13 February – The RCP has been working with peers throughout the Bill’s progress through the House of Lords in order to achieve positive changes to the reforms. As a result, the government have made the further key commitments at the dispatch box that relate to some of RCP’s key concerns regarding education and training:
- ‘Health Education England will draw upon expert advice provided by the Centre for Workforce Intelligence and will work with a range of key partners, including the medical royal colleges, the professional regulators…and the academic and research sectors.’
- ‘ … we … will ensure that Health Education England establishes transparent systems to ensure that organisations that receive MPET funding are held to account for using it for the education and training of the NHS workforce.’
- ‘ … each local board will have an independent chair and that we do not expect the chair to be drawn from employers within the LETB geographic area – it should be an independent person.’
- ‘Postgraduate deans will continue to be a critical part of the medical training arrangements. We expect LETBs to be able to demonstrate that their postgraduate deans will be able to act independently so as to be able, among other things, to provide challenge where necessary.’
- ‘Postgraduate deans will have all the powers that they have now to respond to any concerns about the quality of training, and to take action where required to improve standards.’
The RCP will continue to lobby peers regarding our concerns throughout report stage. Our report stage briefing is available to download.
8 February - The RCP lobbied peers ahead of report stage in the House of Lords. As a result of this lobbying the government made the following key commitments at the dispatch box that relate to some of RCP’s key concerns regarding education and training:
- ‘Professional regulators will continue to set professional standards. The royal colleges will continue to shape curricula and will work in partnership with Health Education England to ensure that education and training reflect best practice and are of high quality.’
- ‘Postgraduate deans will remain critical to these training arrangements. We expect local education and training boards to be able to demonstrate that their postgraduate deans will be able to act independently of any perceived conflict of interest that may arise between training and service priorities.’
- ‘We will ensure that Health Education England establishes transparent systems to make sure that organisations that receive MPET funding are held to account for using it for the education and training of the NHS workforce.’
On the 2 February 2012, the government proposed new amendments to the Health and Social Care bill laid ahead of report stage in the House of Lords. Whilst the RCP welcomes the government amendments we still have outstanding concerns.
The RCP parliamentary briefing outlines these concerns which include:
- Education and training - National planning, national standards, ring fenced funding and independent quality assurance should be the principles underpin HEE's work. This must be committed to at the dispatch box when debating the Health and Social Care Bill.
- Competition - The government should provided examples at the dispatch box of how and in what circumstances competition would be appropriate and will benefit patient care, and where it would be inappropriate and could damage services by fragmenting care pathways. The government must also state clearly that inappropriate competition will not be tolerated. The government should clarify that integration will always trump competition.
- Commissioning - The government must clarify that hospital doctors from within the CCG area can sit on their CCG board. A clear vision from NCB on commissioning arrangements for 'uncommon conditions' is required.
RCP agrees with Health Select Committee conclusions on efficiency savings
On 24 January 2012, the Health Select Committee released its report on public expenditure in health and social care. The report concludes that the 'Nicholson challenge', of making £20 billion efficiency savings is more important to the future of the health service than the management changes. The RCP believes it is crucial that the proposed health reforms help services to meet this challenge, rather than distract from it. Read the RCP's full statement.
Future Forum makes recommendations to government
The second report of the NHS Future Forum, chaired by Professor Steve Field, sets out their recommendations on education and training, public health, integration and information. The Forum’s recommendations have been accepted by government.
Government unveils latest thinking on education and training of healthcare workforce
The Department of Health (DH) issues policy framework for a new approach to workforce planning and the education and training of the health workforce. The report acknowledges that much of the detail of the operation of national and local structures are still to be developed.
Also this month…
- DH issues advice on appointment of directors of public health – for more information see the DH website.
RCP responds to Health Select Committee inquiry on education, training and workforce planning
The RCP’s written evidence to the Health Select Committee highlights that all medical education and training must be underpinned by national standards, national planning, ring-fenced funding and independent quality management and assurance. More about the Health Select Committee inquiry is available on the Parliament UK website.
DH provides clarity on Monitor’s role
The DH publishes a briefing on Monitor’s proposed role and how it relates to the NHS Commissioning Board and Care Quality Commission. The briefing is intended to inform and support peers as they begin to debate part 3 of the Health and Social Care Bill on economic regulation.
House of Lords committee calls for changes to the Health and Social Care Bill
The House of Lords Constitution Committee calls for changes to the Health and Social Care Bill to ensure that ministerial responsibility to Parliament and legal accountability for the NHS are not diluted. Download their full report from the Parliament UK website.
Also this month…
- DH publishes NHS Outcomes Framework 2012/13 – for more information see the DH website.
- DH publishes details of the new public health system – for more information see the Department of Health website.
- DH explains Joint Strategic Needs Assessments and Health and Wellbeing Strategies – for more information see the DH website.
Future Forum sends interim recommendations to secretary of state
Professor Steve Field, chair of the NHS Future Forum, writes to the secretary of state for health outlining his interim recommendations. The RCP issued an interim response to the Future Forum advice.
Also this month…
DH publishes NHS Operating Framework 2012/13 – for more information see the DH website and RCP comment.
RCP calls for House of Lords to amend Bill at committee stage
The RCP produces a detailed briefing for House of Lords committee stage, focusing on specialist involvement in commissioning, integrated working, competition and education and training. The briefing highlights 32 specific areas where the Bill should be amended or further clarification provided.
RCP briefs peers in advance of their first Health and Social Care Bill debate
Ahead of the second reading in the House of Lords, the RCP briefs peers on the Health and Social Care Bill. The first day of debate in the House of Lords is dominated by discussion of the impact of the reforms on medical education and training, a key issue for the RCP.
RCP responds to second phase of Future Forum’s work
The RCP submits evidence to the Future Forum on education and training, information, public health, and integration. The government announced in August 2011 that the Future Forum, chaired by Professor Steve Field, would undertake a second consultation exercise, building on the NHS Listening exercise.
Also this month…
- NHS Commissioning Board Authority goes live – for more information see the DH website.
- DH publishes guidance on choice of consultant-led team - for more information see the DH website
RCP briefs MPs on Health and Social Care Bill prior to third reading
The RCP provides parliamentarians with a third reading and report stage briefing in advance the Bill’s final days in the House of Commons on 6 and 7 September. The RCP briefing emphasises the importance of ensuring that quality is at the heart of the reforms and service design, and highlights outstanding concerns about the application of European procurement and competition law to the NHS, the phased extension of any qualified provider, and around medical education and training.
RCP gives evidence on the NHS budget and efficiency savings to the Health Select Committee
The RCP’s written evidence to the Health Select Committee inquiry into NHS expenditure highlights that the NHS is a comparatively efficient system by global comparison, and that the government needs to make long-term plans for affordability, considering the level and rate at which the NHS budget will need to rise to meet future demands. You can read about the remit of the inquiry on the Health Select Committee's website.
Also this month…
- DH publishes guidance on developing clinical senates and networks – for more information see the DH website.
RCP submits written evidence to House of Commons bill committee
The RCP submits written evidence to the bill committee, building on the RCP president Sir Richard Thompson’s oral evidence at the end of June. The committee reconvened on 28 June 2011 to scrutinise the Health and Social Care Bill for a second time, following amendments made as a result of the NHS listening exercise.
Also this month…
- Health Committee conducts inquiry into the Future Forum – for more information see the Parliament UK website.
- DH publishes update on public health reforms – for more information see the DH website.
- DH releases guidance on any qualified provider (AQP) – for more information see the DH website.
Results of NHS listening exercise made public
On 13 June, the Future Forum’s recommendations to government following the NHS listening exercise were published. The government’s response to the Future Forum’s recommendations, issued in the same week, outlines how they plan to respond. The RCP's summary of the government's response to the Future Forum highlights the key points.
The government response includes an announcement of a mandated place for secondary care doctors on the board of each clinical commissioning group, which the RCP has been calling for.
RCP responds to Health Select Committee inquiry on public health
The RCP submits evidence to the Health Select Committee inquiry on public health. The RCP worked closely with the Faculty of Public Health to develop the submission. Download the Faculty of Public Health’s evidence from their website.
Government launches NHS listening exercise
The government launches a two-month listening exercise to hear views on their proposed health reforms. The NHS Future Forum, chaired by Professor Steve Field, will lead the listening process and report its findings back to government. The Forum comprised 40 representatives from the health service, local government and voluntary sector. Find out more about the listening exercise on the DH website.
RCP gives evidence to committee of MPs scrutinising Health and Social Care Bill
The RCP submits written evidence to the House of Commons Bill Committee, the group of MPs charged with scrutinising the Health and Social Care Bill line-by-line. The RCP president, Sir Richard Thompson, gave oral evidence to the committee on 10 February 2011.
RCP raises concerns about government proposals for education and training
In the DH consultation Developing the healthcare workforce, the government sets out proposals to establish a new framework for developing the healthcare workforce. The RCP response to the education and training white paper highlights the need for strong national planning and intelligence gathering for medical education and training, and the importance of retaining an independent quality management and assurance of postgraduate medical education.
RCP responds to government’s vision for public health
The RCP response to the public health white papers emphasises the important role that secondary care doctors play in reducing health inequalities and promoting and protecting the people’s health. The government’s vision for public health in England is set out in four consultation documents: Healthy lives healthy people: our strategy for public health in England (the public health white paper); Funding and commissioning routes for public health; Transparency in outcomes – proposals for a public health outcomes framework; Review of public health professional regulation.
Also this month…
- RCP does not sign up to public health responsibility deal – go to the RCP website to view the RCP, Alcohol Concern, British Association for the Study of the Liver, British Liver Trust, British Medical Association and Institute of Alcohol Studies joint statement outlining the reason for not signing up.
RCP briefs MPs in advance of first debate on Health and Social Care Bill
The RCP sets out its position on the health reforms in its briefing for MPs in advance of the Health and Social Care Bill’s second reading in the House of Commons, the first opportunity for MPs to debate the Bill.
RCP gives evidence to Health Select Committee inquiry on commissioning
The Health Select Committee receives written evidence on written evidence on the new commissioning arrangements from the RCP. The Committee report, published in April 2011, quotes the RCP's evidence.
RCP sets out position on the Health and Social Care Bill
In its first briefing on the Health and Social Care Bill, the RCP calls on government to ensure that:
- hospital specialists and public health doctors are integral to commissioning and service planning arrangements, locally and nationally
- competition is not at the expense of quality, collaboration between professionals or the integration of services
- strong safeguards are put in place to prevent service fragmentation, enshrine integrated working and collaboration, and ensure accountability, equity and comprehensive health services for all.
Health and Social Care Bill laid before parliament
On 19 January, the Health and Social Care Bill 2011 is laid before parliament. The Bill provides the legislative framework for the reforms first set out in Equity and excellence: liberating the NHS.
RCP calls for a real information revolution
The RCP’s response to the DH information revolution consultation urges the government to conduct a fundamental review of how and what information is gathered and stored in the NHS.
RCP sets out position on patient choice
The RCP’s response to the DH's consultation on greater choice and control highlights that patients and carers need to be empowered to participate in their care and involved in service design, improvement and evaluation.
RCP responds to NHS constitution and whistleblowing consultation
The RCP response to the DH NHS constitution and whistleblowing consultation argues that every healthcare professional needs to experience a supportive and open working culture.
RCP responds to health reforms
The RCP’s response to the Liberating the NHS white paper, argues that the crucial test of the reforms will be the extent to which they translate into meaningful improvements on the front line. The reforms must promote the principle of joint working across institutional boundaries that would enable healthcare professionals to deliver integrated, personalised care.
RCP calls for more work to identify meaningful outcome measures
The RCP response to the Liberating the NHS: transparency in outcomes welcomes the move towards outcome measures, but highlights that investment will be needed to ensure these measures are fit for purpose.
RCP flags up importance of secondary care involvement in commissioning
In Liberating the NHS: commissioning for patients, the government set out the intended arrangements for GP commissioning and the NHS Commissioning Board’s role in supporting ‘consortia’ and holding them to account. The RCP response calls for the government to do more to ensure secondary care doctors are also involved in commissioning.
RCP responds to proposals to increase local government’s health role
The future role of local government in health were first set out in Liberating the NHS: local democratic legitimacy in health. The DH proposals increase councils’ responsibilities for public health, give them a new role in the promoting integration of health and social care services, and launch local HealthWatch organisations acting on behalf of healthcare consumers. The RCP response welcomes the opportunities that increased local government involvement presents, but highlights the need to carefully manage the transition to ensure skills, resources and expertise are not lost.
RCP comments on the health service regulation
In Liberating the NHS: regulating healthcare providers, the government sets out proposals for all NHS trusts to move to foundation status and make Monitor, the foundation trust regulator, the economic regulator for health and adult social care. The RCP's response the need to ensure that the pursuit of foundation status at a time of huge financial strain does not compromise patient care.
Government sets out vision for the NHS
The DH publishes Equity and excellence: liberating the NHS, which proposes the radical reorganisation of the NHS. Key proposals include:
- abolishing primary care trusts (PCTs) and strategic health authorities (SHAs)
- giving clinician-led groups across England the task of commissioning healthcare
- establishing the NHS National Commissioning Board to commission certain services and 'oversee' local commissioning
- giving Monitor, currently the regulatory body for foundation trusts, a wider role in promoting competition; the Care Quality Commission will continue ensure a minimum quality standard
- compelling all NHS hospitals in England to become foundation trusts
- moving responsibility for health improvement from PCTs to local councils and establishing local authority-led health and wellbeing boards.