Sitra study trip Service Voucher and Customer Right to Choose Social and Healthcare Services

Anna Walker: Member of Consumer Focus BoardIntroduction to Consumer Focus21 May 2010

Anna Walker – background note• Wide experience of regulation gained across

government and regulatory authorities – Telecommunications– Energy– Agriculture– Water – Rail

• From 2004 – 09 Chief Executive of the Healthcare Commission

What is Consumer Focus?

• Created by an Act of Parliament – Non Departmental Public Body

• 2008 merger of National Consumer Council, Postwatch and energywatch

• Independent of government and industry• Able to work across all sectors of the economy• With particular responsibilities for energy and postal

markets

What do we look like• We have a devolved structure

– Consumer Focus; Consumer Focus Scotland; Consumer Focus Wales; Consumer Focus Post (Northern Ireland)

• Responsible to a UK Board• Around 180 staff with a core budget of £15 million• We do research, policy development and advocacy• We directly support consumers at risk of disconnection

from energy supply• We are also home to the National Social Marketing Centre

Our statutory functions• To represent the interests of consumers• Undertake research into areas of consumer detriment

and welfare• To refer ‘supercomplaints’ to regulators requiring

them to investigate areas of consumer detriment• Provide information and advice to help consumers

and to improve standards of service• Use general powers of investigation to require

regulators and companies to provide information• We must assist vulnerable energy or postal

complainants and energy disconnection cases

How are we funded

Our Planning Process 

 

 

 

Consumer Focus 

2009/10 Roll‐over Work

Detriment

Trend

Advocacy GapImpact

Value

Our Work 

Criteria for Work Planning 

Statutory* Responsibilities

Public Services

Horizon Scanning

Evidence Based 

Priorities

* Consumers, Estate Agents and Redress Act 2007

How do we act?• We campaign for a fair deal for consumers and to

make markets and services work better– Energy prices and standards of service

• We represent consumers across public policy, industry and regulatory debates– Reform of financial services

• We report on consumer experience of the economy– Consumer research on copyright law and file-sharing

• We help consumers make more informed choices– Web advice, working through the media and with advice agencies

• Take action on behalf of vulnerable consumers– Our ‘Extra Help Unit’ stops consumers from being disconnected

from their energy supply

Consumer Priorities for Consumer Focus

What drives our work

“we will make a difference to people’s lives as consumers, particularly the most vulnerable, by championing policy changes that can help make people as powerful as the institutions that serve then.

we will engage, inform and support consumers to act. Where they cannot act for themselves, we will act for them by working to improve the performance of those who serve them.”

Our priority areas• Public and Community Services

– Engage consumer experience to get more effective and efficient services

• Building service delivery around the user experience• ‘Community levers ‘ how can local communities engage without being asked?

– How good are public services at customer service• Jobcentre Plus and the personalisation of service delivery• Police and responding to citizen complaints

• For vulnerable and disadvantaged consumers– Articulate the real experience of consumers in debt– Provide expert knowledge to front line advice agencies– Challenge the poverty premium where the poor pay more for

essential goods and services.

Our priority areas• Energy

– Keeping companies honest • Challenge assumptions about price• Monitor standards of service• Refer poor behaviour to regulators

– Consumers and the low carbon transition• Make sure costs are fairly distributed• Contribute to the design of energy efficiency programmes• Help consumers understand the changes

– Protecting the most vulnerable• Drive fuel poverty initiatives• Work with regulator to improve standards of debt management• Extra help unit

Our priority areas

• Post and Post Offices– Better value and service from Royal Mail– A modern post office network that people can access, want to use

and are happy with their– post office as a community hub for banking and access to

government services

• Financial Services– Reform of regulatory regime– Promote the interests of those neglected by mainstream banking

Our recent impact• Directgov - online access to public services

– Created a community of online users to improve the government’s information and services web portal

• Savings market ‘supercomplaint’– Referred the ‘cash ISA’ market to the Office of Fair Trading

• Energy debt and disconnection– A joint review of the performance of energy supplier in relation to

energy debt with clear recommendations for improvement

• Proposals for a community bank in Post Offices– Welcome for our proposals for banking products tailored to the

needs of low income post office customers

• Stand up for consumers on copyright– Working with regulator to protect consumers threatened with

having their broadband cut off for copyright infringement

HEALTH CARE AND SOCIAL CAREVERY DIFFERENT IN THE UK

•Healthcare : largely public money•Social care : - debate on funding

- much less money - more self financing

•Healthcare : patient choice•Social care : some vouchers

? In healthcare for long term conditions

Long tradition of professional regulationBut this of individuals

Late 1990sRecognition that healthcare requires systems for

delivery.Public enquiry into deaths of children from heart

surgery in Bristol: quality of care issue.Concerns about access to care.

Led to establishment of an independent regulator.

Independent healthcare regulation in UK

Huge additional finance since 2009 £47 billion → £120 billion

approx. 9% of GDP.

Moves towards a less centralized healthcare system.

Determination to improve access to healthcare.

Commissioner/provider split.

More of a role for the private sector.

Against a Background of General Healthcare Reform

• All healthcare:o Now has to be registeredo And meet government standards.

• Public Sector (National Health Service) also:

public annual ratings:o Excellent, Good, Fair, Weak.

Targets

National Quality Board to look at standards

New government : full economic regulator.

Legal Framework

A regulatory system based on risk. Emphasis on hospital’s responsibility:

Self assessment against standards.

We checked taking account of: All available information Views of local government Patients’ / staff views: major surveys.

Measuring what is important to: Doctors Patients.

Aim to encourage improvement.

The overall approach

• Standards - covering, e.g.o Safetyo Public healtho Clinical governance.

• Targets - mainly for accesso Accident and emergencyo Waiting time for operationso Cancer treatmento Choice issues.

• “Patient Pathways” - between organizationso Heart diseaseo Maternity service

Areas covered by assessment:

In depth look at individual organizations.

Approx. 100 concerns raised with Healthcare Commission per annum.

We looked at : e.g.o Infection controlo Maternity serviceso Mental health/learning disabilities.

17 investigations over 5 years. But effect of investigations was

major.

Investigations

Hospital associated infections High in UK Public Sector Government asked for annual in depth inspections

of every hospital We looked at processes and outcomes This resulted in tougher standards And real reductions in infection rates.

Handling of national concerns:

It is very powerfulWe used it for comparisonsThe right information has to be

collectedOn a uniform basisAnd published so it can be

understood It ensured we did our job

properly! Identification of deaths in Mid

Staffs Crucial for patient choice

Information

Independent healthcare regulation of systemsis comparatively new in the UK.

It has proved its worth. It covers quality, safety and access. All healthcare organizations have to be

registered and meet general standards and targets for access.

We looked at both processes and outcomes. And our aim was to encourage improvement. In depth investigations into areas of concern

were also very important. Collection and publication of comparative

informative is a very powerful tool for patient choice.

Conclusions

Better health and better healthcare

for everyone

Aim

Anna Walker, Vice Chair, Consumer Focus21 May 2010