Policy Review | Consultation
Live consultations and follow ups - December 08
Stephen Blann, CLB Policy & Networks Officer reports back on the outcomes of consultations which will have a local impact on the delivery of your services. These will be updated roughly on a quarterly basis. You can sign up below if you would like to receive an alert when this page is updated.
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Quick Links to live consultations
- Picture of health 2008 – 12
- Healthcare for London 2008
- Updates on mayoral strategy consultations
- Building a Better Bromley Publication / Implementation 2008-2020 & Local Areas Agreement 2008 - 11
- Department of health consultations
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- Follow this link to find out the latest in national policy that could affect you, your staff and the organisation.
The decision of Joint Committee of PCTs was announced in July. An implementation plan covering the period up to 2012 was produced as a long timescale is needed to make the changes decided. At the end of this time Queen Mary’s Sidcup will loose &AE and only undertake planned surgery (whilst Princess royal will only undertake emergency and day case surgery. Surgery will end Orpington hospital. www.apictureofhealth.nhs.uk
Since then 2 referrals have been made to the secretary of State for Health. One is by Bexley council primarily concerned with changes to Queen Mary’s Sidcup (in the borough of Bexley although taking a lot of patients form the north of Bromley borough). The other is by the Joint Health Overview And Scrutiny Committee of the 4 boroughs covered by A Picture Of Health.
Whilst the secretary of state considers these implementation plan cannot be put into action. The PCTs produced a paper on matters which they considered were outside the referral which they wish to proceed with - the JHOSC saw this and approved it.
- Service Developments to be progressed alongside referral to secretary of State [85 Kb]
- A picture of health: implementation planning [96 kb]
. The Secretary of State should make a decision by spring.
A complicating (or simplifying) factor is the decision to merge three of the 4 hospital trusts involved. This is said to be an administrative merger of managements and will not lead to any service change and so will not have any public consultation.
- Read the report considered by Bromley Hospitals Trust board [30 Kb]
Whilst decision makers may feel confident that APOH is consistent with Healthcare for London this may not be the case. Healthcare for London was concerned with a number of issues - some specialist services and others more general. Following consultations earlier in the year responsibility for implementation plans was given to a set of clinical advisory groups. There will be further consultations in early 2009 on specialist services and centres. The first of these is Stroke.
A stroke strategy has been produced and central to this is the creation of a limited number of specialist hyper acute stroke units, other hospitals having a more routine service. Improving both inpatient and community rehabilitation is important. The strategy identifies Bromley as having amongst the highest incident of stroke in London - but the Bromley Joint Strategic Needs Assessment identifies that Bromley has a lower than average mortality for stroke. This may have an impact on the location of the Hyper acute stroke unit. The consultation is due to begin in early 2009.
- Read the Stroke Strategy [ 4.29 Mb]
There is also expected to be a consultation on trauma services. (Trauma is best thought of as A&E admissions due to injury rather than say heart attacks or stroke). The proposal of healthcare for London is to have fewer major trauma centres (possibly 6 for London) able to deal with the most serious incident or injury with local hospitals dealing with more routine injuries. In relation to local hospitals there may also be an overlap with development of Polyclinics. With regard to polyclinics there have been 6 “early implementers” across London - in Lambeth Harrow, Hounslow and north east London and Healthcare for London Polyclinic group expects polyclinic implementation in Bromley by 2010, although Bromley PCT has been less explicit . Visit the consultation website page about moving towards implementation'.
The potential impact of the merger of local hospital trusts may in the end be a consideration in the decision over the location of the specialist services and units discussed above. www.healthcarefolondon.nhs.uk
The outcomes of the consultations on the mayor’s strategies should be known in early spring. As with the London Development Agency if the draft strategies are implemented there will be significant changes.
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4. Building a Better Bromley Publication / Implementation 2008-2020 & Local Areas Agreement 2008- 11
Building a Better Bromley 2020 vision was consulted on in the summer 2008.
- View the consultation draft presented to the LSP . Note that the final version has not been published on the council website yet. [2.01 Mb]
- View the priorities for2008-10 on the website [49 Kb]
Linked to the vision and deriving its priorities from it is the Local Area Agreement.
The current agreement was agreed this summer and runs for a three year period until 2011. This is a set of targets set with government about improving services and quality of life. If successful “reward payments” can be made by the government. Progress on the targets is monitored quarterly. The monitoring of LAA targets is here -
- LAA Performance monitoring report, Quarter 2, 2008-2009 [164 Kb]
- Appendix - 2008/9 Q2 monitoring - LAA indicators[63 Kb]
The LAA targets are reviewed each year as part of what is called the “refresh” process - to make sure that they remain both relevant ( for example what impact will the recession have?) and also achievable - in view of changed circumstance rather than failure to perform. The Government Office for London then has to agree the “refreshed” targets and they should be in place by April 2009 (and a further refresh in 2010).
- Read the Local Area Agreement 2008 Refresh item from the December 08 LSP meeting [92 Kb]
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Consultation on a national dementia strategy was held over the summer. This is an issue which could affect Bromley given tea g and aging profile of the borough.
[There is not a later version taking account of consultation responses on the department website at present.]
Consultation on new independent process for QOF
The Quality Outcome Framework (QOF) is the system by which GPs can earn additional income by meeting certain targets and having Additional” services under the contract agreed a few years ago. The government will ask NICE to oversee a new independent and objective process for developing and reviewing QOF clinical and health improvement indicators for England from 1 April 2009. this means that the government wants them not to be seen as “government targets” but clinical objective standards and outcomes.
At national level NHS Employers (on behalf of the Department of Health) would then negotiate with the BMA on which indicators should be applied nationally. It is possible Primary Care Trusts (PCTs) could in future select additional indicators from the NICE menu to reflect local priorities, using either resources devolved for this purpose or local resources.