It is something we generally try to avoid thinking about

Most of us would prefer not to be in hospital if we don’t need to, especially if we have a limited time left to live. The key phrase here is – ‘if we don’t need to’ – but need comes in so many different forms: treatment-related, symptom-related, care-related etc.  Sometimes, that need can only be met – safely, efficiently & effectively – in hospital.  When that happens, whether it’s a brief visit or at the very end of someone’s life, we need to be confident that our experience of treatment, care & support is as good as it can possibly be for us, as well as those who matter the most to us.

The notion that dying in hospital is always a poor outcome is too simplistic. So is the notion that dying in someone’s ‘usual place of residence’ is always a good thing. It is time to shift that focus.  Wherever the person is, and at whatever the stage of illness, how can we make it as good as possible?  This should be the focus.

There are many pockets of high quality care, and lots of people are working hard to improve things all the time. We need to hear more about what’s going well – not only to celebrate these successes, but also to learn, adopt and adapt, in a continuous cycle of improvement.

Researched Links:

NHS England:  Transforming end of life care in hospitals: what’s happening?

Perhaps they figure the ‘departed’ won’t be able to complain to the PHSO!

A death without sympathy or proper care

It is not so much dying that worries us, as HOW we will die

One Public Estate: Number Management is Key to a Seamless Transition

Government estimates that the ambitious ‘One Public Estate’ initiative will generate more than £138 million in capital receipts and reduce the running costs of central and local government assets by £56 million.

But any transformation involves an upheaval stage. When organisations change location, such as NHS Trusts, fire and rescue and other vital services, they need to educate the public around a change of numbers as missing a potentially life or death call creates nightmare scenarios.

When consolidating their estate, Northampton Borough Council used BT smartnumbers during and after the move to ensure that the 24h delivery of critical services was unaffected.

Click here to access this latest case study.

Being ‘old’ comes with age and we need to prepare for it
If we are to respond positively to frailty and the challenges it poses we must be prepared to care for people exhibiting the frailty state in just the same way as we care for other long-term conditions.  Frailty can now be screened for & diagnosed with comparative ease using the validated electronic frailty index. This can lead to targeted assessment & person centred care-plans developed as the condition progresses.

NHS England:  Why is diagnosing frailty important?

‘Frailty’ may be inevitable with age, but its ‘management’ can still allow an ‘active’ lifestyle

Sounds like they were not impressed!
The Science and Technology Committee have demanded the Government redraft its Forensics Strategy; criticising the document as vague, incomplete and lacking a vision for forensic services or a route map to deliver improvements.

PC&PE:  MPs demand the Government redraft its Forensics Strategy

Cyber criminals are phishing to ‘land’ victims

Land Registry customers have told them that they are currently receiving fake emails that pretend to be from LR.  

These ‘phishing’ emails state:  “The document attached is an official requisition, reminder or letter from Land Registry. It is not a circular and relates either to an application you have lodged with us or a property in which you have an interest. No paper copy of the item of correspondence will be sent to you.

The document is in ‘HyperText Markup Language’ (HTML) which replicates the appearance of the hard copy version. You will need to open the document with your internet browser”

If you’re unsure about an email claiming to be from Land Registry; Do NOT open the attachment or follow any links, as this may infect your computer with a virus.  Computer viruses can help criminals to steal data from your computer

Researched Links:

Land Registry:  Phishing email scam

FSCS consumer alert! Look out for scam emails

SME Suppliers @ Government ICT 2.0 2016, QEII Conference Centre, Wednesday, 28th September

If you’re attending the Government ICT 2.0 event this Wednesday (28th September) at the QEII Conference Centre, please take some time out to visit the following SME exhibitors:

@ Stand #28

@ Stand #30
They may be ‘young & healthy‘ but they are ‘at risk’
New figures show less than 20% of young people have received the MenW vaccine so far this year.  School leavers, particularly those going to university or college this month, are being strongly encouraged to get vaccinated against meningococcal disease.  The total number of deaths, across all age groups, has risen from around 4 a year up until 2012 to 22 deaths in 2014 to 2015.

DH:  Freshers urged to get meningitis and septicaemia jab

Perhaps Frank Sinatra could have gained digital skills this way
Over the past few months, Tinder Foundation’s Digital Team has been working hard on a whole host of improvements for the Learn My Way site.  Although new features & content will continue to be introduced, they are very proud of the site and believe it is a truly world-class resource for teaching & learning basic digital skills.    They would love to know what you like - or what you don’t - about the site, so please to let them know.
UK online centres:  Say hello to a brand-new Learn My Way
Who censors the Censors?
The issues of freedom of speech on campuses and academic freedom have become major talking points.  Terms like ‘microaggression’, ‘trigger warning’, and ‘safe space’, virtually unheard of a decade ago, have entered mainstream vocabulary.  However, for centuries, scholars have considered intellectual autonomy essential for the pursuit of truth and the advancement of knowledge.

Civitas:  Why Academic Freedom Matters - A response to current challenges

Troubled journeys crossing the water using Tower Bridge
Transport for London (TfL) has set out plans to help reduce disruption during the City of London's vital maintenance work on Tower Bridge. The 3-month closure, which starts on 1 October, will mean vehicles will be unable to use the bridge.

TfL:  Minimising disruption during essential Tower Bridge closure

TfL:  Diversions planned for essential bridge works

Are you eligible for a ‘Boost’ to your business
SMEs based on Port Talbot Waterfront Enterprise Zone are being reminded that applications close on 30 September 2016 for a discretionary grant scheme that could see successful applicants receive up to £55,000 or their business rates paid - whichever is the lowest.

WAG:  SMEs encouraged to apply for Port Talbot Waterfront Enterprise Zone Business Rates Scheme before it closes

It’s healthier to ‘Stop burning money’
Stoptober is back for a 5th year to encourage the nation’s remaining 7m smokers to quit together on 1 October 2016.  Last year, out of the 2.5m smokers who made a quit attempt, 500,000 people (20%) were successful; the highest recorded success rate and up from just 13.6% 6 years ago.

DH:  Quitting smoking sweeps the nation as Stoptober returns

Editorial Comment:  Helping refugees is not the only important issue to consider when dividing the ‘economic cake

The PM has been trying to bring some rational thought to the refugee / migration problem at the UN recently, while (back in the UK) many NGOs & Refugee organisations are urging us to take several multiples of the 20,000 already agreed (plus 3,000 unaccompanied asylum-seeking children) by 2020,  However a NAO report recently ‘costed’ those we have already taken in and expanding the scheme to 100,000 would cost around 5 x £1.734bn – or £8.67bn up to 2020. (Illustrating the potential cost of ‘open borders’ for refugees)

As for unaccompanied children, it costs LAs £50,000 to look after each unaccompanied child every year

As the LGA has previously highlighted ;  "When an unaccompanied child arrives in the UK, it is the council area where they arrive that is responsible for all costs associated with that child up until the age of 25. This includes schooling, foster care or children's homes, through to university fees and housing costs, whether they stay within the area or are moved elsewhere in the country”.

BBC:  Councils demand more funding for child refugees care costs ~ LGA:  Unaccompanied child asylum seeker costs must be reimbursed

So, while we all have sympathy for every one of these individual children seeking ‘an education’ (the majority not from Syria, but rather Afghans, Eritreans and Albanians), who will go & tell individual pensioners in pain (face-to-face) that the UK cannot afford to pay for their essential hip operation, or that their cataract operation is delayed 15 months because there are no funds available and also that the local council cannot afford their social care?  -  Guardian:  NIB report - Patients in England face 15-month wait for cataract surgery

Given that we are still running a £multi-Bn deficit (and have even had to abandon achieving a surplus by 2020 due to Brexit issues), perhaps we should reconsider the requirement to spend 0.7% of GDP on ‘Foreign Aid’ (Where does the UK's aid currently go? - BBC News) and re-assign the money (or at least an increased part of it) to:

  • Fully fund NHS & social care in the UK
  • Address the underfunding of mental health care
  • ‘Solve’ the UK housing crisis
  • Fund the cost of refugees / migrants already in the UK (including illegal ones)
  • Help countries like Jordan and the Lebanon to fund cost of refugees / migrants and schemes such as those that ensure children get an education in times of crisis

Standing well back from the emotional & shocking scenes of drowning migrants, we could even consider whether there is more ‘long-term benefit’ to be gained and lives to be saved ‘for the world’ by using the money to fund research to find new antibiotics, rather than ‘facilitate’ people moving from poverty to the ‘rich’ West.  A suitable subject for the BBC’s Moral Maze programme possibly!

(We need to find an answer to this conundrum ~ Anyone remember those original HIV/Aids Advertisements? ~ DH:  UK secures historic UN Declaration on antimicrobial resistance ~ FSA Chief Scientific Adviser outlines the challenges of Antimicrobial Resistance

The reality is that there are more ’good causes / needs’ than there is tax revenue to fund their requirements and (just as with the EU referendum), there is coming a time when those who live outside the Westminster bubble & metropolitan elite, will start demanding that those who have ‘paid in’ all their lives should be prioritised over those who want to come to the UK and get the ‘benefits’ for ‘Free’, however desperate their need!

Managing the refugee problem:

10DS:  PM calls for a new global approach to respond to unmanaged migration ~ DFID:  PM pledges new UK support to help tackle migration crisis ~ HO:  Joint statement by the governments of the UK and Germany ~ Unicef statement on the New York Declaration on Refugees & Migrants ~ ESRC:  UN Summit to hear new research on why refugees & migrants crossed the Mediterranean in 2015 ~ Guardian:  Lack of Schools & homes threatens Syrian refugee UK resettlement ~ DIFD:  First countries set to benefit from funding to ensure children get an education in times of crisis ~ Unicef calls for an increase in education spending as new report reveals global crisis in learning ~ Does anyone know the size of the problem over the next 5 years? ~ Editorial comment; Points to ponder on the Syrian migration crisis

NHS, Social Care & Mental Health:

NHS:  It always needs more! ~ PC&PE:  Role for whole of Government in improving mental health support ~ NHS Confederation:  More doctors are needed but healthcare will be at risk if numbers keep increasing ~ Working towards better mental health ~ A healthy body is a guest-chamber for the soul; a sick body is a prison (Francis Bacon) ~ Are we prepared to ‘re-slice the revenue cake’ to pay for it ~ Like pensions, most people don’t think about their care needs in old age ~ Kings Fund:  Clear & credible plan needed for digital health


Let’s hope that they don’t build them on a floodplain ~ Everyone needs a ‘home’ ~ ‘Housing’ is not just about ‘home ownership’ ~ The rooms / buildings & gardens also need to be of a decent size ~ PX:  Government will miss its housing target unless Housing Associations are given more freedoms to build


 More contributions following EU Referendum

Still a ‘hot topic’, with widely spread views, for those who put fingers to keyboard in order to ‘share their views’:

Researched Links:

IEA:  Global economic freedom slightly up; UK ranks 10th among 159 jurisdictions

IFG:  Trust in government growing - but it still needs to deliver

Civitas:  The Real Sterling Crisis: Why the UK needs a policy to keep the exchange rate down

ScotGov:  Future of energy in Scotland

WAG:  £136m Fund & Development Bank will help support businesses in Wales post EU referendum, says Economy Secretary

Independent Age:  LGA responds to report on future of migrants in social care workforce

DIT:  Lord Price's speech to the Hungarian Business Leaders' Forum


 More contributions to the UK constitutional debate

More news, opinions, documents, claims & counter-claims;

Researched Links:

Scottish Office:  David Mundell - The case for the union: now stronger than ever speech

HMT:  Ambitious businesses in Scotland open their doors to future opportunities


Please note that previously published newsletters can be accessed from the

Newsletter Archive

Please choose from the links below to view individual sections of interest:

Last week Public Leaders network editor Jane Dudman caught up with Margaret Hodge, senior Labour MP and former chair of the Commons public accounts committee. Hodge was very vocal on the need for reform in Whitehall, but ultimately, that baton has been passed on and now rests with Theresa May’s ministers.
"It’s time for the present crop of civil servants and politicians in No 10, the Treasury and the Cabinet Office to see what they can do. But finding avid reformers and achieving reform, at a time when the civil service has to manage Brexit? Don’t hold your breath," says Dudman.
And finally, there is still time to vote for who should win our Public Servant of the Year award; read about the five public servants shortlisted and make your choice here. Voting closes on 30 September and the winner will be announced in November.

Also on the network

Margaret Hodge is right - Whitehall needs reform. But will it happen?

Margaret Hodge is right - Whitehall needs reform. But will it happen?
Changing civil service culture is now in the hands of May’s new ministers, but achieving this as well as Brexit is a tall order

What is it like to apply for the civil service fast stream? Here's what you said

What is it like to apply for the civil service fast stream? Here's what you said
‘Very, very long-winded’: Guardian readers share their experience of getting on to the civil service fast stream programme

It's getting harder for us health inspectors to protect you from bad landlords

It's getting harder for us health inspectors to protect you from bad landlords
Many landlords seem shocked when we ask them to spend money making their property safe, warm and dry for tenants. Cuts mean we have tough decisions to make about when to step in

News in brief
Senior public service roles almost entirely white, survey finds
• Department for Communities and Local Government loses one in ten staffover three months
• Police to get more training to detect non-physical domestic abuse
• Family courts face 'imminent crisis' over huge rise in care applications
• Khan calls for new powers over taxes and public services
• Council seeks judicial review over Aylesbury Estate decision