The healthmatters blog; commentary, observation and review
The Picker Institute has today published a new report; “The state of Maternity Services in England” which focuses on the meaning of maternity care and evaluates the main characteristics of maternity services in England. In addition, the report, written by Giuseppe Paparella, Policy Officer, outlines the broader implications of changing quality in maternity care settings. Finally, suggestions are included, for further actions and policy measures that are needed to improve the quality of care in English maternity services.
Key highlights for maternity services
Child birth is without doubt one hospital experience that every user hopes will be unforgettable, and one where providing a person centred, family friendly experience is key. Perhaps of all healthcare services areas, maternity care is one that, comparatively speaking, people are more likely to actively choose because it not only offers the right care, but the right experience.
However, evidence from the NHS Maternity Survey, shows a need for improvement in several aspects of maternity services:
- During the period December 2013 to May 2015 almost half of safety assessments in inspections by Care Quality Commission were either “inadequate” (7%) or “requiring improvement” (41%)
- As reported by the most recent NHS Maternity Survey these trends persist to some extent: according to recent findings, only 57% of women said their midwife definitely asked them how they were feeling emotionally during antenatal visits.
- Similarly, just 54% of women giving birth for the first time felt they were definitely given enough information about emotional changes which may be experienced after the birth.
Effective service user involvement, a pillar of person centred care, is not always being achieved – particularly in terms of postnatal care – and there remains significant room for improvement in some key components of maternal patient experience.
As outlined in the report:
Improving people’s experiences of care requires providers to hear and respond to user feedback, and to ensure that staff feel supported to provide the best quality care.
Results from the national and the NHS staff survey should be powerful tools to help services in this task, but they should be complemented by other evidence – including the feedback volunteered by families through compliments and complaints, as well as through targeted efforts to understand and explore people’s experiences.
To pursue improvements in maternity services, as recommended in the 2016 National Maternity Review, maternity care should become safer, more personalised, and more family friendly.
This means that women and families ought to have access to information to enable them to make decisions about care, and that they can access support that is centred on their individual needs and circumstances.
It also means that healthcare staff need to be supported to deliver person centred care.
To enable this, they should have the opportunity to work in high performing teams and organisations which are well led and in cultures which promote innovation, continuous learning, and break down organisational and professional boundaries.
A cross party group of MPs has published a report setting out a new vision for the future of Children’s Centres.
Published ahead of an expected Government Life Chances strategy, ‘Family Hubs: The Future of Children’s Centres’ argues that Children’s Centres have had a crucial role to play in providing support to young children and their parents, intervening early to address problems that prevent children reaching their potential, and tackling poverty and disadvantage.
It sets out a series of recommendations for how Children’s Centres would be even better placed to improve life chances if they operated as Family Hubs – reaching more families and offering support across a broader range of issues.
Having heard evidence from a range of Children’s Centres, local authorities and charities over the last 12 months, the report, Family Hubs: The Future of Children’s Centres recommends:
- Augmenting Children’s Centres into Family Hubs as part of the Government’s Life Chances agenda. This would mean renaming and rebranding them as Family Hubs, broadening the range of services available to make them universally recognised one-stop-shops for sourcing support for families – at all stages and ages – in their local communities, linked with national online support.
- Placing Family Hubs at the heart of local Health and Wellbeing strategies, requiring strong leadership at local and national government levels.
- An emphasis on mental health support, including looking at how support available from other partners such as schools can be integrated into Family Hubs support.
- Delivering employment support, particularly for the long term jobless. This will involve strengthening links between Family Hubs, local employers and Jobcentre Plus
- Relationship support should be delivered in Family Hubs, or signposted from them, to include statutory, voluntary and self-help provision, and be extended beyond parenting support to include couples counselling; pre-marriage courses; post separation support and help with parenting teenagers.
Fiona Bruce, MP for Congleton and Chair of the All Party Parliamentary Group (APPG) on Children’s Centres says: “The Government has rightly made improving the life chances of vulnerable children and families a priority. Children’s Centres across the country have real potential to play a lead role in this by extending their remit and transforming themselves into ‘Family Hubs.’
“Evidence shows excellent examples from across the country where individual centres have broadened their support into a variety of services for the whole family, such as dedicated support for fathers or help to access employment. It’s hard to conceive of a life chances strategy that doesn’t position Family Hubs front and centre.”
Sharon Hodgson, MP for Washington and Sunderland West and Vice Chair of the APPG for Children’s Centres says: “For over the last 15 years, Children’s Centres have been a vital means of support to families who need support in the early stages of family life. These centres have done so much good in that time and it is sad to see so many closing down across the country. Now more than ever, it is important that those families who are struggling do not miss out on the much needed support offered by these centres and that is why we must protect and build on those achievements.
“By expanding the support on offer and opening the doors to more families, Children’s Centres can be a central hub in our communities for all families to use and do what they do best which is identifying problems and intervening early to ensure those problems do not escalate further and irreversibly damage children’s futures.”
A full copy of the report is available on request. For further information or to request a copy please contact Julie Evans on 07825 546461 or 0207 522 6986 or Kate Groucutt (email@example.com) on 0207 522 6929 or 07855 383445.
On the 14th July David Behan, the chair of the Care Quality Commission, wrote in the Guardian:
“Everybody in this country deserves good care, no matter who they are, where they are treated or how complex their case. And as our older population increases, so too will the demand for services and consequently we will have more people with more complex needs in an environment that itself faces increasing pressures.So it’s never been a better time to talk about integrated care. How do we stop people with complex needs falling between the gaps in services?”
Paul Barry, Chief Executive of everyLIFE Technologies, responded:
“David Behan is absolutely right to say that everybody in the country deserves good care no matter who they are. The need for a conversation collectively led by both health and social care has never been so great.
“We know that technology can unite this fragmented system and improve care for people, whether at home, in residential care, or hospital, which is why everyLIFE is spearheading a new movement, The Fourth Age of Care. The Fourth Age of Care is a new movement by a collective of organisations including the Local Government Alliance, New NHS Alliance and everyLIFE Technologies. Their recent white paper, produced from a roundtable attended by a number of stakeholders including NHS England, LGA, Age UK and New NHS Alliance, describes what the future could look like if the care industry grasps the opportunities that digital technology can offer. It’s a way of thinking about a world where the person cared for in their own home or a residential or nursing home is connected to the network of people who support them. That includes their families, the carers who meet their day-to-day needs and health and social care professionals.
We understand from first-hand experience how frustrating it is to have disjointed care. If you don’t have one care plan accessible to multiple providers, health professionals will not receive reliable information, which ultimately puts the person being cared for at risk. That is precisely why everyLIFE developed the PASSsystem, a CQC recognised care management platform that puts the person receiving care at the centre. There’s no need for people to explain the details of their case over and over again. All those involved in a person’s care including GPs, community nurses, care workers and family members can view their care record remotely in real time through openPASS.
The Fourth Age of Care forum is delivering the collective conversation that is so urgently required and has identified five action points to further this important agenda:
Join the debate. That means everyone together, open and pragmatic discussions – public sector, private sector and the voluntary sector
Provide impartial, high quality, individualised information about services to consumers of care. You can’t choose well when you don’t know what is on offer and all the information to make an educated decision
Move to digital platforms for care planning and delivery. Connected care is shared, integrated care – and shared, integrated care requires shared data supported by cross sector digital technology
Develop a common lexicon. Connected care requires all those involved in health and social care to speak the same language – one that puts the person in the centre
- Define a common dataset. What information is it that supports care planning and delivery that must be shared across a connected network?”
Hot weather in the UK matters; in the ten-day August 2003 heatwave, it is estimated that there were 2,000 deaths caused by the hot weather in the UK, and an estimated 70,000 across Europe.
Due to climate change, UK heatwaves are expected to become more frequent. Owing to its location and size, London is particularly vulnerable. Older people, infants and babies, people with physical or mental disabilities, people with long-term illnesses, people who misuse alcohol or drugs and isolated people are all more vulnerable during heatwaves. These people in particular can start to experience difficulties, such as dehydration which can lead to cardiac and respiratory problems, at temperatures as low as 25 degree Celsius (just when many people are celebrating the warm weather). For these groups it is important to drink lots of water, try to stay in a cool place, seek advice if needed (from a GP or NHS 111), and check on friends, family and neighbours who might be susceptible to heat related health issues.
Our research project, Urban Heat, funded by the Joseph Rowntree Foundation, looks at UK heatwaves in urban areas and shows that there are comprehensive local and national heatwave plans in place. At the same time, our research indicates that there is untapped potential for public bodies to work with local community groups. Voluntary and community sector organisations have a lot to offer during heatwaves because they are in contact with ‘vulnerable’ people day in and day out.
Planning for heatwaves does not receive as much attention as preparing for cold weather and floods, and appears in neither building regulations nor urban planning guidance. Since the Met Office predicts that heatwaves will become more frequent in the future, it is important to begin addressing these challenges now.
Dr Kevin Burchell and Ben-Fagan-Watson, Policy Studies Institute, University of Westminster
The House of Lords Committee on the Long-term Sustainability of the NHS has today called for submissions to its inquiry as it tries to identify what the NHS of the future may look like.
The Committee’s inquiry comes as NHS commissioners and providers wrestle with an annual deficient of £1.85bn and imminent demographic changes promise an older population and more patients with increasingly complex long-term health needs. These challenges come alongside changes in healthcare and medical technology which may lead to more personalised prevention and treatment of diseases.
The Committee has divided its inquiry into five themes which it will consider in public evidence sessions in the following order:
1. Resourcing issues – including funding, productivity and demand management. Is the current funding model for the NHS realistic in the long-term? Should new models be considered? Is it time to review exactly what is provided free-at-the-point of use?
2. Workforce – including supply, retention and skills. How can an adequate supply of appropriately trained healthcare professionals be guaranteed? Are enough being trained and how can they be retained? Do staff in the NHS have the right skills for future health care needs?
3. Models of service delivery and integration. How can the move be made to an integrated National Health and Care Service? How can organisations in health and social care be incentivised to work together?
4. Prevention and public engagement. How can people be motivated to take greater responsibility for their own health? How can people be kept healthier for longer?
5. Digitisation, big data and informatics. How can new technology be used to ensure sustainability of the NHS?
The Committee are inviting written evidence to be received Friday 23 September. Evidence can cover one or more of the themes and should focus on the long-term sustainability of the NHS rather than short-term issues. The Committee started taking oral evidence on 12 July and it is expected sessions will focus on resourcing issues throughout September and October before moving to the workforce theme in November. The Committee will agree its report by the end of March 2017. Details on how to submit evidence is available on the Committee’s webpage
Commenting Lord Patel, who chairs the Committee, said: “It seems that on an almost daily basis we hear stories of one NHS crisis or another but we have not yet had a robust long-term analysis of the challenges it faces. The NHS is one of our most beloved institutions with principles that people value and admire but like any public service it must adapt. We need to find long term solutions. Our inquiry will get to the core of the challenges that the NHS will face over the next two decades and beyond. We hope that it will lead to a cross-party consensus on the way forward for a sustainable approach to better healthcare.”
In its report, Building Bridges, Breaking Barriers, it warns that despite a widespread commitment for integration across the sectors, substantial progress is needed to better support people who use a number of services, reduce hospital admissions and avoid confusion about where to go for help. The report concludes that with a growing elderly population, now is the time to act.
People in England are living longer with the number of people aged 65 and over in the UK projected to rise by 40 percent in the next 17 years to nearly 17 million. Older people typically have the most complex needs and consequently receive care from more than one service and often across multiple locations; for example from an acute trust, a community trust, a GP, and a home care provider.
As the population grows, the providers of health and social care need to find more efficient ways of delivering care and reducing costs, the report says. The Government and health and social care organisations have identified integrated care as a key step in responding to an increased number of people who have complex needs.
People with complex needs who use a range of services will often say they are satisfied with individual providers but when they move between different services, their care can become fragmented and have an adverse impact on their experience of using care, the report says.
When staff from different services talk to each other and share information effectively, people experience better, safer care. When they do not, care can become disjointed.
An example of how integrated care can improve the experience of patients is with effective multi-disciplinary working, planning and information sharing, such as the Care Navigation Service that CQC identified in Camden*.
To carry out this review, CQC inspectors gathered evidence from a range of sources, including speaking to older people and their carers to understand their experiences. They inspected services within eight areas across England to look for examples of effectively coordinated care and to identify barriers which prevent care from working well.
The report concludes that substantial progress is needed to achieve the collective ambition that individuals receive joined up personalised care and support.
While there is widespread commitment to deliver integrated care, local leaders such as directors of adult social services, health and commissioning managers, appeared to lack the knowledge about how to put it into practice. Other findings include:
- Where CQC found health and social care was not integrated, the individual services lacked a culture which supported collaboration.
- There are organisational barriers that make it difficult for services to identify older people at risk of deterioration or unplanned hospital admission in a timely manner, including a lack of consistency in the use of assessments and sharing information.
- Many initiatives to encourage and enable joint working were inconsistent, short term and reliant on partial or temporary funding and goodwill between providers rather than part of mainstream service delivery.
- The monitoring and evaluation of integrated care was insufficient or not carried out.
- A lack of connection between services often resulted in older people and their families or carers taking responsibility for navigating complex local services and this could result in people falling through the gaps and only being identified in a crisis.
Inspectors also found that where care was integrated, local leaders were working closely across health and social services to share information, reduce duplicated efforts and use resources more effectively. A number of initiatives, strategies and systems offered a real opportunity to deliver coordinated care in local areas.
CQC’s chief executive, David Behan said: ‘Older people who use health and care services tell us that they want their services to be joined up and work together.
‘This study found examples of effective integrated care but these small steps need to become significant strides to move joined-up services into the mainstream. Everyone deserves seamless quality care, regardless of how many services are involved in delivering it and regardless of how complex your needs are.
‘Local leaders should build on the opportunities offered by initiatives such as the new care models vanguard programme to deliver joined up care.’
The report recommends that local health and social care leaders should agree a shared understanding and definition of what integrated care means for their communities and then work towards delivering this, which means collective and individual leaderships demonstrate ownership and responsibility for integrated care within their areas.
It also urges NHS England and the Association of Directors of Social Services (Adass) to develop an agreed methodology at a national and local level across health and social care to identify people at risk of admission to secondary care or deterioration, underpinned by a clear data set. Older people should also be meaningfully involved in making informed decisions about their care – in particular about the outcomes that are important to them, the report says.
In the recent issue of Renewal (24;2;2016) Jessica Studdert, deputy director of the new local government network, makes a good case for transferring responsibility for the NHS from central to local government. Such a transfer would correct the democratic deficit that was built into the NHS in 1948 and that has never been addressed by any government. As Jessica argues, it might also tilt the NHS’s emphasis from hospital-based ‘cure’ to prevention and community-based care, if only a little. These look like worthy objectives for a future Labour government, but are they realistic?
We should separate the impact of demographic change (essentially, population ageing) and the effects of government funding policies on strains in the hospital sector. Likewise, the possible benefits of local programmes of preventive work and the potential for community-based services to provide better quality care need to be separated.
The cost consequences of an ageing population are surprisingly small; most of the rising costs in health services are due to technological innovation (including new medicines) plus the expansion of clinical activity to new conditions. The two clear examples of the latter are the NHS’ responses to age-related disorders like dementia and frailty. Both conditions are poorly understood and there are no cures for either. Nevertheless services are evolving to identify people with either or both condition, even though we have limited options to help people with them. At the same time hospital services designed to deal with single conditions (heart attacks, infections, strokes) are struggling to manage individuals with long-lasting multiple problems for whom community-based care would be more appropriate and safer, if it were available. Part of this clinical miss-match is due to the way the NHS medical workforce has over-specialised. Over-specialisation has left a generalist-shaped hole in NHS hospital staffing and there are not yet enough geriatricians to fill it.
All these trends have increased the strain experienced by NHS hospitals, but the government’s austerity policy towards the NHS has added to them enormously. By holding funding increases down to 1.8% per year instead of meeting the NHS’s inflation rate of around 4% (due again to innovative technologies and expanding medical activities), the current government has generated a financial crisis, particularly in the hospitals. It is this deliberate policy of under-funding (and expecting shortfalls to be made up by implausibly high levels of improved productivity) that is causing NHS finances to deteriorate, not unprecedented levels of demand. No change in management of the NHS looks fit to correct the accounting deficits, certainly not transfer of responsibility to cash-strapped local government.
Nevertheless, drifting towards local control of the NHS would be a good policy option, especially because it could end a long period of centralisation and strengthen local government. Public health was restored to local government by the 2013 Act, having been annexed by the NHS in 1974. Within local government public health expertise could be fruitfully reunited with expertise about housing, environment, leisure services, the voluntary sector and education, if its budgets were not being cut centrally to support hospital services in financial crisis. Programmes for prevention of ill health that are effective – for example, exercise promotion – need long-term investment. Even then, their impact on NHS service use may be limited compared to their effect on individual and social wellbeing.
The next to follow could be community-based nursing services, which rely on the work of (largely) unpaid family carers and the patchwork of commercial home care resources to be able to support people in their homes. We could use the existing home care resources – in effect bringing them into the public domain -to grow a robust hospital-at-home system that could provide an alternative to hospital care, using the French and Australian models as examples. Hospital at home not only requires a stable nursing workforce, but also a ring-fenced budget to prevent other parts of the NHS from robbing it. This cannot be dependent on short-term financial gains to the NHS or local government, which are by no means guaranteed; for example, hospital admissions of frail older people may not decline but they may get shorter, reducing the risks of hospital care to the frail individual, like injurious falls and resistant infections.
And then there are the hospitals. Do local governments really want control of hospitals? After all, local government (and the NHS) struggle to engage commercial care home chains in health service initiatives. Would they be any better placed to prevent all resources from being tipped into maintaining them? Could local authorities close redundant hospital services any easier than the centralised NHS does, or would they be too much influenced by local political passions? We may not be able to answer these questions without some trials of new management arrangements for the NHS, but if we favour a drift towards local government control, these trials may be needed to clarify the problems and their solutions, empirically. Local variations in how the NHS works would then increase, but as Jessica argues, we cannot allow fears about ‘postcode lotteries’ in services to stifle experimentation.
<h5> Author Steve Iliffe </H5>
Emeritus Professor of Primary Care for Older People, University College London.
Responding to new figures released today by Public Health England which show that around 80,000 people could be living with undiagnosed lung cancer, Dr Fran Woodard, Executive Director of Policy and Impact at Macmillan Cancer Support, says:
“It is extremely worrying that so many people could be living with lung cancer without being aware of it because the sooner someone is diagnosed, the greater their chances of surviving the disease.
“Things to look out for include a cough, hoarse voice or chest infection which has lasted three weeks or more, and if you notice any of these please go and see your GP to get checked out as they could be warning signs of lung cancer.
“If you are diagnosed with lung cancer there are treatments available including surgery, radiotherapy and chemotherapy. Macmillan also has a range of support on our website from information on common symptoms to look out for to an online support group of people with lung cancer.”
NHS ‘Be clear on cancer‘ information website
The majority of ill children in England with life-shortening conditions[i], and their families, are being short changed or ignored, a survey by UK children’s charity Together for Short Lives[ii] has found. There are 40,000 children and young people with life-shortening conditions in England, and the number is rising. Many of these children have conditions that are complex and unpredictable and need specialist children’s palliative care.
- 4 out of 5 (81%) local authorities are failing to plan and fund care for children and young people with life-shortening conditions.
- Local authorities have a legal duty to provide short breaks for disabled children, including those with life-shortening conditions, yet around 1 in 7 (14%) are failing to commission these services.
- Despite government guidance, seven (4%) clinical commissioning groups refuse to commission children’s hospices to provide care because they are charities.
- A new interactive map and rating system allows the public to see how their local authority and clinical commissioning group is performing.
Together for Short Lives is calling on the government and commissioners to work with them to address this shortfall and better plan and fund vital services for these seriously ill children, young people and their families.
The findings have been uncovered by Together for Short Lives following a series of freedom of information (FOIs) requests which the charity made to local authorities and NHS clinical commissioning groups (CCGs) in England during April 2016. The FOIs sought to establish how well these organisations are planning, funding and monitoring (a process known as ‘commissioning’) care for children with life-shortening conditions.
Together for Short Lives has rated [iii] the councils and CCGs by the different aspects of the care needed by ill children with life-shortening conditions, including end of life care, short breaks and bereavement care. The ratings also take into account whether they commission vital local services for these ill children, including community children’s nurses, children’s hospices and specialist medical care. For the first time, the public can see how their local councils and CCGs are performing using an interactive online map at www.togetherforshortlives.org.uk/datamap[iv].
The findings show that most local authorities are failing these ill children:
- A staggering 4 in 5 (81%) councils are failing to plan and fund palliative care for ill children and young people.
- Nearly half (49%) have received the charity’s zero or one-star rating for children’s palliative care.
- Only 10 (7%) achieved the maximum of five stars.
- Local authorities have a legal duty to provide short breaks for disabled children yet still around 1 in 7 (14%) are failing to commission these services.
Overall CCGs performed better than local authorities. 120 (65%) of CCGs received a four or five-star rating with the majority 127 (93%) of CCGs stating that they commission children’s palliative care. However, too few were able to identify exactly how much funding was spent on ill children and young people with life-shortening conditions. Despite evidence of some good practice, the overall picture is inconsistent:
- >More than a quarter (27%) of CCGs are failing to commission community children’s nursing out of hours, meaning that too many children with life-shortening conditions may have to be admitted to hospital if their health deteriorates during evenings and weekends – placing further unnecessary cost and burden on hospitals and families.
- Nearly 1 in 5 (17%) of CCGs do not commission children’s hospices. 4% (7 CCGs) refuse to commission children’s hospices to provide care because they are charities – despite the government and NHS England emphasising the important role of charities generally in providing health and social care services. Local authorities and CCGs have been legally obliged to jointly commission services for children with special educational needs and disabilities (SEND), including those with life-shortening conditions, since the introduction of the Children and Families Act 2014.
- Alarmingly there appears to be a responsibility vacuum with a number of CCGs confused about what they should be doing to support care for children with life-shortening conditions. Six (4%) wrongly say that only NHS England is the commissioning body for all children’s palliative care.
Commenting on the findings, Barbara Gelb OBE, Chief Executive of Together for Short Lives, said:
“These findings show that, despite some good examples, the overall approach to children’s palliative care is at best inconsistent and at worst typified by ignorance. It’s a postcode lottery, with many children and young people being denied the support they need.
“We already know that children’s hospices in England receive on average only 10% of their funding through CCGs, far less than the 30% adult hospices receive[v]. Yet children’s hospice services provide vital lifeline care that saves the NHS millions.
“This survey starkly reveals the shortfalls, whilst also recognising those instances where CCGs and local councils are getting it right. We need to see many more such examples and I make a personal plea to health and social care commissioners across England to work with us to better plan and fund lifeline services for children with life-shortening conditions[vi]. The public overwhelmingly supports more funding to help these children[vii] and I call on the government and NHS England to respond to this by writing to CCGs and local authorities to urge that they now commission care for these children and young people who frankly don’t have any time to wait.”
You can access a full report of Together for Short Lives’ findings here. This includes all the questions CCGs and local authorities were asked as an appendix.
[i]Hearing the news that your child has a life-shortening condition and is likely to die young is completely devastating. For tens of thousands of families in the UK this is the reality. These children have very complex and unpredictable conditions and often need round the clock care, seven days a week.
[ii]Together for Short Lives is a UK wide charity that, together with our members, speaks out for all ill children and young people who are expected to have short lives. We are here to help children and their families to access specialist children’s palliative care services when and where they need it. We provide information so families know where to go for support and have the help they need to make the right choices about their child’s care. Together for Short Lives supports all the professionals, children’s palliative care services and children’s hospices that deliver lifeline care to children and families across the UK. Together with everyone who provides care and support to these ill children and families, we are here to help them have as fulfilling lives as possible and the very best care at the end of life. We can’t change the diagnosis, but we can help children and families make the most of their time together.
[iii]Together for Short Lives has calculated its star rating of CCGs and local authorities based on the number of ‘yes’ answers which they have given to the questions we asked them. The more ‘yes’ answers given, the higher their rating:
- 0% of ‘yes’ answers = 0 stars
- 1 – 20% = one star
- 21% – 40% = two stars
- 41% – 60% = three stars
- 61% – 80% = four stars
- 81% – 100% = five stars
Please note that we have not included the answers to our overarching question ‘Do you commission palliative care for ill children and young people with life-shortening conditions between the ages of 0 and 25’ in our rating calculation. This is because the questions which we do take into account seeks to explore whether CCGs and local authorities are commissioning the different elements which comprise children’s palliative care. We want to show cases where these organisations are not actually commissioning children’s palliative care when they are claiming to do so – and, conversely, if they are actually commissioning children’s palliative care when they think they are not. Our results have found that both scenarios are occurring. This could be because some commissioners do not understand what the term ‘children’s palliative care’ means. By publishing the results of our survey, we hope that CCGs and local authorities will better understand what children’s palliative care is and what their role in commissioning it is.
It is for this reason that Together for Short Lives has been able to give a star rating to CCGs and local authorities who have told us that they do not commission children’s palliative care.
In total, 187 (88%) CCGs and 144 (93%) local authorities provided some or all of the answers to the questions which we used in calculating the star rating.
[iv]Together for Short Lives has produced two unique interactive maps which allow the public to see how their clinical commissioning group and local authority is performing with a new rating system. It can be found herewww.togetherforshortlives.org.uk/datamap
[v]Hospice UK and Together for Short Lives, 2015. Commissioning and statutory funding arrangements for hospices in England: survey results 2015. http://bit.ly/1XwMja4 [Accessed 17 May 2016]. This survey told us that children’s hospices receive on average 10% of their funding through CCGs and adult hospice receive 30%.
[vi]Together for Short Lives’ resource ‘Jointly Commissioning Palliative Care for Children and Young People’ is designed to support CCGs and local authorities in England to effectively commission palliative care for children and young people aged 0–25. Produced as part of our Department for Education-funded special educational needs and disability (SEND) project, our resource also supports health and wellbeing boards to understand their role in the commissioning process. It can be downloaded at: www.togetherforshortlives.org.uk/jointcommissioning
[vii]A survey of 1,682 adults in England conducted by YouGov on behalf of Together for Short Lives on 11 and 12 May 2016 has shown that:
- 81% of the public think that children’s hospices receive too little funding from statutory sources
- the public think that children’s hospices receive 38% of their funding from statutory sources – in reality they only receive 21%
- the public think that children’s hospices should receive more statutory funding (73%, of their total funding).
More than 70 leading figures from the worlds of politics, industry, science and health will be debating obesity, sugar tax, sustainable diets and a host of other topical issues at this year’s Food Matters Live conference.
Ministers from the Department of Health and DEFRA will join business leaders from industry, including Mars, Britvic, Refresco Gerber and Mondelez, alongside the Advertising Standards Authority’s Guy Parker, Raymond Blanc and marathon runner Paula Radcliffe to head an all-star cast of experts taking part in the Food Matters Live education programme.
They will team up with renowned commentators, including food writer and broadcaster Gizzi Erskine and behavioural economist Tim Harford, model Claudia Schiffer’s former chef Sophie Mitchell, and scientist Professor Lord Robert Winston to address the complex and challenging relationship between food, health and nutrition.
Hot topics under the spotlight include: the ethics of marketing food to children, the future for ‘better-for-you’ soft drinks, the impact of celebrity on eating habits and an in-depth look at the food oftomorrow.
BBC presenters Jonathan Dimbleby, Anita Anand and Simon Jack will chair the debates, which are the highlight of the three-day free-to-attend Food Matters Live event, which returns to London’s ExCeL on 22-24 November.
At the same time, a multi-stream seminar programme offers visitors an unparalleled opportunity to gain practical advice from more than 300 expert speakers.
Based on case studies and real-life experience, sessions cover a broad range of issues, such as nutrition for health and wellbeing, personalised nutrition, tackling obesity in practice, improving teenage diets, understanding the scale of the ‘free from’ trend, the future of sustainable proteins, the importance of packaging design and marketing healthier options.
More than 15,000 visitors are expected to attend this year’s Food Matters Live exhibition, featuring over 600 leading organisations, ranging from global multinational companies to young and emerging enterprises from the UK and internationally.
Live attractions, demonstrations and tastings will bring the learning to life, giving visitors a chance to investigate what is shaping the future of food – from consumer food choices at the Experimental Café to new concepts underpinning innovations in ‘better-for-you’ food and drink in the Evidence Base.
In the Catering for Health theatre, chefs and nutritionists will present healthier menu choices to suit different budgets for health conscious consumers, while in the Feed Sensorium attraction, visitors will discover a range of science innovations from advances in cellular agriculture to the exciting potential of electrically stimulated flavour.
Briony Mansell Lewis, Food Matters Live Director, said: “We’re delighted once again to welcome so many experts to showcase and share best practice with colleagues in food, health and nutrition. Food Matters Live is fast becoming an annual business and education opportunity for many in the industry – and for smaller, innovative challenger brands, an unrivalled chance to get their products noticed.”