Chief Executive Writes To Staff And Stakeholders
NHS Isle of Wight Chief Executive, Kevin Flynn, has today written to NHS staff and stakeholders setting out the current position for Isle of Wight NHS Primary Care Trust (the PCT) on the publication of The White Paper on Health – ‘Equity & excellence: Liberating the NHS’.
In the letter Mr Flynn outlines how the White paper affects three keys areas of NHS Isle of Wight:
- Public Health
- Provider Services
NHS Isle of Wight has already started discussions with key stakeholders including our MP, local Councillors and Council officials, our Staff Partnership Forum and commissioning staff and local GPs.
The Department of Health have invited comments on how best to implement the changes and comments on the White Paper should be sent by 5th October to NHSWhitePaper@dh.gsi.gov.uk or to White Paper team, Room 601, Department of Health, 79 Whitehall, London, SW1A 2NS. Consultations on specific elements of the proposals are expected to follow publication of the White paper.
Copies of the White Paper can be downloaded from the Department of Health website at http://www.dh.gov.uk/en/Publichealth/LiberatingtheNHS/index.htm or from the NHS Isle of Wight website at http://www.iow.nhs.uk/index.asp?record=1412.
Letter to staff and stakeholders dated 14th July 2010
To all NHS staff and stakeholders on the Isle of Wight
The White Paper on Health – ‘Equity & excellence: Liberating the NHS’
On Monday 12th July the Secretary of State for Health, Andrew Lansley, published a new NHS White Paper, setting out the coalition Government’s vision for the NHS. In this letter to you I am setting out the position as we understand it and what it means in relation to the NHS on the Island. There is still a lot of detail to be worked through, but this is what we know at this time. I know this is a potentially very stressful time for everyone and I hope that by providing you with regular information about the emerging picture that we can prevent the ‘rumour mill’ from working overtime!
This White Paper is the first step towards the Government’s ambition for the NHS to achieve health outcomes and quality health services that are among the best in the world. This vision puts patients at the heart of everything that we do. This means giving them more choice and the information they need to be able to exercise that choice. It also means putting GPs in charge of local commissioning decisions and setting providers of health services free from top-down targets. You can find a copy of the White Paper on our website at www.iow.nhs.uk under Get Involved, Engagement & Consultation, Live Issues. As more information becomes available we will ensure that it is placed on our website.
In order to achieve its vision for the NHS, the Government has proposed changes to the way the NHS is organised. It plans to create an independent National Commissioning Board for the NHS. The Board will allocate money to local GP consortia for them to use to commission local health services. Local authorities will take on responsibility for health improvement, currently held by primary care trusts. As a result of these changes, the Government expect our current organisational form (PCT) to cease to exist from April 2013 on the successful establishment of GP consortia. It is also planned that strategic health authorities will no longer exist from 2012/13. This means that NHS Isle of Wight has to support transition into a different organisational form. We have started discussions about how this transition might take place and over what timescale.
The proposals in the White Paper for the greater involvement of local people, GPs, clinicians and staff in setting the direction of local healthcare are very positive. This is something we have been working towards in developing our Patient Council and Patient Panel, our work with the Island's Local Involvement Network (LINk) and working more closely with Isle of Wight Council, Island GPs, NHS staff including nurses and doctors and the Island Strategic Partnership (Eco Island).
When we were established in 2006 we were set up as a Primary Care Trust and, uniquely in English healthcare, were given authority to be a combined Commissioner for all health care on the Island and a Provider of Acute, Community, Mental Health, Learning Disability and Ambulance Services (Prison Healthcare was included later). In January we had the opportunity to show Mr Lansley the many positive benefits of the Island's integrated healthcare organisation when he visited the Island.
The White Paper has different approaches for Commissioning, Provider Services and Public Health and the impact locally, as much as we know it, is explained below.
We have already been in discussion with Island GPs including representatives from the Practice Based Commissioning (PBC) Forum as well as the Department of Health, NHS Partners and staff to discuss the future of commissioning. It is likely a GP commissioning organisation will be set up to take forward the commissioning of health services for the Island. The GPs we have spoken to recognise the value and skills of existing commissioning staff, but it is too early in the process to be clear how local GP commissioning will be undertaken in future. It will take some time for the establishment of GP consortia to be worked through.
Further detail on the arrangements for public health is expected later in the year. In the meantime we will be working with our partners, including the Council and mainland PCTs, to determine the options for an Island public health service. We will also engage through the public health network in the development of the national strategy and seek to promote a community driven approach to health improvement.
We are also working with the Department of Health and other stakeholders including Council, staff representatives and our MP to determine the future organisational form for the provision of services where our options include:
- Becoming a Foundation Trust
- Becoming a Social Enterprise
If these don’t work we will have to seriously consider merger with another provider or providers (of which the options are currently limited to those on the mainland). As with commissioning it will take some time for these options to be worked through to identify the most appropriate organisational form to meet the needs of the public and patients for the Island’s unique circumstances.
Securing the future
Whilst we work through the future options the single most important thing we can all do to secure our future, particularly if our provider services are to become a Foundation Trust or Social Enterprise is to speed up our cost savings whilst improving our quality and productivity. So, with this in mind, we are revisiting our financial, quality and performance targets to ensure that our provider services meet the criteria to become a stand alone Foundation Trust or Social Enterprise within the timetable set by the White Paper. If we continue to accelerate our improvement in costs, productivity and quality, a stand alone provider organisation on the Island is a real possibility for us. Revised performance, financial and quality targets will be developed and discussed with you all as soon as possible and it requires everyone of us to support this if provider services are to qualify to be a stand alone organisation in this new future.
The Government have already invited comments on the White Paper by 5th October 2010 and have indicated that there will be public and staff consultation on a number of the proposals in the White Paper.. Senior staff and managers will be aware that we have an Executive Briefing planned for 9.30a.m. on Thursday 22nd July and the White Paper will be the focus for this session. It will be important for those present at the meeting or their deputies to brief staff afterwards and encourage discussion and feedback on the White paper. We will be taking both formal and informal action to communicate progress to staff and stakeholders, as further information becomes available. We will also set up some formal arrangements for staff to provide feedback on developments.
Technical Note for Editors
When NHS Isle of Wight was established by Statutory Instrument in 2006 it was set up as a Primary Care Trust and, uniquely in English healthcare, was given authority to be a combined Commissioner for all health care on the Island and a Provider of Acute, Community, Mental Health, Learning Disability and Ambulance Services (Prison Healthcare was included later). The commissioning (PCT) and public health elements of our work, whilst important and valuable, are relatively small in terms of staffing compared to mainland PCTs. The bulk of NHS staff on the Island are in provider services. It should be noted that some media have quoted a figure of 516 management and administration posts on the Island as being affected by the White Paper; this is not comparable with other PCTs due to our unique set up.