Letter from the CCN to the Secretaries of State for Health & Local Government

fullsizeoutput_1cbeLast week I attended the National Children’s and Adult Services Conference in Bournemouth.  On the way down as Leaders from across the Adult Social Care Councils including me, received an email with a letter attached from SoS DH Jeremy Hunt and co-signed by SoS DCLG Sajid Javid about Delayed Transfers of Care, these happen when a person is medically fit for discharge form a Hospital and we are unable to put in place a suitable package of home or residential care quick enough, this is known in Health and Local Government as DTOC.

As winter approaches and with one of the worse Flu epidemic in the Southern Hemisphere seen in recent years (if you have not yet had the flu jab, I would recommend it, I paid £10 at my local chemist and apparently ASDA are doing them for £5) the NHS is extremely worried about the stress on hospital beds over the winter months, as they are expecting significant numbers of admissions for this simple but dangerous virus to vulnerable groups’.  So the need to feed up beds is important and there are two areas where local government is involved preventing people going to A&E in the first place and how quickly we can facilitate those who need a care package when they are ready to leave hospital obviously the more effective the system the more beds the NHS will have free to cope this winter.

The letter were somewhat condescending and effectively suggest we alongside the other 80 or so local councils responsible for DTOC are failing.  However it was a step back from the threats made earlier in the year about fines and direction of budget if the situation did not get sorted out.  Very DoH, not very DCLG but in this repsect DCLG is very much the junior partner to the might DoH.  During the course of last Wednesday at the conference it emerged that there were in fact three different letters issued, and our was the middle one not praising us but not summonsing us to Department of Health (DoH) as about 32 Councils will find themselves having to go before a panel of experts at DoH, and for experts read people who work in Whitehall, or more precisely civil servants who work in DH in Whitehall who will want to see plans for a lower DTOC target in those areas or they will re-direct monies spent of Adult Social Care to hospitals which will not deal with the issues and probably make them worse.  Adult Social Care cannot be fixed by a summons from DoH, it needs careful partnership working on the ground in each area surrounding a hospital. .  At the conference, we referred to these as naughty step letter and which one you were on – a very flippant comment given the seriousness of the issue but given the patronising letters, as if our social work teams are not working hard to provide the care packages, which they are, its the right term to use.

The issues are complex and the impression you get from the letters is that its entirely Local Governments fault and so DoH can swoop in, divert money to hospitals and all will be right with the world, sorry but this is nonsense.   Fundamentally Local Government needs funding to provide the care, it’s as simple as that, and the threat is that if local Government does not improve then it will have funding withdrawn is worrying.  this is not about simply demanding more money for Local Government has stepped up and made the savings the Government has called for but there comes a point.  Across the county grown up discussion with Hospitals and Clinical Commissioning groups are building a long term system to handle discharge and withdrawing money will not improve that one bit, quite the reverse in fact.

So, on behalf of the County Councils Network on Friday I wrote to both Secretaries of State pointing out the position of CCN member Councils and our concerns.  In Suffolk we work closely with our Acute hospitals planning prevention, avoiding having to go to A&E and when people are admitted discharge planning starts straight away, in West Suffolk the hospital’s enlighten CE Stephen Dunn has contracted beds in a Care Home with nursing to provide people a different setting to recover, what used to be called Convalescence.  As our population ages we are going to need to see a return to this sort of step down care, from our hospitals.

Another false dawn?

fullsizeoutput_1bf4Last Wednesday I was in London for the County Councils Network AGM held this year in the main Hall of the Chartered Insurance Institute in the heart of the City of London, which given the discussion I wanted to have with fellow Leaders was quite fitting setting as the sun shone through the Institutes historic stained-glass windows with the logos & formation dates of the various Great British Insurance companies formed since the 1700’s, depicted.

After the formalities of the AGM we moved into a discussion on the coming Green Paper on Social Care and I led a discussion in my capacity as spokesperson for Health and Social Care on our initial ideas by tabling a discussion paper for Leaders to feedback if they agree that the areas we are considering lobbying on are the right ones and what the emphasis should be.  These are senior gatherings from across the Country of those Councils which provide support for some 48% of all older people and those with Learning and Physical Disabilities, so our thoughts  are based on our practical knowledge of delivering a system and thus I would say important to help Government shape the coming bill.

In my opening remarks, I said that what we must lobby for and encourage from across the sector from ADASS to our MPs that this must not another false dawn.  I have been a Councillors since 2006 and in that time, I have seen successive Governments seek to tackle this issue of funding and the nature of the Health and Social Care integration and indeed if I think there has been false dawns on the Local Government side there is perpetual motion on the NHS side.

We have seen with Gordon Brown’s free Social Care at home proposals which ended in disarray as utterly un-costed, but hey there’s a Labour Government for you, to the collapse of the Westminster cross-party discussions when they accused each other of promoting a Death Tax in the run into the 2010 elections.  Next up we had the Andrew Dilnot Report which fizzled out when the then Chancellor decided far too expensive and so set a higher cap and that came to nothing.  To the recent Conservative Manifesto which was accused of being a Dementia Tax by Labour within hours of being unveiled.  On the NHS side, we’ve seen the arrival of the CCG from the old PCTs, the creation of the Health and Wellbeing Boards, some of which genuinely have shifted the notion of how to tackle an Ageing Populations other not so much.  And now the notion that on DTOC DCLG or is that the NHS will start withholding money from Upper Tier Councils if there is an excessive wait for patients once declared medically fit for discharge and too long a wait for a social care package to be found.

If like me you are involved in this issue is an extremely complex once that requires the NHS to work in collaboration with local government.  DTOC fines are not going to help one little bit by taking further funding away from already stretch services and making the relationship not one of collaboration but performance fines.  In 2010 we moved away from this culture and now through the influence of the mighty NHS we seem to be moving backwards.

So, there is a lot riding on the Green paper from solving the ridiculously complex funding grants and taxes currently in place from the BCF to the National Adult Social Care precept, a threshold here and a cap there – all of which seems to me avoids a fundamental question – how do we, as a nation, pay for Social Care often seen through the prism of Free NHS services. To my mind its relatively simple a per head of population funding formula irrespective of BRR and we will to have a contribution from people’s property wealth but given the Russian roulette of Dementia and frailty we should cap this so people can reasonable expect to be able to hand down much of what they have worked hard for over the years. Equally that the NHS must be required to work with Local Government to shape and deliver communities that service our residents not in shiny new hospital buildings but in the communities in which we all live together.  So, can we have a green paper that is more than activity more than another false dawn and genuinely starts to address the issues of our ageing population.

I’ll be presenting a draft lobby paper to the CNN Conference in November for sign off by the County Council Leaders as our contribution to this debate and when completed I will put up a link to it here.

Deborah Cadman

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Deborah and I with Shaun Whiter at the Suffolk Raising the Bar Awards last night where Shaun spoke of his challenges in life and how he sets himself goals – inspirational stuff.

Today the news will be breaking that Deborah Cadman the Suffolk County Council Chief Executive is leaving us for a new role as Chief Executive of the West Midlands Combined Authority (WMCA).

She told me last week that she was being considered and was offered the job on Friday.  I shall personally be very sad to see her leave but fully understand the exciting challenge and thus reasons for her move.

Deborah has been outstanding, leading our Staff these past 6 years, she steadied the ship when she arrived and has lead the team through major staff reductions and changes in the way they work together and with our partners across Suffolk. Her impact in her time with us cannot be underestimated. Educational attainment levels in Suffolk are now significantly higher, with 86% of schools rated good or outstanding by Ofsted. Over £200 million of essential budget savings have been delivered and staff morale is much higher than when Deborah joined us in 2011.

Today Deborah and I will present to the Cabinet and Senior officer team senior a draft paper which turns our Conservative County election manifesto into corporate priorities, her enthusiasm for this and her vision as we plan with our partners for our great county has been exceptional.  Deborah’s ability to lead partnership working will be something that WMCA will benefit from immensely as it forms its strategies for the long term as well as the short term.

I always knew this day would come.  I know she will not mind me saying that last year I managed to persuade her to remain with us when Government offered her a top job and in part that was because at the time there was the prospect of a Norfolk and Suffolk Combined Authority.  She was as disappointed as I was, that we did not manage to capture the imagination of all the councils in Norfolk to the concept.  So, her move to a Combined Authority that did form!, is no surprise to me.

She is going to the most challenging and exciting job in Local Government.  Andy Street the new Mayor of the WMCA has had a glittering career in Retail as the former CE of John Lewis but is new to the bear pit of politics which is the West Midlands.  I have undertaken work with officers in Birmingham and Sandwell and know some of the areas Leaders that make up the WMCA and if I pondered how complex the Norfolk and Suffolk CA was going to be, it has nothing on the complexity of those Councils working together with a Mayor.

I have known Deborah a long time firstly when she was CE of St. Edmunds Borough Council and in her time as CE of the East Anglian Regional Development Agency.  Funny story is that I was on the original panel who recruited her to the SCC role however for some domestic reason, she was first up and I missed her interview but at the end of the day’s other interviews I voted for her to get the job, she has and is one of this country’s stars of Local Government and blends her considerable operational skills with a deep understanding of the political ‘side of the coin’, as well.

Her personal support of me these past two years as I have started my Leadership role has been brilliant and at a very difficult time for me last summer when my father died in sudden circumstances, I shall long remember her kindness.

Suffolk’s lose is the West Midlands Combined Authority and its new Mayor’s gain.

Deborah is a Brummie and so is returning home, but I know she and Geoff will keep their Suffolk connections where she has forged much of her career and I wish her all the very best.

Deborah will be with us for much of the next three months as we careful plan her exit and together we will make arrangement with our excellent senior officer team, one of whom will cover the CE role as we go out to recruit a new CE.  I know from some of those excellent candidates who I hope will apply that we will have a rich pool of talent to pick our next Chief Executive.

Investment in Ipswich, Investing in Suffolk.

Really pleased that the news has been revealed that the Homes and Community Agency are helping to support the Development of the empty ‘wine rack’ building on Ipswich’s Waterfront officially it’s called Regatta Quay but its known as the wine rack for obvious reasons and is rather a symbol of the last property crash and so an important building to finally see developed.  The Agency will invest £15M and the New Anglia Local Enterprise Partnership (NALEP) of which I am a Director as Leader of Suffolk County Council, is investing £5M from our Growing Places Fund.  These are commercial loans and will be repaid with interest but they get things moving.

The work of the NALEP and more details on the announcement can be found here

www.newanglia.co.uk

Sometimes Ipswich seems a long way for Row Heath but battling for investment and growing our economy is vitally important.  As Leader of the County Council I have been on recorded as stating there is no such thing as a Stronger Suffolk without a Stronger Ipswich, the development of this icon structure on the waterfront alongside the £100M investment being made with Foster and Partners designing the Upper Orwell Crossing there is a determination for Ipswich to become the Powerhouse of Suffolk’s economy.  This benefits us here in the west of Suffolk because the more money that is generated in Ipswich through Business rate growth, shortly, will mean more money for the County Council to spend on vital services in our community.

We want to grow our economy here in West Suffolk as well but Ipswich is uniquely placed to benefit from an overheating London economy as it’s an hour from the heart of the city and we are working to make sure we capitalise on that geography. That’s why I sort and campaigned for there to be one Board to pull together all of the many, many plans I was presented with when I became Leader of the Council two years ago.  Today there is one vision one board, its called Ipswich Vision and I have lead Suffolk’s attendance at the principle Land and Property investment exhibition in London each year called MIPIM, as we seek to put Ipswich and Suffolk on the investment map.

You can read more about the Ipswich Vision Board here

www.newanglia.co.uk/…/major-players-come-together-to-agree-a-vision-for-ipswich/

The way local government is financed is complex but it is changing, I want the economy of Suffolk to be a powerhouse of growth with high value jobs and growing companies to be based here.  In the next few years the stronger our economy, the more money we will have to spend of protecting frontline services for the most vulnerable in our society. This is what we mean by Caring and Campaigning.  Unlike the Lib Dems and Labour who would spend all the money we have earmarked for investing in our economy and growth, they would simply spend it now, not making the savings we need to make and then as they always do when the money runs out, throw their hands up and demand more of your hard-earned money in Council Tax. We believe in investing is Suffolk’s growth and this coupled with a relentless drive to make the back office of the public sector in Suffolk more efficient is how we will deliver for Suffolk over the next 10 years.  We are planning how we go about this and develop a blueprint of growth and efficiency.

End of Year 2016

2016 New YearSo, as 2016 draws to a close, it’s a bizzare year to sum up.

On the personal front, it’s been a terrible one as we lost Dad in far too sudden circumstances.  We all miss him a lot.  It a strange thing to say when you ‘painted’ as this old hard-nosed individual but it’s a moment in life when both your parents have gone, of course we all must go through it, but it still a sobering moment for each of us.  Over Christmas, Lisa and I visited an Aunt of hers who is learning to live with Dementia, a dear lady I have known for 19 years who is struggling and in contrast before we left we travelled further north to visit my Auntie who is older but as sharp as a pin and in top form!  Old age is a strange journey and there is no play-book but what I do know is that this country has to wake up to the needs of an ageing population or we will sleep walk into an unpleasant society where old age is not celebrated but seen as a burden.  There are many things on the horizon but how we change our health and social care system and start building homes that address the needs of older people is right up there.

The highlight of the year for me as a Councillor, was being introduced to Her Majesty the Queen at the Home of Horse-Racing Museum official opening.  As we awaited her arrival I chatted with David Burnip the former CE of FHDC and asked him if he remembered my stance on the Palace House purchase and rescue, by the council, all those years ago.  He did, I was against it!  And we reminisced about the then District Council Leader Geoffrey Jaggard and his vision.  The day was all about the Racing Community and how Newmarket can capitalise more on being the world headquarters of Racing but without the decision taken by these two chaps all those year ago to rescue a tumbled down spooky old house and semi delicate yard, none of it would have been possible.  If you ever find yourself in Newmarket do go along as it’s a world class museum and the way it helps you understand of the science of Horse-racing is impressive. Not to mention the heritage and art which is just stunning.

On the national and international political front, it’s been a staggering year where the rule book has been ripped up.  You can see that Brexit is going to be the most complex, time consuming thing for our Government to get right and make sure our economy does not suffer more that it has too.  I suspect the history books will have a somewhat mixed view on David Cameron’s time as Prime Minister but I briefly met him at Felixstowe Docks 100 days from the Referendum and he spoke with passion and conviction that strangely was not the hallmark of the remain campaign which seemed to me to fail to make the points about access to the single market being vital to our economy and that the vast majority of those working in Britain from Europe where either here ‘Auf Wiedersehen Pet’ style contributing to our industry or here raising their families and paying their taxes, i.e. contributing not taking British jobs.  The government and our new Prime Minister must find a way to get the best possible exit we can and that won’t be easy.

Internationally we will shortly watch the inauguration of a new American President and I recall the hope and expectation that hung in the air at President Obamas’, I suspect the world will watch with different feelings at President Trumps’.

Here in Suffolk I have had the pleasure to lead the County Council and the frustration of Devolution.  I say pleasure to lead the County Council because it is.  There is lots more to do and we are doing it but I am proud of the staff, the Cabinet and my group and how they have all risen to the challenge of significantly less Government funding and our demand that the Council lives within its means and maintains a sensible level of reserves.  As I look about the sector our cautious, prudent approach puts us in a place that is very different from some councils beyond Suffolk, there begins to be real concern that some councils may start to run out of money and fail to deliver front line services, I have often said that unlike the NHS, if councils run out of money the cheques don’t just carry on being honoured, staff will not get paid and services will fail, not here in Suffolk.  As a political party, we pledged and have delivered 7 years of 0% base Council Tax rises only putting up the Council tax to pay for the National Living Wage which everyone agrees is the right thing to do for the lowest paid workers in our society.  However I say a frustrating year in terms of Devolution because across Suffolk we can see how it can help us reshape Public Services and be a part of how we create a community that addresses the needs of our ageing population at the same time as investing in new infrastructure to accelerate growth and housing, which is vital for the quality of life we will want to see.  Yet at the end of the year Suffolk has no deal.  Cambridgeshire does but not Suffolk. The Public surveys, the business leaders and their respective trade bodies and all councils agree we want a Suffolk based Devolution deal, will we get one, it certainly won’t be for the want of trying and or effort.

Looking ahead… well that’s another blog!

If you have been kind enough to read this, may I take the opportunity to wish you and your family a very Happy, Healthy and Successful New Year.

Devolution

National Local signpostLast week I had two principle things on my plate, seemingly in conflict but actually very similar in their principle regard.  Firstly I was in North Yorkshire to do a LGA Corporate Peer Challenge for North Yorkshire County Council, something I committed to before Christmas as a part of the role of LGA Leaders who help provide the LGA’s sector lead improvement work.  At the same time, I played my very active role in the final discussions on the first stage of Cambridgeshire, Norfolk, Peterborough and Suffolk Devolution know in short hand as either CNPS or increasingly ‘East Anglia’.  For both there was many conversations, and complex papers to read and consider, and packed days of numerous meetings and teleconferences.

The devolution deal is embargoed until the Chancellor’s Budget speech and if announced, even then it is but a broad set of headings, a first stage in a process if you will.  I and others have been extremely clear that this ‘deal’ is a first stage. Some people always say ‘done deal’ but as we have seen from Manchester this is a process and journey.  Of course Manchester have, in reality, with the Greater Manchester Authority been on this journey for many years but we can learn from that and use it to inform us as we collectively across our communities, businesses and councils now have a period of real debate to refine and put the ‘flesh on the bone’ of what this means to us, and I am determined we will do this over the coming months.  Then and only then it will be debated by every council to be democratically backed, to move forward. But hey if councils don’t back it then that democracy in action either way.

For me that would be a great shame, for me Devolution has always been built on a simple premise I have long held. Whitehall is far too remote to understand the real issues in our communities and regarding such local and complex issues such as infrastructure, Housing and Health needs, so Whitehall does not, in my opinion, make really informed meaningful decisions.  There is rightly a role for Whitehall and Parliament in policy making and national issues such as Defence but when it comes to know where to invest to unlock Growth or how to organise such important things as Health and Social Care in a geography to make sure only those people who need to go to A&E actual do. These decisions are far, far better made at the local level by people who live and breath their area.

So as I interviewed Councillors, partner organisations and residents in North Yorkshire it struck me the similarity between the two things, here was I, not from the area trying to understand its complexities.  Yes, I hope the external prospective presented to their senior team on Friday, the private conversations with their senior figures and the report the team of us will now be writing up will be useful to them as they ponder the future, I certainly hope so given the hard work that went into it.  But they know their place as a level and complexity we could not hope to understand, they and their community are far, far better able to make decision for their community, just as we are for ours and that is why I think and am working for Devolution as the important next step for this country’s and our county’s delivery of Public Services.

Stonewall Top 100

LGB&T SCC LogoGood news came reached me last Tuesday when I was informed that at an awards ceremony in London, Stonewall announced which organisations have been included in their Workplace Equality Index for 2016 and  Suffolk County Council was confirmed as having been  successful in maintaining a place in the Top 100 at position 78.  This represents a significant rise of 20 places compared to 2015 when Stonewall introduced more challenging criteria. Also congratulations are in order to Suffolk Police at position 15.

This success demonstrates Suffolk CC is a good place to work for LGB&T staff and that SCC makes efforts to ensure that staff across the organisation understand how to support their LGB&T colleagues.  Cllr Sarah Stamp, Cabinet Member for Communities and thus lead member for equalities and inclusion said: “I am delighted that Suffolk County Council is recognised as one of the Top 100 employers in the Stonewall Workplace Equality Index 2016.  This achievement acts as a demonstration of our ongoing commitment to support LGB&T staff across the organisation”.

Matt Woor, Chair of the Suffolk County Council LGB&T Staff Network said: “I am thrilled that Suffolk County Council has improved its position within the Stonewall Workplace Equality Index.  Every year the work involved in making the top 100 gets harder, so it is fantastic that we have been able to rise to this challenge once again.”

I echo both comments, for some this seems a difficult subject area, but not for me, I believe that we are here in public life to protect our values, our heritage and that a tolerant, fair society is at the heart of our great county and I will do all I can in the time, I am involved in Public Life to promote this position in any of the organisations I am involved in.  Being a Stonewall Top 100 employer clearly demonstration the importance that Suffolk County Council places upon supporting LGB&T equality, both within its workforce and also within the wider community of Suffolk.

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