Thursday 31 January 2013

THE YEAR TO COME


FIRST PUBLISHED BY: THE GUARDIAN 


PUBLIC AND VOLUNTARY SECTORS - PREDICTS A CASH-STRAPPED YEAR


The year to come is likely to bring a squeeze on public-sector budgets - and see the beginning of a sea change in the way services are delivered. Legislation going though parliament throws the door open for the third sector - especially charities and social enterprises - to provide and commission services across the board in future. At the same time the comprehensive spending review - the government's 10-year spending plan for the public sector, due in summer - is expected to bring an end to recent years of financial growth, putting greater pressure on overstretched budgets.

Lack of money to push through government reforms has already led to one primary care trust attempting to recruit board members with a background in the charitable sector, so it can tap into their expertise of delivering services within limited resources. This is a move which other trusts are predicted to follow - and an illustration of the new partnerships between the public and third sectors which are likely to dominate the next 12 months.

Winter
In January the Department of Health is launching a survey of 5 million patients to discover how soon they can make a GP appointment. The results, due to be published in May, will determine which practices will have a share of a £72m bonus for best patient access payable in July. At the same time the Department of Health is publishing the Commissioning Framework for Health and Well-Being, which takes forward proposals in the Care Outside of Hospital white paper. It will include details about the creation of new community foundation trusts, which will mirror hospital foundation trusts - and also explain how the third sector, including social enterprises, can deliver health services.

Howard Catton, the head of policy at the Royal College of Nursing, says: "The whole issue of acute services and closer to home care will be big through this year. The focus of primary care trusts will be on commissioning; they aren't being told to give up their provider role, but I think they will look at the new community foundation trusts to keep up a provider function." In February, the Department of Health is due to complete its consultation on the future of regulatory services for health and social care. The results will help shape what happens after the healthcare commission and the commission for social care inspection (CSCI).

The new Association of Directors of Children's Services, following the abolition of the Association of Directors of Social Services, launches in February. Its sister organisation, the Association of Directors of Adult Social Services, follows in March. Health secretary Patricia Hewitt has promised to resign in March if the NHS is still in deficit. Jonathan Fielden, the chairman of the British Medical Association's consultants' committee, says: "The biggest issue for trusts this year will be the desire for financial balance. Finance has become the number one priority for most, if not all trusts in England - which means quality [of services] is being put second."

In February, the next wave of foundation trusts is due to be announced.

Spring
By March, 90% of consultant referrals by GPs should be made through the electronic booking system, Choose and Book, and practice-based commissioning is due to be rolled out nationally. The controversial mental health bill continues its parliamentary process in the spring after reaching committee stage at the end of the year.

The Association of Chief Executives of Voluntary Organisations (Acevo) will begin the year helping charities discover how they can influence the commissioning process and negotiate good contracts. It follows publication of the office of the third sector document, Partnership in Public Services: Action Plan for the Third Sector Involvement, which recommends a three-year funding cycle for charities delivering public services and longer-term contracts.

The new compact commissioner, whose responsibilities include assessing whether charities are paid a fair price for the work they are commissioned to provide, is expected to start to have an impact from now. David Hunter, Acevo's policy and communications officer, says: "He will have a large impact throughout the year, because he will make sure that there is long-term funding and [a] fair share of overheads. If we are to see the third sector transforming public services then we have got to make sure that the resources are being made properly."

The offender management bill, which opens the commissioning of probation services to the voluntary and private sectors, is due to reach its crucial report stage in February. The assistant general secretary of the National Association of Probation Officers, Harry Fletcher, warns: "If the bill is passed it will be a disaster because local accountability will be eroded. Tendering for services will be done on a regional or national level, so small voluntary organisations who already work with offenders in the community will to go to the wall because they will not be able to compete." The chancellor's budget is due in March. It is expected to be his last - but will he ditch prudence?

The delayed report of the Lyons review on the future of local government finance, including the fate of Council Tax, is due to report around the same time as the budget. Lord Sandy Bruce Lockhart, chairman of the Local Government Association (LGA), says: "Local government has some real opportunities within the year and the chance to seize a once-in-a-generation moment to ensure that local people have a greater say in how key services can be delivered for them at the right time in the right place at the right cost. It will also confront some daunting challenges, not least rising demand, increasing legislative costs and tighter financial restraint."

Summer
The chancellor is due in the summer to announce details of the comprehensive spending review - the 10-year spending plan for public services. It is expected to be "revenue neutral", offering only inflation-level increases in spending. The LGA is worried that it could trigger cuts in council spending as boroughs face paying the lion's share for care of the elderly services which are joint-funded with the NHS. By April all patients needing a diagnostic test should be seen within 13 weeks. The inspection of children's services is being taken away from CSCI in April and transferred to the new Ofsted, the Office for Standards in Education, Children's Services and Skills - which will also inspect the Children and Family Court Advisory and Support Service (Cafcass). The controversial welfare reform bill, which changes the incapacity and housing benefit systems, is expected to gain royal assent in May. 

Autumn and winter
The Charity Commission is due to start consulting on the definition of the public benefit clause of the Charities Act, and expects to publish guidance in September. The clause requires that all charities must exist for the public benefit. The local government and public involvement in health bill, which aims to reduce the amount of top-down control from Whitehall, is expected to become law by November.

By the end of the year, the number of established children's centres should be increased - as well as an expansion of the government's extended-schools programme. The president of the Association of Directors of Social Services, John Coughlan, says: "I think we will be in the position of transforming the reforms in children's services into action. I think we will see tangible evidence of delivering integrated children's services."

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