meets the needs of their local community. This framework will support CCGs to deliver this and will help them to transform local services and improve outcomes for all patients.

Dedicated web pages launched for 74 specialised services Clinical Reference Groups (CRGs)

NHS England has today launched a series of web pages dedicated to each of the 74 specialised services Clinical Reference Groups (CRGs).

CRGs cover the full range of specialised services and are responsible for providing NHS England with clinical advice regarding these directly commissioned services. The CRGs are made up of clinicians, commissioners, Public Health experts and patients and carers, and are responsible for the delivery of key ‘products’ such as service specifications and commissioning policies, which enable NHS England to commission services from specialist providers through the contracting arrangements overseen by its Area Teams.

NHS England committed to gold standard for NHS 111

NHS England has today at its board meeting reassured patients that a good NHS 111 service is now operating in most of the country.

The performance standards which have been introduced for NHS 111 represent a gold standard which the majority of NHS 111 services in England are now meeting, though in some areas performance is still unacceptable especially at weekends.

Some local providers of NHS 111 have not provided the prompt reliable service the public need and want. NHS England’s board is determined to ensure that the public have access to a gold standard NHS111 service wherever they live in England.

NHS England releases update to national Cancer Drugs Fund list

NHS England has released an update to the national Cancer Drugs Fund list, further increasing access for patients to an additional three new cancer drugs. The additions to the list have been made following a review of trial data from the drugs by the Chemotherapy Clinical Reference Group (CRG), one of 74 such groups which provide clinical advice to NHS England regarding a range of specialised services.

Register for 6Cs Live webinars

To celebrate International Nurses day on 12 May and International Midwifery day on 5 May we are delivering a number of virtual events on Compassion in Practice, 6Cs Live! and a preview of the new 6Cs Live! Communication Hub. These webinars offer nurses, midwives and care staff an opportunity to find out more about 6Cs Live, share views and ideas on how 6Cs Live can support them and help shape the 6Cs Live! Communication Hub.

The webinars also present a chance to engage and discuss Compassion in Practice and 6Cs with a range of senior leaders who are delivering these events.

Changes announced to the way meningitis c vaccine given

This letter announces some changes to the way the meningitis C vaccine is given. Further resources can be found here. CCG accountable officers will wish to discuss the implementation with GPs and Screening Immunisation leads and consider any local implications.

Sustainable Development

The Sustainable Development Unit is running a consultation www.sdu.nhs.uk/sds to help shape the ‘Sustainable Development Strategy for the Health, Public Health and Social Care System 2014-2020’ which aims to launch in January 2014. It is fully supported by both Public Health England and NHS England. CCG clinical leaders and NHS chief executives should note the deadline for responses is 5pm on 31 May 2013.

NHS England welcomes publishing of medicines optimisation

The Royal Pharmaceutical Society has published Medicines Optimisation: helping patients make the most of medicines, and NHS England is supporting its call for health professionals and patients to work together to ensure better use of medicines.

CCG clinical leadersand NHS chief executives will wish to encourage staff in their organisation who prescribes, dispenses, administers or take medicines to adopt these principles.

Summer has arrived – ticks will be active and Lyme disease more prevalent

Lyme disease can be found anywhere in the country where ticks exist including parks and gardens. A third of patients may not have the classical rash and present with fever and occasionally neurological symptoms. They should be tested for Lyme disease if there is a likely exposure.

• http://www.hpa.org.uk/Topics/InfectiousDiseases/InfectionsAZ/LymeDisease/
• http://www.hpa.org.uk/web/HPAweb&HPAwebStandard/HPAweb_C/1257260375837

CCG clinical leaders will wish to ensure GPs are aware of the increased risk of Lyme disease and to note the contact details for the PHE Lyme reference laboratory.

NHS trusts deliver 35 patient improvement IT projects

A range of NHS trusts across England have successfully delivered 35 innovative IT projects to improve patient care and help share information more easily across the NHS, supported by funding from the NHS Interoperability Toolkit (ITK) Information Sharing Challenge Fund.

To help NHS organisations understand more, each project has been documented in the form of a case study or project closure report

CCG clinical leaders and NHS chief executives may wish to review and consider how the fund could benefit your organisation.

Extra notes

All communications requiring the attention of NHS commissioning organisations must include a publications gateway reference number. In order to streamline the number of communications issued by NHS England, these will continue to be sent via ‘NHS news’ every Thursday.

Unless otherwise stated, guidance referred to in the bulletin has not been commissioned or endorsed by NHS England – it is evidence that organisations and professionals may find helpful in improving practice. The National Institute for Health and Clinical Excellence is the provider of accredited evidence and guidance, which can be found on the Institute’s website www.nice.org.uk

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The beginning of April saw the launch of the new NHS, with shadow form organisations nationwide commencing fully. My role with NHS England has system-wide responsibility to provide  professional and clinical advice about allied health professions and  services, including advising Health Education England. Recent system  changes mean that capacity for this work is significantly reduced, with  just my Deputy, Shelagh Morris to support me and so, like many  clinicians, we must find new ways of working.

Shelagh  and I are meeting with people from across the system in order to  understand how AHPs can add best value and creating systems and  processes to facilitate us working effectively and efficiently.

Given  the loss of the Strategic Health Authority AHP Lead post, we are keen  to ensure that AHPs remain connected across the system and to this end  have identified the Clinical Senates and Strategic Clinical networks

In addition, each of the four regions have a regional network of AHPs who wish to stay connected with a named contact point:

North – Sue Louth – sue.louth@srft.nhs.uk or Bryony Simpson – bryony.simpson@nhs.net

Midlands and the East – Helen Marriott – h.marriott@nhs.net

South – Beverley Harden – Beverley.harden@hhft.nhs.uk.

London – Your local AHP Fora Chair:

• Redbridge Community, Nita Madhani
• Kings College Hospital, Patricia Hill
• Croydon Health, Sarah Vernon
• Royal National Orthopaedic Hospital, Susanne Selvaduria
• Homerton University Hospital, Csaba Barody

AHPs  do need, however, to find ways of working with and influencing local  commissioners and the Integrated Clinical Commissioning Network (ICCN)  is an excellent way of doing so. I attended last week’s meeting which  specifically discussed the commissioning role in light of the Government’s response to Francis

It was great to work with other AHPs, healthcare scientists, GPs and  pharmacists to debate this issue. I strongly urge you to get connected  via this network too.

Twitter is also enormously valuable, as evidenced by the huge response to my  tweet requesting an AHP to represent me at a recent accreditation  meeting.

Lastly,  this bulletin has also provided a great way of connecting and I am  delighted that NHS England intends to ensure the bulletin continues, and  moreover, evolves and improves to enable staff working in the NHS to  receive important information in an engaging and accessible way.

Karen Middleton

A Landmark Day: Launch of NHS England

The  second of April 2013 was a landmark day as NHS England began its  journey to transform health and healthcare for all, not just now but for  generations to come.

The  launch, which comes two and a half years after the NHS White Paper was  first published, kicks off a huge opportunity to prioritise patients in  every decision, creating the culture and conditions for staff to deliver  to the highest standard of care.

Business Plan

NHS England has published its Business Plan for 2013/14 – 2015/16, called Putting Patients First, which  explains how we will deliver our mandate from the Government and ensure  the best possible outcomes for patients. Plans include extension of the Friends and Family Test to include primary care. Organisation structure charts for NHS England have also been published.

NHS Change Day 2013

On the 13 March 2013, NHS Change Day brought together the individual creativity, energy and innovative  thinking of thousands of NHS staff from across clinical and non-clinical  areas of work, in a single day of collective action to improve care for  patients, their families and their carers. The aim was for 65,000  people to take part, 65 being the number of years the NHS has been in  existence. There have now been more than 180,000 pledges.

Compassion in Practice implementation plans

Compassion in Practice implementation plans which promise to transform care throughout England in all settings, every day and for everyone have now been published.  The plans cover six areas of action to achieve key values and  behaviours relating to Care, Compassion, Competence, Communication,  Courage and Commitment. During the next three years, there is a  commitment to review, refresh the plans on a quarterly basis, update the  timescales and report on what has been achieved.

Good Clinical Commissioning – everyone’s responsibility

In October 2012 two major clinical commissioning networks of  multi-professional clinical practitioners and social care merged to establish the Integrated Clinical Commissioning Network (ICCN).

Through the Good Clinical Commissioning network of nearly 2000 participants, leaders from social care, public health, local authorities and Health and Wellbeing Boards are finding new ways to engage. The community now  comprises of clinicians and managers from across the wider NHS, people  whose voices do not usually get heard.

Personal Independence Payment (PIP)

As part of the wider welfare reform, Disability Living Allowance (DLA) will be replaced by Personal Independence Payment (PIP) for people aged 16 to 64 with a health condition or  disability. PIP will be introduced gradually from April 2013, starting  with new claims in a limited geographic area, before launching  nationally in June. A PIP toolkit and PIP impact checker for existing claimants are available.

Changes to legislation on vitamin B12 Supplements

The statutory prescribing restrictions for Cyanocobalamin have been removed. GPs and other relevant prescribers may prescribe Cyanocobalamin to patients who they consider have a clinical need.  This  may be particularly relevant for diabetic patients being treated with  Metformin.

NHS England urges parents to get their children vaccinated against measles

NHS England today joins with Public Health England, the Department of  Health and local authorities across the country to urge parents of 10-16 year olds to prevent measles by getting their children vaccinated with the MMR jab.

Figures  published today show high numbers of confirmed measles cases in England  in the first three months of 2013 (587 by the end of March), following a  record number of almost 2,000 cases in 2012.  The rise in measles cases  is mostly due to 10-16 year olds who missed out on vaccination in the  late 1990s and early 2000s when concerns were raised by discredited  fears of the MMR vaccine.

Future of bulletins

Over the next six months our communications team colleagues aim to  evolve bulletins to create a new and more interactive format that will  give us greater flexibility in how we communicate. To assist this, if  you have any ideas for improvement or feedback on current bulletins,  please get in touch with Melody Laker – melodylaker@nhs.net

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The launch of NHS England at the beginning of this month marked a key milestone in the journey to transform and improve healthcare for all. The transition to the new world has at times been challenging over the last two years and I truly appreciate the important role that nurses and midwives have played in keeping services going during this difficult period, so thank you for all your hard work and dedication.

The creation of my role in NHS England right at the very outset, signals the importance of nurses and midwives in the new system and there are countless opportunities for shaping the NHS for the better. NHS England’s overarching principle of placing patients at the centre of every decision gives us a great freedom to come up with innovative approaches to ensure staff and services deliver the highest standards of care, both today and tomorrow. Whether through delivering compassionate care on the frontline or providing sound clinical leadership, nurses and midwives have a fundamental role in embedding this patient-centred approach across all parts of the new health and social care system.

As Chief Nursing Officer for England I’ve been moved and impressed by the enthusiasm, commitment, compassion and clinical skills of the nurses, midwives and care staff who I have been in contact with in commissioning and provider organisations. The recently developed implementation plans for Compassion in Practice could not have been produced without your contribution. The actions set out in these plans will change the way we work, transform the care of our patients and ensure we further develop our culture of compassionate care.

At NHS England, supporting and enabling this kind of positive cultural change is a fundamental part of our purpose. We want to create the right conditions and culture for health and care services and staff to support the delivery of the highest standard of care. We recognise the impact of positive staff experience and health and wellbeing on the quality of patient care, as well as ensuring that valuable public resources are used effectively to get the best outcomes for individuals, communities and society for now and for future generations.

Our vision is for everyone to have greater control of their health and their wellbeing, supported to live longer, healthier lives by high quality health and care services. The Compassion in Practice implementation plans, explained in more detail below are key in supporting this purpose.

On NHS Change Day on 13 March 2013, I made a pledge along with senior nurses from all of our national organisations. Our pledge is to work with nurses, midwives and care staff across England to implement and embed  the vision within Compassion in Practice for everyone in our care, every day. As part of my commitment to this pledge, I will be working hard to deliver the national actions set out in the Compassion in Practice implementation plans, supporting the delivery of local and regional actions wherever I can with the support of the Federation of Nurse Leaders, and working with new organisations such as HEE and PHE to ensure that there are no barriers to each nurse, midwife and member of care staff responding to the call to action and applying the 6Cs as part of their individual role. Of course, the 6Cs are applicable to all staff and I have been thrilled to see them used by other staff all over England.

At a local level, nurses on the governing bodies of newly established clinical commissioning groups are perfectly positioned to ensure that the 6Cs and the action areas set out in the implementation plans are considered in commissioning decisions. In giving nurses a clinical leadership role at this level and at Provider level, the new system offers a golden opportunity for those with experience and role in commissioning and frontline care delivery to share both their colleagues’ and their own learning from dealing with patients first hand. Another added benefit of having senior clinical leadership within both provider and commissioner landscape is the opportunity for both to work together as nurse leaders to create the right environment for compassion in practice to be implemented right across all sectors of our health care system to ensure decisions made are truly patient led . This will take courage to look beyond our own organisations and commitment to support the wider system to make sure we have the right staff in the right place with the right skills to bring about the changes we need in this challenging environment to ensure decisions and care is truly patient centred.

There is a lot of work to do to deliver the Compassion in Practice vision but we have made a good start. The High Quality Care Metrics for Nursing report, launched in December last year, provides a foundation for exploring how we measure the quality of nursing care going forward. Measuring the quality of care is central to providing an NHS that is more transparent, accountable and focused on improvement. Last month saw the publication of Making a Difference in Dementia: Nursing Vision and Strategy, setting out the contribution of nursing to the Prime Minister’s dementia challenge. Nurses play a vital role in caring for those with dementia, and their ideas have already made a significant difference in delivering improvements for patients. This vision and strategy provides a useful framework to help nurses understand their role in dementia care so that they can continue to innovate in the future.

At a more local level, nurses, midwives and care staff can help deliver Compassion in Practice by supporting the Friends and Family Test in their trust or clinical commissioning group and encouraging patients to take part. More importantly, they can also be vigilant in raising concerns and challenging practice if it is not contributing towards the delivery of compassionate care. The lessons learnt from the Francis report cannot be overstated, and now more than ever it’s key that staff speak up when they have concerns about care.

I for one am truly excited about the work which we will be undertaking going forward to implement Compassion in Practice and the opportunity which this presents to bring real improvements for patients. We have an excellent opportunity to revolutionise the care we give, but it will take commitment from every single nurse, midwife and health care support worker everywhere in England. I look forward to working with you all as we take on this challenge.

To celebrate Nurses Day (12th May) and Midwives Day (5th May) we are hosting a simple series of webinars about Compassion in Practice, including a preview of the 6CsLive! communication hub. For more information contact – NHSCB.sixcslive@nhs.net

Jane Cummings

________________________________________________________________________

A Landmark Day: Launch of NHS England

The 2 April 2013 was a landmark day as NHS England began its journey to transform health and healthcare for all, not just now but for generations to come.

The launch, which comes two and a half years after the NHS White Paper was first published, kicks off a huge opportunity to prioritise patients in every decision, creating the culture and conditions for staff to deliver to the highest standard of care.

Compassion in Practice implementation plans

Compassion in Practice implementation plans which promise to transform care throughout England in all settings, every day and for everyone have now been published. The plans cover six areas of action to achieve key values and behaviours relating to Care, Compassion, Competence, Communication, Courage and Commitment. During the next three years, there is a commitment to review, refresh the plans on a quarterly basis, update the timescales and report on what has been achieved.

Be Clear on Cancer: Programme for 2013/14

The Department of Health, NHS England and Public Health England have written to the NHS and local authorities announcing plans for the Be Clear on Cancer campaign 2013/14. The campaign, which has run since 2011, improves public awareness of the symptoms of cancer and urges people with these symptoms to present promptly to their GP.

The Queen’s Nursing Institute/Burdett Trust Fund for Innovation and Leadership 2014

The Queen’s Nursing Institute (QNI) is seeking local projects that aim to improve the care of patients and enhance the leadership skills of nurses. Chosen projects, which can be led by community nurses, midwives and health visitors, will receive grants of up to £5000 in addition to a year’s professional development and support. All project leaders will benefit from unique and highly-rated developmental workshops. The application deadline for projects is Monday 7 October 2013. Contact Anne Pearson for further information.

Choice and competition in commissioning website to be developed

NHS England and Monitor are working in partnership to develop a Choice & Competition website. The Choice and competition in commissioning clinical services in the NHS in England website aims to help commissioners and providers understand where competition may deliver improved outcomes for patients and bring together all of the key material that has a bearing on choice and competition in the NHS in England.

Business Plan

NHS England has published its Business Plan for 2013/14 – 2015/16, called Putting Patients First, which explains how we will deliver our mandate from the Government and ensure the best possible outcomes for patients. Plans include extension of the Friends and Family Test to include primary care. Organisation structure charts for NHS England have also been published.

NHS Change Day 2013

The 13 March 2013, NHS Change Day saw a mass movement of NHS staff make more than 180,000 pledges to change the NHS for the better. The goal was to secure 65,000 pledges, 1,000 for every year of the NHS’ existence, so this entirely exceeded expectations, demonstrating the huge enthusiasm amongst NHS staff for playing an active part in driving local change.

Updated NHS Constitution published

The Department of Health has updated the NHS Constitution improving areas such as patient involvement, feedback and dignity, and bringing it in-line with the new health and care system. The changes follow a consultation on NHS proposals and nurses are asked to note the commitments pledged in the revised publication.

NHS England publishes clinical access policies for specialised services

For the first time ever, patients will have equal access to high quality services regardless of where they live, as specialised services will be commissioned using a nationally consistent approach – the clinical access policies for specialised services.  The clinical access policies for specialised commissioning along with a number of specialised services were the subject of a public consultation receiving more than 3500 responses.  A full consultation report of the findings will be published by NHS England in due course.

New national system for Cancer Drugs Fund

From 1 April 2013, NHS England took on responsibility for the operational management of the Cancer Drugs Fund, creating for the first time a single national system for deciding which drugs are available and for which conditions. There will now be one national list of approved fast-track drugs giving uniform access to treatment across the country, ending regional variation of access to the Cancer Drugs Fund.

Friends and Family Test rolled out across England

Every patient visiting AÈor staying in hospital overnight will be asked whether they would recommend the service they used to their friends and family. Results of the Friends and Family Test will be published on NHS Choices allowing the public to compare feedback and make better choices about their care.

Personal Independence Payment (PIP)

As part of the wider welfare reform, Disability Living Allowance (DLA) will be replaced by Personal Independence Payment (PIP) for people aged 16 to 64 with a health condition or disability. PIP will be introduced gradually from April 2013, starting with new claims in a limited geographic area, before launching nationally in June. A PIP toolkit and PIP impact checker for existing claimants are available.

Healthcare Professional Alert Notices

An Health Care alert notice is the way that an NHS employer can make other bodies aware that a healthcare professional may pose a threat to patients or staff. A letter has been sent to trusts by Sir Bruce Keogh, medical director of NHS England setting out the interim arrangements for issuing alert notices via the NHS Litigation Authority who operate the alert notice system.

Public health nursing conference

On 26 June 2013, Public Health England will be holding a free conference in London about the nursing and midwifery contribution to public health. Improving the public’s health: the key roles of nurses and midwives will include presentations from experts on current thinking and evidence about how nurses and midwives key make a difference in improving health and promoting wellbeing. Participants will also have the opportunity to share their views on their contribution in this area.

Future of bulletins

Over the next six months our communications team colleagues aim to evolve bulletins to create a new and more interactive format that will give us greater flexibility in how we communicate. To assist this, if you have any ideas for improvement or feedback on current bulletins, please get in touch – melodylaker@nhs.net

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