Thursday 28 March 2013
The Hound was off early for a walk this morning. Cold enough for some form of snow I thought. "Dog walking not leg chopping" is the only sane approach to diabetes care. And we are chopping at an alarming rate (rising to 7,000 a year Barbara Young Diabetes UK head and ACEVO member tells me) in our repair not prevention NHS. So today I was amused by the story in The Times which said that for an average dog walker we will cover the equivalent of 2863 marathons over their dog's life! Each year we Hound owners clock up 575 miles according to a recent survey. And I see that we stroke our dogs 58,000 times and can expect to be licked 50,000 times. I'm sure my Hound exceeds these national averages!
So Jeremy Hunt; stop the NHS chopping and give us all dog vouchers. I'm sure my friend Clarissa Baldwin at the Dogs Trust will happily participate in a voucher scheme. All diabetics need a dog. I can see the national campaign now.
And what great news about the major advance in cancer care; identifying genetic markers will both help identify risk and lead to better prognosis and treatment. So let's remember who funded this. Was it the government? Or the NHS? No; it was our sector. This breakthrough is the result of work by Cancer Research UK. When people talk about the role of charities they think too much about volunteers and forget (or don't even know) that much of the medical research in this country is done through charities. In some conditions practically all research is funded by charities. Whether that is neurological conditions or cancer, migraine or heart disease. I also like to remind those who try to belittle the work of national charities that these mostly national charities work at a level where they save lives and promote better health, so the old battle of local vs. national is so unhelpful.
And of course our charities are not just doing research. They campaign for change. Demand action from Government on things like obesity or drinking. To look at just one of those national charities, Prostate Cancer UK, ably led by Owen Sharp, they are at the forefront of pioneering research but also campaign to raise awareness of this little discussed disease and work to persuade Government and the NHS to do get better at diagnosis and treatment.
So let's give a big hand to ACEVO member Harpal Kumar, CEO of Cancer UK and remember that if George Osborne had not seen sense on the Charity tax this work would have been significantly damaged.
Anyway, enough on that. I'm off to lunch with the CEO of Leonard Cheshire and then Maundy Thursday Mass in Westminster Abbey. Then to the Charlbury for a relaxing Easter break.
Have a very Happy Easter all.
Tuesday 26 March 2013
A big day in the health world. Obviously our ACEVO health and social care conference, the launch of the Monitor report on a fair playing field and the Government's response to the Francis report. Not to mention that next week the new national Commissioning Board and CCG structure gets fully into operation.
But at the Royal Mint ACEVO's conference swung into action with a fine speech from Norman Lamb MP. I introduced him as a progressive force and it’s true. He gave us a brilliant speech.
As reported in Third Sector magazine, one of the barriers preventing voluntary sector organisations from playing a larger role in providing NHS services is the "hopelessness of commissioning in many parts of the country"; he said to great applause from assembled delegates.
Commissioning was poor in too many areas.
"It's quite a young science and the skill levels are quite low," he said. "If we're to move to a new system where work is contracted out rather than done centrally, it will work only if the commissioning is good."
Lamb said that too many local authorities procured care services on the basis of who could charge the least for an hour. How true. And how wrong.
"As a result, you get a race to the bottom," he said. "There’s no incentive for providers to help people. It’s in their interest for individuals’ needs to grow so they can get paid for more care. We should be commissioning to improve the lives of people."
He said the traditional way of commissioning services was "professional people making assumptions about what people want or need". Voluntary sector organisations had "pioneered the remarkable idea" of asking people what they needed, he said.
I much agreed with his comment that the NHS was "like a national religion" that people were reluctant to challenge or change.
"There's a sense that something awful happening in an NHS hospital is better than something awful happening elsewhere," he said.
In introducing Lamb I argued that the third sector had a "central role to play" in meeting the challenges of providing healthcare and wellbeing. I said it’s difficult to imagine how you can tackle the funding challenges, the growing prevalence of long term conditions and the fact that the majority of people in hospital are frail elderly. He picked this up when he said, "I hope the voluntary sector gets involved enthusiastically and optimistically, because you can bring so much to the table."
And Lamb was a good warm up act for the launch of ACEVO's taskforce report on prevention. Chaired by Hugh Taylor, former Perm Secretary at DH.
As Lamb said earlier we must move from repair to prevention. More resources into community support and care and into prevention.
I also stressed to Lamb how we need to implement the conclusions of the Monitor report on a fair playing field. I particularly stressed the need for action on VAT. I said they needed to accept the recommendation on lifting VAT for charities and promised him our support in fighting the Treasury to get this sorted. We have argued this for ages. Will we now make progress ?
Healthcare charities should be entitled to the same VAT rebate as public sector providers when they bid for NHS contracts, a report from the healthcare regulator Monitor is expected to say tomorrow.
The Fair Playing Field report makes a wide range of other recommendations aimed at removing obstacles to fair competition between voluntary, private and public providers in the NHS.
Monitor was asked to produce the report a year ago by the government after complaints from a range of charities like Sue Ryder or Leonard Cheshire that VAT rules made its services more expensive than NHS rivals.
Under existing tax rules, NHS providers can recover VAT on some non-business supplies that voluntary sector organisations cannot.
There are no estimates for how much a VAT rebate would save but irrecoverable VAT is typically from between 3 and 5 per cent of a charity’s costs.
Monitor’s review is based on interviews with more than 200 organisations involved with the NHS. ACEVO was closely involved .
Other recommendations are that commissioners should create smaller contacts and reduce the amount of capital they require bidders to hold. Another is that commissioners must consider social value when assessing bids.
I gave evidence to Monitor and took part in several public meetings during the review process. I'm clear that VAT has been a long-running sore in the sector.
If changes to the VAT regime were recommended in the report, the government should implement them swiftly as I told Lamb.
The government mustn’t wimp out or wriggle out. We don’t want weasel words or lengthy consultations. It should be implemented.
Monday 25 March 2013
Fortunately the trains were still running to Devon on Sunday despite the snow on the ground as I left the house. Off to spend a morning with Devon County Council.
I was staying in Topsham overnight. A marvelous small town on the estuary of the River Exe, just outside Exeter. The sort of place which makes England the very special country it is. Charming quirky houses set along the estuary banks. Ships and barges moored and some fantastic old Inns. A pint of Devon ale and my Sunday roast beef and I was in clover, as they say. And I even got to Palm Sunday evensong in the cathedral, one of England’s finest. I sat near the magnificent Bishop's Throne and had fantasies about sitting there in a Mitre.
But it was work and I and my ACEVO Solutions Director John Gillespie had an early Monday morning meeting with the Chief Executive and his Directors team. Devon is a forward thinking council. They are developing their strategic approach for reshaping services from 2015. They are clear on the implications of the financial framework for councils over the next 7 years. It’s incredibly tight but as Phil Norrey, the CEO pointed out, between the County Council and the local health service they have multi-million pound budgets. A huge challenge and therefore a time for a strategic rethink and looking at new ideas and approaches. And that is where the third sector comes in and why we were there to challenge them to new thinking on how to use our sector.
The old local councils' approach to the sector has been one of “support" and general non intervention. I argued we need a more aggressively strategic approach. One based on commissioning outcomes and therefore helping the sector to be part of new structures and approaches. I believe they can play a big role in helping develop consortia. We have done this with other councils (as I blogged recently on Knowsley).
We had a good discussion. I particularly liked the comments of the County Treasurer who was clear on the need to stop thinking of the elderly as a burden and a problem but think of them as an asset. She is right. Yes, we have growing numbers of frail elderly but also growing numbers of elderly who are up and running and organising and volunteering and making huge contributions. They are the backbone of many rural communities. Let's use that asset.
They have a very high proportion of elderly residents so they are thinking about how to use their new powers on public health and the potential for integrated services across social care and health.
We are taking these discussions forward. We have some ideas about potential for more work which we will explore, but I have a feeling we will do some interesting thing in Devon!
Then it was back to the great but cold metropolis, via a guided tour of the Cathedral. We have our major health conference tomorrow, with Norman Lamb and I need to prepare my speech.
Today Google launched the Global Impact Challenge. Over the past few months ACEVO has been working very closely with Google and think that this game-changing award will celebrate the innovative work happening within the sector. So we are inviting charities and voluntary organisations to showcase how they would use technology to transform the lives of their beneficiaries. The top four entries of the competition will each receive £500,000 and support to help their project become a reality. A team at Google will announce 10 finalists in mid-May and the public will be invited to vote and donate to their favourite project.
The prestigious panel judging the finalists will be inventor of the Internet Sir Tim Berners-Lee, Mogul Richard Branson and founder and CEO of Forster Communications Jilly Forster.
The Global Impact Challenge is a stunning way to highlight, celebrate, and develop cutting edge work within the 21st Century charitable sector. For Google to turn its entrepreneurial zeal towards social innovation, working with ACEVO in such an open-spirited way, will result in much needed resource and good news for hard-pressed charities. It’s thrilling to know how similar Google and ACEVO’s approach is in celebrating innovation.
I feel that this is the start of a great corporate friendship.
Applications opened today so apply here www.g.co/impactchallenge for your chance win.