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Health: reports, guidance and policy



Briefing: Maximising resources in adult mental health - June 2010

This Audit Commission briefing asks what scope there is for improving the efficiency of the acute care pathway in adult mental health, while maximising quality. The data shows there is wide variation in the use of inpatient beds and between bed days and spending on crisis resolution and home treatment teams. The data is only the starting point. Mental health trusts and primary care trusts need to work together to understand the detail behind the headline figures.

Access: 'Maximising resources in adult mental health' (PDF file, 16 pages, 1.3 MB).



Breifing: Making the most of frontline staff - June 2010

This Audit Commission briefing identifies areas where NHS trusts and foundation trusts may be able to make efficiency savings by making the most of their frontline staff. The data suggests there is the potential to make significant savings by making better use of doctors and nurses. Variations in nurse numbers, use of bank and agency nurses, and grade mix, suggest there is scope to improve productivity and reduce costs. Organisations first need to understand the reasons for variations on their wards and learn from other similar organisations how savings could be made.

Access: 'Making the most of frontline staff' (PDF file, 14 pages, 1 MB).



Government sets out plans for National Care Service

Health Secretary Andy Burnham has published a White Paper on setting up a National Care Service, which would mean that the state meets the cost of supporting older people in England after they have been in residential care for two years. It would also establish a commission to develop a political consensus for a longer-term solution.

Legislation to introduce the service will not be introduced until after the election, and a lot of uncertainty remains as to how the proposed system would be funded – with ministers not specifying whether a special so-called ‘death tax’ would be introduced. In addition, the Government still hopes to persuade the House of Lords to pass the Personal Care at Home Bill that would mean those most in need would receive care at home free at the point of delivery.



Marmot Review highlights cost of health inequalities

The Marmot Review has concluded that most people in England are not living as long as the best off and spend longer in ill-health. The report: 'Fair Society, Healthy Lives' found that people living in the poorest neighbourhoods in England will on average die seven years earlier than people living in the richest areas, and spend more of their lives with disability – an average total difference of 17 years. It estimated that health inequalities in England cost the country tens of billions of pounds every year, through productivity losses, lower tax revenues, higher welfare payments and increased demands on the NHS.



NHS accounts guides for non-executives and governors

The Audit Commission and the Healthcare Financial Management Association (HFMA) have revised their guides which help non-executives and governors to get a more detailed grasp of their organisation's annual accounts. Access the new guides.



A guide to finance for hospital doctors

The Audit Commission and the Academy of Medical Royal Colleges have jointly published a short, practical manual that aims to help hospital doctors to get to grips with the way the money works in the health service. By understanding how the money flows and some of the principles of financial management in the NHS, hospital doctors will be well equipped to deliver better patient care.



The Health Bill

The Health Bill includes provision to require all healthcare providers working for or on behalf of the NHS to publish their "Quality Accounts" from April 2010. Quality Accounts will be produced annually and provide the public with information about the quality of services in terms of safety, experience and outcomes. Quality Accounts will comprise two parts: a centrally-set core element set by the Department of Health and laid out in regulations; and a larger, locally determined element decided by the providers themselves, based on the strategic priorities they have identified for improvement.



Engaging people in health services

Listening, learning and working together? was published on 26 March 2009. It sets out the findings and recommendations of the Healthcare Commission’s national study of how well healthcare organisations in England engage with local people in planning and improving their services. It also looks at the extent to which people can influence decisions taken by health services.

The report includes a performance framework developed with trusts, patients and community groups. The framework is designed to be used by trusts, alongside existing checklists set out for PCTs and provider organisations, to help them work towards a higher level of performance.

Access from the Care Quality Commission website:



Focus on PCTs

The Health Bill proposes a number of policies to help Primary Care Trusts (PCTs) drive improvements in their local areas. The World Class Commissioning Programme is assessing local commissioning capability, and the King’s Fund published two reports on differences in spending between PCTs and Practice-Based Commissioning (PBC).

In September 2008, the King’s Fund’s NHS spending: local variations in priorities - an update examined the data collected by the Department of Health on the amounts PCTs spend on 23 programmes of care. It asked how PCTs decide on their spending priorities and looked at changes in overall PCT spending between 2004/05 and 2006/07.

The King’s Fund also published: Practice-based commissioning: reinvigorate, replace or abandon. Drawing on interviews conducted with a range of key stakeholders at four PCT sample sites, the report examined the progress of practice-based commissioning (PBC) and asked what the future might hold for the policy.

The Audit Commission's November 2007 national report: 'Putting Commissioning into Practice' found that PBC’s most substantial positive impact has been on relationships and communication.



Facing facts and tomorrow’s reality today: the cost of care

This is the second of three papers we are producing as part of the series ‘Fit for the future: a new vision for adult social care’. The first, ‘Our lives, our choices’, set out our initial thoughts and explored how a simplified, locally-based system of care and support could address a number of the challenges which make the current system unsustainable. The third and final paper will be published in the Spring and will set out a proposed model for a future care and support system.



Improving safety in the NHS

Patients expect and are entitled to the safest possible care and the boards of NHS trusts are ultimately responsible for the safety of the care that their services provide. In March 2009, the Heathcare Commission published two reports, which focus on improving the safety of care within the NHS.



Guidance for PCTs and Strategic Health Authorities

In January 2009, the Department of Health published: 'Transforming community services: enabling new patterns of provision'. The Transforming Community Services (TCS) programme is a major element in the primary and community care vision as set out in ‘High Quality Care for All’. The enabling guidance is for PCT providers when considering their commissioning relationships and the change management required to support the transformation of services to patients.

In March 2008, the Department of Health published addtional guidance for Strategic Health Authorities (SHAs). It is designed to help support PCTs in internally separating their commissioning and provision functions, and to help them provide high quality services.



Health Policy for Local Government

The Improvement & Development Agency (IDeA) Healthy Communities Programme provides information on the latest government legislation and guidance relating to health as it affects local government.


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