Representatives Conference June 2009

Today’s briefing should provide…

• Understanding of government's direction of travel/future of community services

• Understanding of options available to PCTs• Explanation of PCT decision-making process• Details of opportunities for Trade Union

input• Explanation of implications for staff and the

NHS

What is Transforming Community Services?

• Part of broader government agenda:– ‘Choice/competition/innovation’– Commissioning a Patient Lead NHS

(2005) – Our Health, Our Care, Our Say (2006)– Purchaser/Provider split

• Programme of changes: – ‘Enabling New Patterns of Provision’

• What has TU involvement been so far?– SPF/Staff Passport– Twin track approach

TCS P9 / TU guide P4

Guiding principles of TCS

• Benefits for patients and carers • Staff employment rights and interests

matter• Early engagement and full consultation• Staff have ‘first call’ to offer to provide

services• Workforce capacity - critical• World Class Commissioning• Competition

TCS P19-21

Key dates for PCTs

•April 2009: Separate PCT commissioner and provider arms contractual relationship – Service Level Agreement

•Oct 2009 :–Detailed plan for transforming community services–PCT provider services review governance arrangements–Decision on social enterprise or Community Foundation

Trust

•From Oct 2009:–PCT commissioning arms should complete service reviews

and market analysis–PCTs to agree intentions for future of provider services

with SHA

•By April 2010: PCTs to agree strategy for future of community estate with SHA

•During 2010: PCTs should develop implementation planTCS P25-26

Possible models

• Arms-length Provider Organisation• Polyclinics/GP-led health centres• Community Foundation Trusts (CFT)• Vertical Integration• Horizontal Integration• Integrated Care• Private/Independent providers• Social Enterprise

TCS Pages 43 to 54, TU Guide Pages 6 to 8

Dept of Health says “No blueprint”

But…• Pressure on staff to exercise ‘Right to

request’ for SE• “Through…social enterprises, clinical

leaders and others can exert their influence to improve outcomes like never before”, DH

• Preferable treatment for SE• Threat of procurement if do not request SE• Co-operation and Competition Panel

TCS Page 37

April

2010

October

2009

April

2009

April

2008

PCT

Commissioners

PCT

Commissioners

PCT

Commissioners

PCT

CommissionersPCT

PS

PCT

PS

CFT

Provider

Services

Provider

Services

V

E

R

T

I

C

A

L

INT.

COMMERCIAL

ORGANISATION

Social Enterprise

LA PARTNERSHIP

HORIZONTAL INTEGRATION

COMBINED ORGANISATION

INTERNAL SEPARATION

CONTRACTUAL/SLA RELATIONSHIP (April)

IMPLEMENTATION PLAN (October)

ESTATE STRATEGY

(April)

SERVICE LINE

DIVERSITY

(2010)

TCS Page 24

Trade Union view

• PCTs and SHAs must ensure high level and early engagement and consultation

• Use local machinery e.g. Local Partnership Bodies/Forums (PFs)

• Agree timetable and process at PCT and SHA

• Seek views of members• Discuss alternatives/mobilise opposition• Extend timetables if necessary

TU Guide Page 9

• PCT Level : Use Joint Consultative Committee and local PFs or new joint bodies

• SHA Level – oversight and review role. Use regional SPFs to consider PCT proposals

• Unions should use regional SPFs to ensure engagement and information sharing

• See key questions for TU Reps to ask PCTs/SHAs

TCS Appendix 2, Pages 76 &77 TU Guide Page 9 & 10

Mechanisms for early engagement and consultation

Other Issues for Staff

• Equality – to ensure no unlawful discrimination against employees

• Public Sector duty - PCTs must do Equality Impact Assessment. Ensure this is embedded in contractual relationships

• Must embed NHS Constitution and Handbook in provider contracts

• See key questions to ask PCT

CS Appendix 2, Pages 77 &78 TU Guide Page 11 & 12

Protection - Pay T&Cs

• Where staff transfer – TUPE applies. But ETO reason could negate TUPE protections

• Cabinet Office Statement of Practice – Fair Deal for Staff Pensions (2000)

• Code of Practice on Workforce Matters (2005)

• Retention of Employment model restricted• See table summary (TCS pages 86 to 90)• See key questions to ask the PCT

TCS Appendix 2, Pages 78 to 90, TU Guide Page 12 to 13

Human Resource issues

• Providers are expected to demonstrate:‐ An HR Strategy ‐ HR policies and workforce planning‐ Provision of access to Continuous

Professional/Personal Development‐ Staff engagement – through a staff

survey, TU recognition, partnership working, consistent with NHS Constitution principles

• See key questions for new provider(s)TCS App.2 Pages 82 to 85, TU Guide Pages 13 /14

Key tasks for Trade Unions

Insist on early engagement/consultation Local staff side to agree timetable with PCT Regional officials to agree timetable with SHA Build in timetable for reporting back to members Ensure staff informed about pitfalls of social

enterprise and loss of rights/job security under privatisation

Contact LA Overview and Scrutiny Committees Ensure NHS options considered Campaign for direct NHS Provision Build in Code and other protections to contract

documents and procurement process Keep your national office informed – co-ordination

and sharing experience helps us all Ensure all unions working together at all levels

Key Reference Documents (web links)

Transforming Community Serviceshttp://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_093197

Next Stage Reviewhttp://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_085825

NHS Constitutionhttp://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_085814

Social Enterprise - Making a Difference: a guide to the Right to Requesthttp://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_090460

Transfer of Undertakings (Protection of Employment) Regulationshttp://www.berr.gov.uk/files/file20761.pdf

Cabinet Office Code of Practice http://archive.cabinetoffice.gov.uk/opsr/workforce_reform/code_of_practice/index.asp