Essays%collected%by%the%Associate Parliamentary%Health ......Dame Jo Williams Ð Chair, Care Quality Commission 22 Reßections Lord Hunt of Kings Heath Ð APHG Parliamentary OfÞcer

Associate Parliamentary Health Group

Essays collected by the Associate

Parliamentary Health Group

in association with The King’s Fund

FOR PARLIAMENT

POLICY PRIORITIES HEALTH

‘ HEALTH IS AN INTRINSICALLY INTERESTING POLICY AREA AND AS PARLIAMENTARIANS, OUR ENGAGEMENT WITH IT IS ESSENTIAL’

Baroness Cumberlege, APHG Chair Lord Hunt of Kings Heath, APHG Parliamentary Officer

4 5

Foreword 6Commissioning Professor Chris Ham - Chief Executive, The King’s Fund 8Competition within the NHS Dr Jennifer Dixon - Director, The Nuffield Trust 10NHS finances and productivity Professor John Appleby – Chief Economist, The King’s Fund 12The NHS Workforce Dr Peter Carter – Chief Executive, Royal College of Nursing 14Patient Experience Jeremy Taylor – Chief Executive, National Voices 16Public Health Professor Steve Field – Former Chair, Royal College of General Practitioners 18Social Care Richard Jones – President, Association of Directors of Adult Social Services 20Quality Dame Jo Williams – Chair, Care Quality Commission 22Reflections Lord Hunt of Kings Heath – APHG Parliamentary Officer 24Reflections Mark Simmonds MP – APHG Parliamentary Officer 26About the APHG 28About The King’s Fund 30

Health Policy Priorities for ParliamentA collection of essays presented by the Associate Parliamentary Health Group and The King’s Fund

CONTENTS

6 7

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

8%'()'0*'%&()'<#)()'%&#%'(*'CDDE4'6"'#*1'0%&"+'/#+$(#3"*%#+-',0$$"#.5")'&"$/"1'")%#<$()&'%&"'F))0,(#%"'2#+$(#3"*%#+-'!"#$%&'G+05/'HF2!GI'#)'#'90+53'%&+05.&'6&(,&'%0'/+0:(1"';2)'#*1'2""+)'6(%&'&(.&'=5#$(%-4'(3/#+%(#$'(*90+3#%(0*'#<05%'&"#$%&'())5")7'J0,5)(*.'0*'$0,#$'#)'6"$$'#)'*#%(0*#$'())5")4'%&"'F2!G'()'1"1(,#%"1'%0'1())"3(*#%(*.'A*06$"1."'#*1'."*"+#%(*.'1"<#%"'0*'%0/(,#$'&"#$%&'())5")'(*'#',+0))K/#+%-')"%%(*.7'

J0+'%&"'30)%'/#+%'6"'#,&(":"'%&()'<-'&0$1(*.'+".5$#+')"3(*#+)'0*'%&"'2#+$(#3"*%#+-'L)%#%"'#11+"))"1'<-'"@/"+%'/#*"$()%)'1+#6*'9+03'%&"'&"#$%&')",%0+7'?(*,"'%&"'.+05/M)'(*,"/%(0*4'6"'&#:"'<""*'90+%5*#%"'%0'&#:"'<""*'#11+"))"1'<-')03"'09'%&"'30)%')"*(0+':0(,")'0*'&"#$%&'(*,$51(*.'?",+"%#+(")'09'?%#%"4'N&("9'L@",5%(:")'09'A"-'>!?'#*1'+".5$#%0+-'<01(")4')"*(0+',(:($')"+:#*%)'#*1'$"#1(*.'#,#1"3(,)7'8*'05+'3())(0*'%0'0/"*'5/'%&"'&"#$%&'/0$(,-'

1"<#%"'%0'%&"'<+0#1")%'/#+$(#3"*%#+-'#51("*,"'/0))(<$"4'6"'&#:"'"*$()%"1'%&"')5//0+%'09'#'1()%(*.5()&"1'/#*"$'09'#1:()0+)'6&04'#$0*.)(1"'05+'9"$$06'2#+$(#3"*%#+-'

1"%#($)'#<05%'%&"'(*1(:(15#$)'(*:0$:"1'(*'%&"'.+05/'#*1'%&"')"+:(,")'/+0:(1"1'<-'%&"'F2!G',#*'<"'905*1'0*'/#."'CO'09'%&()'<00A$"%7

F)'6"'"3<#+A'5/0*'#'/"+(01'09')5<)%#*%(#$'+"90+3'90+'%&"'&"#$%&')"+:(,"4'#*1'(*'%&"'

/#+$(#3"*%#+-'/#+%(,(/#%(0*'(*'%&"'90+6#+1'&"#$%&'1"<#%"'6($$'<"'/#+#305*%7'P0'&"$/'0+("*%#%"'*"6'#*1'+"%5+*(*.';2)'#*1'2""+)'0*'%&"')&#/"'09'%&"'&"#$%&'/0$(,-'#."*1#4'6"'#+"'1"$(.&%"1'%0'/+")"*%'%&()',0$$",%(0*'09')&0+%'"))#-)'(*'/#+%*"+)&(/'6(%&'P&"'Q(*.M)'J5*1'0*')03"'09'%&"',"*%+#$'())5")'%&#%'6($$'103(*#%"'%&"'&"#$%&'/0$(,-'#."*1#'0:"+'%&"',05+)"'09'%&()'2#+$(#3"*%7'

,033"*%#%0+)4'"#,&'"))#-'/+0:(1")'"))"*%(#$'(*90+3#%(0*'0*'#'/#+%(,5$#+'/0$(,-'/+(0+(%-4'"@/$0+(*.'(%)'1":"$0/3"*%'#*1'%&"'6#-)'(*'6&(,&'(%',#*'<"'#11+"))"1'#*1'#1:#*,"1'(*'%&"',03(*.'-"#+)7'

R"'605$1'$(A"'%0'099"+'05+'%&#*A)'%0'#$$'%&0)"'6&0'&#:"',0*%+(<5%"1'%0'%&()'/5<$(,#%(0*'90+'$"*1(*.'5)'%&"(+'%(3"4'(*)(.&%'#*1'"@/"+%()"'#*1'05+'/#+%*"+)'(*'%&()'/+0B",%4'P&"'Q(*.M)'J5*14'90+'%&"(+':#$5#<$"'(*/5%'#*1')5//0+%7'R"'&0/"':"+-'35,&'%&#%4',0$$",%(:"$-4'%&"'


FOREWORD "))#-)'6($$'"*,05+#."',0$$"#.5")'%0'(*(%(#%"4'+")53"'0+',0*%(*5"'%&"(+'"*.#."3"*%'(*'&"#$%&'/0$(,-'#*1'%&#%'%&"'F2!G'6($$'#,%'#)'#'5)"95$'90+53'%&+05.&'6&(,&'%0'1":"$0/'#*1'"*&#*,"'-05+'5*1"+)%#*1(*.'09'%&()'9#),(*#%(*.'/0$(,-'#+"#7'

Baroness Cumberlege APHG Chair

Lord Hunt of Kings HeathAPHG Parliamentary Officer


‘As we embark upon a period of substantial reform for the health service, and in the context of a challenging financial climate, parliamentary participation in the forward health debate will be paramount’

8 9

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

V")"#+,&'(*%0'/+(3#+-',#+"K$"1',033())(0*(*.'(*'%&"'>!?'&#)'&(.&$(.&%"1'(%)'/0%"*%(#$'%0',0*%+(<5%"'%0'(3/+0:"3"*%)'(*'/"+90+3#*,"4'")/",(#$$-'(*'(*,+"#)(*.'+")/0*)(:"*"))'%0'/#%("*%)'#,,"))(*.'/$#**"1',#+"'#*1'1"$(:"+(*.'30+"',#+"',$0)"+'%0'&03"7'W*'%&"'0%&"+'&#*14'%&"+"'()'$(%%$"'":(1"*,"'%&#%'/+(3#+-',#+"K$"1',033())(0*(*.'&#)'3#1"'#'

0+'0*'301"+#%(*.'1"3#*1'90+'5*/$#**"1',#+"7'L:(1"*,"'9+03'%&"'X*(%"1'?%#%")'6&"+"'3"1(,#$'.+05/)'&#:"'%#A"*'0*',#/(%#%"1'<51."%)')5..")%)'%&#%'G2',033())(0*(*.'6($$'1"/"*1',+(%(,#$$-'0*'1":"$0/(*.',#/#<$"'G2'$"#1"+)'#*1'/+0:(1(*.'#1"=5#%"'<51."%)'%0'"*#<$"',0*)0+%(#'%0'<5-'(*'3#*#."3"*%')5//0+%4'#30*.'0%&"+'%&(*.)7

Y#+(05)')%51(")'(*'%&"'$#)%'%6"*%-'-"#+)'&#:"'1"),+(<"1',033())(0*(*.'#)'%&"'6"#A'$(*A'6(%&(*'%&"'>!?7'P&"',&#$$"*."'90+'%&"'N0#$(%(0*'G0:"+*3"*%'6($$'<"'%0'"*)5+"'%&#%'&()%0+-'10")'*0%'+"/"#%'(%)"$9'#*1'%&#%'%&"'$"#1"+)&(/'#*1'3#*#."3"*%'#+"'/5%'(*'/$#,"',05*%"+'%&"'/06"+'09'/+0:(1"+)'(*'0+1"+'%0'


COMMISSIONING Professor Chris Ham Chief Executive, The King’s Fund


‘The challenge for the Coalition Government will be to ensure that history does not repeat itself and that the leadership and management are put in place counter the power of providers in order to deliver benefits for patients and the public’

10 11

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

%0'%#@/#-"+)['#*1'%&"',0)%)'09'1":"$0/(*.'#*1'3#(*%#(*(*.'#'3#+A"%'605$1'<"'&(.&7'

\5%')03"%(3"'*"#+'CDDD4'%&"'>"6']#<05+'G0:"+*3"*%',0*,$51"1'*0%'0*$-'%&#%'"@%+#'H/+(:#%"I')5//$-'09',#+"'6#)'*""1"1'%0'+"15,"'6#(%(*.'$()%)4'<5%'30+"'95*1#3"*%#$$-'%&#%',03/"%(%(0*'90+',$(*(,#$')"+:(,")',05$1'

9#,($(%(")'3(.&%'099"+'.+"#%"+'(**0:#%(0*7'!"*,"'%&"'(*(%(#$'^,0*,0+1#%M'6(%&'%&"'/+(:#%"')",%0+')(.*"1'<-'%&"*'?",+"%#+-'09'?%#%"'90+'!"#$%&4'F$#*';($<5+*4'%&"'*#%(0*#$',0*%+#,%)'<"%6""*'%&"'_"/#+%3"*%'09'!"#$%&'#*1'(*1"/"*1"*%'%+"#%3"*%',"*%+")'H8?PN)I4'%&"'/0$(,-'09'905*1#%(0*'%+5)%)'H)=5""`"1'%&+05.&'2#+$(#3"*%'6(%&'#'3#B0+(%-'09'0*$-'aI'6&(,&'

,0*9"++"1'.+"#%"+'9+""103)'0*'>!?'P+5)%)4'#*1'/0$(,(")'%0'/+030%"'/#%("*%',&0(,"'09'&0)/(%#$7'2#%("*%)'6"+"'.(:"*'9+""103'%0',&00)"'%&"'&0)/(%#$'09'+"9"++#$4'9+03'CDDb'9+03'#*-'6($$(*.'/+0:(1"+7'P&"',03/"%(%(0*c,&0(,"'/0$(,-'*0%#<$-'1(1'*0%'"@%"*1'%0'0%&"+'/+0:(1"+)4'#*1'*0%'%0',033())(0*"+)4')5,&'#)'/+(3#+-',#+"'%+5)%)7'F$0*.)(1"'%&")"'/0$(,(")')&05$1'<"',0*)(1"+"1'0%&"+'^3#+A"%'3",&#*()3)M'

/+(,")'90+'&0)/(%#$)'5*1"+'^2#-3"*%'\-'V")5$%)M4'#*1'30+"'$#%%"+$-'.5(1#*,"'9+03'%&"'>!?'N03/"%(%(0*'#*1'N00/"+#%(0*'2#*"$7

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

W*'%&()'<#)()4'%&"'+")5$%)'$00A'%"*%#%(:"$-'"*,05+#.(*.4'#%'$"#)%'%0')%(,A'%0'%&"'<+0#1'


COMPETITION WITHIN THE NHSDr. Jennifer DixonDirector, The Nuffield Trust


/0$(,-'1(+",%(0*'09'%+#:"$7'!06":"+4'%&"'5*(%'09',03/"%(%(0*'d'%&"'&0)/(%#$'0+'"$",%(:"',#+"'9#,($(%-'d'()'*0%'0/%(3#$'90+'%&"'<(.'/+(0+(%(")'09',#+(*.'90+'0$1"+'/"0/$"'#*1'%&0)"'6(%&'$0*.'%"+3',0*1(%(0*)7'!"+"'(*%".+#%"1',#+"'()'*""1"1')/#**(*.'&03"'%0'&0)/(%#$'d'<5%'%&()'()'%00'09%"*':("6"1'#)'#*%(K,03/"%(%(:"'<-'",0*03()%)'5)"1'%0'%&"0+()(*.'#<05%'

)"+(05)$-',0*)(1"+'&06',03/"%(%(0*'<"%6""*':"+%(,#$$-'(*%".+#%"1'*"%60+A)'09'/+0:(1"+)'3(.&%'<"'"*,05+#."17

J(*#$$-'#*1'+"$#%"14'#'$0%'09'&"#$%&'/0$(,-'&#)'<""*'0+("*%"1'%0'6&#%'3(.&%'<"'10*"'%0',&#$$"*."'/+0:(1"+)'9+03'6(%&05%'%0'(3/+0:"'/"+90+3#*,"'H".',03/"%(%(0*4'+".5$#%(0*4'1(+",%(:"I'#*1'*0%'0*'6&#%'%-/"'09'^(*%+#M'/+0:(1"+'"*:(+0*3"*%'3(.&%'<"',+"#%"1'%0'(*,+"#)"'/"+90+3#*,"7'J0+'"@#3/$"'5)(*.'(*90+3#%(0*4'/""+'+":("6'09'/"+90+3#*,"4'

$"#1"+)&(/4'#*1'(*:0$:(*.'/#%("*%)c,0335*(%(")'%0'/+0:(1"'%&"'^1()+5/%(:"'(**0:#%(0*M'9+03'6(%&(*7'P&()'()')5+"$-'%&"'#+"*#'+(/"'90+'1":"$0/3"*%'0:"+'%&"'*"@%'1",#1"7'89'%&"'$#)%'1",#1"'&#)'%#5.&%'5)'#*-%&(*.4',03/"%(%(0*4'+".5$#%(0*'#*1'1(+",%(:"',#*'0*$-'.0')0'9#+'d'#*1'%00'35,&'$"#1)''%0'9#($5+"7

12 13

J0$$06(*.'%&"'?/"*1(*.'V":("64'%&"+"')""3)'

95%5+"'90+'%&"'>!?'#*1'6&#%'%&"'_"/#+%3"*%'09'!"#$%&M)'/5)&'%0'(3/+0:"'/+015,%(:(%-'6($$'3"#*'90+'%&"')"+:(,"4')%#99'#*1'/#%("*%)7'?0'6&#%'#+"'%&"'9#,%)e

W*'95*1(*.4')(*,"'CDDfcb4'%&"'L*.$()&'>!?'<51."%'(*,+"#)"1'<-'*"#+$-'ESU'(*'+"#$'%"+3)7'\5%'0:"+'%&"'*"@%'905+'-"#+)'%&"'/$#**"1'+"#$'+()"'6($$'<"'D7TgU'K'0+'B5)%'D7DOTU'#'-"#+'0*'#:"+#."7'P&()')$06'106*'(*'95*1(*.'.+06%&'(*'9#,%')%#+%"1'%&()'-"#+4'6(%&'#'+"#$'+()"'09'B5)%'D7bU7'2#+%'09'%&"'>!?')"%%$"3"*%'#$)0'(*,$51")'#*'#:"+#."'#**5#$'#305*%'09'hSaD'3($$(0*'"#+3#+A"1'90+'B0(*%')/"*1(*.'<"%6""*'%&"'>!?'#*1')0,(#$',#+"7'

R&"%&"+'%&"'>!?'#,%5#$$-'+","(:")'#'+"#$'(*,+"#)"'<-'CDEgcEa'1"/"*1)'0*'%&"'#,,5+#,-'

3"#)5+"'5)"1'<-'%&"'P+"#)5+-'%0'")%(3#%"'

%&#*'6(/"'05%'%&"')3#$$'+"#$'(*,+"#)"7'F*1'6&"%&"+'>!?'/5+,&#)(*.'/06"+'(*,+"#)")'(*'

"@/"+("*,"1'<-'%&"'>!?7'P&"')%#99'/#-'9+""`"'

%&"'$#)%'%60'-"#+)'09'%&"')/"*1(*.'+":("6e'''

W:"+#$$4'1")/(%"'6&#%'6($$'<"'#*'5*/+","1"*%"1'+5*'09':"+-'$06'+"#$'.+06%&4'%&"'>!?',#*'/"+&#/)',05*%'(%)"$9'90+%5*#%"',03/#+"1'6(%&'"=5#$$-'5*/+","1"*%"1'+"#$'

,5%)'(*'30)%'0%&"+'1"/#+%3"*%)7'

\5%'%&"'>!?'6($$'*0%'<"'"@"3/%'9+03'%&"',&#$$"*."'%0'(3/+0:"'(%)'/+015,%(:(%-7'P&"'30*"%#+-':#$5"'09'3""%(*.'(*,+"#)(*.'1"3#*1'9+03'#'.+06(*.'#*1'(*,+"#)(*.$-'#."(*.'/0/5$#%(0*'#*14',+5,(#$$-4'(3/+0:(*.'%&"'=5#$(%-'09'(%)')"+:(,")'&#)'<""*':#+(05)$-'")%(3#%"1'<-'%&"'_"/#+%3"*%'09'!"#$%&'#*1'B0(*%'#*#$-)()'<-'%&"'Q(*.M)'J5*1'#*1'+")"#+,&"+)'9+03'%&"'8*)%(%5%"'90+'J(),#$'?%51(")'%0'<"'<"%6""*'ha'<($$(0*'#*1'hb'<($$(0*'#'-"#+7

P&")"'#+"'<+0#1'")%(3#%")'#*1'1"/"*1(*.'0*'1",()(0*)'#<05%4'90+'"@#3/$"4'95%5+"'/#-'+()")4'6&"%&"+'0+'*0%'%0'(*:")%'(*'95+%&"+'6#(%(*.'%(3")'+"15,%(0*)'#*1'(*9+#)%+5,%5+"'(3/+0:"3"*%)')5..")%"1'<-'?(+'_"+"A'R#*$"))'(*'&()'CDDC'+":("6'09'95%5+"'>!?'95*1(*.'*""1)4'%&"':#$5"'09'%&"'/+015,%(:(%-',&#$$"*."',05$1'<"'$"))'K'09'%&"'0+1"+'09'hT'<($$(0*'%0'ha'<($$(0*'#'-"#+7

89'%&"'/+015,%(:(%-',&#$$"*."',#*'<"'3"%4'%&"*'90+'/#%("*%)'(%'6($$'3"#*'<"%%"+')"+:(,")'#*1'30+"'09'%&"'%&(*.)'%&"-':#$5"'K'9"6"+'&0)/(%#$'(*9",%(0*)4'30+"'0/"+#%(0*)4'&(.&"+'=5#$(%-'

%&"',0)%')(1"'09'%&"'"=5#%(0*'K')#:(*.'30*"-'0+'3#A(*.',5%)'K'%&")"'#+"'*0%'(3/+0:"3"*%)'(*'/+015,%(:(%-7'V#%&"+4'(%'*""1)'90,5)'0*'%&"'

)"+:(,")'%&#%'(*,+"#)"'%&"':#$5"'09',#+"''%0'/#%("*%)7''


Professor John Appleby Chief Economist, The King’s Fund

NHS FINANCES AND PRODUCTIVITY


‘The task for the NHS is not to fixate on the cost side of the equation . . . rather, it needs to focus on the benefits side to find new ways of providing services that increase the value of care to patients’

14 15

F9%"+'%&"'+","*%'N03/+"&"*)(:"'?/"*1(*.'V":("64'0:"+#$$')/"*1(*.'0*'%&"'>!?'6($$'(*,+"#)"'<-'D7gU'(*'+"#$'%"+3)'0:"+'%&"'$(9"'09'%&()'2#+$(#3"*%7'8*'+"#$(%-'&06":"+4'%&()'()'6($$'*0%'A""/'5/'6(%&'#'.+06(*.'1"3#*1'0*')"+:(,")'#*1'#*'#."(*.'/0/5$#%(0*7'25%')(3/$-4'%&"'>!?'6($$')%($$'&#:"'%0'10'30+"'6(%&'$"))7''

P&"'>!?'60+A90+,"'&#)'%0'+")/0*1'%0'5*/+","1"*%"1',&#$$"*.")4'/#+%(,5$#+$-'%&0)"'05%$(*"1'(*'%&"'+","*%'>!?'6&(%"'/#/"+7'?5,&'#3<(%(05)',&#*.")'(*'%&"'6#-'&"#$%&,#+"'()'1"$(:"+"1'6($$'+"=5(+"'35$%(1(),(/$(*#+-')5//0+%4'(*,$51(*.'9+03'%&0)"'0*'%&"'9+0*%$(*"'09',#+"7'_")/(%"'%&()4'%&"'6&(%"'/#/"+'3"*%(0*)'^*5+)(*.M'0*$-'0*,"7''

?%#99'#+"'9#,(*.'#'%60'-"#+'/#-'9+""`"4'/"*)(0*'+"90+3)4',&#*.")'%0'6#-)'09'60+A(*.4'#*1'%&"'":"+K/+")"*%'/+0)/",%'09',5%)'(*'B0<)'#*1')"+:(,")7'P&"'V0-#$'N0$$"."'09'>5+)(*.'HVN>I'()'#6#+"'%&#%')%#99'#+"'#$+"#1-'1"#$(*.'6(%&'

<#*1(*.'09')#$#+(")7'F$$'#+"'1""/$-'5*)"%%$(*.7'8%'()*M%':"+-')5+/+()(*.4'%&"+"90+"4'%&#%'#')%51-'<-'%&"'VN>'"#+$("+'%&()'-"#+')&06"1'%&#%'%&")"'9#,%0+)'#+"',#5)(*.'&"(.&%"*"1'$":"$)'09'#*@("%-'#30*.')%#99['/#+%(,5$#+$-'+".#+1(*.''B0<')",5+(%-'#*1'%&"'#<($(%-'%0'/+0:(1"'&(.&'=5#$(%-',#+"7''

P&"'VN>'&#)')#(1',$"#+$-'%&#%'%&"'60+A90+,"'*""1)'%0'60+A'(*'*"6'#*1'(**0:#%(:"'6#-)'%0'(*,+"#)"'/+015,%(:(%-4'+"15,"'6#)%"'#*1'

!"#$%&'$()!'"*%),#3/#(.*4'6"'&#:"'<""*'#)A(*.'05+'gDD4DDD'3"3<"+)'90+'"@#3/$")'09'%&"'*5+)"K$"1'(**0:#%(0*)'%&#%'$"#1'%0'<"%%"+'#*1'30+"'

"3<+#,")'%&"'+(,&*"))'#*1'%&"'/0))(<($(%(")'09',#+"'#*1'8'605$1'5+."'%+5)%)'%0'"*.#."'30+"'+"#1($-'6(%&')%#997

P&"')5//0+%'09'*5+)(*.')%#99'()'"))"*%(#$'%0'#*-',&#*.")'(*'&"#$%&,#+"'K'")/",(#$$-'(9'%&"'60+A90+,"'()'"@/",%"1'%0',0/"'6(%&')5,&'#'

,&#*."4'%+5)%'<0#+1)'6($$'*""1'%0'<"'/+#.3#%(,'#*1'"*.#."'6(%&'%&"'60+A90+,"'#*1'6(%&''%+#1"'5*(0*)['%&"-'#+"'/#+%'09'%&"')0$5%(0*'*0%'%&"'/+0<$"37

!#:(*.'#'&"#$%&-'60+A90+,"'()':(%#$7'P&"'CDDS'\00+3#*'V"/0+%4'>!?'!"#$%&'#*1'R"$$K<"(*.4'"3/&#)()"1'%&"'(3/0+%#*,"'09')%#99'#,&(":(*.'/&-)(,#$4'3"*%#$4'#*1')0,(#$'&"#$%&7'F)'%&"'+"/0+%'05%$(*"14'%&"'>!?',05$1'+"15,"'(%)'+#%")'09')%#99')(,A*"))'#<)"*,"'<-'#'%&(+1'#*14'(*')0'10(*.4',+"#%"'#*'#11(%(0*#$'T7g'3($$(0*'#:#($#<$"'60+A(*.'1#-)4')#:(*.'#*'")%(3#%"1'haaa'3($$(0*'/"+'-"#+7'P&"'":(1"*,"'09'#'$(*A'<"%6""*')%#99'6"$$K<"(*.'#*1'/#%("*%'"@/"+("*,"'()'*0%'0*$-',+"1(<$"4'<5%'/+0:"*7

P&"'60+A90+,"'*""1)'%0'<"'&"#$%&-4'

%(3")4'<0%&'*06'#*1'#&"#14'%&")"'#+"'%&"'0*$-'6#-)'%&#%'=5#$(%-'/#%("*%',#+"4'#*1'<-'


THE NHS WORKFORCEDr Peter Carter Chief Executive, Royal College of Nursing


‘The workforce needs to be healthy, empowered and innovative. In the difficult times, both now and ahead, these are the only ways that quality patient care, and by extension good nursing practice, will flourish’

16 17

!"#$%&'6($$'$003'$#+."'(*'%&()'2#+$(#3"*%'#*1'35,&'%(3"'6($$'<"')/"*%'0*'%&"'G0:"+*3"*%M)'95*1(*.'#*1'+"90+3'/$#*)'90+'%&"'>!?'(*'L*.$#*17'>#%(0*#$'Y0(,")'()'%&"',0#$(%(0*'09'*#%(0*#$':0$5*%#+-'0+.#*()#%(0*)'/+030%(*.'

05+'3"3<"+)'%&"+"'()'#$)0'#'6(1"+'#."*1#Z'/"+)()%"*%'&"#$%&'(*"=5#$(%(")['%&"'&"#$%&'(3/#,%)'09'#5)%"+(%-['#*1'":"+K+()(*.'1"3#*1)'90+',#+"7'W5+',&#$$"*."'%0'/#+$(#3"*%#+(#*)'(*'

3#(*%#(*'#'90,5)'0*'%&"'*""1)'09'(*1(:(15#$)'#*1',0335*(%(")4'/#+%(,5$#+$-'%&"'30)%':5$*"+#<$"7'R&#%'10")'%&()'3"#*'(*'/+#,%(,"e

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

?",0*1$-4'/"0/$"'*""1'&"$/'%0'$00A'#9%"+'%&"3)"$:")'<"%%"+7'2"0/$"'6#*%'%0'<"'(*',0*%+0$4'-"%'3#*-'09'5)4'(*,$51(*.'%&"'

.+06(*.'*53<"+)'09'/"0/$"'6(%&'$0*.'%"+3',0*1(%(0*)'#*1'1()#<($(%(")4'&#:"'30+"',0*%#,%'6(%&'&"#$%&')"+:(,")'%&#*'6"'6#*%'0+'*""14'#*1')/"*1'%00'35,&'%(3"'(*'&0)/(%#$7'P&"'%+#1(%(0*#$'3"1(,#$'301"$'09',#+"'K'&(.&$-'/#(1'"@/"+%)'10(*.'30+"'#*1'30+"'%&(*.)'%0'/#))(:"'+",(/("*%)'d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

P&(+1$-4'6"'*""1'%0'."%'+"#$'#<05%'/#%("*%'#*1'/5<$(,'(*:0$:"3"*%'(*')"+:(,"'1",()(0*)7'P&"'(3/0+%#*,"'09'(*:0$:(*.'/"0/$"'()'."*"+#$$-'#,,"/%"14'<5%'/+#,%(,"'()'%00'09%"*'90+35$#(,'#*1'%0A"*()%(,Z'=5")%(0**#(+")''+#%&"+'%&#*',0$$#<0+#%(0*)7'P&"':"+-'#,+0*-3'i228j'K'6&(,&'3#A")'3"'6(*,"'K'()'(*1(,#%(:"'09'%&()'3(*1)"%7'R"'A*06'%&#%'1",()(0*)'3#1"'(*'/#+%*"+)&(/'<"%6""*')"+:(,"'/+0:(1"+)'#*1',(%(`"*)'#+"'30+"'$(A"$-'%0'<"'%&"'+(.&%'1",()(0*)'#*1'30+"'

3#A"'#'+"#$(%-'09'%&#%'/#+%*"+)&(/'#//+0#,&'*""1)'1(99"+"*%'<"&#:(05+)'#*1'#%%(%51")7'8%'3"#*)4'90+'"@#3/$"4'10,%0+)',0#,&(*.'+#%&"+'%&#*'(*)%+5,%(*.7'F%'%&"',0$$",%(:"'$":"$'(%'


PATIENT EXPERIENCEJeremy Taylor Chief Executive, National Voices


3"#*)',033())(0*(*.'<",03(*.'9#+'30+"'1"30,+#%(,4'#*1'/5<$(,')"+:#*%)'+"#,&(*.'05%'%0'"@,$51"1',0335*(%(")7

V#1(,#$'+"90+3'09')"+:(,")'#%'#'%(3"'09'#5)%"+(%-'+()A)',+"#%(*.'#'/"+9",%')%0+37'8%'6($$'#$)0'."*"+#%"'0//0+%5*(%(")'90+'10(*.'%&(*.)'<"%%"+7'8'&0/"'%&#%'/#+$(#3"*%#+(#*)'6($$')"(`"'%&"(+'0//0+%5*(%(")'%0')",5+"'#'<"%%"+'1"#$'90+'/#%("*%)4',#+"+)4'9#3($(")'#*1',(%(`"*)7

18 19

F)'#'/+#,%()(*.'G2'60+A(*.'(*'#'<5)-'(**"+',(%-'#+"#4'8'60+A'#%'%&"'&"#+%'09'#',0335*(%-4'/+0:(1(*.'$(9"$0*.',#+"'%0'05+'/#%("*%)'#*1'%&"(+'9#3($(")7'\5%'%&"'/5<$(,M)'&"#$%&'()'":"+-<01-M)'<5)(*"))4'*0%'B5)%'&"#$%&,#+"'/+09"))(0*#$)M7'

&"#$%&'(*"=5#$(%(")4'#*1'#)'2+09"))0+'?(+';(,&#$';#+30%')#(1'(*'J#(+'?0,("%-4'!"#$%&-'](:")Z'iP&"+"'()'#')0,(#$'.+#1("*%'(*'&"#$%&'d'%&"'$06"+'#'/"+)0*M)')0,(#$'/0)(%(0*4'%&"'60+)"'&()'0+'&"+'&"#$%&7'F,%(0*')&05$1'90,5)'0*'+"15,(*.'%&"'.+#1("*%'(*'&"#$%&j'#*1'(*'/#+%(,5$#+'90,5)'0*')(@'0<B",%(:")Z'

%0'3#@(3()"'%&"(+',#/#<($(%(")'#*1'&#:"',0*%+0$'0:"+'%&"(+'$(:")

'60+A'90+'#$$

/$#,")'#*1',0335*(%(")'

&"#$%&'/+":"*%(0*'

$(*"'<"%6""*'/+030%(*.'.001'&"#$%&'#*1'#'*#**-')%#%"'%&#%'%"$$)'/"0/$"'&06'%0'$(:"'%&"(+'$(:")7'F%'%&"'&"#+%'09'%&"'#."*1#')&05$1'<"'%&"'/+(*,(/$"'%&#%'/+":"*%(0*'()'<"%%"+'%&#*',5+"'#*1'%&"'*""1'90+'#'$".(%(3#%"'/5<$(,'&"#$%&'

)"+:(,"'%&#%'"@()%)'*0%'B5)%'%0'/#%,&'/"0/$"'5/'6&"*'%&"-'#+"'($$'<5%'%&#%'/+":"*%)'%&"3'9+03'

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d'%&"'&"#$%&'(*"=5#$(%(")'.#/'/"+&#/)'#<0:"'#$$'0%&"+)'d'#*1'(%'()'#*'0//0+%5*(%-'%00'(3/0+%#*%''%0'6#)%"7'P&"'/5<$(,'&"#$%&'()'":"+-<01-M)'&"#$%&4'

*53<"+'09'/"0/$"'6&0'#+"'."*"+#$$-')0,(#$$-'"@,$51"17'P&")"'(*,$51"'%&"'&03"$"))4')%+""%')"@'60+A"+)4'#)-$53')""A"+)'#*1'


PUBLIC HEALTHProfessor Steve Field Former Chair, Royal College of General Practitioners

%&"+"'&#)'<""*'#'90,5)'0*'%+"#%(*.'&#+34'+#%&"+'%&#*'/+":"*%(*.'(%4'<5%'":(1"*,"')&06)'%&#%'/#+%*"+)&(/'d''<"%6""*'/+(3#+-',#+"4'$0,#$'#5%&0+(%-'#*1'%&(+1')",%0+'d'%0'1"$(:"+'5*(:"+)#$'#*1'%#+."%)'/+":"*%#%(:"'

P&()'#."*1#'()',#$$"1'8*,$5)(0*'!"#$%&7'P&"'6&0$"'/0/5$#%(0*M)'&"#$%&'35)%'<",03"'#)'<(.'#'/+(0+(%-'90+';2)'#)'(%'()'90+'G2)7'R"'35)%'#$$'60+A'%0."%&"+'%0'%+#*)90+3'%&"')%#%"'09'%&"'*#%(0*M)'&"#$%&'90+'%&"'<"%%"+7'P&"')%#A")'#+"'%00'&(.&'(9'6"'."%'(%'6+0*.7


20 21

P&"'9#,%)'#$30)%')/"#A'90+'%&"3)"$:")7'W:"+'%&"'*"@%'Ea'-"#+)'%&"'*53<"+'09'/"0/$"'#."1'0:"+'Oa'6($$'105<$"7'R(%&(*'CD'-"#+)')03"'E7b'3($$(0*'30+"'/"0/$"'H0$1"+'/"0/$"'#*1'1()#<$"1'60+A(*.'#."'#15$%)I'6($$'&#:"'#'/0%"*%(#$',#+"'*""1'%&#*'10'%01#-7'8*'%&"'/"+(01'09'%&"')/"*1(*.'+":("6'TbD4DDD'30+"'/"0/$"'6($$'+"=5(+"',#+"'#*1')5//0+%7

?0,(#$',#+"'/+0:(1"1'%&+05.&',05*,($)'()')5//0+%(*.'E7b'3($$(0*'/"0/$"'<5%'(*,+"#)(*.$-'/"0/$"'#+"'&#:(*.'%0'95*1'%&"(+'06*',#+"',0)%)7'F15$%')0,(#$',#+"')/"*1'0*'0$1"+'/"0/$"'()'#+05*1'hO<*'<5%'()'0*$-'#')3#$$',03/0*"*%'09'/5<$(,'"@/"*1(%5+"'0*'0:"+'faM)4'6&"+"')0,(#$'

#305*%'%0'hOT<*'#*1'>!?')/"*1'%0'haD<*7

P&"',&#$$"*."'()'&06'6"'(*,+"#)"'%&"'$":"$'09'+")05+,"'(*%0'%&"',#+"'#*1')5//0+%'/0%7'F*1+"6'_($*0%M)'N033())(0*'0*'N#+"'J5*1(*.'6($$'*""1'%0',03"'90+6#+1'6(%&'#',$"#+'0/%(0*'90+'#')5)%#(*#<$"4'


SOCIAL CARERichard Jones President, Association of Directors of Adult Social Services

+")($("*%'#*1'9#(+')"%%$"3"*%7'8%'6($$'*""1'%0'<"'#')"%%$"3"*%'%&#%'+",0.*()")'%&"'$":"$'09'(*90+3#$')5//0+%4'")%(3#%"1'#%'#':#$5"'

#*1'&"$/)'%&"'/5<$(,'5*1"+)%#*1'%&#%'#'/#+%*"+)&(/'#//+0#,&'6($$'<"'*""1"1'<"%6""*'(*1(:(15#$)c9#3($(")'#*1'%&"')%#%"'#)'6"'30:"'90+6#+17'R"'*""1'/"0/$"'%0'5*1"+)%#*1'%&#%'%&"-'&#:"'#'EZg',&#*,"'09'+","(:(*.'+")(1"*%(#$',#+"'(*'%&"(+'$#%"+'-"#+)'#*1'#'faU'+()A'09'+","(:(*.',0335*(%-'<#)"1')5//0+%'6(%&'#'&5."',0)%)'60+A(*.'05%'#%'hgD4gDD'90+'603"*'#*1'hCC4TDD'90+'3"*7

P&"',&#$$"*."'90+')0,(#$',#+"'(*'%&"')&0+%'%0'3"1(53'%"+3'()'#<05%'<5($1(*.'#'+"90+3'#."*1#'<#)"1'0*'T'A"-'/+(*,(/$")7

/"+)0*#$'<51."%)'K'<-'%&"'"*1'09';#+,&'CDEE4'TDD4DDD'/"0/$"'6($$'&#:"'30+"',0*%+0$'09'%&"(+',#+"'#*1')5//0+%'%&+05.&'#'/"+)0*#$'<51."%7'R"'6#*%'%0')""'/"0/$"'(*,+"#)(*.$-'/00$(*.'%&"(+'06*'+")05+,")'6(%&'/5<$(,'95*1(*.'%0'1":"$0/'1(99"+"*%'#*1'

%&"(+')%+"*.%&)'#*1'60+A(*.'%&"3'#)'#,%(:"',(%(`"*)7'8*'0+1"+'%0'#,&(":"'/"+)0*#$()#%(0*'6"'*""1'%0')""'#',#+"'#*1')5//0+%'3#+A"%'6&(,&'()'1(:"+)"'#*1':(<+#*%'6(%&'*"6'"*%+#*%)'099"+(*.'1(99"+"*%')"+:(,")7

#*1')0,(#$',#+"'()'*""1"1'%0'A""/'/"0/$"'(*1"/"*1"*%'#*1'+")/0*)(<$"'90+'%&"3)"$:")7'R"'A*06'(*:")%3"*%'(*'.001'(*90+3#%(0*'#*1'#1:(,"'()',+5,(#$'%0'&"$/'/"0/$"'3#A"'.001'1",()(0*)7'L#+$-'(*%"+:"*%(0*4',+()()')5//0+%')"+:(,")4'%"$",#+"'#*1'%&"'6(1"+'5)"'09'8P4'"*1'09'$(9"')"+:(,")4'.001')5//0+%'90+'1"3"*%(#'/#%("*%)'#*1'&03"'<#)"1'&"#$%&,#+"',#*'#$$'&"$/'%0'(3/+0:"'05%,03")'#*1')#:"'30*"-'(*'#,5%"'(*%"+:"*%(0*)7

09'<51."%)'#*1',033())(0*(*.'%06#+1)',0335*(%-'<#)"1'(*%"+:"*%(0*)4'(3/+0:"1'05%,03")'90+'/"0/$"'#*1'+"15,"1'15/$(,#%(0*'09':()(%)7'R"'*""1'%0'<5($1'1(99"+"*%'/#+%*"+)&(/)'6&(,&'#+"'#$(.*"1'%0')",5+"')&#+"1'.0#$)'#*1'5*1"+)%#*1'%&"'(*%"+1"/"*1"*,-'09'&"#$%&'#*1')0,(#$',#+"7'

/+015,%(:(%-'.#(*)'%&+05.&'#'3#B0+'/+0.+#33"'09'+"90+37';0+"'09'%&"')#3"'60*M%'60+A7


22 23

P&"'N#+"'k5#$(%-'N033())(0*'HNkNI'6#)'")%#<$()&"1'(*'F/+($'CDDS7'8%'6#)'90+3"1'9+03'%&+""'/+"1","))0+'0+.#*()#%(0*)Z'%&"'!"#$%&,#+"'N033())(0*4'%&"'N033())(0*'90+'?0,(#$'N#+"'8*)/",%(0*4'#*1'%&"';"*%#$'!"#$%&'F,%'N033())(0*7'NkN'&#)'<5($%'0*'%&"'"@/"+%()"'09'%&0)"'0+.#*()#%(0*)'<5%'0/"+#%")'6(%&(*'#'1(99"+"*%'$".()$#%(:"'9+#3"60+A'H!"#$%&'#*1'?0,(#$'N#+"'F,%'CDDOI7'W5+'"3/&#)()'()'0*'05%,03")'90+'/"0/$"4'"*)5+(*.'%&#%'6&#%":"+'%&"')"+:(,"'()4'(%'90,5)")'0*'%&"'(*1(:(15#$'#*1'()'+")/0*)(:"'%0'"#,&'/"+)0*M)'/#+%(,5$#+',(+,53)%#*,")7''

,$(*(,#$'(*%"+:"*%(0*)'0+',#+"'#*1'#*'"@/"+("*,"'%&#%'%&"'(*1(:(15#$':#$5")'<",#5)"'(%'"*&#*,")'%&"(+'."*"+#$'6"$$<"(*.7'R"'&#:"'Ef'"))"*%(#$')%#*1#+1)'09'=5#$(%-'#*1')#9"%-'6(%&(*'#')(*.$"'9+#3"60+A'%&#%'#//$(")'%0'#$$')"+:(,")'6"'+".5$#%"7

R"'30*(%0+',03/$(#*,"'#.#(*)%'%&")"')%#*1#+1)'5)(*.'#',03<(*#%(0*'09'9""1<#,A'9+03'/"0/$"'6&0'5)"')"+:(,")4'%&"(+'9#3($(")'#*1',#+"+)4')%#99'(*'&0)/(%#$)'#*1',#+"'&03")4'#*1'0%&"+'$0,#$'.+05/)'H(*,$51(*.']0,#$'8*:0$:"3"*%'>"%60+A)'H]8>A)I'#*1'%&"':0$5*%#+-')",%0+I7'R"'#$)0'$00A'#%'1#%#'%0')""'(9'6"',#*'(1"*%(9-'60++-(*.'/#%%"+*)7'89',0*,"+*)'"3"+."'NkN'()'"3/06"+"1'%0'%#A"'#,%(0*'%0'+"=5(+"'(3/+0:"3"*%'#*1'(9'*","))#+-',#*'#//$-'+")%+(,%(:"',0*1(%(0*)'%0'+"15,"'%&"'+()A'09'&#+3'%0'/"0/$"7'8*'"@%+"3"')(%5#%(0*)4'%&()',#*'$"#1'%0')"+:(,"',$0)5+"7

,&#$$"*."'%0',033())(0*"+)'#*1'/+0:(1"+)4'6&0'*""1'%0'"*)5+"'%&"-'3#(*%#(*'=5#$(%-'(*'

,5%)7'8*'#11(%(0*4'%&"'%+#*)(%(0*'/"+(01'09',&#*."'6(%&(*'%&"'>!?'6($$'/0%"*%(#$$-'$"#1'%0'#'$#,A'09'90,5)'0*'=5#$(%-['3#*-'09'%&"'>!?M'^"#+$-'6#+*(*.')-)%"3)M'#+"'<"(*.'1()3#*%$"1'#*1'+"90+3"1'd')%+#%".(,'&"#%$%&'#5%&0+(%(")'#*1'/+(3#+-',#+"'%+5)%)'&#:"'#*'(3/0+%#*%'+0$"'(*'%#,A$(*.'/00+'=5#$(%-',#+"'#*1'%&"(+'3#*%$"'*""1)'%0'<"'/(,A"1'5/7''P&"'+".5$#%0+'6($$'/$#-'(%)'/#+%'<5%'":"+-0*"'60+A(*.'(*'%&"')",%0+'*""1)'%0'<"':(.($#*%'#*1'<"'/+"/#+"1'%0'=5")%(0*'#*1',&#$$"*."'(9'%&"-')""'/00+'/+#,%(,"7

R"'#+"'<".(**(*.'%0'1"%",%'#'*""1'%0'10'%&(*.)'1(99"+"*%$-'(*'0+1"+'%0'3""%'%&"',&#$$"*.")'

(**0:#%(0*'#*1'6"'#+"'1(),5))(*.'%&")"'())5")'6(%&'/+0:(1"+)'#*1',033())(0*"+)7

()'0*"'6#-')#:(*.)'3#-'<"'#,&(":"1'%0'/+0%",%'9+0*%K$(*"')"+:(,")7'!"+"90+1)&(+"',05*,($'/$#*)'%0'90+3'#'B0(*%':"*%5+"'0+.#*()#%(0*'(*'F/+($'CDEE'6(%&'>!?'!"+"90+1)&(+"'#*1'!"+"90+1'!0)/(%#$)'P+5)%7'\-')&#+(*.'#*1'

6&(,&'6($$'<"'+"(*:")%"1'(*'"))"*%(#$')"+:(,")7


QUALITYDame Jo Williams Chair, Care Quality Commission

R")%3(*)%"+4'!#33"+)3(%&'l'J5$&#34'#*1'Q"*)(*.%0*'l'N&"$)"#',05*,($)'(*%"*1'%0'.0'":"*'95+%&"+4'6(%&'/$#*)'%0')&#+"'":"+-',05*,($')"+:(,"'<"%6""*'%&"3''%0'1"$(:"+'30+"'90+'$"))''6&($"'/+0%",%(*.'9+0*%K$(*"''/5<$(,')"+:(,")7

J0+'/"0/$"'5)(*.')"+:(,")4'(%'()'"))"*%(#$'90+'%&"'+(.&%'(*90+3#%(0*'%0'<"'#:#($#<$"'(*'#*'#,,"))(<$"'90+3#%'%0'(*90+3'%&"(+',&0(,")7'2"0/$"'35)%'#$)0'<"'(*:0$:"1'(*'1",()(0*)'#<05%'%&"(+',#+"4'(*'$(*"'6(%&'%&"'!"#$%&'?",+"%#+-M)'/$"1."'094'^*0'1",()(0*'#<05%'5)4'6(%&05%'5)M7'P&()'&#)'#'&5."'(3/#,%'0*'%&"'=5#$(%-'09'/"0/$"M)'"@/"+("*,"7'F'^10'6(%&M'+#%&"+'%&#*'#'^10'%0M'#%%(%51"'35)%'/+":#($'#30*.)%',#+"'/+09"))(0*#$)7

k5#$(%-',#*'<"'"*&#*,"1'%&+05.&'#'90,5)'0*'/+":"*%(0*4'."%%(*.'(%'+(.&%'

&0)/(%#$'+"K#13())(0*)7'8*:")%3"*%'(*'%&"'+(.&%'+"#<$"3"*%')"+:(,")'()'30*"-'6"$$')/"*%'(9'(%'"*)5+")'/"0/$"'&#:"'#//+0/+(#%"'#*1'%(3"$-')5//0+%'%0'+",5/"+#%"'(*'%&"(+'06*'&03")7'P&"'$#,A'09')5,&')5//0+%'()'$(A"$-'%0'$"#1'%0'&(.&"+',0)%)'#*1'/00+"+'$0*.'%"+3'05%,03")7


24 25

P&"'>!?'()'*":"+'9#+'9+03'%&"'%&05.&%)'09'/0$(%(,(#*)'#%'R")%3(*)%"+7'P&()')"))(0*'()'*0'"@,"/%(0*'#)'6"'#6#(%'%&"'>!?'\($$'6&(,&'6($$'(3/$"3"*%'F*1+"6']#*)$"-M)'+"90+3)7

P&"'(*%"*1"1'05%,03")'09'%&"'6&(%"'/#/"+'#+"'

/#%("*%',"*%+"1')"+:(,"4'30+"',0*%+0$'0:"+'05+'06*'%+"#%3"*%'#*1',&0(,"'09'10,%0+7'8%'6#)'#')%+0*.'%&"3"'09']#<05+M)'#//+0#,&'%0'%&"'>!?7

8*%"+")%(*.$-4'%&"'+")/0*)"'09'%&"'>!?'#*1'/#%("*%)'0+.#*()#%(0*)'%0'%&"'G0:"+*3"*%M)'/$#*)'&#)'<""*'/+"%%-'5*"*%&5)(#)%(,7'N0*,"+*)'0:"+'5*(*%"*1"1',0*)"=5"*,")''#*1'%&"'/0%"*%(#$'1"K)%#<($()#%(0*'09'%&"'?"+:(,"'&#:"'<""*'#',0*)()%"*%'%&"3"'09''%&"(+'+"/+")"*%#%(0*)7

P&"'A"-'9"#%5+"'()'%&"'#<0$(%(0*'09'/+(3#+-',#+"'%+5)%)'#*1')%+#%".(,'&"#$%&'#5%&0+(%(")'#*1'%&"',+"#%(0*'09'G2',0*)0+%(#'%0',033())(0*'hSD'<($$(0*'60+%&'09'&"#$%&',#+"'9+03'/+0:(1"+)7'!0)/(%#$)'6($$'0/"+#%"'(*'#'35,&'30+"',03/"%(%(:"'3#+A"%'5*1"+'%&"'3#*%+#'^#*-'6($$(*.'/+0:(1"+M7'F*%(K,03/"%(%(:"'/+#,%(,")'<-'/+0:(1"+)'6($$'<"'/0$(,"1'<-'#*'",0*03(,'+".5$#%0+'$(A"'WJGL;7

?0'6&-'()'%&"'?",+"%#+-'09'?%#%"')0'6($$(*.'%0'"*%"+%#(*')5,&'#*'5/&"#:#$e'J+03':#+(05)',033"*%)'&"'&#)'3#1"'%0'/#+$(#3"*%#+(#*)4'(%'()')%+(A(*.'%&"'"3/&#)()'&"'/$#,")'0*'%&"'

F)'&"')"")'(%4'/#%("*%)'3#A"'1"3#*1)'6&(,&',$(*(,(#*)'#+"'&#//-'%0'+")/0*1'%0'<",#5)"'%&"',0)%)'6($$'<"'3"%'<-')03"0*"'"$)"7'!"'3#A")'%&"'/0(*%'%&#%'G2)'(*,5+'30)%'09'%&"'"@/"*1(%5+"'09'%&"'>!?'(*'%"+3)'0+'/+"),+(<(*.'#*1'+"9"++#$)4'<5%'10*M%'&#:"'%&"'+")/0*)(<($(%-'90+')""(*.'&06'%&"'3#*#."3"*%'09',#+"'()'<")%'+",0*,($"1'6(%&'%&"'3#*#."3"*%'09'+")05+,")7

F/#+%'9+03'%&"'=5")%(0*'09'6&"%&"+'G2)',0$$",%(:"$-'6#*%'%0'%#A"'0*'%&"'+")/0*)(<($(%-'09',033())(0*(*.4'(%M)'#'300%'/0(*%'#)'%0'6&"%&"+'%&"-'+"#$$-'6($$'<"'/+"/#+"1'%0'/0$(,"'9"$$06'10,%0+)'6&0'#+"'5*#<$"'%0',0*%+0$'1"3#*1)'0*')"+:(,")7

W9'30+"'(33"1(#%"',0*,"+*4'()'6&"%&"+'%&"'>!?',#*'6(%&)%#*1'%&"'1()+5/%(0*',#5)"1'<-'%&"')"%%(*.'5/'09'#',03/$"%"$-'*"6')-)%"34'6&"*'%&"',5++"*%'3#*#."3"*%'<01(")'#+"'0*'%&"'6#-'05%'#*1'95*1(*.'/+"))5+")'#+"'+()(*.e

P&"'>!?'3#-'&#:"'#'+(*.K9"*,"1'<51."%4'<5%'

(*'%&"'*"@%'9"6'-"#+)7'W*'%0/'09'%&#%4'%&"-'6($$'&#:"'%0',03/"*)#%"'$0,#$'#5%&0+(%(")'90+'#15$%'

$0,#$'.0:"+*3"*%'()'%#A(*.7

F*0%&"+'60++-'()'%&"'/0%"*%(#$'+"%5+*'09'/0)%K,01"'/+"),+(<(*.'6(%&'%&"'1",()(0*'%0'+"30:"'%&"'3#*1#%0+-'*#%5+"'09'>8NLM)'.5(1#*,"7'G2)'6($$'."%'30+"'1(),+"%(0*'(*'/+"),+(<(*.'<5%'(*":(%#<$-'%&"-'6($$',03"'5*1"+'%+"3"*105)'


REFLECTIONSLord Hunt of Kings Heath APHG Parliamentary Officer


/+"))5+"'%0'95*1'1+5.)'6&(,&'>8NL'6($$'&#:"'+5$"1'#.#(*)%'0*',0)%K"99",%(:"*"))'%"+3)7

F*0%&"+'=5")%(0*'6($$'<"'%&"'+0$"'09';(*()%"+)7';+']#*)$"-'()'A""*'%0')%"/'<#,A'#*1'&#*1'0:"+'%&"'30*"-'#*1',033())(0*(*.'+")/0*)(<($(%-'%0'#'*"6'>!?'N033())(0*(*.'\0#+17'\5%',#*';(*()%"+)'#<)0$:"'%&"3)"$:")'9+03'+")/0*)(<($(%-e'89'%&(*.)'.0'6+0*.4'(%'()'(*":(%#<$"'%&#%';2)'6($$'6#*%'#*)6"+)'9+03'%&"'?",+"%#+-'09'?%#%"'+#%&"+'%&#*')03"'+"30%"'=5#*.07

F$$'(*'#$$4'%&"'>!?'6($$'/+0:0A"'"*1$"))'1"<#%"'#*1'#*#$-)()'(*'6&(,&';2)'#*1'2""+)'6($$'/$#-'#'95$$'/#+%7

26 27

!06":"+4'%&"+"'#$)0'*""1)'%0'<"'#'.+"#%'1"#$'09'%&05.&%'.(:"*'%0'60+A(*.'6(%&')/",(#$()%)'#*1'0%&"+)'%0'"*)5+"'(*%".+#%"1')"+:(,")'90+'/#%("*%)4'/#+%(,5$#+$-'(*'%&"',0*%"@%'09'#*'#."(*.'/0/5$#%(0*'#*1'%&"'.+06(*.'(3/0+%#*,"'09',0335*(%-')"+:(,")7

P&(+1$-4'35,&'.+"#%"+'#*1'30+"'"#)($-'#,,"))(<$"'(*90+3#%(0*'90+'/#%("*%)'35)%'<"'/+0:(1"1'%0'"*#<$"'/#%("*%)'%0'&#:"'."*5(*"',&0(,"'<0%&'#<05%'6&"+"'%&"-'+","(:"'%&"(+'%+"#%3"*%'#*1'#<05%'6&#%'%-/"'09'%+"#%3"*%'%&"-'."%'90+'%&"(+'(*1(:(15#$'#($3"*%)7'P&")"'1",()(0*)')&05$1'<"'<#)"1'5/0*'#*'5*1"+)%#*1(*.'09'%&"'/0%"*%(#$'05%,03")'09'#'/#%("*%M)',&0(,"7

8')""'*0'+"#)0*'6&-'(*'#*'^#*-'6($$(*.'/+0:(1"+M')"+:(,"4'(*90+3#%(0*')&05$1'*0%'<"',03/#+#<$"7'P&()'6($$'*0%'0*$-'1+(:"'05%,03")'<5%'#$)0')%#*1#+1)'09')#9"%-'#*1'=5#$(%-'09',#+"'#)'/5<$(,#$$-'#,,"))(<$"'(*90+3#%(0*'+#%,&"%)')%#*1#+1)'5/6#+1)'(*'#':(+%505)',-,$"7

J05+%&$-4'8'605$1'$(A"'%0')""'.+"#%"+'5*1"+)%#*1(*.4')5//0+%'90+'#*1'(**0:#%(0*'(*'/5<$(,'&"#$%&'#*1'/+":"*%(0*4'%&()'#$$'(3/0+%#*%'#*1'%00'09%"*')(1"$(*"1'/#+%'09'&"#$%&,#+"7'8*1"/"*1"*%')",%0+'0+.#*()#%(0*)')&05$1'<"'(*,"*%(:()"1'%0'1"$(:"+'(3/+0:"1'/5<$(,'&"#$%&'(*'%#+."%"1'#+"#)'/#+%(,5$#+$-'6&"+"'&"#$%&'(*"=5#$(%(")'#+"'6(1"7';5,&'.+"#%"+'5)"'09'3#//(*.'#*1'#*#$-%(,)')&05$1'<"'/5%'(*'/$#,"'%0'%#+."%'+")05+,")'%0'1"$(:"+'%&"'3#@(353'(3/#,%7

J(*#$$-4'%&"'90,5)'35)%'<"'0*'(3/+0:"3"*%'(*'&"#$%&'05%,03")'#*1'/#%("*%M)'"@/"+("*,")7'R"'35)%'30:"'#6#-'9+03'#+.53"*%)'#<05%'%&"'1"$(:"+-'3",&#*()3)'#*1'90,5)'0*'=5#$(%-'09',#+"7

P&"'>#%(0*#$'!"#$%&'?"+:(,"'()'+(.&%$-'#'A"-'/+(0+(%-'90+'%&"'N0#$(%(0*'G0:"+*3"*%7'W5+'&"#$%&'05%,03")'#+"')%($$'/00+'6&"*',03/#+"1'%0'0%&"+'1":"$0/(*.',05*%+(")'6&"%&"+'(%'<"',#*,"+')5+:(:#$'+#%")4')%+0A"'30+%#$(%-'0+',#+1(0K:#),5$#+'05%,03")7

R&($)%'+"%#(*(*.'#')"+:(,"'6&(,&'()'%#@/#-"+'95*1"1'#*1'9+""'#%'%&"'/0(*%'09'1"$(:"+-4'%&"'G0:"+*3"*%'*""1)'%0'+"90,5)'>!?'+")05+,")'%0'9+0*%$(*"'/#%("*%',#+"'#*1'/5%',$(*(,(#*)'#%'%&"'&"#+%'09'%&"'>!?'6&($)%')&(9%(*.'%&"'"3/&#)()'09'%&"'>!?'#*1',0*,"*%+#%(*.'0*'3#A(*.'%&"'/#%("*%4'%&"'5)"+'09'%&"')"+:(,"4',"*%+#$'%0'":"+-%&(*.'%&#%'&#//"*)'6(%&(*'%&"')"+:(,"7

J(+)%$-4'%&()'+"=5(+")'#'+"$"*%$"))'90,5)'0*'05%,03")'*0%'/+0,"))")7'N$(*(,#$$-'":(1"*,"'<#)"1'05%,03")')&05$1'1+(:"'1",()(0*'3#A(*.'(*'%&"'/$#**(*.4'3#*#."3"*%'#*1'#$$0,#%(0*'09':#$5#<$"'+")05+,")7'P&()'6($$'3#A"'()'"#)("+'%0',03/#+"'#*1',0*%+#)%'/+0:(1"+'/"+90+3#*,"'#*1'(*90+3'."*5(*"''/#%("*%',&0(,"7

?",0*1$-4'%&"+"'*""1)'%0'<"'#',03/$"%"',&#*."'(*',033())(0*(*.'6(%&'G2)'$"#1(*.'%&"'/5+,&#)"'09')"+:(,")'0*'<"&#$9'09'%&"(+'/#%("*%)7'G(:(*.',$(*(,(#*)'6&0'5*1"+)%#*1'%&"'/#%("*%'<")%'#'.+"#%"+'+")/0*)(<($(%-'90+'<51."%)'&#)'%0'<"',0++",%7'


REFLECTIONSMark Simmonds MP APHG Parliamentary Officer


‘ ...the Government needs to refocus NHS resources to frontline patient care and put clinicians at the heart of the NHS whilst shifting the emphasis of the NHS and concentrating on making the patient central to everything that happens within the service.’

28 29

P&"'F))0,(#%"'2#+$(#3"*%#+-'!"#$%&'G+05/'HF2!GI'()'#*'#$$K/#+%-'/#+$(#3"*%#+-')5<B",%'.+05/'1"1(,#%"1'%0'1())"3(*#%(*.'A*06$"1."4'."*"+#%(*.'1"<#%"'#*1'9#,($(%#%(*.'"*.#."3"*%'6(%&'&"#$%&'())5")'#30*.)%';"3<"+)'09'2#+$(#3"*%7'P&"'F2!G',03/+()")'/#+$(#3"*%#+(#*)'09'#$$'/0$(%(,#$'/#+%(")'#*1'<0%&'!05)")4'/+0:(1")'(*90+3#%(0*'6(%&'<#$#*,"'#*1'(3/#+%(#$(%-'#*1'90,5)")'0*'$0,#$'#)'6"$$'#)'*#%(0*#$'&"#$%&'())5")7

P&"'F2!G'6#)'$#5*,&"1'(*'>0:"3<"+'CDDE4'0*'%&"'<#)()'%&#%';"3<"+)'09'2#+$(#3"*%'*""1'#)'35,&'&(.&'=5#$(%-'#*1'(3/#+%(#$'

+0$"'(*'%&"'XQM)'&"#$%&'/+0.+#33"7'R(%&'%&"'

9+03'<0%&'!05)")'09'2#+$(#3"*%4'%&"'>!?'#*1'%&"'/5<$(,4'/+(:#%"'#*1':0$5*%#+-')",%0+)4'6"'#(3'%0'/+0:(1"'%&()'#*1'95+%&"+'"*,05+#."''%&()'(*:0$:"3"*%7

R"'(*90+3'#*1'"*.#."'/#+$(#3"*%#+(#*)'%&+05.&'%60'3#B0+'#:"*5")Z'

,0*9"+"*,")'5*1"+'N&#%&#3'!05)"'V5$"'#11+"))(*.'#*1'/+0:(1(*.'(*90+3#%(0*'0*'%&"'3#B0+'1":"$0/3"*%)'(*'&"#$%&'#*1'%&"'&"#$%&')"+:(,"

+")05+,")4'(*,$51(*.'#'5*(=5"')(%"'%&#%',03/#+")'$0,#$'&0)/(%#$'%+5)%'/"+90+3#*,"'0*'#',0*)%(%5"*,-'<-',0*)%(%5"*,-'<#)()4'#'6""A$-'2#+$(#3"*%#+-'30*(%0+(*.'5/1#%"'#*1'#'1#($-'3"1(#'<5$$"%(*')"+:(,"

P&"'F2!GM)'#."*1#'()')"%'<-'(%)'#$$K/#+%-'''

(*',0*)5$%#%(0*'6(%&'(%)'1()%(*.5()&"1''F1:()0+-'2#*"$4'#*1'1"$(:"+"1'<-'#''1"1(,#%"1')",+"%#+(#%7'

P&"'.+05/'()')5//0+%"1'<-'#*'F))0,(#%"';"3<"+)&(/'09'Ca'09'%&"'XQM)'$"#1(*.'0+.#*()#%(0*)'60+A(*.'(*'%&"'&"#$%&')",%0+4'6&(,&'#)'6"$$'#)'/+0:(1(*.'#*'(*1"/"*1"*%')05+,"'09'95*1(*.4'099"+'#':#$5"1'(*)(.&%'(*%0'/+")"*%'1":"$0/3"*%)'0,,5++(*.'6(%&(*'6(1"+'%&"'&"#$%&,#+"',0335*(%-'(*'%&"'XQ7

\-'#,%(*.'#)'#'90+53'90+'1(),5))(0*'#*1'#':"&(,$"'90+'%&"'1())"3(*#%(0*'09'(*90+3#%(0*4'6"'"*#<$"'/#+$(#3"*%#+(#*)4'/0$(,-'3#A"+)4'&"#$%&,#+"'/+09"))(0*#$)4')5//$("+)4'/5+,&#)"+)4'5*(:"+)(%(")4':0$5*%#+-'0+.#*()#%(0*)'#*1',&#+(%(")'#$$'%0'/$#-'%&"(+'/#+%'(*'%&"'1"$(:"+-'09'%&"'*#%(0*#$'&"#$%&'/+0.+#33"7


ABOUT THE APHGAPHG Parliamentary Officers\#+0*"))'N53<"+$"."' N&#(+V%'!0*'Q":(*'\#++0*';2' N0KN&#(+\#+0*"))';#)&#3'09'8$%0*' N0KN&#(+;#+A'?(330*1)';2' N0KN&#(+]0+1'!5*%'09'Q(*.)'!"#%&' P+"#)5+"+>"($'N#+3(,&#"$';2' ?",+"%#+-

Advisory Panel2+09"))0+'?(+'G"0+."'F$<"+%('' N&#(+3#*4'_(#<"%")'XQ\"+*#+1'_5*A$"-' F2!G'](9"'2+")(1"*%_5*,#*'L#%0*' F2!G'L@",5%(:"'F1:()0+]0+1'N+()/' ' J0+3"+'N&("9'L@",5%(:"'09'%&"'>!?

]0+1'!#++()'09'!#+(*."-' ;"3<"+'09'%&"']0*10*'F3<5$#*,"'?"+:(,"'' ' ' >!?'P+5)%_+'2"%"+'N#+%"+' N&("9'L@",5%(:"4'V0-#$'N0$$"."'09'>5+)(*.2+09"))0+'Q"**"%&'N#$3#*' N&#(+4'>#%(0*#$'N#*,"+'V")"#+,&'8*)%(%5%"2+09"))0+'N&+()'!#3' N&("9'L@",5%(:"4'P&"'Q(*.M)'J5*1_#3"'m0'R($$(#3)' N&#(+4'N#+"'k5#$(%-'N033())(0*2+09"))0+'?(+'N-+($'N&#*%$"+' N&#(+3#*4'XN]'2#+%*"+)2+09"))0+'?%":"'J("$1' J0+3"+'N&#(+4'V0-#$'N0$$"."'09'' ' ' G"*"+#$'2+#,%(%(0*"+)2+09"))0+'_#:(1'P#-$0+' 2+09"))0+'09'2&#+3#,"5%(,#$'#*1'25<$(,'' ' ' !"#$%&'20$(,-4']0*10*'?,&00$'09'2&#+3#,-_+'_#:(1'N0$(*KP&03"' >#%(0*#$'N$(*(,#$'_(+",%0+'90+'2+(3#+-'N#+"4' ' ' _"/#+%3"*%'09'!"#$%&\#++-'?&""+3#*';2' J0+3"+'N&#(+4'N&($1+"*4'?,&00$)'#*1'J#3($(")'' ' ' ?"$",%'N033(%%""?(+'m0&*'P00A"' Y(,"'2+0:0)%'H!"#$%&I4'X*(:"+)(%-'' ' ' N0$$"."']0*10*]-*1#'!#3$-*' N&("9'L@",5%(:"4'>!?'\$001'l'P+#*)/$#*%


30 31

P&"'Q(*.M)'J5*1'()'#',&#+(%-'%&#%')""A)'%0'5*1"+)%#*1'&06'%&"'&"#$%&')-)%"3'(*'L*.$#*1',#*'<"'(3/+0:"17'X)(*.'%&#%'(*)(.&%4'6"'&"$/'%0')&#/"'/0$(,-4'%+#*)90+3')"+:(,")'#*1'<+(*.'#<05%'<"&#:(05+',&#*."7'W5+'60+A'(*,$51")'+")"#+,&4'#*#$-)()4'$"#1"+)&(/'1":"$0/3"*%'#*1')"+:(,"'(3/+0:"3"*%7'R"'#$)0'099"+'#'6(1"'+#*."'09'+")05+,")'%0'&"$/'":"+-0*"'60+A(*.'(*'&"#$%&'%0')&#+"'A*06$"1."4'$"#+*(*.'#*1'(1"#)7

P&"'Q(*.M)'J5*1' 'EEKET'N#:"*1()&'?=5#+"' ']0*10*4'REG'DF>

DCD'bTDb'CgDD"*=5(+-nA(*.)95*170+.75A

V".()%"+"1'N&#+(%-'EECfSOD6667A(*.)95*170+.75A


ABOUT THE KING’S FUND

For further information, please contact

Sally Percy, Group Manager

Associate Parliamentary Health Group

Policy Connect

CAN Mezzanine

32-36 Loman Street

London SE1 0EH

020 7202 8574

[email protected]

www.healthinparliament.org.uk

Printed on recycled paper

Sponsored by

FOR PARLIAMENT

POLICY PRIORITIES

Documents

Essays%collected%by%the%Associate Parliamentary%Health ......Dame Jo Williams Ð Chair, Care Quality Commission 22 Reßections Lord Hunt of Kings Heath Ð APHG Parliamentary OfÞcer