Coverage from the Labour party conference, including Labour leader Ed Miliband’s announcement he would provide real terms funding increases to the NHS funding if he forms a government next May, in a “£2.5bn NHS Time to Care Fund”, and Andy Burnham’s announcement he would ask”all hospitals to become integrated care organisations”.

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6.24pm: James Illman (@Jamesillman) tweets: “Announcement from @andyburnhammp at #Lab14 fringe session: ‘all hospitals to become integrated care organisations’.”


4.38pm Nuffield Trust chief executive Nigel Edwards told HSJ: “Credit [to Ed Miliband] for breaking the political consensus which has been not to talk about money. That’s the good news but I have two main concerns. 

“Firstly, the idea that giving out topline numbers [for how many nurses, GPs and midwives to hire] belies a thinking that big ideas come from the centre. It misses the point. What is required is funding to re-design services [but] the decision on what you need to staff that redesign needs be a local one.

“They have not broken the standard political approach of centrally delivered change.  

“Secondly, £2bn is what we need to bridge the current funding gap, so this really is just a start.” 

4.25pm Responding to Ed Miliband’s speech to the Labour party 2014 annual conference, NHS Confederation chief executive Rob Webster said: “Ed Miliband’s commitment to invest £12.5 billion in the health service over five years is a welcome piece of the jigsaw on future NHS funding, but only part of the picture. 

“We will wait for the whole image to emerge when Labour set out their spending plans. It is vital, for example that investment in health services is matched with a settlement in social care that allows a similar, much needed transformation.

“This early and clear commitment is a sign that politicians have taken on board calls to address the challenges facing the NHS and social care. In the 2015 Challenge Manifesto, published earlier this month, the most influential coalition of health and care bodies called for adequate funding for the NHS so that services could be transformed to better meet 21st century needs.

“More of the same is not an option. So, we asked for longer term funding and a  transition fund of at least £4 billion in new money spread over two years. Today’s announcement overlaps with these asks and begins a process by which we can engage in a real debate about the future of health and care.

“The very nature of health service delivery means that most NHS spending goes on staff costs – on nurses, GPs, speech therapists, midwives, oncologists, porters, cleaners and all the other professions that make up the NHS team. So it is right that money for service transformation is targeted at ensuring we have more staff with the right skills working in the right places.

“Often this is in the community, and includes GPs, community-based nurses, mental health specialists, and staff who can help people live more healthily, for longer, in their own homes. Linking transformation to staffing needs to be done in ways that will support local models and the numbers announced today should reflect local plans rather than a top-down allocation of posts.

“No matter how big the pot, a transition fund alone cannot and will not deliver the extent of change needed to tackle the challenges facing the NHS and social care. We need the next government to commit to making much faster progress towards implementing new payment mechanisms that support integrated, personalised care and reward good outcomes for patients, not just activity. And we need the stability which a 10-year funding settlement for health would offer, creating a framework for the kind of change which NHS leaders are chomping at the bit to deliver for patients and local communities.

“What we are missing, however, is a firm commitment from all political parties to ensure none of their proposals will impose yet another top-down structural re-organisation. It is vital that the health service has the stability to implement service changes that reflect local people’s needs and wishes, and take account of the local landscape.

“We have been very clear that the time for action is now. Ed Miliband has today made a powerful speech, which contains much promise. Once the applause from conference delegates has faded, it is vital that he and other politicians move swiftly from words to deeds.”

4.05pm Pledging more funding for the health service is a tough political choice. Ed Miliband’s announcement of a five year fund to help drive the transformation of services is exactly what we have been calling for, says Johnny Marshall, director of policy at the NHS Confederation, in a comment piece for HSJ.

3.50pm Chris Hopson, chief executive, Foundation Trust Network, said: “The FTN welcomes the Labour Party’s recognition that the NHS is underfunded to consistently provide the quality of care we would want for all our families. We welcome the necessary additional funding from the Time to Care Fund.

“We also welcome Labour’s commitment to the core principle of the NHS - that patients should get the treatment they require based on medical need not ability to pay - and that the NHS should remain publicly funded. We also recognise that there can be no blank cheques and that the NHS has to demonstrate we are running the service as efficiently as possible.

“This now firmly places the spotlight on the Conservatives and Liberal Democrats and their plans for the future funding of the NHS and, since they are currently in Government, their plans for 2015/16.

“A wide range of health commentators, including the Kings Fund and the Health Foundation, have stated that 2015-16 will be the most difficult financial year for the NHS in its recent history. Health and social care have lost £1.9bn via the better care fund; there are increased pension costs; and providers are having to absorb the impact of thousands of extra, mandated, unfunded staff posts. Just last week, it was revealed that 60 per cent of acute hospitals were in deficit and that the financial problems all NHS providers are facing are growing rapidly.

“There is a widely acknowledged gap of between £1bn and 2bn in the current 2015-16 NHS plans. The Government either needs to fill this gap with extra funding or work out how it will commission less care from providers. The level of provider deficits shows that asking providers to once again make 4 per cent efficiency savings that they have no hope of delivering is no longer available.

“Because of the way the NHS tariff is set, the decision on overall 2015-16 NHS funding levels is needed now. If the Government is to support the NHS in its hour of need, we need an announcement before the statutory NHS tariff consultation starts in mid October. The ball is firmly in the Government’s court.”

3.46pm Chris Ham, chief executive of The King’s Fund, said in response to Ed Miliband’s speech: “Ed Miliband’s announcement on increased funding for the NHS shows politicians are now acknowledging the scale of the financial problem facing health and social care.

“Labour’s commitment to transform the way care is delivered, not just to focus on the immediate funding crisis, is welcome and points towards putting health and social care on a sustainable footing in the future.

“The gap in NHS funding can’t be solved in isolation from social care. The recent Barker Commission report recommended a single ring-fenced budget for health and social care adequately funded by a rise in health and social care spending to 11 - 12 per cent of GDP by 2025 – broadly comparable to current expenditure on health alone in many other countries.

“A combination of a mansion tax, tobacco levy and tax avoidance initiatives alone will not fill the growing funding gap. Today’s announcement is a significant step forward but we will need to see Labour’s spending plans in full before we know whether they will be enough to meet the funding gap.

“The Barker report looked at the different options available to increase funding for a combined health and social care budget and suggested that a range of measures from a review of wealth taxes, changes to prescription charges and national insurance increases could all play a part. These are hard choices while the public finances are still recovering but they cannot be ducked in the lead up to the general election.”

3.35pm HSJ’s James Illman tweets from Manchester:

3.27pm Responding to Ed Miliband’s announcement on an increase in nursing numbers, Dr Peter Carter, chief executive & general secretary of the Royal College of Nursing said: “Recent years have seen nurse staffing levels become deeply eroded, and many posts left vacant for long periods.

“Too often, nursing staff are seen as a target for cost savings, only for the NHS to find itself dangerously short and having to spend more on agency staff and recruitment from overseas.

“A long term plan to keep the nurses we have and to recruit more for the coming demand is very welcome, and nurses on the front line will be relieved to know that their concerns have been heeded.

“It is difficult to overstate the scale of the challenge which will face health and social care over the coming decade. More nurses are needed to tackle a range of issues - people are living longer, with a 70 per cent rise in people reaching the age of 100 over the past decade.

“At the same time, people of all ages are living for decades with long term conditions - and they are in need of expert support to stay healthy. This is before we even consider the effects of the multiple public health crises we are facing, with alcohol, obesity and smoking all threatening public health.

“These proposals are not only very welcome, but investing in nursing is absolutely necessary, whoever wins the next election. We need to celebrate the difference nurses can make if they are properly resourced across the board, whether they are staffing an A & E unit, delivering public health messages, helping a patient to manage their diabetes or providing long term care at home.

“The challenge is significant, but we have the expertise within the nursing profession to make the NHS we want to see in the future a reality. Today’s announcement is a very important signal that this has been recognised at a political level and we look forward to working with the Labour Party to further develop the way forward.”

3.25pm Labour party leader Ed Miliband today announced it would introduce a “£2.5bn NHS Time to Care Fund”, increasing health service funding, if he formed a government next year.

Speaking at the Labour party conference in Manchester Mr Miliband said the first priority for the new fund would be to fund 20,000 more nurses, 8,000 more GPs, 5,000 more careworkers and 3,000 more midwives.

The funding would be raised by a new “mansion tax”; a “sin tax”, levied against tobacco manufacturers, and a clampdown on tax avoidance, with hedge funds singled out as a targeted sector, Mr Miliband said.

FULL STORY HERE

3.21pm Responding to Labour Leader Ed Miliband’s speech at the Labour Party conference in Manchester today, RCGP Chair Dr Maureen Baker said: “This announcement is a clear and impressive response to the crisis currently engulfing general practice, and will be warmly welcomed by many GPs and practice nurses across the country.

“We at the RCGP have been saying for many months now that unless urgent measures are put in place, general practice as we know it faces extinction, due to soaring patient demand, plummeting resources and a mass exodus of clinical staff.

“Today’s announcement, if translated into action, would help to pull general practice back from the brink of disaster and pave the way for a revitalised and refreshed GP service.

“We are particularly pleased that this announcement is part of a wider package that includes the recruitment of more practice nurses, district nurses and home care.

“We welcome Mr Miliband’s announcement today and look forward to working with all the political parties to discuss how general practice can be properly funded to provide excellent patient care in the community, thereby alleviating pressure on our hospitals.”

3.18pm Miliband repeats his pledge to repeal the Health and Social Care Act. Followed by rapturous applause.

3.16pm Snippets from Ed Miliband’s speech:

“A hospital is only as good as the services in the community. If elderly people can’t get the care they need - they end up in hospital.

“Let’s face it - those services are creaking.

“We have had the scandal of home care visits restricted to just 15 minutes.

“We will transform our NHS.

“It’s time to care about our NHS. We need doctors and nurses to spend enough time to care for us.”

3.05pm Labour’s statement today indicates the £2.5bn funding will be on an annual basis, saying it will “raise £2.5bn a year for our NHS Time to Care Fund”.

It also states that, that as well as increasing funding it will “enshrine a powerful new set of rights for patients in the NHS Constitution to address the 21st  Century challenges that come from an ageing population, more people living with chronic conditions, the rise of mental health, and a higher premium on preventing illness.”

3.00pm From the Labour Party: Ed Miliband today announces that the next Labour government will create a £2.5 billion a year NHS Time to Care Fund as part of his plan to save and transform our health service.

In his speech to the Labour Party Conference, he will say the first priority for the fund will be to support 20,000 more nurses, 8,000 more GPs, 5,000 more careworkers and 3,000 more midwives.

The full statement can be found attached to the right.

2.31pm Labour will commit to what it is describing as a “£2.5bn NHS Time to Care Fund”, it has been announced.

Briefings state that the money will “go towards 20,000 more nurses, 8,000 more GPs, 5,000 new homecare workers and 3,000 midwives”

It will be raised from a mansion tax, a crackdown on tax avoidance and “fees for tobacco firms”.

He was expected to say: “We will raise £1bn from tax avoidance including by closing the loopholes for the hedge funds. We will use the proceeds from a tax on houses worth over £2m and we will raise revenue from the tobacco companies who make soaring profits on the back of ill health.

“The NHS is currently creaking. One in four people wait a week or more for a GP appointment. We have seen the scandal of care visits restricted to just 15 minutes for the elderly. It is time to care about the NHS so that doctors, nurses, care workers, midwives are able to spend proper time with

2.30pm HSJ’s James Illman tweets:

2.05pm HSJ’s Shaun Lintern tweets:

1.50pm Ed Miliband’s speech to Labour conference is due to get underway at 2.15pm

1.32pm Labour’s Margaret Hodge, chair of the public accounts committee, has reportedly said this at the Labour conference:

1.13pm Following debates at the Labour party conference about the NHS, Anita Charlesworth, chief economist, and Jennifer Dixon, chief executive of the Health Foundation, give their reactions.

Anita Charlesworth said: “Over this parliament, health spending will have increased by around 1 per cent a year above inflation. Figures released last week showed that two thirds of acute hospitals are currently in deficit, to the sum of £0.5bn.

“In 2015/16 alone, the NHS has a £2 billion hole in its finances. By the end of the decade, health spending would need to be £30bn higher than today due to additional pressures. Productivity savings might be able to bridge about a third of this gap but there is still a big financial hole.

“Doing nothing is not an option. It is therefore welcome that, at the first of the main party conferences, the Labour Party is engaging with what is rapidly becoming a dire financial situation.”

Jennifer Dixon said: “The financial settlement for the NHS over this parliament has been tight, and extra injections of funds are now critical. Any additional funds must help to lubricate needed change to help the NHS become more efficient. But, by itself, money isn’t enough.

There needs to be much more practical political commitment to supporting the NHS in dealing with difficult change, as identified in our More than money: closing the NHS funding gap report which we released last week. This includes moving to new models of care, greater support for people to stay well and support for providers to innovate and improve care.’

1.04pm The BBC’s Norman Smith has this interesting nugget:

12.32pm NHS England has appointed Richard Jeavons to lead its commissioning of specialised services in an interim capacity, HSJ can reveal.

The national organisation has failed to recruit a substantive director of specialised services, despite using head hunting firms. Simon Stevens said he wanted to create the post shortly after he became NHS England chief executive in April.

12.01pm HSJ reporter Shaun Lintern tweets:

11.58pm The Guardian’s Micheal White writes in his HSJ column this week that sceptical NHS watchers in Manchester doubt if Miliband’s lofty “save the NHS” rhetoric is matched or undermined by such modest tax proposals.

Read his column here

11.36am HSJ’s Dave West tweets:

11.22am Shadow health secretary Andy Burnham yesterday unveiled further details of his 10 year plan to merge health and social care services.

Addressing a fringe session at the Labour party conference, Mr Burnham argued the move would not require a structural reorganisation.

He told a session in Manchester that this “big idea” of a “national health and care service” would be “at the heart” of his party’s 2015 election manifesto and campaign.

More details here.

11.12am The Liberal Democrats want GP services to be commissioned by health and wellbeing boards, according to a paper setting out the party’s likely policy direction in the run up to next year’s general election.

Protecting Public Services and Making Them Work for You signals the party’s favoured approach across a range of public services including health, education and transport, and has been published in advance of its annual autumn conference.

11.05am Mr Hunt continues:

11.05am Health secretary Jeremy Hunt aniticipating Ed Miliband’s speech later today:

11.03am NHS England has revealed details of the long awaited successor to its 3 Million Lives telehealth programme, which has been scrapped.

A letter from medical director Sir Bruce Keogh, sent today to organisations involved in the health and care technology, outlined the key tenets of the organisation’s new “technology enabled care services” (TECS) programme. 

The ambition of the 3 Million Lives project, to support 3 million people to use telehealth and telecare by 2017, has been ditched. However, an NHS England spokeswoman insisted it still had a “commitment to make significant progress towards [that target]” in its mandate from the government.

10.52am The Daily Mail is critical of Ed Miliband’s 10-year plan for governing Britain, which is expected to prioritise health.

The paper’s editorial states: “We are told that, in his own conference speech today, Ed Miliband – ever the statist – will say Labour has a ‘ten-year plan’ for governing Britain.

“In reality, it’s a likely to be a ten-year plan for wrecking the economy all over again.” 

10.50am HSJ’s James Illman tweets:

10.25am Welcoming the announcement by the Royal College of Physicians of four sites it will be working with as part of its Future Hospitals Programme, Matthew Winn, chair of the NHS Confederation’s Community Health Services Forum, said: “The absolute essence of the NHS is that we want people to stay healthy, and live in as good health as possible, for as long as possible. All over the country, community-based health services are already supporting people to stay healthy in their own homes, preventing ill-health and preserving independence.

“Patients and their families tell us they want to stay in their own homes for as long as possible, and get care in their community when they need it, so it is absolutely right that the RCP’s Future Hospitals programme will focus on improving how frail older people are supported.

“Getting the right care at the right time, in the right place, for frail older people requires focus and investment in community-based care, not further reliance on hospital buildings. Focusing on frail older people once they have already been admitted to hospital is too late.

“My hope is that this phase of the Future Hospitals programme will help demonstrate the value that community health services can contribute to the health service of the future. What is equally important, however, is that we ensure the full range of services that support frail older people are joined up, including local government services and other parts of the NHS. Successfully bringing healthcare outside hospital walls must involve all elements of the health, care and other support services.”

10.17am The Guardian reports that Ed Miliband is to put the nation’s health at the centre of a 10-year-plan for Britain’s future today, backing the NHS with funding from a novel windfall tax on the profits of UK tobacco companies and the proceeds of a mansion tax on homes worth more than £2m.

A mansion tax could raise £1.7bn and had originally been earmarked by the shadow chancellor Ed Balls, to fund a 10p starting rate of income tax, but that is now due to be funded by abolishing the marriage tax rate.

10.15am Some sources have suggested to HSJ that Labour leader Ed Miliband will in his speech today make a pledge to increase the numbers of registered nurses working in the NHS by 20,000 if Labour wins the next election.

It is suggested that Mr Miliband’s pledge will be for full-time equivalent nurses and cover the five years of the next Parliament. It will be aimed at filling existing shortages and meeting future demand from the increasing acuity of patients.

If the rumours are accurate the pledge will follow months of intense registered nurse recruitment by the NHS following the Francis Report into failures at Mid Staffordshire Foundation Trust. Since August last year the number of full time equivalent registered nurses in the service has increased by more than 8,000.

In the acute setting, where recruitment has been focused, the number of nurses has risen from 169,000 nurses in August 2013 to a high of 175,000 in May this year.

Latest figures from the Health and Social Care Information Centre, released today, show the numbers of nurses isbeginning to fall again. Overall across the NHS the numbers of nurses, midwives and health visiting staff have dropped from a high of nearly 315,000 in March 2014 to 313,700 in June.

In the acute setting numbers have leveled off dropping from 175,235 in May to 175,039 in June 2014.

This recruitment has exposed a shortage of registered nurses in the UK with many trusts now going overseas to recruit foreign staff. Meanwhile Health Education England has increase the number of university training places by 9 per cent and has launched project to encourage thousands of nurses back into the profession.

10.03am To get the best coverage of today’s events at the Labour conference, follow HSJ reporter James Illman as he tweets proceedings from the conference floor in Manchester.

10.00am NHS staff in England working full-time are paid an estimated average basic annual wage of £29,754, a rise of 0.7 per cent on last year and 9.4 per cent on five years ago, new figures show.

The report from the Health and Social Care Information Centre covering the 12 months to June 2014 looks at the earnings of 1.16 million staff working in NHS hospital and community health services in England (excluding GP surgeries).

Looking at mean full-time equivalent salaries, the most appropriate measure for comparing earnings between staff groups, over the last year the largest annual increase of 4.4 per cent per cent went to locum hospital practitioners and clinical assistant doctors taking their pay up to £62,895. The largest decrease of 0.7 per cent went to health visitors, taking their pay to £34,038. 

Variations over time in the average pay of a staff group can be caused by a change in the composition of that group (for example a greater proportion of lower-paid, junior staff joining a group would bring down average pay) as well as changes in pay for staff who have remained within a staff group from one year to the next.

Today’s report also includes for the first time figures on bonuses and performance related pay. It shows that over the 12 months to the end of February 2014, 87 managers and senior managers across the NHS in England are recorded as having received such a payment and the total paid was £399,131. There were 37,049 such managers in February 2014.

NHS Staff Earnings Estimates to June 2014, Provisional statistics show that looking at average basic pay per FTE member of staff:

  • Doctors (including consultants and registrars, but excluding locums and GPs), earned on average £59,051, a 0.4 per cent increase on 2013. Within this staff group, ‘other medical and dental staff’ saw the largest percentage increase on 2013 at 1.6 per cent (to £64,161) while ‘other doctors in training’ saw a drop of 0.2 per cent (to £26,007).
  • Qualified nurses including midwives and health visitors earned on average £30,761, a 0.5 per cent increase on 2013. Within this staff group school nurses saw the largest percentage increase on 2013 at 1.2 per cent (to £33,004) while health visitors saw the largest reduction at 0.7 per cent (to £34,038)
  • Infrastructure support staff earned on average £27,969, a 1.5 per cent increase on 2013. Within this group, senior managers saw the largest percentage increase on 2013 at 3.0 per cent (to £78,064) while hotel, property and estates staff saw the smallest increase at 0.5 per cent (to £17,266).
  • Qualified ambulance staff earned on average £26,885, a 0.8 per cent increase on 2013.
  • Clinical support staff earned on average £18,598, a 0.5 per cent increase on 2013.
  • Qualified scientific, therapeutic and technical staff, a group which includes speech therapists, radiographers and others, earned on average £34,509, a 0.2 per cent increase on 2013. Within this group the largest increase went to qualified healthcare scientists at 0.9 per cent (to £35,568) and the largest reduction of 0.4 per cent to speech therapists (to £34,688).

You can find the full report at http://www.hscic.gov.uk/pubs/staffearntojun14

9.55am The Times reports that patients are being asked to promise not go to the doctor for at least five days if they have a cough, cold or sore throat in an attempt to slow the rise of superbugs.

Public Health England wants every patient to take a series of pledges designed to stop them asking for antibiotics, the first time people have been urged to promise not to see a doctor.

“Back up prescriptions,” which instruct patients only to collect drugs if they do not feel better after a certain number of days, will also be issued to cut the number of antibiotics handed out for minor ailments.

Also in The Times, the majority of heart attacks in men could be prevented if they adopted healthier habits, according to new research.

Maintaining a healthy weight and diet, regular exercise, not smoking, and drinking only a moderate amount could prevent four out of five coronary attacks in men.

9.53am King’s Fund chief executive Professor Chris Ham tweets:

9.50am HSJ’s Dave West tweets:

9.47am Discussing the mansion tax proposal to fund the NHS, the editor of Local Government Chronicle, Nick Golding, tweets:

9.45am Many of the newspapers this morning focus on Labour leader Ed Miliband’s speech to his party’s conference in Manchester later today.

The Daily Telegraph reports that Mr Miliband will announce that he will use up to £5bn a year raised from new taxes to “save the NHS”.

As well as the ‘Mansion tax’, the Labour leader is likely to say that he will use the money from restoring the 50p income tax rate to help reduce the “huge pressures” on the NHS.

Mr Miliband is also expected to use his key note speech in Manchester to announce policies aimed at reducing waiting times and improving access to GPs, the paper reports.

Meanwhile, the paper also writes that shadow home secretary Andy Burnham has also said that a “new vision” for the NHS will be in the party manifesto.

7.00am: Labour leader Ed Miliband is today expected to announce his party would provide real terms funding increases to the NHS funding if it formed a government next May.

Several reports say Mr Miliband will announce the move in his speech to the party’s conference in Manchester today.

They say the move could be funded by a “mansion tax”, expected to raise about £1.7bn annually, and a windfall tax on tobacco companies. They suggest additional funds could be provided quite rapidly under a new government.

The size of any increases is unclear, although reports point to a total of £3bn. It is unclear how the additional funding would be phased, and whether there would be additional funding requirements on the NHS, for example extending its contributions to social care.

Mr Miliband will also reiterate Labour’s intention to create greater integration of the NHS and social care.

More details are expected later in the day, and Mr Miliband is due to speak at 2pm. HSJ Live will cover developments.

The BBC, Guardian and Times all carry reports. There is a comment piece in response on the Health Policy Insight website.

7.00am Good morning and welcome to HSJ Live. We begin the day with a comment piece from Rory Hegarty and Luke Blair on why the NHS needs get better at explaining the need for change and the benefits of these reconfiguration programmes.

The authors argue that robust clinical and managerial leadership and widespread public engagement are key to successful service change.

 

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