Select Committee on Health Minutes of Evidence

Examination of Witnesses (Questions 180 - 185)



  180. Where does the Change Agent Team fit in the general modernisation agenda within the NHS? What progress to date?
  (Mr Humphries) The team will have a full complement of staff by 4 March and we intend to hit the road fairly quickly after that. We will be working very closely with the NHS Modernisation Agency, in fact part of my reporting arrangement is to that agency. Many of the service design issues are ones which are for the whole system of health and social care, not just the social care bit of it. We will also be making contact with the Local Government Improvement and Development Agency to make sure that we are not duplicating. What we sense from health and social care colleagues out there in the field is that they do not want more people coming in to tell them what is wrong, but they do want people who will come in, roll their sleeves up and give them some practical help. That is what the team is about.

  181. Did you not look at the question of possible overlap before you put the team together?
  (Mr Humphries) It was because of that potential for overlap that it was agreed that the team would work very, very closely, indeed as a part of the modernisation agency.
  (Ms Platt) Also the reason why Richard's team is part of the modernisation agency is that the problems we might identify might be something with which another team within the modernisation agency are best suited to deal. It is not that people are in there doing the same thing. They may be using the same sorts of techniques but it is using the repertoire of skills of all the different teams which are available that the location of the team within the modernisation agency actually helps.

  182. Steady progress so far but nothing spectacular and more to come.
  (Ms Platt) Yes; only just going.

  183. The National Service Framework we have been speaking about repeatedly this afternoon has some fairly exacting targets within it, does it not? Are those NHS managers who fail to meet these going to get the no star treatment which we have heard about from other managers in other quarters?
  (Ms Platt) At the moment it is trusts which are being assessed around no star or four star ratings. To the extent to which various trusts make their contribution to the National Service Framework for Older People, it will be taken into account in their star ratings and indeed in the social services star rating which we will announce this summer. The standards in the National Service Framework will be inspected by the Social Services Inspectorate working together. We will be able to get a total systems view. Whether it will ultimately be possible to assign star ratings to services, is an intention, but we are a long, long way away from it at the minute because we need to look at the performance of the individual parts and make sure that they are actually functioning properly before we can start looking at services across the piece. Yes, they will get some intervention if they get a no star, is the answer to your question.

  184. Do you think that will involve Job Search?
  (Ms Platt) It depends whether there is improvement. People are always allowed to improve.
  (Professor Philp) The main way in which the National Service Framework will be implemented will not be through command and control, although there are control and command systems to ensure that we are making progress and that we do hit the targets. The way in which the National Service Framework for Older People will be delivered will be by the field, by the more than one million plus practitioners and managers in the front line. The National Service Framework was developed over a period of just over two years, but it was developed as an inclusive process with the field, looking at the whole system of care. It is much more ambitious, it is much larger in its span than other national service frameworks. Therefore it is not possible to regulate every detailed aspect for every practitioner in every organisation. My approach to supporting implementation is now to work again with the field to unite the field around the enduring principles that underpin the National Service Framework on person centred care, whole systems working, access to care at the right time and promoting health and active life and asking them to use the National Service Framework as a tool in their organisations to help modernise and improve older people's services. We see it very much as an enabling tool which the field will use because they believe in it. You can only deliver this degree of system change if you get buy-in from the people in the field. You do not deliver it from my desk or from Denise's desk in Whitehall. We have inspection systems, but it is the ownership by the field which will really count.
  (Ms Platt) It is important to say too that the ongoing development of the NSF has always been informed by a user reference group of older people and it is still informed by a user reference group of older people. The ultimate say as to whether it has been a success will be the feedback we get from older people.


  185. May I say that you did undertake to give us some written feedback? I am particularly interested in the cost estimates in respect of delayed discharges and in other areas as well.
  (Ms Platt) Yes, I shall do that.

  Chairman: May I thank you all for a very interesting session? We are most grateful for your help in this inquiry.

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Prepared 29 July 2002