Contact me: Health Act is the Coalition's biggest localist reform30 March 2012 08.00The passing of the Health and Social Care Act is the most important localist reform of this government. It brings with it great responsibilities; over £2bn of additional funding, and the best opportunity since the 1970s for local government to improve the health of its communities.The new directors of public health will be big players in the local authority. Reporting directly to the chief executive and with a ringfenced budget, their key skill will be engaging officers across the council so that public health begins to permeate everything the authority does.For many, the key aim will be reducing health inequalities. This is doomed to fail unless the middle classes agree to stop their life expectancy increasing. A better objective would simply be to improve the health of deprived communities.Read the full article on the Guardian local government network…Integrated care fails to deliver promised benefits29 March 2012 14.00Integrating care across the NHS and social care holds the promise of giving patients a better service at the same time as cutting costs. But a study for the government of 16 integrated care pilots shows just how difficult it is to do. The dream of happier patients, greater productivity, and lower costs never materialised.The evaluation of the pilots by Rand Corporation and Ernst & Young showed that after two years patient satisfaction was down, emergency admissions were up, and there was no clear evidence of cost savings despite falls in elective admissions and outpatient appointments.Most of the pilots focused on integration between primary and secondary care. Few staff felt able to claim their patients had received a “seamless service,” and integration with social care was woeful. Staff complained about lack of training for new roles, and poor integration of patient records was a constant frustration.Read the full article at the British Medical Journal…No relief for local government from the chancellor23 March 2012 08.00This was a bleak budget for local government. The long term spending projections buried in the Treasury's Red Book confirm that the financial pain for local services will stretch well into the next parliament. We have barely begun the age of austerity and there is no end in sight.The projections for government departments over 2015-17 contract even faster than in the autumn statement. Total managed expenditure – the best definition of public spending – will fall from 45.8% of GDP in 2011-12 to 39% in 2016-17. This is not a cut or a saving; this is a profound shift in national priorities, and it has been all but invisible in the media coverage.Sir Merrick Cockell, chairman of the Local Government Association, has understandably been pleading for other parts of the public sector to take more of the pain. Health has cleverly defended itself by developing its own cuts story around the pressures caused by flat cash for the foreseeable future, and is an unlikely target for more savings. The cuts made byWhitehall departments are paltry compared with councils – and could be driven harder. Perhaps the billions squirrelled away in school reserves might start to attract attention.Read the full article on the Guardian local government network…Comms teams need to surrender to social media16 March 2012 08.00Last week WeLoveLocalGovernment posted a fascinating blog on Monmouthshire's experience of allowing staff across the council to use social media. Both the article and the comments which it provoked highlighted the fact that using social media means challenging the primacy of the council communications department. Is that the right way to go? And what are the risks?Twenty years ago too few councils saw communications as central to their priorities, and fewer still had a communications director on the executive team. But in the following years council comms went through a period of rapid professionalisation.Read the full article on the Guardian local government network…Ministers play a dangerous game on cohesion9 March 2012 08.00The publication of the government's strategy for creating integrated communities has passed almost unnoticed, yet it has important implications for councils in what it does and does not say.The meagre coverage it attracted seemed to focus on the fact that it involved Pickles having a Big Lunch – an association that clearly caused the communities secretary some discomfort during media questioning. (It is actually an initiative launched last year to encourage people to share a meal with neighbours.)The most striking aspect of 'Creating the conditions for integration' is that it is an avowedly localist creed. It says: "Integration is achieved when neighbourhoods, families and individuals come together on issues that matter to them, and so we are committed to rebalancing activity from centrally led to locally led action and from the public to the voluntary and private sectors."So not only is it accepting the increasing evidence that integration is best approached as a local issue rather than through national prescription, but it is trying to get the public sector out of the integration business altogether.Read the full article on the Guardian local government network…Can councils benefit from the ‘devo-max’ debate?2 March 2012 10.00With constitutional reform at the epicentre of current political debate – growing tensions over the House of Lords and the Scottish National Party trying to wring a federal UK out of the 2014 independence referendum – it is no surprise that the constitutional position of local government is beginning to be aired again.The Political and Constitutional Reform Select Committee, chaired by Labour MP Graham Allen, has raised the question of whether the relationship between local and central government in England should be codified, so Whitehall would see councils less as their local delivery agents and more as independent democratic bodies accountable to local people.History tells us that concordats between central and local government are a waste of time. Both Tony Blair and John Major signed such bits of paper, and they proved to be worthless.Read the full article on the Guardian local government network…
Contact me:
Health Act is the Coalition's biggest localist reform
30 March 2012 08.00
The passing of the Health and Social Care Act is the most important localist reform of this
government. It brings with it great responsibilities; over £2bn of additional funding, and the
best opportunity since the 1970s for local government to improve the health of its
communities.
The new directors of public health will be big players in the local authority. Reporting directly
to the chief executive and with a ringfenced budget, their key skill will be engaging officers
across the council so that public health begins to permeate everything the authority does.
For many, the key aim will be reducing health inequalities. This is doomed to fail unless the
middle classes agree to stop their life expectancy increasing. A better objective would simply
be to improve the health of deprived communities.
Read the full article on the Guardian local government network…
Integrated care fails to deliver promised benefits
29 March 2012 14.00
Integrating care across the NHS and social care holds the promise of giving patients a better
service at the same time as cutting costs. But a study for the government of 16 integrated care
pilots shows just how difficult it is to do. The dream of happier patients, greater productivity,
and lower costs never materialised.
The evaluation of the pilots by Rand Corporation and Ernst & Young showed that after two
years patient satisfaction was down, emergency admissions were up, and there was no clear
evidence of cost savings despite falls in elective admissions and outpatient appointments.
Most of the pilots focused on integration between primary and secondary care. Few staff felt
able to claim their patients had received a “seamless service,” and integration with social care
was woeful. Staff complained about lack of training for new roles, and poor integration of
patient records was a constant frustration.
Read the full article at the British Medical Journal…
No relief for local government from the chancellor
23 March 2012 08.00
This was a bleak budget for local government. The long term spending projections buried in the
Treasury's Red Book confirm that the financial pain for local services will stretch well into the
next parliament. We have barely begun the age of austerity and there is no end in sight.
The projections for government departments over 2015-17 contract even faster than in the
autumn statement. Total managed expenditure – the best definition of public spending – will
fall from 45.8% of GDP in 2011-12 to 39% in 2016-17. This is not a cut or a saving; this is a
profound shift in national priorities, and it has been all but invisible in the media coverage.
Sir Merrick Cockell, chairman of the Local Government Association, has understandably been
pleading for other parts of the public sector to take more of the pain. Health has cleverly
defended itself by developing its own cuts story around the pressures caused by flat cash for
the foreseeable future, and is an unlikely target for more savings. The cuts made by
Whitehall departments are paltry compared with councils – and could be driven harder. Perhaps
the billions squirrelled away in school reserves might start to attract attention.
Read the full article on the Guardian local government network…
Comms teams need to surrender to social media
16 March 2012 08.00
Last week WeLoveLocalGovernment posted a fascinating blog on Monmouthshire's experience of
allowing staff across the council to use social media. Both the article and the comments which
it provoked highlighted the fact that using social media means challenging the primacy of the
council communications department. Is that the right way to go? And what are the risks?
Twenty years ago too few councils saw communications as central to their priorities, and fewer
still had a communications director on the executive team. But in the following years council
comms went through a period of rapid professionalisation.
Read the full article on the Guardian local government network…
Ministers play a dangerous game on cohesion
9 March 2012 08.00
The publication of the government's strategy for creating integrated communities has passed
almost unnoticed, yet it has important implications for councils in what it does and does not
say.
The meagre coverage it attracted seemed to focus on the fact that it involved Pickles having a
Big Lunch – an association that clearly caused the communities secretary some discomfort
during media questioning. (It is actually an initiative launched last year to encourage people to
share a meal with neighbours.)
The most striking aspect of 'Creating the conditions for integration' is that it is an avowedly
localist creed. It says: "Integration is achieved when neighbourhoods, families and individuals
come together on issues that matter to them, and so we are committed to rebalancing activity
from centrally led to locally led action and from the public to the voluntary and private
sectors."
So not only is it accepting the increasing evidence that integration is best approached as a local
issue rather than through national prescription, but it is trying to get the public sector out of
the integration business altogether.
Read the full article on the Guardian local government network…
Can councils benefit from the ‘devo-max’ debate?
2 March 2012 10.00
With constitutional reform at the epicentre of current political debate – growing tensions over
the House of Lords and the Scottish National Party trying to wring a federal UK out of the 2014
independence referendum – it is no surprise that the constitutional position of local
government is beginning to be aired again.
The Political and Constitutional Reform Select Committee, chaired by Labour MP Graham Allen,
has raised the question of whether the relationship between local and central government in
England should be codified, so Whitehall would see councils less as their local delivery agents
and more as independent democratic bodies accountable to local people.
History tells us that concordats between central and local government are a waste of time.
Both Tony Blair and John Major signed such bits of paper, and they proved to be worthless.
Read the full article on the Guardian local government network…
