The Health and Social Care Bill currently making its way through parliament will introduce tighter integration of the NHS with social care. Northumbria NHS Trust has announced this week it is to enter the home care market, suggesting that such a shift is already underway.
Local authority leaders have expressed their fears, however, that the new Integrated Care Boards (ICBs) will be dominated by NHS organisations at the expense of local councils – and that acute trusts will seize the lion’s share of money and resources.
Northumbria Healthcare NHS Foundation Trust is to provide home care services in North Tyneside and Northumberland, creating up to 250 jobs.
The acute trust currently provides hospital and community services in the area. It is believed to be the first in the country to move into provision of home care services. Once the service is established, it could employ up to 250 people, the trust has said.
It has already begun recruiting the first wave of 25 staff, including a manager to oversee delivery of home care services. Sir James Mackey, the trust’s chief executive, said: “Having effective social care services is vital to the entire health system, because to allow the region’s hospitals to cope with the demand from new patients coming in, we need to be able to move on those patients who no longer need hospital care in order to free up beds.”
The national database responsible for recording whether NHS staff have been vaccinated against coronavirus is “inaccurate”, HSJ has been told.
A number of trust chief executives and directors told the publication they were concerned about the National Immunisation Management Service (NIMS) and the National Immunisation and Vaccination System (NIVS). These are pieces of software that support the management of the flu and covid vaccination programmes across England. They help to identify priority patients and record vaccinations given.
NHS staff must be vaccinated by 3 February or face dismissal or redeployment. However, one NHS chief executive in the north of England told HSJ that almost a third of staff members identified by NIMS as unvaccinated have since shown proof of vaccination. Another trust leader said they had “resorted to really labour-intensive methods of validating and checking info” to obtain reliable information on their staff’s vaccine status. This included cross-checking information and ring-arounds.
Local authority leaders are worried that the new integrated care boards (ICBs) will be dominated by NHS organisations. At a meeting of the Local Government Association’s city regions board, councillors heard that NHS England’s model constitution for ICBs “explicitly excludes councillors and MPs.”
Graeme Miller, the leader of Sunderland City Council, described it as an “attempt at political castration” that would mean “scrutiny is effectively ignored at a local level”.
John Merry, deputy city mayor of Salford City Council, said that the new structure felt like a “step backwards” because Greater Manchester already has a “fully integrated budget with the NHS.” He was particularly concerned because the area has two major acute NHS trusts: “We’re going to have some fairly big behemoths clashing with each other… and I’m worried the integrated budget we’ve carefully developed in places like Salford is going to be taken away from us.”
Some patients are having to wait two year waits for dental check-ups, and the British Dental Association (BDA) has described NHS dentistry as “hanging by a thread”. Department of Health data shows that almost 1,000 dentists in England and Wales left the NHS last year.
The worst-affected area was NHS Portsmouth Clinical Commissioning Group (CCG), which lost 26% of its NHS dentists over a 12-month period. Twenty-eight other CCGs lost more than 10% of their NHS dentists. One woman in Carlisle told the BBC she had been waiting more than a year for root canal surgery.
The BDA said the problem was caused by the NHS contract, which uses a system known as units of dental activity (UDA). Under this system, dental practices are given targets for the number of treatments they carry out, and rewarded if they meet them. The UDA system does not incentivise preventative work and may be one of the reasons dentists are leaving the health service.
Ian Dilks, a senior accountant and insurance leader, has been named as the government’s preferred candidate to chair the Care Quality Commission.
Dilks is the senior independent director of Royal London Insurance, and was chair of NHS Resolution until the end of 2020. For many years he worked for PwC in its global financial services leadership team. He has also worked as an expert adviser to the Commons Treasury committee.
He is the third person from the financial sector to be appointed to senior NHS roles in recent months. Former banker Richard Meddings has been named as the new chair of NHS England, while Samantha Roberts, Legal and General’s managing director of health and care, will replace Gillian Leng as chief executive of the National Institute for Health and Care Excellence.