Health and care service reform in England - policy developments, implementation, collaboration, integration, funding, accountability, and health outcomes
***Full-scale policy conference taking place online***
This conference will look ahead to the Health and Care Bill proposed in the Queen’s Speech, focusing on proposed reforms set out in the Government’s Integration and Innovation: working together to improve health and social care for all white paper.
Delegates will examine key issues and priorities for achieving the white paper’s aims on collaboration, integration, funding, accountability and improving health outcomes going forward. We also expect discussion on on implications of social care not being included in the new Bill, and the continuing priorities for social care reform.
The discussion also takes place in the context of the Transforming the public health system policy paper published by DHSC, and significant developments, including:
- the new Office for Health Promotion - set up to tackle public health concerns and promote preventative care;
- the UK Health Security Agency - to be responsible for the protection of public health and ensuring the UK’s capability of dealing with future pandemics.
The conference will consider what the reforms mean for the delivery of the NHS Long Term Plan in the context of the pandemic - including ambitions for preventative healthcare, the establishment of integrated care systems and population health management, as well as for the long-term sustainability of the NHS organisations.
Overall, areas for discussion include:
- priorities for funding and collaboration in the NHS;
- what is needed for effective integration in health and social care for the future;
- the potential of the reforms in improving value and health outcomes;
- how to achieve effective accountability throughout the process of reform and going forward.
The agenda
- Priorities for funding, collaboration in the NHS going forward, and addressing reforms in the wider landscape of COVID-19 recovery;
- Assessing the proposed NHS reforms, issues for implementation, and progress in integration so far;
- Latest thinking on integration across health and social care, and options for the future;
- Reform and primary care - integration, responsibilities, funding and support for the workforce;
- Meeting the challenges for accountability and adapting to change;
- Assessing options for improving value for money in NHS reform;
- What is needed from NHS reform to improve local health outcomes - priorities for service integration, public health, utilising population health approaches, and tackling inequalities;
- The way forward for improvements to healthcare - improving value and addressing variation.
Key areas for discussion:
The context for reform:
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the pre-pandemic landscape - issues and opportunities as they appeared at the beginning of 2020:
- chronic challenges - including financial difficulties, increased demand, a decline in performance statistics, and workforce shortages
- social care - the nature and extent of problems, and how they were viewed before the pandemic
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the impact of COVID-19 - how proposals for reform of the health system have been affected:
- alleviating future pressures - including the need for improving efficiency across primary and secondary care
- recovery - what is needed from reform to restore and move forward services
- the NHS Long Term Plan - what is needed to implement its aims on health inequalities, expanding community services, whole population health, system working, and improving patient pathways
Stakeholder views on the proposed reform:
- the White Paper and looking ahead to Health and Care Bill Bill - looking at questions over its timing, scope, and ambition
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integration:
- assessing the legislative proposals, as well progress in integration so far
- next steps for integration implementation and how it can be delivered
- the future of commissioning - the impact of the reforms on primary care systems and patient pathways
- social care - implications of the omission of social care in the Health and Care Bill, and the continuing priorities for social care reform
- integration of other sectors - the role of the voluntary and independent sectors in a reformed NHS, and understanding the NHS’ new relationships with local organisations
Collaboration and integration - looking at priorities and opportunities:
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primary care - including the impact of proposed changes for GP interactions with patients, with priorities for:
- patient care - the future for integration with patient care pathways and patient interaction
- a consolidated approach - priorities for eliminating fragmentation to improve patient care, and creating GP communities to establish better networks
- responsibilities - with RCGP calling for GPs to have a strong voice and autonomy within ICSs as they take over CCG budgets and commissioning powers under the white paper’s reforms
- local integration - discussing the potential for support that proposed legislation might offer for aiding progress and removing barriers to integration
- funding - priorities and how investment and resources should be directed
- implementation - priorities across health and social care integration, and what it means for addressing key challenges in the NHS, many of which were set out in the Long Term Plan
Accountability:
- transparency and accountability - how can accountability and transparent processes be best maintained and enhanced as powers move
- the DHSC - assessing its role following proposals to change the powers of the Secretary of State for Health, as well as the way ahead following the retirement of Sir Simon Stevens
Public health:
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the wider policy landscape:
- aligning reforms with other aspects of developments in public health, such as the new Office for Health Promotion, and proposals set out in the government policy paper on public health
- how reform can be refined and implemented so as to maximise opportunities for public health
- the way forward for tackling inequalities in line with the localised and place-based approach in the Long Term Plan
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data and technology:
- data sharing - possibilities, safeguards and communication, and the impact this will have on public health goals, both in the Long Term Plan and more widely
- innovation - priorities for utilising new technology and population health methods to inform local systems in their approach to improving public health
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reducing regional variation:
- the potential impact of reform in moving forward from the variation experienced around the country highlighted in the Marmot Review
- dovetailing with the Government’s ‘levelling up’ agenda and the Long Term Plan’s aims for reducing health inequalities
- building on existing policy and approaches - considering how reform can advance already-established programmes and improve public health
Improvements for patients, value for money and measuring the impact of reform:
- safety - the impact of the HSIB being embedded in the white paper
- legislation on integration - what this might mean for improved patient experience, through enabling better aligned care
- impact - ways that the reforms can improve value in the NHS and the opportunities presented by taking a systems approach in monitoring progress in improvements and addressing variation
The background:
Integration and Innovation: working together to improve health and social care for all - the recent Government white paper, with proposals for:
- integrated care systems (ICS) - with the NHS and local government coming together legally as part of ICSs to improve meeting patient needs and place a focus on preventative care
- NHS workforce - only tendering out services when there is the potential to lead to better outcomes for patients, allowing for more time to provide care
- patient safety - the Healthcare Safety Investigations Branch (HSIB) to become a statutory body, so as to strengthen its legal footing for further action to recommendations
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social care proposals, including:
- new assurance and data-sharing measures to achieve oversight and accountability in the delivery of services
- enabling person-centred models of hospital discharge through updating the legal framework
- introducing powers for the Secretary of State to directly make payments to adult social care providers
- supporting public health - legislation on the introduction of new requirements for calorie labelling on food and drink packaging, and the advertising of HFSS food before the 9pm watershed
The Health and Care Bill - outlined in the Queen’s Speech, aiming to legislate the aims of the white paper, with reference to:
- introducing an ICS to every part of the country to drive forward integration
- improving patient-centred care, with proposals for more local care and increased preventative care
- NHS innovation and increased use of technology
- legislating for a Healthcare Safety Investigation Branch for greater independence of investigations into healthcare incidents, and improved patient safety
- social care oversight and commissioning, integration of health and social care services, and provisions for improved data collection, with extensive social care reforms to be brought about later in 2021
First Report: The Government’s White Paper proposals for the reform of Health and Social Care - from the Health and Social Care Committee
- outlining recommendations for proceeding with legislating the white paper
- highlighting concerns over social care reform and workforce planning
The NHS Long Term Plan - which includes ambitions for:
- preventative healthcare and the establishment of integrated care systems
- population health management
- promoting better health and wellbeing, and better quality healthcare
- ensuring the financial sustainability of the NHS
The Office for Health Promotion:
- established to tackle health concerns and promote preventative care
- aimed at enabling more joined-up, sustained interaction between national and local government, the NHS and cross-government, where many of the wider determinants of health sit
The Transformation Directorate - bringing together NHS England’s operational improvement team and NHSX, the digital arm, to maintain the pace of innovation seen during the pandemic
Transforming the public health system: reforming the public health system for the challenges of our times - the DHSC policy paper outlining possible areas for public health reform, especially around health security and health improvement
Integrating care: Next steps to building strong and effective integrated care systems across England:
- guidance from the NHS - detailing the role and function of effective integrated care systems, and the immediate and long-term challenges resulting from the pandemic
- NHS England consultation on integrated care systems - opened to consider the above proposals, to understand how to better plan, shape, and deliver services across health and social care
Health Equity In England: The Marmot Review 10 Years On:
- finding that health improvement has stalled, and that people living in deprived areas spend longer in poor health, with the gap between affluent and deprived areas growing
- Build Back Fairer: The COVID-19 Marmot Review - outlining priorities for a recovery from the pandemic that reduces health inequalities, including those made worse by the pandemic, with long-term, equitable policies
Advancing Our Health: Prevention in the 2020s - the green paper from the Government to tackle preventable ill health in England, as well as ongoing work on preventative healthcare
1948 Moment for Adult Social Care letter to the Prime Minister - signed by Chief Executives from Care England and the Chair of the NHS Confederation, amongst others, calling for reform to the social care sector and a strategy for the long-term
Policy officials attending:
Our forums are known for attracting strong interest from policymakers and stakeholders. Places have been reserved by officials from the Cabinet Office; the Care Quality Commission; the Department of Health and Social Care; the Department of Health, NI; HM Prison and Probation Service; the Prime Minister’s Office; and the Welsh Government.
Overall, we expect speakers and attendees to be a senior and informed group including Members of both Houses of Parliament, senior government and regulatory officials involved in this area of policy, as well as from regulators, pharmaceutical companies, representatives from the NHS, executive agencies including clinical staff, pharmacists, local government, CCGs, integrated care systems, the social care sector, public health specialists, the independent and third sectors, patients groups, law firms, consultancies, and others affected by the issues discussed as well as academics and think tanks, together with reporters from the national and specialist media.
This is a full-scale conference taking place online***
- full, four-hour programme including comfort breaks - you’ll also get a full recording and transcript to refer back to
- information-rich discussion involving key policymakers and stakeholders
- conference materials provided in advance, including speaker biographies
- speakers presenting via webcam, accompanied by slides if they wish, using the Cisco WebEx professional online conference platform (easy for delegates - we’ll provide full details)
- opportunities for live delegate questions and comments with all speakers
- a recording of the addresses, all slides cleared by speakers, and further materials, is made available to all delegates afterwards as a permanent record of the proceedings
- delegates are able to add their own written comments and articles following the conference, to be distributed to all attendees and more widely
- networking too - there will be opportunities for delegates to e-meet and interact - we’ll tell you how
Keynote Speakers
Richard Sloggett
Founder and Programme Director, Future Health; former Special Adviser to the Health and Social Care Secretary
Professor Tim Briggs
Chair, GIRFT and National Director for Clinical Improvement, NHS England
Dr Tim Phillips
Director, Health, National Audit Office
Chris Hopson
Chief Executive, NHS Providers
Nigel Edwards
Chief Executive, Nuffield Trust
Professor Martin Marshall
Chair, Royal College of General Practitioners
Speakers
Dr Farzana Hussain
GP Principal, The Project Surgery and Co-Chair, NHS Confederation National PCN Network
Sarah Price
Chief Officer, Greater Manchester Health and Social Care Partnership
Ian Trenholm
Chief Executive, CQC
Sir Robert Francis QC
Chair, Healthwatch England
Lou Patten
Chief Executive, NHS Clinical Commissioners and Director, NHS Confederation’s ICS Network