The NHS White Paper:
Equity and Excellence: Liberating the NHS
Report of an event held on
Monday 13 September 2010
at Newcastle Civic Centre
Report by
Newcastle Council for Voluntary Service (NCVS)
www.cvsnewcastle.org.uk
Contents
Introduction
Page 3
The NHS White paper and accompanying consultations
an overview by Mark Adams
Page 3
The view from:
Dr Fu-Meng Khaw
Page 4
Dr Guy Pilkington
Page 5
Sally Young
Page 6
Discussion groups
Page 8
Action and next steps
Page 18
Appendix 1 Speakers and participants
Page 19
Appendix 2 Feedback comments
Page 21
If you would like this report in another format
please contact NCVS
Call
0191 232 7445
Email [email protected]
Fax
0191 230 5640
Visit
www.cvsnewcastle.org.uk
Write to NCVS, MEA House, Ellison Place,
Newcastle upon Tyne, NE1 8XS
Report of Newcastle voluntary and community sector event on the NHS White Paper
13 September 2010
Page 2 of 24
Introduction
NCVS held a voluntary and community sector event on the NHS White
Paper on 13 September in Newcastle Civic Centre, chaired by Sally Young,
NCVS Chief Executive. Discussion groups were held to inform a response
to the NHS White Paper and the four associated consultation documents




Commissioning for patients
Increasing local democratic legitimacy in health
Regulating healthcare providers
Transparency in outcomes
A NCVS briefing on the NHS White Paper was sent to participants and is
available on NCVS website.
The NHS White Paper and the accompanying consultations:
an overview given by Mark Adams, Executive Director, Planning,
Performance and Estates, NHS North of Tyne
Mark spoke to a PowerPoint Presentation which is available on NCVS
website. The main points Mark made included:
 PCTs and Strategic Health Authorities will be gone by 2013 and there
will be a shadow NHS Commissioning Board from April 2011
 Particular mention of the new maternity networks
 Mental health is going to GP consortia as part of the package, but
there are complexities such as is no price and tariff in mental health
 GP consortia might be about 100,000 – 150,000 patients or larger
 They will do the job the PCT is doing now
 The NHS Commissioning Board will have a discussion with the
government about outcomes
 There will be an accountable Officer, who is expected to be a GP not
a manager
 This is the most fundamental change that there has ever been – in
how the NHS works and how the money will flow
 Public and patients have more say
 There is a slimmed down structure
 Public health chimes especially with the Newcastle agenda for
tackling inequalities
Report of Newcastle voluntary and community sector event on the NHS White Paper
13 September 2010
Page 3 of 24
2
The view from
Dr Fu-Meng Khaw, Acting Director of Public Health for Newcastle
Meng spoke to a PowerPoint Presentation which is available on NCVS
website. The main points Meng made included:
 A White Paper on public health is expected in November
 If the budget is ring-fenced for health improvement it will be a
significant budget as it has not happened before
 Also a health premium is expected which is to address inequalities
 Public Health will be a national service (not sure of local
arrangements) combining the National Treatment Agency (NTA) and
the Health Protection Agency (HPA). The HPA role is, for example, to
deal with anthrax cases
 Measuring health improvement is a challenge
 Shadow arrangements are from April 2011
 The new arrangements will take in the local authority viewpoint as the
Directors of Public Health will be joint local authority and Public Health
Service appointments
 Healthcare is about quality effectiveness /improvement of service and
equity of access
 The factors affecting health improvement are
o Lifestyle – a small part
o Health inequalities – housing, education, employment
o Understanding needs by looking at prevalent disease, risk
factors, wellbeing
 The opportunity for public health to join the local authority means
getting to influence the wider determinants of health improvement.
There will be a significant impact on ability to influence, for example,
putting health and wellbeing messages into contracts and
procurement
 Public health brings a population based perspective to strategic
decisions tackling inequalities in Newcastle
 This is a real opportunity to recognize the importance of the
prevention agenda – prevention is better than cure
www.fph.org.uk the faculty of public health has a definition of public health
Report of Newcastle voluntary and community sector event on the NHS White Paper
13 September 2010
Page 4 of 24
Dr Guy Pilkington, a lead GP based in west Newcastle
Guy spoke about the proposed changes from a personal informal
perspective. The main points made by Guy included:
 As a GP he is very involved in the Practice Based Commissioning
(PBC) group in the west which is a developing consortia
 The White Paper has two main components, which are fundamental
very radical proposals
1 liberating NHS – for GPs challenging exciting,
2 marketisation – e.g. patient choice
 In Newcastle it is likely, if criteria allows, there will be 2 consortia with
approximately the Great North Road as the boundary in the middle
 If there are two consortia they can determine different local services
as the west is distinct to the east
 There is the opportunity to create a better health service because of
the components in Newcastle, such as
o Good relations with GPs and the RVI and Freeman hospitals
o The Community Services which provide GPs with care for the
elderly, Health Visitors, district community nursing. Whatever
happens GPs want to strengthen relationships with community
nurses
o Developing a relationship with the local authority and the shift of
pubic health into local authority
o Community – patient groups, voluntary organisations, and long
history in west end – in 90’s West PBC commissioned groups
such as CAOH, Families First, and Streetwise. There is a history
of not being afraid to look at a wider model of healthcare
 GP consortia cannot do what the PCT currently does in its entirety as
management costs to be slashed, so the GP consortia will not do the
formal reporting that the PCT does
 It is still an area of uncertainty – how much will be held to the
bureaucracy of accountability
 A £20 billion saving to be made means pressure to be innovative and
more efficient
 The nature of being a GP is to assess people quickly and balance the
pros and cons; they don’t want to spend time writing papers
 The main focus will be long term conditions: Chronic Obstructive
Pulmonary Disorder (COPD), diabetes, heart disease
 If improve management and keep people out of hospital this will lead
to savings. Now close due to work during the last 5 years – ready to
do it on a bigger scale
Report of Newcastle voluntary and community sector event on the NHS White Paper
13 September 2010
Page 5 of 24
 Rooted in community low level preventative services
 An example is work with HealthWORKS for people to loose weight,
exercise, breathe better. That will be the innovative model, made
accessible to the public
 The voluntary and community sector brings important challenges: GP
consortia will want effective help, and voluntary and community sector
services to show real impact
 The budget will seem to get smaller with the aging population
 Mental health which will be in the remit of GP consortia
commissioning currently sits outside GP practice
 The GP consortia model is likely to be a community based approach –
primary care initiative and with less reliance on specialized services
 Challenge: exciting real opportunity
 Work with the sector in the future
Sally Young, Chief Executive, NCVS
Sally spoke to a paper, ‘the view from the voluntary and community sector’,
which is available on NCVS website. The main points made by Sally
included:
 It is a huge risk – a unique experiment
 There is an emphasis on local arrangements; the flip side is post code
lottery
 Most expect local input to maternity services
 Specialized services are 15% of services, so there is a significant
commissioning role outside GP consortia
 Given Newcastle’s history, we expect the local health and wellbeing
board will involve the sector
 There is a great focus on health improvement and prevention
 the White Paper says Boards may choose to invite the voluntary and
community sector – in some areas they may not
 Health Watch – new structures take time to get established
 This is yet another change to the formal involvement mechanism –
FPC, CHC, PPI Forum, LINk…
 Do you attract new people in new structures?
 How will local Health Watch liaise with the national Health Watch?
 If Health Watch includes complaints and advocacy – will there be
group or individual places - could there be conflicts of interest?
Report of Newcastle voluntary and community sector event on the NHS White Paper
13 September 2010
Page 6 of 24
 GP consortia – much of the voluntary and community sector has little
or no direct experience of working with GPs
 Funding is a key issue – the PCT funds work in the sector now
 For city-wide services, what if one GP consortia funds but the other
does not?
 Sometimes it takes years to get health outcomes; who will fund
o Prevention
o Excluded communities
o Involvement, engagement, advocacy
 One issue was that hard copies of the documents are not available
from the Dept of Health – it is only on internet. Initially it was not
available in large print even electronically
 There is a similar issue for people with Choose and Book
 What is our role for those who cannot access info via the internet?
Report of Newcastle voluntary and community sector event on the NHS White Paper
13 September 2010
Page 7 of 24
3
Discussion groups
The Discussion groups were held to consider the implications for
Newcastle’s voluntary and community sector. All groups considered the first
set of questions on Commissioning for patients and then chose one other
1
Commissioning for patients:
The Dept of Health questions about Partnership
 How can GP consortia and the NHS Commissioning Board best
involve patients in making commissioning decisions that are built on
patient insight?
 How can GP consortia best work alongside community partners
(including seldom heard groups) to ensure that commissioning
decisions are equitable and reflect public voice and local priorities?
 How can we build on and strengthen existing systems of
engagement?
2
Increasing democratic legitimacy in health: what are the key things
that you would like to see in the proposed wellbeing and health
board? Consider membership and strategic functions
3
Regulating healthcare providers: what, to you, makes a good
provider? Include NHS funded work in the voluntary and community
sector
4
Transparency in outcomes: What do you think the new structures
should do in order to reduce health inequalities? Consider especially
in relation to older people, children, and people with long term
conditions
Report of Newcastle voluntary and community sector event on the NHS White Paper
13 September 2010
Page 8 of 24
1 Commissioning for patients
How can GP consortia and the NHS Commissioning Board best
involve patients in making commissioning decisions that are built on
patient insight?
Table 1
 If there are existing systems, that work well, don’t dismiss and start
again. Don’t throw baby out with bath water!
 Make sure community groups are involved
 Use current links
 Problems in working with a wide range of consortia – can this be
made easier or more joined up
 Ensure that small organisations are able to contribute – help to
understand
 Can NVCS co-ordinate service information for the consortia – what
about the compact?
Table 2
Perhaps the word patient could be changed to “community and how we best
involve the community”. Reps from “the community” need to be on the
Board and one must ensure an appropriate mix to ensure inclusion
throughout – clear representation. Perhaps to keep this manageable create
a “community” group who meet and then have representation to the Board
Also if we are talking about ‘patients’ what about those excluded groups
who are not linked to a GP service – these are the most vulnerable (with
this group the Third Sector are the ones in contact with this group so this
must be considered at commissioning and Board level)
Table 3








Impact on transient communities
More choice = better service? (Evidence)
Preservation of GP inability to refuse service
Importance of geographical link to patient and GP
How can you show best practice in pockets of different skill existing
Excess choice fails to address inequalities
How can GPs “buy in” care if patients can change service?
How can you create business plans and contingencies in Newcastle
(population)?
Report of Newcastle voluntary and community sector event on the NHS White Paper
13 September 2010
Page 9 of 24
 How confidence can be developed by consortia if you are a small
organisation. GP consortia locally engage secondary care but NHS
Commissioning Board who funds GP consortia has lack of local
knowledge? (Evidence-based commissioning)
 National bodies arguing nationally for local commissioning
 Need to gather evidence of what resource is existing locally already.
 Representatives from bodies like NCVS for organisations with small
workforce.
 Individual contracts have potential to cripple GPs
 Need for longer transition?
 Consideration for how shadow boards understand local need.
 Stronger record-keeping across demographics needed for proposed
commissioning
 Conflict of interests for GPs as commissioners
 Varying quality of commissioners
 How will GPs commission and practice; what management will be
there?
 Local policy on engagement
 Mapping of existing services to inform
 VCS representation on GP consortia?
 Quality – hard and soft outcomes




Clear access points
Preventative
Local commissioning could save money
What will be the commissioning process?
 How will the voices and opinion of those who have ‘traditionally’ been
excluded be heard in commissioning of services? E.g. learning
disabilities, homeless, immigrants etc…
Table 4
 Use the JSNA – this is supposed to be based on what communities
want and local people’s experiences. This should be tied in more
strongly. The GPs need to know about it and how to use it. Don’t
reinvent the wheel
 Use all voluntary and community organisations that are embedded in
the community
Report of Newcastle voluntary and community sector event on the NHS White Paper
13 September 2010
Page 10 of 24
 GP’s need to become part of their community; they should know
about the groups available in their communities and refer people to
them
 Use existing community networks and local authority networks
 There should be a statutory obligation for GP’s to involve – involve –
incentivise or penalise
 There is concern about how the GPs will be monitored around patient
and public involvement
Table 5
General concerns
 Issue re deprived areas – North boundary issues
 How are marginalised people going to be consulted: older people,
people with learning disabilities?
 User forums
 How will commissioners act to actively engage these groups
 Compact? with new GP consortia
 Responsibility of voluntary and community sector to inform
 Link with NTW Trust is concern
 Very important that do not duplicate existing structures – use what we
have and build upon
 Evaluation of services against health outcomes – can be very narrow
1. Commissioning for patients
 Co-ordination at a community level is an issue
 Consultation for those who get a particular health problem in the
future
 Large scale communication tool to have mapping and relationships
within the VCS
 Digital divide? Disenfranchise of these who are not able to use
technology
 These who are most vulnerable need to be able to have a voice
 Specialist services – N of Tyne/ Tyneside: how are GP consortia going
to get together with these regional specialist services
 Concern re GP knowledge of what local VCS do in community
 Advocacy – how much knowledge will GPs have of this
 Concerns re the transition, vacuum i.e. next 2 years
Report of Newcastle voluntary and community sector event on the NHS White Paper
13 September 2010
Page 11 of 24
Table 6
 Consortia need to be proactive use existing voluntary and community
sector and local authority data on what is already out there (& PCT
data)
 Organisations – who what where
 Scoping and mapping
 Structures
 This work needs to be properly funded – the info may already exist,
but engaging and involving in partnerships with VCS groups needs to
be recognised as a crucial task i.e. service user involvement in
commissioning needs to be properly structured and funded
 NOT LOSE KNOWLEDGE BASE OF OUTGOING COMMISSIONING
 PRACTICE LEVEL FORA – these can feed into GP consortia
Table 7
 Liaison with wellbeing health board and moving public health to the
local authority is an opportunity
 How to relate to 2 or more GP consortia?
 Potential conflict of interest
 GP may not take up the consortia role – will need payment to do it
 What if it fails? Government was not elected to do this. Is it
privatisation by the back door?
 For people with complex conditions most GPs do not have the
expertise
 What if the local Foundation Trust excludes someone?
 The White Paper has disregarded the green paper system
 The change is already happening before the process is right
 Should the GP consortia have VCS representation?
 Little or no mention of the voluntary and community sector
 Don’t want to have to go to the GP consortia as an individual patient
 District nursing has been downgraded and is very variable; it is very
business orientated which has had a negative impact on system; e.g.
Report of Newcastle voluntary and community sector event on the NHS White Paper
13 September 2010
Page 12 of 24















o peg feeding practice is very very variable across the city, which
is not good for services users whether west or east
o Community physiotherapy does not allow enough time for the
professional staff to use their skills
o District nurses are isolated in the role and there is little working
together in teams and no continuity when a district nurse leaves
Will these reforms only be better for elective type surgery?
Consortia – will they be managed by organisations based on the
American model – which will end up offering little choice
The NHS brand is being franchised out
GP consortia need to use NCVS to liaise with the sector and enable
people to work with the consortia
Patient choice – people need to be better informed to make choice
Prevention starts at social care level
The general public doesn’t not understand the impact of the White
Paper - it is not written in ordinary language for people to understand
Health Watch should be piloted first like the LINk early adopters
How much will all of the redundancy payment cost!
It is a big experiment without a trial
Will it lead to people buying their own health insurance?
Experience of health care will be variable for individuals
How will patient groups influence maternity service if it is
commissioned nationally?
Community mental health services are being cut in some areas
leading to re-admissions
PCTs are not funding long term conditions
How can GP consortia best work alongside community partners
(including seldom heard groups) to ensure that commissioning
decisions are equitable and reflect public voice and local priorities?
Table 1
 Need for vehicle as a go between
 Robust consultation system - agreed principles for working with and
buy in from organisations in Newcastle
 These rules and criteria to be adopted from outset so that the process
doesn’t have to be repeated for every subject consulted on
 Use health demographics as a basis for identifying priorities in
specific areas and then consult further
Report of Newcastle voluntary and community sector event on the NHS White Paper
13 September 2010
Page 13 of 24
 Entering expertise and skill of grassroots community groups are
harnessed
Table 2
 This goes back to Question 1. But in addition what are the priorities
and who makes the decisions, this could be a real challenge
 There needs to be a “body” who acts as a conduit for the Sector
which helps identify the priorities with the Board.
 Should we have a consortia of Third Sector providers for this –
greater partnership as this needs to be embraced by the
commissioners
 Innovation – 3rd sector can deliver this but how does this gets
funded from now on – often commissioning negates innovation
How can we build on and strengthen existing systems of
engagement?
Table 1
 At a low level many groups are good at this engagement
 Need a structure that people are aware of, to advise people how you
take information forward to the right place
 Transparent process and ensure that ‘consultations are real’ with
enough notice about the duties for the consortia so people can
arrange to attend/send response
 GP consortium needs to be clear about what they want to hear about
e.g. have priorities
 Using easily accessible places – libraries, GP’s surgeries, pubs,
supermarkets - places where people are comfortable and already
access
Table 2
 Make them more obvious and more transparent than they currently
are
 Currently we felt systems of engagement were poor and almost non
existent
 We also must have the ability and effectively engage and negotiate
Report of Newcastle voluntary and community sector event on the NHS White Paper
13 September 2010
Page 14 of 24
2
Increasing democratic legitimacy in health: what are the key things
that you would like to see in the proposed wellbeing and health
board? Consider membership and strategic functions
Table 2
 Voluntary and community sector must be included especially in health
and wellbeing board.
 Strategic functions should be for an H & W Board to ensure
o their agenda has impact on the commissioning
o Importance of the joining up of services. Representatives of 3rd
sector is key
 We need a strong voice and representative body for the 3rd Sector at
all levels including Central Govt.
 Who’s accountable for performance of consortia – who manages the
competition and the operations of the consortia to ensure they all
listen to the 3rd sector
Table 4
 Good to bring everyone together – develop a seamless health and
social care model
 Worry that services could fall through the gaps during transition
 There should be a separate scrutiny function
 Just having everyone round the table doesn’t make it happen. There
could be an imbalance of power – need to give careful thought and
have clear terms of reference and responsibilities for members
 Imagine that the group will make high level decisions then devolve
responsibilities ‘to make it happen’
Health boards
 Should be voluntary and community sector involvement in all levels
 Clarity on conflict of interest
 General concern that accountability and government is not strong
enough
 Know GPs reluctant to do the paper work and if there is none then
how will standards be maintained? Removing all the bureaucracy is
too far
 Positive – potential for stronger joint planning with health and social
care
Report of Newcastle voluntary and community sector event on the NHS White Paper
13 September 2010
Page 15 of 24
3
Regulating healthcare providers: what, to you, makes a good
provider? Include NHS funded work in the voluntary and community sector
Table 1








Need clarity on what the regulatory framework is and looks like
Consortium will need a standard that people know how to achieve
Evidence that organisation puts patient at centre of care
Service users will vote with their feet on good and bad services
The values of organisation
Well run, viable (financially, capacity etc)
Follow model of CQC
Standard framework to compare services against – framework
standard across all of the GP consortia
 If all consortia have same framework and collect same info, it will be
easier for organisations and also will make information comparable
between organisations and consortia regardless of geography
 Evidencing a good organisation
 Opportunities to build relationships between organisations and
representatives of consortia
Table 2
 Who’s accountable for performance of consortia?
 Who manages the competition and the operations of the consortia to
ensure they all listen to the 3rd sector
4
Transparency in outcomes: What do you think the new structures
should do in order to reduce health inequalities? Consider especially in
relation to older people, children, and people with long term conditions
Table 2
 Importance of the joining up of services.
 Representatives of 3rd sector is key
Report of Newcastle voluntary and community sector event on the NHS White Paper
13 September 2010
Page 16 of 24
 Outcomes for vulnerable people are often hard to evaluate in short
timescales – this could be a problem for outcome based
funding/commissioning
Table 5







All groups of cancer treat equally
Reduce post code lottery
Issues about housing
BME access to services
Active engagement with hard to reach group
Will there be money set aside to reduce health inequalities
Targets/prevention conflict quick fix
Report of Newcastle voluntary and community sector event on the NHS White Paper
13 September 2010
Page 17 of 24
Action and next steps
It is clear from the participants’ feedback that an ongoing discussion with
the voluntary and community sector and the emerging GP consortia, the
developing health and wellbeing arrangements, and Health Watch is
essential.
NCVS will
 compile a response to the NHS White Paper based on the discussion
groups and send to participants for their comment before submitting it
to the Dept of Health
 continue to support voluntary and community sector liaison and
involvement in Newcastle over the new and developing arrangements
For the full list of suggested next steps see the feedback comments in
Appendix 2.
Report of Newcastle voluntary and community sector event on the NHS White Paper
13 September 2010
Page 18 of 24
Appendix 1
Speakers
Sally Young
Mark Adams
Dr Fu-Meng Khaw
Dr Guy Pilkington
Chief Executive, Newcastle CVS
Executive Director, Planning, Performance and
Estates, NHS North of Tyne
Acting Director of Public Health for Newcastle
a lead GP in the west of Newcastle
Participants
Alister Brown
Action for Children
Colleen Bilton
Addaction
Sue Pearson
Age Concern Newcastle upon Tyne
Claire Davidson
Alzheimer’s Society Newcastle
Alan Wigham
Anchor Staying Put
Katie Dodd
Carers Centre Newcastle
Leah Blacklock
Community Action on Health
Julie Marshall
Community Action on Health
Jane Shaw
Community Action on Health
Elaine Cusack
Cruse Bereavement Care Tyneside
Ron Ferguson
Cruse Bereavement Care Tyneside
Carol Brown
Dementia Care Partnership
John Patterson
Dementia Care Partnership
Ruth Abrahams
Disability North
Carol Hunter
East End Community Development Alliance
Chris Irwin
Edward Lloyd Trust
Vera Bolter
Elders Council of Newcastle
Bob Dennis
Independent Living Zone CIC
Linda Van Zwanenberg
Alisdair Cameron
Launchpad
Annette McGlade
Learning Disabilities Federation
Dr Edd Nowicki
Learning Disabilities Federation
Barbara Taylor
MENCAP
Maureen Eccleston
Mental Health Concern
Steve Nash
Mental Health North East
James Herbert
Mindful Employer
Jean Fraser
NALC/NDF
Colin Hutchinson
NECA
Jacqui Jobson
Newcastle Advocacy Centre
David Large
Newcastle City Council
Amy Redpath
Newcastle City Council
Report of Newcastle voluntary and community sector event on the NHS White Paper
13 September 2010
Page 19 of 24
Liz Robinson
Pam Jobbins
Violet Rook
Kate Bradley
Ellen Vick
Rachel Chapman
Annemarie Norman
Lesley Clark
Brian Morphew
Pete Woodward
Sandra Hillyard
Fran O'Brien
Pauline Bishop
Christine Allen
Deborah Heron
Maggy Crane
Liz Wright
Barbra Robson
Trevor Moon
Neil Baird
Safina Siddique
Carol Nevison
Newcastle City Council
Newcastle CVS
Newcastle LINk
Newcastle United Foundation
New Prospects Assoc
NHS North of Tyne
NIWE Eating Distress Service
Norcare
North West Carers Group
Northumbria Students Union
Quality of Life Partnership
Quality of Life Partnership
St Anthony of Padua Community Assoc.
St Oswalds Hospice Ltd
St Oswalds Hospice Ltd
Search Project
Skills for People
Them Wifies Ltd
The Welcome Club
Tyneside Cyrenians Ltd
Tyneside Rape Crisis Centre
WRVS
Report of Newcastle voluntary and community sector event on the NHS White Paper
13 September 2010
Page 20 of 24
Appendix 2
Feedback comments (out of 30) completed forms
The information sent out before the event was…
Excellent 3
Good
15
Okay 11 Poor
(1 no reply)
The handouts provided at the event are…
Excellent 3
Good
22
Okay
5
Poor
How useful and informative did you find the presentations?
Excellent 4
Good
21
Okay 5 Poor
How useful and informative did you find the discussion groups?
Excellent 4
Good
17
Okay 6 Poor 3
The organisation of the event has been…
Excellent 3
Good
21
Okay 3
(3 no reply)
Poor
The venue was…
Excellent 3
Good
(3 no reply)
Okay
Poor
Partly 7
Not at all
24
Were your expectations met?
Fully 5
Mostly
15
(3 no reply)
What is the key thing you will take away with you from today?
 Need a range of approaches to involving patients in commissioning
decisions
 Finding ways to help small but significant groups e.g. carers- who lack
‘spare time’ to input views – and for there to be a system to know
when help needed by them with new local resources – professional
and voluntary
 Raised lots of questions. Will take away various opinions and points
of view and discuss with colleagues
Report of Newcastle voluntary and community sector event on the NHS White Paper
13 September 2010
Page 21 of 24
 It isn’t going to be easy, but if it’s going to work anywhere, it will be
Newcastle
 The work remaining to be done in a very short period just to keep MH
involvement on the agenda, let alone functioning well
 A need for the third sector to work closely!
 VCS need to talk to GPs, fast
 Thoughts of others from discussions
 We need lots of time to understand and assemble this major change –
thanks for your help with this
 Still a long way to go!
 The need to read the white paper! Consider more the impact on the c
+ v sector and how to organise and respond to consortia. Thank you
 The government has not the mandate from the recent election to have
such a radical change to the NHS which will result in the NHS being
privatised
 Majority of participants seemed unfamiliar with the Paper and to have
thought of their response
 I don’t think everyone has considered the paper in enough detail yet!
 3rd Sector needs a ‘Loud Voice’
 The understanding of others views??
 Ensure I keep abreast with changes
 Better understanding of the changes ahead
 The importance of keeping a watchful eye on developments and of
the voluntary sector and CVS continuing to talk to each other! We
must be as prepared as possible for GP commissioning and for the
inevitable competition with private sector
 That there is much to be done around creating the “community space”
for all sides involved to map support
 We (VCS and LD providers) need to be known to and working with
GP consortia
 Overview of white paper and from different viewing? Questions for
discussion were very good
 Complexity of future developments – uncertainty about outcomes –
and complexity of consultations – spread over 4 different documents
 Lots of change, unclear impact on the voluntary sector – how much
will the provider lines be blurred between current NHS providers or
voluntary sector. Lots of opportunities for voluntary sector
 What’s happening regional and national
 Responding to consultation and taking info back to partner
organisations
Report of Newcastle voluntary and community sector event on the NHS White Paper
13 September 2010
Page 22 of 24
What do you think should be the next steps?
 Obtain as much city feedback – in the limited time – as can be
obtained – all relevant groups in the city
 Find out what regional/national 3rd sector structure is
 Need to keep discussion going if it becomes clearer how exactly
commissioning will happen
 Feedback on today’s discussions
 Not sure
 Meeting re; this
 As the legislation proceeds through parliament – further events to
disseminate information
 Further involvement in discussions about how to link in with the
development of Health Watch
 Education of the public on the topics and future of health
 NCVS to provide briefings/training about the potential impact of the
paper and ways forward
 That all organisations should write to the Dept of Health asking for
feedback from the consultation so that we know whether or not they
have considered the responses that organisations have sent in
 Consider changes to White Paper after consultation has evolved and
Dept of Health response/changes
 More clarity about how it will work – who decides budgets that
consortia will manage, what directions they have around spending it,
etc…
 Continue this process – to help us engage in this major change and
represent us stakeholders effectively
 Ensuring that this information is taken forward, attending VONNE
event re. white paper
 Lobby for social clauses in all commissioning procedures
 Set up a VCS health capacity fund (Council, GP consortia) to run from
April 2012
 Depends on all the replies to a very short discussion
 More information to be sent out about what is happening and further
developments
Do you have any other comments?
 Thank you for organising this!
 Thanks
 Well done CVS
Report of Newcastle voluntary and community sector event on the NHS White Paper
13 September 2010
Page 23 of 24
 Raised more questions than it answered but I think that reflects the
stage we’re currently in – not the last of these event’s I’m sure!
 If the government wants to make these changes it should first pilot
them in more than one area to see if it works. The consultation
documents lack clarity on how the various elements will work together
and the time line is unrealistic
 This seems to me a reorganisation too far, splitting responsibilities
between GPs, hospital trusts and local authorities is against the
concept of a comprehensive health service and a retrograde step
 It will be difficult for small organisation such Search (3 staff), NIWE,
RCC etc to find the time and make all the connections required to
approach and organise working with new consortia. I wonder if there
is a role for NCVS to play to support/enable this process? We are in
danger of not being funded otherwise and unable to compete with
larger voluntary sector organisations despite excellent grass roots
support
 Ongoing consultation - voluntary and professional interests when new
‘system;’ begins to come in
 Will there be any VCS health service provision by April 12?
 What happens between April 11 and 12?
 Fine words butter no parsnips
Report of Newcastle voluntary and community sector event on the NHS White Paper
13 September 2010
Page 24 of 24