Transcript ncpc policy priorities & parliamentary activities

NCPC POLICY PRIORITIES
& PARLIAMENTARY ACTIVITIES
Simon Chapman
Director of Policy & Parliamentary Affairs
8 July 2010
[email protected]
www.ncpc.org.uk
OVERVIEW
• Influencing the new government
• What is the new agenda?
• What does that mean for palliative & end of life care?
• How can we influence that?
• NCPC’s Intelligence & Quality think-tank
• Working with the new National End of Life Care
Intelligence Network (“NEoLCIN”)
• Shaping services around people
COALITION GOVERNMENT
New politics
•Without recent precedent
•Aim for a 5-year parliament
– next election 7 May 2015
•Andrew Lansley (C) –
Secretary of State for Health
•Manifestos superseded by
the coalition’s “programme
for government”
Liberal Conservatives
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PAUL BURSTOW MP (LD)
Minister of State
for Care Services:
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End of Life Care
Adult Social Care
Carers
Personal Health Budgets
Long Term Conditions,
including cancer and
diabetes
– Dementia
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OTHER DH MINISTERS
Simon Burns
(C) Minister of State
for Health:
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Reconfiguration of
Services
Application of Quality
Regulation
NHS Workforce
Connecting for Health
Anne Milton MP (C) Parliamentary Under Secretary of State
(PUS) for Public Health:
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Nursing and Midwifery
Health Visiting
Professional Regulation
Medical Education and Training
Earl Howe (C) – PUS for Quality
(Lords):
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NHS Constitution
NHS Commissioning Reform
Primary Care
NICE
Innovation
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DEFICIT REDUCTION IS THE
OVERALL PRIORITY
“We will guarantee that
health spending will rise
in real terms in each
year of the Parliament,
while recognising the
impact this decision will
have on other
departments”
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5 MINISTERIAL PRIORITIES
• A patient-led service culture - “nothing about us
without us”
• Focus on better health outcomes - aligning patientreported experiences with clinical outcomes
• Autonomy and accountability - empowering clinicians
free from target-centred and bureaucratic systems
• Improving public health - promoting health, well-being
and individual responsibility as part of the Big Society
• Reform of long term care - with better integration of
health and social care
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STRUCTURAL CHANGES
• What will the DH & infrastructure look like?
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Cuts in quangos (significant) and NHS administration (1/3)
Strengthen CQC role
Develop Monitor as an economic regulator
Independent Health Board
SHAs to be abolished from April 2012
• GPs: “patients’ expert guides” & commissioners
• 500-600 consortia, spending c. £80 billion (?)
• PCTs will:
• commission “residual” services best undertaken at a wider level
• Be responsible for local public health
• Have some directly-elected board members www.ncpc.org.uk
THE PROGRAMME FOR
GOVERNMENT
• “New per-patient funding system for all hospices and
providers of palliative care”
• 24/7 urgent care service including GP out of hours
• Personalisation:
– “Put patients in charge of making decisions about their care,
including control of their health records”
– “Give every patient the power to choose any healthcare provider
that meets NHS standards within NHS prices”
– Break down barriers between health and social care
– Personal budgets & direct payments
• Commission on long-term care to report within a year
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NOT FORGETTING...
•Public services: employeeowned co-operatives; mutuals;
social enterprises
•Encouraging volunteering
•Reinvigorating civil society
•Dying Matters
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PEOPLE’S NEEDS DON’T
CHANGE JUST BECAUSE
THERE’S A NEW GOVERNMENT
True on 4 May;
true today:
– More older people
– More dementia and
multiple conditions
– More people will die
each year
– Numbers of home
deaths currently falling
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DEMOGRAPHICS & CAPACITY
MEAN MORE PEOPLE WILL DIE IN
THE COMMUNITY
• Building capacity to enable more people to die well in the
community
• Key to include:
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Training staff in health & social care and housing
Models of care that join-up services
Using data & intelligence to inform productivity & quality
Building community resilience & capacity
All community settings & sectors: care homes; GPs etc
Planning ahead together (2030 project)
• And don’t forget hospitals!
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NCPC PRIORITIESOVERVIEW
• Vision: making end of life care everybody’s
business
– Equipping everyone to improve people’s end
of life care whoever & wherever they are
– Equipping : informing; enabling; inspiring
• What will success look like? Some of the
deliverables:
SHAPING SERVICES & CARE:
WHAT DO THE DELIVERABLES LOOK
LIKE?
• Publication on Personalisation
– Significant document at outset of a new parliament
– Will identify and link the different factors that can help shape care
around people
• 24/7 project
– Survey and conference
– Vital to give people the confidence to be in the community
– Building on manifesto call
• Establish new Transformation & Personalisation group
• Intelligence & Quality
– The Essex factor
– Funding survey
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EQUIPPING
PEOPLE IN PRACTICE
• People with personal experience – new publications
• Intelligence: MDS & workforce
– Inform service planning & development
– Trending
• Discussion document on specialist palliative care & end
of life care
• Practice & ethical issues
• Guidance on use of sedative medications
• Discussion document on spiritual support & conference on
October 14
• Advance Care Planning
• Continuing to develop Eolc & dementia – Power of Partnership
PERSONALISATION
WHAT DOES IT MEAN?
• Should not be defined simply by money
mechanisms:
• personal budgets; direct payments
• Non-financial choice as well
• Control
• Dignity
• Being seen and treated as an individual
person....“you matter because you are you!”
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PERSONALISATION...
• Sees people as actively involved coproducers, not recipients
• “Fits services around people’s needs, not
people to services”
• Focuses on outcomes, not existing
services
Personalising Care; a route map to delivery for care
providers
The Care Provider Alliance 2010
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LIFE THROUGH LANGUAGE
• Our roles vary – sometimes we might be called...
• Patients
• Residents
• Carers
• None of us likes being called a “user”…or a coproducer?
• We are always...
• People
• Citizens
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SOME LEVERS TO SHAPE
SERVICES AROUND PEOPLE
• Financial
• Personal budgets/direct payments
• Per-patient funding system
• Commissioning
• Careful contract drafting
• Outcome measures & quality standards
• Involving people with experience
• Practice:
• care plans and advance care planning
• 24/7 care
• Legislation:
– Mental Capacity Act
– NHS Constitution - a right to choose to die at home?
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NATIONAL END OF LIFE
CARE INTELLIGENCE
NETWORK
• Key objectives include:
• Co-ordinate a national data to enable people to create
intelligence from the data and improve quality & productivity
• Utilise and disseminate existing data sources more effectively for
local service planning and driving improvement in standards
• Exploring better use of data for commissioning, service delivery,
research and audit
• Project manager appointed: Linda Charles-Ozuzu
• Website live: www.endoflifecare-intelligence.org.uk
• NCPC on steering group
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NCPC’s DATA &
INTELLIGENCE
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BAND 8 SPC NURSES
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OTHER DATA SOURCES
• South West Public Health Observatory
• Variations in place of death in England
• Deaths from Neurodegenerative Diseases in
England, 2002 to 2008
• Deaths from Renal Diseases in England,
2002 to 2008
• InstantAtlas local profiles
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WIRRAL PLACE OF DEATH
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WIGAN PLACE OF DEATH
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HIGHEST INCIDENCE OF
HOSPITAL DEATHS
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HIGHEST INCIDENCE OF
HOME DEATHS
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3 CHALLENGES FOR THIS
PARLIAMENT
• “Ensuring a good death for everyone” should be
a key quality outcome for all commissioners and
providers across health and social care
• Access to co-ordinated 24/7 end of life care
services to enable people to remain in home and
community settings of their choice
• Empowering people to talk about dying, death
and bereavement and to make plans for their
the end of life care and support
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