School nursing commissioning concerns.
School nursing (Forecasts and trends)
Health planning (Political aspects)
|Publication:||Name: Community Practitioner Publisher: Ten Alps Publishing Audience: Academic Format: Magazine/Journal Subject: Health; Health care industry Copyright: COPYRIGHT 2011 Ten Alps Publishing ISSN: 1462-2815|
|Issue:||Date: Feb, 2011 Source Volume: 84 Source Issue: 2|
|Topic:||Event Code: 010 Forecasts, trends, outlooks Computer Subject: Market trend/market analysis|
|Product:||Product Code: 8000310 Health Planning NAICS Code: 62 Health Care and Social Assistance|
|Geographic:||Geographic Scope: United Kingdom Geographic Code: 4EUUK United Kingdom|
Ahead of the publication of the Health and Social Care Bill--to enact plans outlined in the Liberating the NHS White Paper, details of which were due as this issue went to press--Unite/CPHVA raised concerns over the commissioning of services for five-to 19-year-olds as detailed in the public health White Paper consultation.
Local authority commissioning
The consultation on public health funding and commissioning, open for consultation until 31 March, proposes that services for five- to 19-year-olds, including school nursing, will be commissioned by local authorities and funded by the ring-fenced public health budget.
While Unite/CPHVA professional officer Ros Godson said it would be positive for school nursing to be commissioned by local authorities because there would 'be clear lines of communication' and 'schools would be able to articulate to local government what the health priorities are and what services need to be commissioned', she also stressed: 'For schools that do not come under local authorities--academies or private schools, for example--there is the potential that they will lose out on a school nurse because there is less chance of it being commissioned there.'
Ros added: 'Numbers of specialist community public health nurse (SCPHN) qualified school nurses need to increase so that there is at least one qualified and fulltime school nurse in every secondary and cluster of primary schools in England.'
There are worries that school nursing will come lower in priority to other services. Ros noted: 'It would be difficult for school nursing to compete with other services for five- to 19-year-olds if there is no ring-fenced budget for the training and recruiting of SCPHN-qualified school nurses.'
Other services for five- to 19-year-olds to be commissioned by local authorities would include the Healthy Child programme, health promotion and preventative and early intervention services. However, the NHS Commissioning Board will commission services for nought- to five-year-olds on behalf of Public Health England.
Lines of accountability
Despite that the consultation made clear that local governments will be held accountable to Public Health England for the appropriate use of allocated ring-fenced grants, Ros said that this provides no assurances that school nursing services would be commissioned. She encouraged school nurses to have early dialogue with their director of public health--who will be placed within local government--to articulate the need for more SCPHN-qualified school nurses.
Under the consultation proposals, local authorities would also need to demonstrate to Public Health England that commissioned services are value for money.
Fragmenting the service
Shifting commissioning responsibilities to local authorities could potentially create a fragmented school nursing service, the association has also highlighted.
The consultation report said that the Department of Health would 'encourage and expect' local authorities to commission services on an 'any willing provider' and 'competitive tender' basis, which Unite/CPHVA has said could mean that the voluntary and private sectors would be able to bid to provide school nursing services.
Ros added: 'This could mean that NHS staff terms and conditions will be compromised and so would access to continuing professional development training.'
|Gale Copyright:||Copyright 2011 Gale, Cengage Learning. All rights reserved.|