Conviction or just politics

The week before last a new Health and Social Care funding deal was announced for the Greater Manchester Combined Authorities,gmca_small_logo1 and whilst it is built on the city region deal that has been worked on for months, the scope and size of the pooling was a surprise to many of us. i.e. the completely pooling of all of the city region’s Health and Social Care funding under the control of a sort of super-sized Health and Wellbeing Board. Of course as with all things, the ‘devil is in the detail’ but it’s fair to say the deal is clearly not something matured and nurtured by the Department of Health and DCLG but a Treasury and more specifically a George Osborne big bang.

I think I can speak with some knowledge on this process given that in my role at the LGA Community Wellbeing Board where I hold the national Portfolio for Health and Social Care integration, and we are currently grappling with the minutiae of the Better Care Fund’s modest proposals all councils are having to work thought, well that is apart from it seems, the Manchester combined authorities!

So it is to be welcomed rather than the rather negative response from Labour’s Shadow Health Minister Andy Burnham who despite speech after speech that he wants to see just such an acceleration of the pooling, came out against it on twitter as it was leaking out. It is a shame he could not be more supportive of the very thing he has been saying he wants to see, but that politics!

Public Health: Post 2015 Challenge Conference

2014_11_05 Public Health Conference Plenary Group PictureLast Wednesday I travelled to London to meet with officers from the LGA to discuss aspect of my new portfolio responsibilities on The LGA Community Wellbeing Board and then it was off to the Mermaid Theatre for a Public Health Conference where we had been asked to provide a speaker for a closing plenary Question Time session about Public Health the local Government prospective going forward.

On the platform with me were Natalie Bennett, Leader of the Green Party, Cllr. Mike Roberts, a senior Labour Local Government figure in the LGA and the session was moderated by Tam Fry.

For my part in my opening few words I spoke about the role of Public Health and the landscape in which it operates and my opinion that the greatest single challenge ahead was their role in an evidence based approach to how we cope with an Ageing Population. The House of Lords Committee on Public Services and Demographic change warned in March 2013 in its report ‘Ready for Ageing? That the UK was ‘woefully underprepared’ for the social and economic challenges presented by an ageing society. For example, with the number of people living with long-term medical conditions is set to rise sharply, so a ‘radically different model’ of care will be needed to support people in their homes and to prevent pressure on the NHS. I think this can currently be seen manifesting itself at the sharp end with the debates about pressure on A&E frankly the tip of the Ageing Population and these debates will gather in strength and urgency as the realities of an Ageing Population and a lack of systemic planning hit home, we are simply not keeping up with the rising demand.

It was an interesting question time session and it is strange how you find yourself slipping into a sort political party mode at times. One of the reoccurring themes used by both Natalie Bennett and Cllr. Roberts was that this country is the 6th wealthiest in the world and so we should be able to do this and that. And so in response I had to do what Conservatives always seem to have to do! Both seemed to be determined to ignore the fundamentals of our underlying economic challenge, promising the earth with a default position of how we pay for it, lots more taxes. I hoped I interjected a sense of realism that Local Government and Public Health better look to itself for the solutions to the challenges ahead because there was not likely to be additional monies from Central government for many years to come. A really excellent Q&A session and well worth the trip form my point of view and I hoped the audience agreed.

LGA CWB TLAP BCC – how’s that for Local Gov speak!

TLAP LogoToday I reach a small milestone in my blogging as this is my 300th blog, probably does not mean much to you but it seems a long way from when I first logged into word press, set up an account and well had a go. If you’re one of those kind people who follow it, thanks for reading. I do try to be as brief as possible, sometimes I succeed and sometimes I don’t. Hopefully it gives a bit of an insight into the things I get involved in and am passionate about.

Speaking of which, last Wednesday I was in London representing the LGA Community Wellbeing Board at two meetings firstly the Building Community Capacity steering group and later at the TLAP Board Meeting. I wanted to be a part of the Building Community Capacity work as it is very much what I started in Suffolk as we came up with the Supporting Lives Connecting Communities Programme (SLCC) about how the Council can develop services that communities truly need that compliment rather than crush the work that existing in Communities now and to help build community based services where there are none. In short how to delivery more services to an ever growing number of people who need care services but with less money with which to do so.

In the afternoon, the main Board meeting took place, where I am able to give the programme a sense of what Local Government and Councillors need from the various work streams and how the reports and initiatives its provides and funds can help Local Government can make its services more relevant and personal to those who need them.

The latest papers to shortly be available from their web site and being launched at this week’s National Adult and Children’s Conference in Manchester are called ‘Shaping the future- information, advice and brokerage in the context of the Care Act’  – essentially 3 reports co-badged with ADASS, DH and LGA to support the Care Act implementation.

I’ll pop the links to those papers up when they are on the TLAP website, the other recent ones that I think are useful reading are:

‘Getting Serious about personalisation in the NHS’ – Partner publication to the IPC (integrated Personal Commissioning) with ADASS LGA and NHS England http://bit.ly/1rxvKeD

‘No Assumption: a narrative for personalisation, co-ordinated care and support in Mental Health’ – with National Voices and NHS England http://bit.ly/1ywCMoU

‘A Wealth of information: your questions on personal health budgets answered’ – NHS Confederation briefing produced in partnership with TLPA http://bit.ly/1mG7gPW

Board Appointments

Last week I had confirmation that I’m continuing on the Local Government Association’s Community Wellbeing Board for my second year, following my two years as a substitute member. The work of the board and its voice to central government have never been more important as we look towards the next parliament and influencing the incoming government’s agenda around Health and Social Care from a local government prospective. This year because of the changes in the political control of the LGA we take the chairmanship of the board and I delighted that Cllr. Isobel Secombe, Leader of Warwickshire is our Chairman.

A couple of Wednesday’s ago the importance of such policy forums was reinforced to me as I attended my first board meeting of the national ‘Think Local Act Personal’ (TLAP) Board having recently been appointed to the LGA’s representative on this important national Programme board.

I am particularly pleased to take up this role as it’s got a real local community focus and making it real has an effect in the villages in my Division. One of the programmes I helped shape in Suffolk when I was Cabinet Member for Adult and Community Services is called Supporting Lives, Connecting Communities, put simply it’s about helping communities to do more for themselves and developing the community to support our residents as we face both budget pressures and a growing and ageing population.

In many ways the TLAP nation initiative is very similar but at the national policy formation, system thinking and lobbying level, so I’m really pleased to be involved. As I read through the considerable background papers to my new role it’s really interesting to see many of the organisations I drew upon as we in Suffolk came up with our policy are represented on its board.

on its board.

Back in Manchester

Chairing Supporting People or Social Care? session at NHF Conference

Chairing Supporting People or Social Care? session at NHF Conference

Listening to a response from the platform

Listening to a response from the platform

Wednesday I was back in Manchester at the National Housing Federation (NHF) conference called ‘Rethink Refocus’- Care and Support representing the LGA’s Community Wellbeing Board speaking and chairing a session entitled ‘Do we need to spend more time expanding our role in social care, and less time talking about supporting people?’.

I was joined on the platform by Patricia Kearney, Director of Innovation and Development, Social Care Institute for Excellence (SCIE) and Mike Lawlor Regional Manager, Riverside. Clearly from the questions from the floor after our presentations there was a concern that in all the cuts and removal of ring-fencing firstly the monies will be diverted to other services and that whilst the big issue group, an ageing population, will get focus other vital more specialist but hidden supporting people work around supporting those with mental health or drug and alcohol issues.

I said that “clearly the prime concern of our government was the rising cost of the NHS as it consumed a 6th of the national spend. The primary cause of this is our ageing population and so I think from the conference speech last week across the road at the Manchester Central by Jeremy Hunt, the £3.4billion announced by the Chancellor couple of weeks back to be ring-fenced for social care and in a more private meeting with Norman Lamb they collectively grasped the need to put money into preventative services to keep older people from going to hospital in the first place and to then get then out quicker which is good for the older person and for the NHS budgets, but yes if the focus is on this area there is a danger other services will suffer, so you have to be advocates for those other services.”

The rest of the conference was a really interest mix of social care, health and housing. The reason I agreed to travel so far and attend and speak was that this triangle of Housing the NHS and Social Care support are the cornerstone of how we delivery better outcomes for our communities. Get it right and in this area we should be able to provide better, more person focused support and health care along with better life enhancing housing.

All for less money, it is achievable? – Debatable but it’s certainly challenging.

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