Public Eye Winter 2015/16

Winter 2015/2016 Issue 6 

BALANCING 

THE BOOKS? 

Andrew Cooper looks at the key points from the 

Spending Review 2015 for the public sector. 

ARE WE HEADING 

TOWARDS A SINGLE JOINED 

EMERGENCY SERVICE? 

The demands and roles of ambulance trusts, fire 

and police organisations are ever changing but 

there is a strong impetus and defined measures to 

improve closer working between these emergency 

services, says Nathan East. 

CHANGING THE FACE 

OF HEALTHCARE 

SERVICE DELIVERY 

Stuart Cowley, Director of Adult Social Care and 

Health at Wigan Borough Council and Karen 

James, CEO of Tameside Hospital NHS Foundation 

Trust examine how NHS organisations and local 

authorities are turning to health and social care 

integration to meet the challenges of reducing 

spending and improving services. 

FUNDRAISING POTENTIAL 

OF ENTERPRISING 

PUBLIC BODIES 

Public bodies are under increased pressure to 

find alternative methods of income generation. 

Vincent King examines the issues.

2 Public Eye Focusing on emerging issues in the public sector 

CONTENTS 

3 

4-7 

INTRODUCTION 

Andrew Cooper, Public Sector Director. 

BALANCING 

THE BOOKS? 

Andrew Cooper looks at the key points from the 

Spending Review 2015 for the public sector. 

8-9 

10-13 

THE BALANCE OF POWER 

Graeme Creer explains why the Northern Powerhouse 

could drive regional growth and rebalance Britain. 

CHANGING THE FACE 

OF HEALTHCARE 

SERVICE DELIVERY 

Stuart Cowley, Director of Adult Social Care and Health at Wigan 

Borough Council and Karen James, CEO of Tameside Hospital 

NHS Foundation Trust examine how NHS organisations and local 

authorities are turning to health and social care integration to meet 

the challenges of reducing spending and improving services. 

14-15 

RISING TO THE 

CHALLENGES OF CHANGE 

Organisational change in the public sector 

has wide-ranging implications for employers. 

Emlyn Williams reveals some of the issues – 

and suggests solutions. 

18-19 

The demands and roles of ambulance trusts, fire and police 

organisations are ever changing but there is a strong impetus 

and defined measures to improve closer working between these 

emergency services, says Nathan East. 

20-21 

22 

16-17 

NEW HEALTHCARE MODEL IS 

PART OF REVOLUTIONARY CHANGE 

As healthcare delivery continues to undergo 

radical reform, Edwina Farrell discusses one 

of the government’s major new initiatives. 

ARE WE HEADING 

TOWARDS A 

SINGLE JOINED 

EMERGENCY SERVICE? 

23 

FUNDRAISING POTENTIAL OF 

ENTERPRISING PUBLIC BODIES 

Public bodies are under increased pressure to find 

alternative methods of income generation. Vincent King 

examines the issues. 

UNIVERSITY FUNDING 

SCHEMES FACE TOUGH TIMES 

Patricia Grinyer explains why universities 

managing public sector loan funds for small firms 

are under pressure. 

IN FOCUS 

Get the very latest news and views from 

across Weightmans. 

© Copyright. Weightmans 2015/2016. All rights reserved.

Issue 6 Winter 2015/2016 

3 

INTRODUCTION 

The pressing political agenda to improve services 

with less funding is central to every area of public 

sector management with numerous innovators 

across a wide variety of public bodies delivering 

new, more cost-effective service models. 

In this issue, we are particularly thankful to external 

contributors Stuart Cowley, of Wigan Borough 

Council, and Karen James at Tameside Hospital 

NHS Foundation Trust, for sharing their enlightening 

and often uplifting insights into the human and 

budgetary benefits of integrated health and social 

care services. 

Meanwhile, Vincent King discusses the fundraising 

potential of enterprising public bodies and Emlyn 

Williams reveals some of the problems – and 

solutions – faced by employers involved in 

organisational change. 

We hope you enjoy the read. If you have any 

questions or comments about these articles, or 

requests for information on topics we have not 

been able to include in this issue, please don’t 

hesitate to let us know. 

Following the Chancellor’s Autumn Statement 

and Spending Review, we also examine the wideranging 

implications for public sector organisations 

in a new political and fiscal landscape. 

Another key element of the Chancellor’s programme 

this parliament is the ongoing development of 

the Northern Powerhouse. Graeme Creer explains 

how this new initiative, embraced by many Labour 

leaders of big city councils, could drive regional 

growth and rebalance Britain. 

A radically different approach to healthcare 

delivery is equally integral to policy, but how will 

this work on the ground? Following the Vanguard 

GP schemes, Edwina Farrell discusses a further 

initiative to place larger, more comprehensive GP 

practices at the heart of NHS reform. 

Elsewhere in this issue, Patricia Grinyer explains 

why universities managing public sector loan funds 

for small firms are under pressure, while Nathan 

East discusses the options and challenges of 

introducing single emergency service organisations. 

Andrew Cooper, Public Sector Director 

0151 243 9898 

andrew.cooper@weightmans.com


BALANCING 

THE 

BOOKS? 



5 

Andrew Cooper looks at the key points from 

the Spending Review 2015 for the public sector 

With the Autumn Statement and Spending Review 2015 now delivered, Chancellor George Osborne 

has taken the key decisions which he hopes will enable him to deliver on the Conservatives’ 2015 

general election manifesto pledges to deliver a surplus in public finances of £10.1 billion from a deficit 

of £73.5 billion in 2015/16 by the end of this Parliament, the financial year 2019/20. 

The biggest surprise of the Chancellor’s speech was the U-turn on cuts to tax credits. This measure, 

which would have generated savings of £4.4 billion, has been abandoned following defeat in the 

House of Lords and concerns expressed by some of the Government’s own backbenchers. In addition 

to the ring-fenced budgets, police spending has also been protected. 

So what were the key measures? 

Local government and social care 

Central government grants to town halls in England 

will be abolished and councils will instead be able to 

keep all of their business rates, and raise council tax 

by 2% in order to pay for social care. 

Mr Osborne said that the new “social care precept” 

on council tax could see an additional £2 billion 

go into the system, although some councils have 

expressed fears that the wider cuts will worsen an 

existing £3 billion spending gap in providing care 

services to look after older people and people with 

mental health problems in the community. 

The Local Government Association has said the 

measures will affect poor areas more because they 

have lower council tax revenues and it does of 

course mean that the decision as to whether to raise 

the council tax in order to generate the additional 

money for social care will lie with local authorities, 

who are likely to get any resultant blame for a tax 

increase, as opposed to central government. 

The central government grant, which totalled £18 

billion in 2013/14 and equated to about a third of 

council revenues, will also have gone by 2020, while 

the right to keep 100% of business rates will deliver 

an estimated extra £11.5 billion a year to council 

budgets by then, councils have said. 

Elected city-wide mayors will be able to add 

a premium to business rates to pay for new 

infrastructure, provided they have the support of 

the local business community through a majority 

of business members of their Local Enterprise 

Partnership. The Local Growth Fund, created 

following the Heseltine Review, puts money under 

the direct control of Local Enterprise Partnerships 

and the government will deliver on its commitment 

to a £12 billion Local Growth Fund between 2015/16 

and 2020/21. 

It is worth noting that the Department for 

Communities and Local Government took the 

biggest hit in percentage terms in spending 

cuts during the last Parliament, with the 

communities-focused part of its budget halved 

and direct grants to local authorities reduced by 

27% in real terms. The initial headline figure for 

the next four years is cuts that average out to 30%, 

although it has been suggested that this figure may 

be significantly higher. 

Elected city-wide mayors will 

be able to add a premium 

to business rates to pay for 

new infrastructure... 

Continued overleaf >


Police 

There will be no real term cuts in police budgets in 

England and Wales, with spending to rise by £900 

million by 2020. This will include an extra £500 

million of funding for the counter-terrorism budget, 

more than £1.3 billion of capital investment on 

improved border security and £1 billion to “overhaul 

the emergency services network”, including 

investment in mobile communications. 

Savings will be made through the borders and 

immigration system and reductions of 30% to the 

administrations budget compared with 2015/16 

and Mr Osborne said that police reform needed to 

continue in this Parliament, with forces expected to 

make further savings by merging back offices and 

“sharing expertise.” 

Police and Crime Commissioners will also have 

“greater flexibility” to raise precepts – the money 

given to police through council tax – where they had 

been “historically low.” 

Health 

The NHS budget was not only ring-fenced but an 

additional £10 billion of funding has been promised. 

The overall health budget in England, currently 

£101 billion, will rise to £120 billion by 2020/21 and, 

significantly, the NHS in England will get an upfront 

cash injection of £6 billion next year as part of the 

additional funding. However, the NHS in England 

is still expected to make £22 billion in efficiency 

savings. There will be an extra £600 million 

earmarked for mental health services and the 

Better Care Social Fund will be increased by 1.9%. 

The price to pay, however, is that the Department 

of Health’s own budget – the chunk of its current 

£116 billion income that does not give the NHS its 

£101 billion – is being cut by 25%. This principally 

means cuts to the key health bodies funded by that 

money, notably Health Education, which pays for 

the recruitment, education and training of health 

professionals, and Public Health England, intended 

to help improve public health in general, while 

the fact that significant efficiency savings are still 

expected means that the immediate pressure on 

frontline healthcare bodies is not likely to lessen. 

The NHS budget was 

not only ring-fenced 

but an additional 

£10 billion of 

funding has 

been promised. 

Education 

The education sector got off more lightly from the 

cuts than many had anticipated, prompting sighs 

of relief from universities and further education 

colleges. But the government’s offer to extend 

free childcare has been trimmed while services 

provided to schools by local authorities were hit by 

a significant cut. A major shake-up of the formula 

for funding schools in England is to take place by 

2017, which is likely to see funding shifted away 

from inner city schools. The largest cut in education 

will be the scrapping of the £600 million education 

services grant paid to local authorities, which will 

cut back on the school improvement and support 

functions provided by those bodies. 



7 

...the government’s offer 

to extend free childcare 

has been trimmed while 

services provided to schools 

by local authorities were hit 

by a significant cut. 

Conclusions 

Beyond the Chancellor’s eye-catching and 

headline grabbing U-turn on cuts to tax credits, 

there is not a great deal that was not expected, 

although the rumour mill was certainly in 

overdrive about the risks of potential cuts to 

police spending. 

What is apparent from the package as a 

whole, however, is that public bodies are 

going to have to continue not just to deliver 

but to develop and modernise their services, 

alongside ever greater public expectations, 

whilst budgets are reduced. 

Andrew Cooper, 

Public Sector Director 

0151 243 9898 

andrew.cooper@weightmans.com


THE 

BALANCE 

Graeme Creer explains why 

the Northern Powerhouse 

could drive regional growth 

and rebalance Britain. 

The powerhouse of London 

dominates more and more, we 

need a Northern Powerhouse too. 

It is always exciting when the government thinks up 

the slogan first, and fills in the rest as it goes along. 

George Osborne’s brainchild is a cracking brand, 

rippling with muscular purpose: “The powerhouse 

of London dominates more and more, we need a 

Northern Powerhouse too.” It can be tacked on 

to any press release, features in the Spending 

Review and even has its own government minister. 

But what is it all about? 

There are three main elements. The first is about 

infrastructure, and transport links joining up the 

big northern cities with new roads and fast trains. 

This took a hit when key elements of the rail plans 

were shelved, and the road and rail schemes include 

existing projects. But the idea is strong, and the 

investment is welcome. 

The second aim is to boost innovation and 

overseas trade. 

The third element is “serious devolution of powers 

and budgets for any city that wants to move to a 

new model of city government – and have an elected 

Mayor.” Labour’s old regional arrangements stalled, 

and were scrapped in 2011, leaving a vacuum only 

partially filled by Local Economic Partnerships. The 

Coalition government re-imagined devolution as 

“localism”, but the winds of change from Scotland 

and Wales were too strong, and England is next. The 

big prize is economic growth outside the South East. 

Devolution is the chosen mechanism. The primary 

vehicle is the “combined authority”, a 2009 invention 

where groups of local authorities promote a new 

body covering transport and economic development. 

They are popping up in most “city regions”, 

with Manchester well in the lead. The deals that 

government strikes with local authorities, giving 

them extra powers and funding, were re-titled 

“devolution deals”, and in July this became a 

frantic, secret bidding process with no rules and an 

eight week deadline. New “devolution agreements” 

are emerging, mostly with Northern Powerhouse 

authorities and involving a combined authority made 

up of the Leaders or Mayors of the local councils, 

and from 2017 a directly elected city region mayor, 

majoring on control over economic development 

funding, transport powers and funding, joint working 

and devolution on skills training and business 

support, strategic planning functions, a coordinated 

approach to public sector land, and oversight of 

health and social care integration. 



9 

OF 

POWER 

And the Government intends to phase 

out local authority grants in favour 

of allowing them to keep a higher 

proportion of business rates, and the 

income from business rate growth. 

But there are big questions: 

Government funding for local authority spending will 

be halved over the next five years. Local authorities 

are told to cut senior pay and sell local assets. Is there 

new money in devolution, or is existing funding – or 

less funding – being redistributed? 

The Cities and Local Government Devolution Bill 

seeks to free up the creation and alteration of 

combined authorities, and to allow them to be 

given extra responsibilities like police and crime 

commissioner and fire and rescue authority functions. 

Will they be new super-councils, or a substitute for old 

regional structures? 

The deals are carefully worded. Many of the promises 

are conditional, vague and aspirational. Do they have 

any resonance outside the political arena? 

Does it matter if the governance of Manchester 

is radically different from the governance of Bristol 

or Norwich? 

Will elected mayors have any real powers, or will 

councils be able to veto initiatives they do not like? 

Will business rate retention be less redistributive, 

to the disadvantage of the less affluent regions? 

And will the focus on regional growth re-orientate 

the planning system, so environmental, amenity and 

aesthetic considerations become secondary? 

Make no mistake, though, the Northern Powerhouse 

is a serious project. It could drive regional growth and 

rebalance Britain. 

Time will tell. 

Graeme Creer, 

Consultant 

0151 243 9834 

graeme.creer@weightmans.com


CHANGING 

THE FACE OF 

HEALTHCARE 

SERVICE 

DELIVERY 

More and more 

NHS organisations 

and local authorities are 

turning to health and 

social care integration to 

meet the challenges of 

reducing spending and 

improving services. 



11 

Many healthcare and social 

care leaders regard the 

integrated approach as a 

once in a generation opportunity 

to empower individuals, while 

reshaping a late 20th century 

service model that no longer 

works in 2015. 

“In his 2002 report on the long term 

future of health services, the late 

Sir Derek Wanless said that if we 

carried on as we had been doing, 

the NHS would go bust by 2020,” 

said Stuart Cowley, Director of Adult 

Social Care and Health at Wigan 

Borough Council. “Simon Stevens, 

CEO of NHS England, reiterated a 

similar view last year.” 

Continued overleaf >


Turning disjointed services into cohesive teams 

Stuart’s views are endorsed by Karen James, CEO of 

Tameside Hospital NHS Foundation Trust. 

“If you have been a patient or carer, you will understand how 

fragmented our systems and organisations are. We are working 

in silos and it is becoming more and more important to integrate 

services,” said Karen. “We must change the way we operate so 

that community care, primary care and hospital care services 

become as seamless as possible.” 

This means cutting across organisational boundaries because they 

are not relevant to the care patients and service users need today. 

“We do a lot of duplication and have inefficient services that are 

difficult for people to move between,” added Karen. “We have 

deficits across the system and we need to pool budgets so we can 

address priorities and manage patients in the most appropriate 

environment. For example, 13% of our bed-stock in Tameside 

is currently being taken up by patients whose discharge into 

community care is delayed. An integrated service would address 

this disjointed situation.” 

“We must change the way 

we operate so that community 

care, primary care and hospital 

care services become as 

seamless as possible.” 

Prevention is better – and cheaper – than cure 

So what are the alternatives to the current system and what sort 

of changes in philosophy are needed to deliver the new model of 

integrated services? 

Stuart commented: “We are reaching for professional reform to 

deliver a vision of keeping people well, rather than treating them 

when they are ill, by doing some very basic things. We have a 

way of working where we fix ill people and act as practitioners to 

dependents. We are starting instead to approach people from a 

human angle and ask them questions such as ‘What is your best 

day like?’ and ‘What are your talents and interests?’. We are getting 

to know the person as a starting point.” 

By doing this Stuart believes service providers can connect people 

to their most appropriate form of support in their local community. 

“This approach is better for the individual and cheaper for 

the community than an eight minute GP appointment and a 

prescription that in some cases may not be needed, and is not 

necessarily the solution. Sometimes it is not Prozac that a person 

requires but debt counselling,” he said. “If you help people to 

make the connections and have a genuine menu of options to keep 

them connected in the community, you can very often keep them 

out of hospitals.” 

Multi-disciplinary solutions delivered under one roof 

Meanwhile, Tameside Hospital NHS Foundation Trust is introducing 

an exciting new programme to create an integrated care system, 

which involves radically fresh approaches to working practices. 

“Our outpatients’ outcomes have not improved for decades, so 

this way of working is clearly not fit for purpose,” said Karen. 

“To rectify this situation we will concentrate on an ill-health 

prevention strategy that involves mobilising community care 

assets to look after well-being.” 

Karen continued: “In terms of primary care we will work around 

GP localities with the support of consultants and specialist nurses 

who can provide senior level advice. This will enable us to more 

effectively manage patients recognised as being at risk, so they 

don’t end up in a crisis situation. 

“This will involve wrapping our services such as community 

services, social care, around GP localities with links to specialist 

support from the acute hospitals consultants. It is about preventing 

at-risk patients from getting to crisis point by being proactive.” 

When emergencies do arise, Tameside’s programme will involve 

pulling services together, so there will be urgent integrated 

response for example, out-of-hours services and walk-in centres 

as well as rapid intermediate response teams will be integrated 

and managed as one service to form under one roof in an 

‘emergency care village’. 

“There will be a single point of contact and all services will be 

totally integrated to deliver the most appropriate response,” 

explained Karen. 

“The other element is the local authority and health commissioners 

sharing a pooled budget. They will jointly decide on the outcomes 

they want to achieve and will commission an integrated delivery 

system to deliver the health outcomes required.” 



13 

Taking the ‘human-to-human’ approach 

Recent initiatives have involved teams in both Wigan and 

Tameside demonstrating the effectiveness of integrated teamwork. 

“We had a professional who was going to see a woman with a 

broken hip. The professional took the time to look around the 

room and saw framed embroidery on the wall,” said Stuart. 

“She said how nice this was and the woman flushed with pride. 

The professional knew the Clifton Street Community Centre was 

just down the road and contacted the manager, who was happy 

to come and talk to the woman with the broken hip, to explain 

that there were sewing classes at the centre.” 

Stuart continued: “We are recognising that by putting community 

connections and wellness front and centre, we can achieve better 

with less expense. We are seeing that people stay healthy and well 

when they feel valued and connected. We are surprising ourselves 

by finding out how many community resources are available to 

help people to stay healthy.” 

Under the old model, this situation would have involved the 

professional recommending a day centre with transport laid on – 

mainly because this was the standard procedure. 

“If the professional had a busy workload, he or she may well have 

looked at the care plan and arranged the day care and transport 

without really thinking it through,” commented Stuart. “However, 

by investing more time in the first place you can get to know the 

person better yourself. People don’t come defined by their social 

care needs and I believe that, two or three years down the line, 

workers will be routinely having human-to-human conversations 

first and a professional to patient dialogue second.” 

Stuart added: “The starting point is bonding frontline workers – 

such as social workers, occupational therapists, health visitors, 

early years workers – with the needs and interests of individuals 

so that NHS and local authorities have a common way and the two 

areas we are focusing on are schools and GP practices.” 

Children see the benefits of a joined-up paediatric service 

In Tameside, the paediatric service represents a strong illustration 

of how integrated services can operate effectively. 

“The team is moving patients from the community to hospital, 

and from the hospital back into the community in a way that 

is really positive for parents and children. I’ve been out with 

the team and been very impressed by the huge improvements 

in communications – because our practitioners aren’t stuck in 

professional and organisational boundaries,” explained Karen. 

“Children who you never would have believed could be managed 

outside a hospital are being looked after at home and this is largely 

thanks to the single, multi-disciplinary team. Our aim is to produce 

a much more efficient service with better outcomes for patients, 

while addressing the budgetary challenges faced by all public 

sector organisations.” 

Karen James, CEO, Tameside 

Hospital NHS Foundation Trust 

Stuart Cowley, Director of 

Adult Social Care and Health 

at Wigan Borough Council. 

“We are recognising that by 

putting community connections 

and wellness front and centre, 

we can achieve better with 

less expense.”


RISING 

TO THE 

CHALLENGES 

OF CHANGE 

Organisational change in the public sector 

has wide-ranging implications for employers. 

Emlyn Williams reveals some of the issues – 

and suggests solutions. 

When public bodies undergo a reconfiguration or merger, 

it can be tempting to look first at what is going to happen 

to the employees. However, from an employment law 

perspective, this is putting the cart before the horse. 

The first consideration should be the nature and 

organisational implications of the changes: because what 

happens to employees will flow from the reorganisation, 

not the other way round. 

What if a brand new organisation is being established? 

There is often a time lag between the decision to merge 

or reorganise and the creation of the new body. This can 

lead to a lack of direction. One way to handle this issue is 

to have a shadow management structure. As long as this is 

set up carefully the shadow management body can assess 

the implications for employees and ensure they are fully 

understood from the outset. 



15 

It’s good to talk 

This links in with communication. In any reorganisation it is 

essential to put in place a clear communication strategy so all staff 

know what is going to happen and when. No one likes change, 

but change combined with uncertainty is doubly unsettling for 

employees and should be avoided wherever possible. 

There can also be legal obligations to consult. If there is a 

transfer of undertakings, which can include a service changing 

hands or if there is a collective redundancy situation affecting 

more than 20 staff at one ‘establishment’ there are separate 

obligations to consult. 

Such consultation may need to take place concurrently, but 

separately, which requires careful planning for both the ‘old’ and 

‘new’ employer where a service is changing hands. An important 

prerequisite for successful consultation is knowing what change is 

going to look like. In practical terms, public bodies that are going to 

take a service forward after a merger will either have a ‘Brave New 

World’- plan for instant change, or a ‘wait-and-see’ approach that 

involves transferring staff in and reviewing the situation once the 

service is up and running. 

What if some employees are made redundant? The government’s 

proposed cap of £95,000 for public sector termination payments 

from April 2016 represents another potential issue for employers. 

Many public sector employees have a much greater redundancy 

entitlement than this. When enhanced pension costs are 

included, the settlement figure for some individuals can 

easily exceed £200,000. 

The upshot of this could be that employees in organisations 

undergoing change before April 2016 will be keen to argue that 

they want to leave by reason of redundancy. Even if they are 

offered a suitable alternative position, they could contend that it 

is not suitable in order to ensure they receive their money before 

April when the £95,000 cap is introduced. Employers need to be 

ready to deal with this argument if it arises and not leave the details 

of any proposed new role too vague, or communicate it at the 

11th hour. 

There is often a time lag 

between the decision to merge 

or reorganise and the creation 

of the new body. This can lead 

to a lack of direction. 

Practical points on mergers 

When TUPE applies, employees will transfer on their existing 

terms and conditions. There is sometimes an insufficiently robust 

analysis of what is contractual (and so transfers over) and what is 

not. This can lead, for example, to the new combined team working 

under two different sets of disciplinary rules. If there is a thorough 

assessment of whether or not such rules are contractual, this type 

of situation can be managed. 

A major hidden cost of organisational change relates to whether 

relevant policies say excess travel costs may be reclaimed by 

employees whose place of work change. In one case we handled 

recently, these costs amounted to more than £500,000. If changes 

are being made to drive cost efficiencies and financial planning, 

this sort of extra cost can come as a nasty surprise if not 

considered in advance. 

Changes in location are often the trickiest to manage. Organisations 

should look to see if there are mobility clauses requiring employees 

to move to a different location. If there is a potential redundancy 

situation, the employer should find out if it can help with transport, 

or by allowing flexible working for affected staff. Whilst changing 

location where there is a TUPE transfer has become slightly easier 

in legal terms, it remains quite fraught and difficult. 

It is important to be positive about change. If you do not have 

effective mobility clauses, it is still possible to engage with your 

staff and persuade them to want to make the move. If people feel 

that they are genuine stakeholders who are being consulted and 

have a genuine say in changes which affect them, they are much 

more likely to embrace a move than if they feel it is being imposed 

on them. 

Emlyn Williams, Partner, Employment 

0151 243 9569 

emlyn.williams@weightmans.com

16 Public Eye Focusing on emerging issues in the public sector 

NEW HEALTHCARE 

MODEL IS PART OF 

REVOLUTIONARY 

CHANGE 

The new wave of integrated healthcare provision and an 

examination and analysis of the potential models of care 

is well underway following the launch earlier this year 

of the government’s Vanguard initiative. More recently, 

the new Primary Care Home (PCH) model aimed at larger 

populations has been announced. Endorsed by NHS 

England, the programme has been launched by the NAPC 

with the target for the pilot programme being a list size of 

30,000 to 50,000. 

In the long term, if the pilot proves successful, we may see 

more practice mergers to enable service provision at scale. 

However, fundamentally collaborative working with other 

services across the whole health and social care spectrum 

is at the centre of the project. 

The project is part of the ongoing agenda to provide 

local completely seamless care with patient need at the 

centre. GPs are at the heart of the service provision via the 

philosophy that the registered list and a capitated budget 

are a logical basis for healthcare provision. Whilst this 

pilot programme is offered to general practice, it is clear 

that GPs will need to work with other providers. As with 

the Vanguard programme, PCH promotes the concept 

of provision by a “complete clinical community with an 

integrated primary, secondary and social care workforce 

delivering more personalised and better coordinated care 

close to home.” The goal is that PCH should be provided 

through modern health centres with strong diagnostic 

facilities and IT systems. 

As healthcare delivery 

continues to undergo 

radical reform, 

Edwina Farrell 

discusses one of 

the government’s 

major new 

initiatives. 



17 

In essence, the model does look from the outset to be 

similar to Vanguard Multi Specialty Community Providers 

so that for practices which were unsuccessful in their bids, 

this could be seen as ‘another bite at the cherry’. However, 

there are differences between the two which will emerge as 

the model is brought into practice. 

Integrated care service delivery aims to bring down the 

perceived barriers between primary and secondary care, 

mental health and social care. The myriad of organisations 

have their own management systems and cultures which 

are not always helpful for the overall patient experience, 

and can lead to delay in a patient’s journey through the 

system, with a lack of personalisation. 

As well as improving the patient experience by removing 

organisational barriers, one of the key drivers of change is 

the sustainability of a model which allows the provision of 

more services within the community rather than admission 

to hospital. It is well documented that the current system of 

care has to make radical changes. As with other integrated 

care models, the view is that unnecessary admissions can 

be cut saving the public purse and where an admission is 

the right course of action, the ability for the patient to be 

returned to their own surroundings with an appropriate 

level of support from within their community as soon as 

is reasonably possible, is better for patient well being. 

It is well 

documented 

that the current 

system of care 

has to make 

radical changes. 

PCH was only announced at the end of October so 

much detail will need to emerge before its merits 

can be truly evaluated. However, the timetable is 

ambitious which gives an indication of how rapidly 

primary care is changing – the deadline for submissions 

of interest has already passed and shortlisting of 

successful test sites was due to take place in December. 

From the shortlist, approximately 10-15 Rapid Test 

Sites will be identified. Development of the sites will 

take place between January and March 2016 and the 

implementation of the programme starting from 

April 2016. 

There are concerns, as with many new proposals. 

For example, there have been questions as to the 

nature of the contract on offer as part of PCH, and 

how it will compare to those aspects of a GMS or 

PMS contract that work well with general practice 

and, in the event that it proves unpopular or 

unsuccessful, will there be a right to return to the 

GMS/PMS contracts previously held? 

The role of the family doctor is evolving and the signs 

are that we won’t have to wait long to get a clear 

picture of PCH in action. There is much encouraging 

food for thought and anyone with an interest in 

healthcare will be following this development with 

eager anticipation. 

Edwina Farrell, Partner, Real Estate 

0207 822 1926 

edwina.farrell@weightmans.com


ARE WE 

HEADING 

TOWARDS 

A SINGLE 

JOINED 

EMERGENCY 

SERVICE? 

The demands and roles of ambulance trusts, fire and police 

organisations are ever changing but there is a strong impetus 

and defined measures to improve closer working between 

these emergency services, says Nathan East. 



19 

The pressures emergency services face to meet demand continues 

to make headlines. A recent high profile case of an accident victim 

left waiting for three hours following a crash near the boundary 

between three police forces has raised questions as to the effective 

co-ordination across emergency services. 

A new Consultation Paper ‘Enabling closer working between 

the Emergency Services’ formalises an existing push towards 

collaboration between emergency services by introducing 

a statutory duty to collaborate to improve efficiency and 

effectiveness, and puts the issue into the spotlight. So are we 

heading towards a single joined emergency service? If not, 

what are the objectives? 

Some commentators see the new proposals as a precursor to 

more radical integration. There is precedent for effective single 

combined emergency services in other countries, but the 

consultation proposes evolution rather than revolution. 

Recent years have witnessed a welcome trend towards closer 

working including successful ambulance and fire authority 

co-responding initiatives which have been shown to save lives. 

...a large majority of fire 

deaths are amongst the over 

70s who have pre-existing 

health issues. 

The consultation recognises increasing demand on ambulance 

services, and the evolving role of fire and to a lesser extent police 

services to focus on protection and assisting those at risk or 

vulnerable. Service demand tends to overlap significantly in some 

communities due to socio-economic or urban conditions. For 

example, a large majority of fire deaths are amongst the over 70s 

who have pre-existing health issues. 

The proposed collaboration duties are fairly generic and 

recommend local solutions allowing the Services to take the lead. 

Suggested efficiencies around shared back office and further 

co-location suggest fiscal rather than operational objectives 

behind the proposals. 

The marquee measure will enable Police and Crime Commissioners 

(PCC) to take on the responsibilities of fire and rescue authorities. 

Transfer is not mandatory but is anticipated where it is in the 

‘interests of economy, efficiency and effectiveness or public safety’. 

As such local agreement between police and fire will be required. 

It is likely PCCs would take no direct responsibility for operational 

aspects of the fire service which would continue to be directed by 

Chief Fire Officers. 

There is a concern that these proposals could affect the autonomy 

of the fire service in particular. To allay fears, separate funding 

streams for the two services will continue to exist for fiscal clarity 

but this must be robustly enforced if the independence of two 

distinct services is to be protected. 

There remain a number of structural barriers. Vast cultural 

differences exist between services with ambulance closely aligned 

to the wider NHS in terms of governance, and each has very 

different statutory powers, regulation and funding. If greater 

integration is the ultimate goal, these will need to be aligned. 

However, there is understandable public concern that this could 

lead to services becoming less specialised. 

Currently, ambulance trusts tend to cover much larger populations 

than fire and police authorities meaning collaboration may only 

be possible on a piecemeal basis with different fire and police 

authorities within its geographical area. 

Overall, closer working and greater efficiency can only benefit the 

public provided recognition of the highly trained specialism of the 

core aspects of each emergency service remains paramount. 

Nathan East, Partner, Real Estate 

0207 822 1932 

nathan.east@weightmans.com


Fundraising 

potential of 

enterprising 

public bodies 

Public bodies are under increased pressure to 

find alternative methods of income generation. 

Vincent King examines the issues. 

The current squeeze on public sector budgets produces two 

interrelated options: one is to reduce costs and the other to 

generate income. 

In some cases public sector bodies have been able to cut costs 

and raise income by sharing services and then providing these 

services to third parties on a commercial basis. These ‘win-win’ 

scenarios are rare, however, for a number of reasons, including 

the nature of the organisations, statutory and regulatory 

constraints, and the lack of a viable market. 

An exit strategy is also 

critical and should be 

integral to the planning 

process from the outset. 



21 

Income generation across the public sector 

How do the various components of the public sector compare 

in their income generation activities? 

Without doubt universities are at the most active end of the income 

generation spectrum, especially in the areas of innovation and 

intellectual property (IP), selling training programmes, and offering 

consultancy services. 

Some of this activity can be seen as a catalyst for wider economic 

regeneration. For example, we have been working with Bradford 

University to establish a University Enterprise Zone that is partfunded 

by the government. The project also involves a joint venture 

company set up with Bradford Council and a partnership agreement 

with BT. The university and council are each contributing a building 

to the initiative, which aims to promote closer working between the 

university and digital health businesses. 

Moving across the spectrum of the public sector, local authorities 

are more active in income generation and trading than, say, the 

NHS (with the exception of the exploitation of intellectual property), 

while at the opposite end of the spectrum you have the emergency 

services including fire and rescue authorities and the police, where 

inevitably the opportunities are more limited given the nature of 

their activities. 

Intellectual property 

The commercialisation of intellectual property is an interesting 

area. We have advised universities and health trusts on IP spinouts 

of various kinds. Despite this we consider that IP remains 

under-utilised as a means of income generation. It is advisable for 

universities and health trusts to carry out a regular audit of their 

activities to check whether any IP is being generated which could 

be commercialised, and also review their employment contracts 

and IP policies as regards ownership of IP and the sharing of 

any commercialisation proceeds. This is less of an issue for local 

authorities and the police day-to-day but they should also be 

aware of the potential generation of IP when undertaking particular 

activities and as a firm we have given advice to local authorities 

and the police on trademarks and copyright respectively. 

Selling services 

A crucial point is not only whether a public body has the legal 

powers to undertake a specific trading activity, but also whether 

it can sell certain services for a profit, and this varies from one 

type of organisation to the next, and also from one activity or 

service to another. 

Equally essential is a thorough understanding of procurement 

rules and what impact these will have on any planned activity, 

particularly if a new legal entity is established. 

An important point that relates to any public body and any 

potential fund generating activity is business planning in order 

to establish that there is a genuine market for the services you are 

proposing to sell. 

Another factor is whether you have the skills and resources 

which will be needed in order to undertake the particular activity 

successfully. As an example, some local authority legal teams are 

now creating alternative business structures (ABSs) to sell their inhouse 

legal services. 

An exit strategy is also critical and should be integral to the 

planning process from the outset. Public bodies need to think about 

all the possible outcomes of a venture. It might, for instance, evolve 

into an activity that is different to what was initially anticipated. So 

there must be flexibility in the arrangements from the start. 

Conclusions 

Public bodies have never been more free to take the 

initiative and raise funds to mitigate budget constraints. 

However, before taking any action, the importance of detailed 

planning, market analysis, and due diligence around legal 

constraints cannot be overstated. 

Vincent King, Partner, Corporate 

0161 214 0653 

vincent.king@weightmans.com


UNIVERSITY 

FUNDING SCHEMES 

FACE TOUGH TIMES 

Patricia Grinyer explains why universities managing 

public sector loan funds for small firms are under pressure. 

Universities that facilitate loans to start-up and 

early-stage businesses are facing a financial crisis as 

central government efficiencies are implemented with 

greater rigour. 

Unless universities recover much larger proportions of 

the loans they hand out to research-driven enterprises, 

ongoing funding from the UK government and Europe 

could dry up. 

As a result, fledgling firms in the lucrative knowledge 

economy could fail, with the loss of jobs and enormous 

potential wealth they might have created. 

Traditionally universities have administered public sector 

funds because, unlike local authorities, they have deep 

specialist knowledge in areas such as biotech, digital and 

low carbon industries. 

The reason public funding pots were set up was to 

bridge the funding gap faced by start-up, early-stage 

and university ‘spin out’ businesses whose only assets 

are their intellectual property (IP), which remains in 

the heads of the founders until the business gets the 

cash to develop. 

Understandably, banks and other commercial lenders 

have not been willing to lend to these ventures until a 

later stage in their commercial life-cycle. 

In the past, universities have focused their resources 

on nurturing these research and development (R&D) 

based enterprises, rather than collecting the money they 

have leant. However, as the UK government ramps up its 

public sector spending constraints, many universities 

are finding themselves in a position where they must 

be much more rigorous with their lending criteria, 

and a great deal more efficient in recovering funds. 

This puts them between a rock and a hard place, 

with commitments to the early-stage businesses 

they are supporting on the one hand, and an obligation 

to responsibly manage the funds entrusted to them on 

the other. 

If universities fail to tighten up their loan management 

there may be far-reaching consequences. These could 

seriously affect universities as well as many early-stage, 

knowledge economy enterprises that the government 

itself is keen to support. 

Patricia Grinyer, Partner 

Corporate 

0151 243 9527 

patricia.grinyer@weightmans.com 



23 

DATES FOR 

YOUR DIARY 

JANUARY 

FEBRUARY 

MARCH 

13 

15 

26 

NHS BREAKFAST CLUB 

13 JAN 2016 – LIVERPOOL 

15 JAN 2016 – MANCHESTER 

Can you escape… the medical 

workforce management maze?! 

MIDLANDS HEALTHCARE FORUM 

26 JAN 2016 – BIRMINGHAM 

Covering topics such as harassment 

of staff, the impact of social media, 

a litigation update, recent criminal 

prosecutions against healthcare 

professionals, the role of the GMC 

and NMC and a short update on 

relevant regulatory cases. 

9 

MONITORING OFFICERS 

CONFERENCE 

9 

9 FEB 2016 – LONDON 

10 

11 

This successful event has already 

taken place in Leicester, Manchester 

and Birmingham. The cost to attend 

is £150 + VAT, for more information 

please visit our website. 

NLGN DEVOLUTION ROUNDTABLE 

10 FEB 2016 – LEEDS 

At this high level roundtable we will 

discuss how to make devolution work 

in practice. We will explore how areas 

can make devolution work for them 

and consider the relationships, the 

partnerships and the powers. 

NWLC CHILDCARE 

11 FEB 2016 – LIVERPOOL 

An update on the latest developments 

in child care law including the latest 

case law, practice directions, guidance 

and legislative changes. 

10 

21-23 

THE LIABILITY LANDSCAPE FOR 

LOCAL AUTHORITIES 

9 MARCH 2016 – MANCHESTER 

A combined public sector and 

disease seminar looking at impact 

of asbestos and duties of health and 

safety stakeholders together with 

issue of abuse. 

THREE PACK 

10 MARCH 2016 – BIRMINGHAM 

This seminar covers new duty of 

candour, fit and proper persons 

test and whistleblowing. 

AUA ANNUAL CONFERENCE 

21-23 MARCH 2016 – ROYAL 

ARMOURIES, LEEDS 

Karen Stephenson and Jo Farrington 

will be leading a workshop based 

session on the impact of consumer 

law on the higher education sector. 

MERGER WITH FORD 

& WARREN COMPLETED 

We completed our merger with Leeds based firm Ford & Warren 

in July 2015, further strengthening our position as a top 45 

national law firm bringing the combined staff count to over 1400 

people, with a combined turnover in excess of £100 million. 

The firm will continue to operate at Westgate Point, Leeds, adding to its existing 

eight locations across the UK. The merger builds on Weightmans’ national 

presence, with outstanding expertise and the resources to focus on the needs 

of our clients. 

Peter McWilliams and John Schorah 

Weightmans Managing Partner, John Schorah said: “We are absolutely delighted to have completed the merger with Ford & Warren. 

We look forward to being stronger together, and working in synergy to maintain the high standards we set ourselves for our clients.” 

Ford & Warren Managing Partner, Peter McWilliams commented: “The two firms share a common ethos, with similar cultures and strategies. 

It became apparent early on that we were well matched, and we look forward to growing the business, overcoming new challenges and 

exceeding client expectations together, both in the North and nationwide.”

Law is our business. 

Weightmans’ public sector reputation speaks for itself. 

A top 45 law firm in nine locations, employing more than 1,400 people. 

We offer a full range of legal services and a strong and fast-growing 

reputation in the public sector market. We act for many local, police 

and fire authorities and a range of NHS trusts, such work forms part 

of our heritage. 

With client satisfaction scores higher than the legal industry average, 

we work hard to get results for our clients each and every day. 

For further information, please contact Andrew Cooper, 

Public Sector Director on 0345 073 9900 or email 

andrew.cooper@weightmans.com 

For more information visit www.weightmans.com

Public Eye Winter 2015/16

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