The fifth and final annual report of the NHS Workforce Review Team (WRT) report covers April 2009 to March 2010 and also looks ahead to the end of June 2010.

On 18 January 2011 the House of Commons Health Committee published the Third Report of Session 2010–11 entitled ‘Commissioning’.

The report followed an inquiry by the Health Committee which sought evidence from the Secretary of State for Health, Andrew Lansley MP on 15 December 2010 along with Department of Health officials. The Committee’s report and the issues that it raises have been carefully considered.

This paper sets out the Coalition Government’s response to the Health Committee’s Third Report of the Session 2010/11.

Click here to view the response.

The vision set out in the white paper Equity and Excellence: Liberating the NHS can only be achieved if healthcare providers employ staff with the skill mix appropriate to deliver a high quality service to patients in every circumstance.

Public investment is central to securing high quality services and training. In future the DH will have progressively less direct involvement in planning and development of the healthcare workforce, except for the public health services.

Employers will be given greater responsibility for planning and developing the healthcare workforce. Local ‘skills networks’ of employers will take on many of the workforce functions currently discharged by Strategic Health Authorities, while the quality of education and training will remain under the stewardship of the healthcare professions.

The final date for responses to this consultation is 31st March 2011. A summary of the response will be made available before or alongside any further action, such as laying legislation before Parliament, and will be placed on the Department of Health consultations website. This will occur after the consultation is completed on 31 March 2011.

To view some of the key diagrams from this consultation document in more detail click on the below links:

• Workforce Planning, Education & Training: Main Functions
• A new framework for planning and developing the workforce
• Distribution of multi-professional education and training funding (MPET)

Public Health England will be created as a service that gives more power to local people over their health, whilst keeping a firm national grip on crucial population-wide issues such as flu pandemics.

The White Paper, Healthy Lives, Healthy People also sets out how funding from the overall NHS budget will be ring-fenced for spending on public health – a recognition that prevention is better than cure. Early estimates suggest that current spend on areas that are likely to be the responsibility of Public Health England could be in the range of £4 billion.

The majority of public health services will be commissioned by Local Authorities from their ring-fenced budget, or by the NHS, all funded from Public Health England’s new public health budget.

These briefs and policy summaries were prepared at the request of the Belgian Federal Public Service–Health, Food Chain Safety and the Environment, for the Belgian EU Presidency Ministerial Conference on ‘Investing in Europe’s health workforce of tomorrow: scope for innovation and collaboration’.

These documents can be viewed here.

All parts of the health service are required to work across organisational boundaries to respond positively to the reform set out in Equity and Excellence: Legislation for, whilst ensuring that service quality and financial performance are maintained and improved at a time of change.

Click here to view the Operating Framework.

The King’s Fund set up a commission on leadership and management in the NHS with a brief to:

• take a view on the current state of management and leadership in the NHS
• establish the nature of management and leadership that will be required to meet the quality and financial challenges now facing the health care system
• recommend what needs to be done to strengthen and develop management and leadership in the NHS.

The future of  leadership and management in the NHS: no more heroes reflects the conclusions of the commission’s work.

The conclusions challenge some of the negative attitudes towards managers, as well as current plans for major reductions in management and administration costs. The commission believes that the NHS needs to move beyond the outdated model of heroic leadership to recognise the value of leadership that is shared, distributed and adaptive. In the new model, leaders must focus on systems of care and not just institutions and on engaging staff in delivering results.

The commission emphasises the contribution of both general managers and clinical managers to leadership, the fact that leaders exist at all levels – from the board to the ward – and the increasing importance of leadership across systems of care as well as in individual organisations.

The NHS Future Forum has published the results of its two-month consultation, calling for the Government’s proposed changes to the NHS to happen more gradually.

The report makes 16 recommendations to the Government:

• The enduring values of the NHS and the right of patients and citizens as set out in the NHS Constitution are universally supported and should be protected and promoted at all times.
• The NHS should be freed from day-to-day political interference but the Secretary of State for Health must remain ultimately accountable.
• Patients and carers want to be equal partners with healthcare professionals in discussions and decisions about their health and care.
• There must be transparency about how public money is spent and how and why decisions are made.
• GPs, specialist doctors, nurses, allied health professionals and all other health and care professionals state there must be effective and multi-professional involvement in designing and commissioning services.
• Managers have a critical role to play in working with and supporting clinicians and clinical leaders.
• There should be a comprehensive system of commissioning consortia but they should only take on their full range of responsibilities when they can demonstrate they have the right skills, capacity and capability.
• Patients want to have real choice and control over their care that extends well beyond just choice of provider.
• Competition should be used as a tool for supporting choice, promoting integration and improving quality and must never be pursued as an end in itself.
• Private providers should not be allowed to ‘cherry pick’ patients and the Government should not seek to increase the role of the private sector as an end in itself.
• The duties placed on the Secretary of State for Health, the NHS Commissioning Board and commissioning consortia to reduce health inequalities need to be translated into practical action.
• Local government and NHS staff see huge potential in health and well-being boards becoming the generators of health and social care integration.
• Better integration of commissioning across health and social care should be the ambition for all local areas.
• Those NHS staff who are aware of the Government’s proposed changes to the education and training of the healthcare workforce feel much more time is needed to work through the detail.
• Improving the public’s health is everyone’s business but should be supported by independent, expert public health advice at every level of the system.
• Clinical leaders, managers and all those who care about the success of the NHS agree that quality, safety and meeting the financial challenge must take primacy and the pace of transition should reflect this.

The Commission on Funding of Care and Support, set up by the Government in July 2010, was asked to recommend a fair and sustainable funding system for adult social care in England. Its findings are presented to the Government in the report Fairer Care Funding.

The report’s recommendations include the following:

• Individuals’ lifetime contributions towards their social care costs – which are currently potentially unlimited – should be capped. After the cap is reached, individuals would be eligible for full state support. This cap should be between £25,000 and £50,000. £35,000 is considered the most appropriate and fair figure.
• The means-tested threshold, above which people are liable for their full care costs, should be increased from £23,250 to £100,000.
• National eligibility criteria and portable assessments should be introduced to ensure greater consistency.
• All those who enter adulthood with a care and support need should be eligible for free state support immediately rather than being subjected to a means test.

The simulation exercise enabled senior managers and thought leaders from across the NHS, local government and the third sector to test out a remodelling of the health and social care system in a safe learning environment.

Routes for social and health care: A simulation exercise focuses on Crafton – a hypothetical metropolitan borough in central England – and sets up a number of routes to managing change.

The publication offers some important reflections for policymakers, commissioners and providers, including

• the challenge of moving beyond short-term efficiency savings to longer-term transformational design of services
• the  tension between top-down managerially led approaches to change and a more devolved outlook that stresses individual control and choice
• the potential of health and well-being boards to offer system leadership in moving towards different models of care.

The independent NHS Future Forum report confirmed that there was support for the principles of reform, but that some of the ways in which the Government was putting those principles into practice could be improved.

This Department of Health publication sets out the Government's detailed response to the Forum's report. It explains how significant changes will be made in line with the Forum's recommendations.