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The Health White Paper provides challenges, risks and opportunities for better health and care service here…

But, as long as there is an obsessive focus on better health outcomes for Staffordshire people and not on artificial Health organisational issues which could re-create many smaller PCTs in all but name, the opportunities will be greater.

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Full County Council on the road visiting Newcastle Borough Council

The key changes the proposals bring are moving health commissioning responsibility from existing Primary Care Trusts to GPs and moving the budget and responsibility around Public Health to Counties and Unitary local government.

It’s bigger than it sounds. There are currently three PCTs in Staffordshire, one for the southern six districts, one for the two northern districts and one for Stoke with a combined total spend of around £1.6billion.

The County has been working in earnest for ten months to bring together community NHS services with social care services across Staffordshire.

That will mean significant improvements, efficiency wise and, most importantly, to the parity and quality of healthcare services across the whole county and the work to do that is ongoing and will be completed in the next nine months.

The demise of the three PCTs by 2013 and the move of well over a billion pound health commissioning money to doctors in the community is huge. The County already has a successful Joint Commissioning Unit which brings together the NHS and Social Care commissioning to maximise efficiencies and align much better the provision of services.

Clearly, it is important that we continue the same principles under the new arrangements. How we do that and how we can support GPs in their new role whilst ensuring the joint approach between care and health deepens has been, and will be, the subject of dozens of hours of talks.

And why does greater collaboration matter? Well, because high quality social care services prevent many people going into high cost acute services (hospitals) and also get people out faster if they are in hospital.

It’s partly about money and partly about the quality of life and future prospects for individuals. In every aspect it makes sense.

I’ll be writing far more about this whole agenda as things move on and as negotiations take place over the summer. It’s hugely important for Staffordshire and the people who live and work here. I’ll also write about the Public Health changes which, again, will potentially enhance what we are already doing around things such as obesity and alcohol abuse.

So, a very busy time which is going to get even busyer. 

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“The ‘Big Society’ has now arrived but six months ago we started work on recognising volunteering”

It was actually a couple of years ago that, in opposition, I criticised in committee the then Labour Administration in Staffordshire for not properly recognising or promoting the role of volunteers.

That could be someone who does their bit for the scouts, or at a Sunday morning kids’ football match, or people that pay friendship visits to those in hospital or individuals that support bigger charities like Age UK or Mencap or many others.

In fact anyone that gives back to society, something for nothing. There are already millions of people across the country who volunteer and many of those don’t even think of it as volunteering… it’s just what they do.

And just before Christmas last year my colleague, Ben Adams, who is Staffordshire’s Cabinet Member for Communities kicked off work on the countywide campaign to highlight the good volunteering work which is ongoing and find better ways to support and get even more people actively involved.

That work has resulted in Volunteer Staffordshire.  It brings together information on thousands of volunteering opportunities, offers advice on where and how to get involved and will recognise formally those individuals or groups who who go that extra mile to give something back as well as celebrating everyone who volunteers, no matter how small or infrequently.

It will also be the conduit for a new Staffordshire Award which will be akin to the national Honours but specifically for individuals that have done something in the voluntary sector here which is unique and benefits people right across the county.

The latter Award will not be given easily and they will be few and far between recognising a uniquely important contribution to Staffordshire life. But whatever level of volunteering if you know someone who helps out for the good of others, even if it’s nowhere near the level required for the Staffordshire Award, you can nominate them for recognition here.

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A year ago we set out our Manifesto for Staffordshire which resulted in a landslide election win last June…

So, where are we now and what do the hugely difficult economic times mean for the next few years? Certainly for all of our four year term.

A bit of context. On Thursday June 4th last year we won Staffordshire after 28 years of uninterrupted Labour control. And by late afternoon the day after that, any sign of the previous Labour Administration had been removed by officials with offices cleared out and the ‘mechanics’ of new people taking over well underway.

The New Breman Room in County Buildings where Cabinet meets weekly

 When I walked into historic County Buildings on that afternoon to meet for our inaugural informal Cabinet get together, the responsibility for 35,000 employees and 300 public services affecting the lives of of nearly a million people every day began to sink in. Bizarrely, I remember the very moment that happened for me.

Just in case that last statement sounds a bit too dramatic, one thing over the last year is clear as absolute fact. And that is, whilst officials are the ‘constant’ in both local and national government, meaning things happen day to day and services are delivered as a matter of course with or without politicians, the decisions, philosophies, approach, mindset and competence of elected Members sets the fundamentals for everything.

That’s true in national government and local government but particularly in what’s called ‘top tier’ local government, like County, where policies affecting life and death, jobs and the wider economy are part of the day job. The political decisions at County can, and do, lead to outcomes as stark as black and white or up and down depending on those decisions.

As a brand new administration back in June it really was going into the unknown both for us and for the officials who had little idea of what to expect as individuals around day to day relationships.

It was clear that the previous Labour Administration were not ‘as one’, even in Cabinet, didn’t have a clear focus or plan on where Staffordshire needs to be in ten years time and the extent to which politicians were genuinely in charge varied massively department by department as well as being highly questionable overall.

That’s not a criticism of officials because if there’s a vacuum in leadership it has to be filled but that doesn’t change the fact that a fundamental culture change in the relationship between the Paid Service and new politicians was the first massive challenge. I suppose the first thing as far as the title of this post is concerned lies around the fact that relationships between officials and the new Conservative Administration could have been catastrophic because of that big cultural change that was needed.

That scenario didn’t happen and whilst things are not Utopian there is a clear sense of direction, a clear understanding who is accountable and responsible and a firm sense of basic political principles and values which we have set down around fairness, openess and shifting the fundamental approach more towards personal responsibility and away from ever greater state dependency.

So, I guess the first positive was getting through the political transition with the place in one piece and that, I believe, very firm foundations and values now underpin Staffordshire’s next few years. It is nearly as difficult to describe how challenging that journey has been as it is for anyone not directly involved to understand why it was so crucial and tough.

Then policy wise we’ve made a decent dent in our Manifesto pledges already as well as dealing with some pretty big issues we found unexpectedly…

Major retail development in Stafford including two new state-of-the-art office buildings:

This was one of the first surprises within days of taking office. It had been planned by Labour over several years at a cost of around £30million. It was about rationalising some of the many buildings which County has across Stafford town. It wasn’t a particularly robust business case when we opposed it in opposition and with the terrible state of public finances we were going to mothball the project until more stable finacial times when we’d try to improve it. 

The surprise was that just weeks before election day Labour had committed us to it. Our first real achievement was revamping and renegotiating the contracts, squeezing the costs, all in a matter of a couple of months, and turning the overall deal into a substantial cost saving for tax payers instead of the inherited additional cost. In short we made the very best of what potentially was a problem.

Lowest ever increase in council tax by the County Council:

The work to balance the budget ended up with just a 1.9% increase. A far cry from a few years ago when the County under Labour made a series of high increases the largest of which was a staggering 15%. And we plan to keep it below 2% next year meaning Staffordshire will qualify for the new national government scheme to match that cost resulting in no increase in council tax.

£30million pounds capital injection into Staffordshire’s roads:

A key pledge from last June. Moving money around and using an invest to save approach to start major improvements to our crumbling highways. The programme has now started across the county and it will take three years to complete.

Labour’s quarrying increases crushed:

The last Administration let quarrying in Staffordshire get out of hand with big increases in the amount of sand and gravel works our county provides over decades. A further increase in aggregate tonnage was due this year and Staffordshire was already providing two thirds of the total West Midlands quota. We’ve stopped any more increases in a measured way meaning job protection in existing quarries but no new ones. 

New road safety initiatives across hundreds of schools:

Another pledge from the Manifesto which has started the role out across Staffordshire of 20mph speed limits which are only operative at the times when children are arriving at or going home from school. The programme will focus on primary schools and will continue over the next three years. It’s got off to a solid start.

Business Support Fund helping through difficult times:

Banks still aren’t lending even to viable companies that want to grow. We set up in partnership with a commercial lending partner to underwrite a £1million small business scheme. The money lent so far has saved and supported a significant number of jobs. The numbers of applicants is growing and we’ll look at increasing funding further to keep viable businesses in business until banks start lending again.

Joined up services between the NHS and Social Care:

A fundamental change to social care which I’ve been working on for nine months. Including a ground breaking integration between front line social care teams and NHS ones it will mean a step change in the quality of services for people coming out of hospital, getting older and frailer and adults living life with disabilities.

Massive investment in independent supported living:

A four fold increase in the number of FlexiCare housing developments by the end of our first term. We’re on target with a big increase in schemes meaning more independence safe in the knowledge that 24/7 support is on hand. And now more and more will be homes for life meaning those who develop complex needs through Dementia or other illness can stay in the place they know. By the way, these are literally like four star hotels with amazing facilities and are available across Staffordshire for rent, shared equity purchase or outright purchase.

Staffordshire Cares – a better future for older and vulnerable people in our county:

And on the theme of greater independence and choice, Staffordshire Cares, the development of which is ongoing, will revolutionise people’s lives as they get older and need some support and also put Staffordshire in the national spotlight for helping people live life the way they want to. Watch this space for the launch shortly. It will be impressive… I promise.

Above are just a few specifics that come to mind. There are many more around education, a completely new approach to tackling alcohol misuse, encouraging volunteering, a mass reorganisation of Connexions, the careers service for young people, a countywide programme to bring pride to living in our wonderful county and more boring (but vital) things like just manging the money, Staffordshire’s assets and the ‘business’ better and more efficiently than in the past.

As far as the future is concerned, our country is in a bad way financially. Staffordshire must play its part in paying down the national debt. That will be a contribution of between a hundred and two hundred million in the next three years. Tough choices and tight public purse strings.

We will do our bit for the national crisis and I think we are better placed now than a year ago to see Staffordshire and its people through the challenges of the next few years and out the other side safely and very much in one piece if a little leaner, more efficient with some services changed or no longer there but overall better.

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Tougher processes for investigations planned…

By vulnerable it means those less able to look after themselves. Elderly people or adults with physical disabilities or mental health issues.

Safeguarding is a big priority for me and I’m taking a hands on approach to moving this forwards in Staffordshire.

There are many different ways that their welfare could be threatened. It could be conmen fleecing older people of their savings to isolation and accidents in the home or neglect and poor care in places which should be providing the opposite. Stafford Hospital being a tragic and high profile example of the latter in years gone by.

And there is plenty going on to tackle this problem, particularly with a growing proportion of the population who are older and more frail or with mental or physical disabilities but still want to stay independent in their own homes amongst their own friends and family.

Of course, there are many whose needs are so complex that some form of 24/7 support is essential. But many people could, with a little extra support stay healthy and live a fuller more normal life. And it is those individuals that our increasing efforts need to ’safeguard’.

Pevention wise, more and more public agencies in Staffordshire are being trained what to look for when they visit people’s homes in their different roles. Police, health visitors, the fire service (who are doing amazing stuff on this) and some others can now identify risks such as fire, trip hazzards and security issues.

And if, sadly, vulnerable adults do suffer some harm there are changes coming to investigating the circumstances. The national statutory process means that the public body responsible for the aspect of ’care’ in question is also responsible for investigating the circumstances around the harm. 

To me that is wrong and not the transparency and accountability I believe should be in place. Perhaps I’m a cinic but I can’t help thinking that, even if not intentionally, there is a risk of self investigation leading to a benefit of the doubt or worse. At the very least from a public point of view that arrangement surely is questionable.

We made significant progress earlier this year when I appointed a new Independent Chairman to oversee the work of all the senior officials from key public sector bodies who make up the Safeguarding Board for Staffordshire. Now I want to take that another major step forwards so that everything which is investigated by any public body also goes to that Independent Chair to assess.

A really important check and balance which to me is common sense. And other investigations which are carried out by that group of senior officials will also be assessed and signed off by the Independent Chair as a matter of course.

A clear impartial arbitor which will strengthen accountability and raise public confidence. It’s worth remembering that the years during the questionable and tragic patient deaths at Stafford Hospital saw a negligable number of of even low level investigations carried out. That’s just not right.

So, we are making good progress on both trying to mitigate against the risk of harm to vulnerable people and also putting tougher, more transparent processes in place if cases need investigating.

We are also working on a new and easier to use public front end for reporting concerns around vulnerable adults. In the meantime if you are worried about someone you know you can find out who to tell adn how here.

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