1. Representatives Conference June 2009

2. 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

3. 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

4. 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

5. 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 plan TCS P25-26

6. 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

7. 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

8. April 2010 October 2009 April 2009 April 2008 PCT Commissioners PCT Commissioners PCT Commissioners PCT Commissioners PCT 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

9. 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

10. 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

11. 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

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

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

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

15. Key Reference Documents (web links) Transforming Community Services http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_093197 Next Stage Review http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_085825 NHS Constitution http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_085814 Social Enterprise - Making a Difference: a guide to the Right to Request http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_090460 Transfer of Undertakings (Protection of Employment) Regulations http://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