The government published a 5-year strategy for the National Health Service in England. It said that there was a need to accelerate the pace of reform and make the system more productive. Hospital income would increasingly be linked to patient satisfaction. There would be more choice for patients – through abolishing family doctor practice boundaries, and improving access to a family doctor. There would be more freedom for the best hospitals to expand their services out into the community across a wider area including family doctor centres. Personal health budgets would give patients more control over their care.
Source: NHS 2010-2015: From good to great – preventative, people-centred, productive, Cm 7775, Department of Health/TSO
Links: Strategy | Hansard | DH press release | Kings Fund press release | NHS Confederation press release | NHS Employers press release | BMA press release | Guardian report | BBC report | Community Care report | Local Government Chronicle report
Date: 2009-Dec
The government published the operating framework for the National Health Service in England in 2010-11. The five priorities continued to be: improving cleanliness and reducing healthcare associated infections; improving access through achievement of the 18-week referral to treatment pledge, and improving access (including at evenings and weekends) to family doctor services; keeping adults and children well, improving their health, and reducing health inequalities; improving patient experience, staff satisfaction, and engagement; and preparing to respond in a state of emergency such as an outbreak of pandemic flu.
Source: The Operating Framework for the NHS in England 2010/11, Department of Health
Links: Framework | Hansard | Kings Fund press release | NHS Confederation press release | Pulse report
Date: 2009-Dec
A report called on local authorities, health trusts, and care providers in England to work with housing organizations in a more integrated way. It set out how better partnership working could help support care closer to home, give people more independence, and deliver greater efficiencies.
Source: Sarah Davis, Jeremy Porteus and Clare Skidmore, Housing, Health and Care, Chartered Institute of Housing
Links: Report | CIH press release | Children & Young People Now report | Inside Housing report | Local Government Chronicle report
Date: 2009-Dec
The government began consultation on measures required to prepare the National Health Service and social care services in England for the age discrimination requirements in the Equality Bill.
Source: Age Equality in Health and Social Care, Department of Health (08701 555455)
Links: Consultation document | DH press release | Community Care report
Date: 2009-Nov
The government began consultation on proposed new patient rights in England to treatment within a maximum of 18 weeks from a family doctor referral, and to be seen by a cancer specialist within 2 weeks from a family doctor referral – or, where this was not possible, for the National Health Service to take reasonable steps to offer a range of alternative providers. There would also be NHS checks for those aged 40-74 to assess their risk of heart disease, stroke, diabetes, and kidney disease.
Source: The NHS Constitution: A Consultation on New Patient Rights, Department of Health (08701 555455)
Links: Consultation document | Impact assessment | Hansard | DH press release | BMA press release | NHS Confederation press release | NHS Employers press release | CBI press release | BBC report | Pulse report
Date: 2009-Nov
A survey found that, three years after patients in England were first entitled to choose where to go for an outpatient appointment, only one-half (49 per cent) recalled being offered a choice of hospital or treatment centre. Rather than consulting official information sources, most patients relied on their own past experience (56 per cent), the experience of family or friends (52 per cent), or the advice of their family doctor (13 per cent) to judge a hospital's performance.
Source: Ruth Robertson and Anna Dixon, Choice at the Point of Referral: Early results of a patient survey, King's Fund (020 7307 2591)
Links: Report | King's Fund press release | Pulse report | Guardian report
Date: 2009-Nov
A manifesto was published that called for full accountability for the use of National Health Service resources to be transferred from primary care trusts to family doctors, working in co-operation with local communities.
Source: NAPC Manifesto, National Association of Primary Care
Links: Manifesto | NAPC press release | Pulse report
Date: 2009-Nov
A report said that family doctors should have their contracts rewritten in order to increase incentives for them to work with specialists, pharmacists, and nurses in the commissioning of services.
Source: Judith Smith, Julie Wood and Jo Elias, Beyond Practice-Based Commissioning: The local clinical partnership, Nuffield Trust (020 631 8450) and NHS Alliance
Links: Report | Nuffield Trust press release | NHS Alliance press release | Civitas blog | Pulse report
Date: 2009-Nov
The report of an official review examined age discrimination and age equality in the health and social care sector in England. It included a recommendation to implement the Equality Bill's age discrimination ban in health and social care at the same time as in other sectors. The government said that it was 'minded to accept' the review's recommendation on the timing of implementation.
Source: Ian Carruthers and Jan Ormondroyd, Achieving Age Equality in Health and Social Care, Department of Health (08701 555455) | House of Commons Hansard, Written Ministerial Statement 22 October 2009, column 72WS, TSO (0870 600 5522)
Links: Report | Annex | Hansard | NHS press release | WRVS press release | RCPsych press release | Guardian report | Telegraph report | Community Care report
Date: 2009-Oct
A report examined best practice in the provision of health services for disabled children.
Source: Aiming High for Disabled Children: Delivering improved health services, NHS Confederation (020 7959 7272)
Date: 2009-Sep
A report examined how much the National Health Service spent on management consultancy, and the types of work that management consultants did. It said that the NHS spent around 0.3 per cent of its budget on management consultancy in 2008, and that many consultancy projects led to NHS savings far in excess of their cost.
Source: Improving Care, Reducing Cost: Helping the NHS meet its 21st century challenge, Management Consultancies Association (020 7321 3990)
Links: Report | MCA press release | Guardian report | Telegraph report
Date: 2009-Sep
A report said that the Department of Health should introduce a more 'assertive, coherent and explicit' system for managing its relationships with stakeholder organizations.
Source: Jigsaw Research, Stakeholder Relationship Research: Report of findings from qualitative research, Department of Health (web publication only)
Date: 2009-Aug
An article examined the use of individuals or organizations as 'knowledge brokers' in transferring healthcare research into policy and practice.
Source: Vicky Ward, Allan House and Susan Hamer, 'Transferring healthcare research into policy and practice', Evidence & Policy, Volume 5 Number 3
Links: Abstract
Date: 2009-Aug
A think-tank report examined the pharmaceutical industry. It said that the decline in innovation and rising costs raised concerns, as the companies tried to squeeze more from less through 'increasingly dubious methods' that brought little benefit to National Health Service patients or taxpayers. The report called for a more effective regulatory framework.
Source: Jon Cruddas MP and Zoe Gannon, A Bitter Pill to Swallow: Drugs for people not for profit, Compass (020 7463 0633)
Links: Report | Guardian report
Date: 2009-Aug
The opposition Conservative Party published an independent review into information technology in the National Health Service, and announced plans to overhaul the existing system. The key proposals were to: seek to dismantle the central NHS IT infrastructure, delivering its benefits through local systems instead; halt and renegotiate the contracts signed for IT service providers, in order to prevent further inefficiencies; and stop imposing central systems on the NHS, instead allowing healthcare providers to use and develop the IT that they had already purchased and developed, within a 'rigorous framework of interoperability'.
Source: Independent Review of NHS and Social Care IT, Conservative Party (020 7222 9000)
Links: Report | Conservative Party response | Conservative Party press release | DH press release | NHS Confederation press release | BMA press release | Telegraph report | Guardian report | BBC report
Date: 2009-Aug
The government announced that when the first wave of contracts for 'Independent Treatment Centres' came to an end in 2010, each contract would be reviewed on a case-by-case basis, and new services would be commissioned by the local primary care trust (instead of centrally by the Department of Health) according to whether they met local needs, provided value for money, and benefited patients. Where the National Health Service identified an ongoing need for services, there would be a competitive procurement process: bidders would be invited to deliver services at NHS tariff prices, under the same contract used by NHS providers.
Source: Press release 30 July 2009, Department of Health (020 7210 4850)
Links: DH press release | BMA press release
Date: 2009-Jul
An article examined evidence-based adoption of organizational innovations in nine National Health Service primary care trusts in England. Although the majority of innovations were not 'politicized' – in the sense of having their objectives exposed to distortion as a result of conflicts of interest – a substantial minority were. Innovations whose adoption was motivated by evidence could therefore be differentiated from politicized innovations whose adoption was not so motivated, even when they nevertheless did have evidential support.
Source: Rod Sheaff, Susan Pickard and Bernard Dowling, 'Is evidence-based organizational innovation in the NHS a chimaera – or just elusive?', Social Policy and Administration, Volume 43 Number 3
Links: Abstract
Date: 2009-Jun
The government responded to a report by a committee of MPs on cross-border health services for Wales. It said that the border between England and Wales should not represent a barrier to the provision of healthcare. Some divergence in health policy between England and Wales was an 'inevitable and healthy consequence' of devolution.
Source: The Government's Response to the House of Commons Welsh Affairs Committee Report: The Provision of Cross-border Health Services for Wales, Cm 7647, Department of Health, TSO (0870 600 5522)
Links: Response | MPs report | Hansard
Date: 2009-Jun
A report by a committee of MPs said that the National Health Service had no way of knowing whether it was getting value for the large sums of money spent on management consultants.
Source: The Use of Management Consultants by the NHS and the Department of Health, Fifth Report (Session 2008-09), HC 28, House of Commons Health Select Committee, TSO (0870 600 5522)
Links: Report | BMA press release | RCN press release | Guardian report
Date: 2009-Jun
A report by a committee of MPs expressed concern about potential disadvantages to National Health Service patients as a result of the decision to allow 'top-up' payments for expensive drugs – including the formation of a 'two-tier' system.
Source: Top-up Fees, Fourth Report (Session 2008-09), HC 194i, House of Commons Health Select Committee, TSO (0870 600 5522)
Links: Report | NICE press release | Telegraph report | Guardian report | BBC report | FT report | Pulse report
Date: 2009-May
The government published a new operating model for commercial capability in the National Health Service – describing the way commercial skills would be organized and applied at different levels across the NHS to have maximum impact.
Source: Necessity – Not Nicety: A new commercial operating model for the NHS and Department of Health, Department of Health (08701 555455)
Links: Report
Date: 2009-May
A report said that self care could make a significant contribution to health outcomes and quality of life: but engagement with some schemes had been relatively low, with recruitment skewed towards certain socio-demographic groups.
Source: Peter Bower et al., What Influences People to Self Care?, National Primary Care Research and Development Centre (0161 275 0611)
Links: Report | NPCRDC press release
Date: 2009-Apr
A think-tank report examined whether the existing structure of the National Health Service was the most effective way of providing health services in Scotland, and looked at the lessons that could be learned from other European countries. It called for a legally binding charter setting out the care and treatment patients were entitled to receive.
Source: Ben Thomson and Geoff Mawdsley, Patient Power, Reform Scotland (0131 524 9500)
Links: Report | Reform Scotland press release
Date: 2009-Apr
A paper examined the issues involved in achieving closer integration of health and social care.
Source: Chris Ham, Only Connect: Policy options for integrating health and social care, Nuffield Trust (020 631 8450)
Links: Paper
Date: 2009-Apr
The Scottish Parliament approved a Bill to promote public engagement in the health service. Elected health boards would make the National Health Service more accountable and responsive to the public by creating a greater sense of ownership and participation in decision-making.
Source: Health Boards (Membership and Elections) (Scotland) Bill, Scottish Government, available from Blackwell's Bookshop (0131 622 8283) | Debate March 2009, columns 15773-15835, Scottish Parliament, TSO (0870 606 5566)
Links: MSP debate | Text of Bill | Explanatory notes | Policy memorandum | SG press release
Date: 2009-Mar
A report by a committee of MPs said that the lack of a permanent protocol for cross-border health services between Wales and England left clinicians and administrators in a 'strained position', and risked adversely affecting patients, as a result of commissioning and funding problems.
Source: The Provision of Cross-border Health Services for Wales, Fifth Report (Session 2008-09), HC 56, House of Commons Welsh Affairs Select Committee, TSO (0870 600 5522)
Links: Report
Date: 2009-Mar
An article examined the difficulties that faced care homes in accessing healthcare services, and the potential for better partnership working between care homes and the National Health Service.
Source: Tom Owen, Julienne Meyer, Jane Bentley, Hazel Heath and Claire Goodman, 'Better partnership between care homes and the NHS: findings from the My Home Life programme', Journal of Care Services Management, Volume 3 Number 1
Links: Article
Date: 2009-Mar
The government responded to a report by a committee of MPs on reform plans for the National Health Service. It said that the key element of the reforms was the devolution of power and decision-making to as close to patients as possible, while supporting and nurturing leadership and innovation across the service.
Source: The Government's Response to the Health Select Committee Report 'NHS Next Stage Review', Cm 7558, Department of Health, TSO (0870 600 5522)
Links: Response | Hansard | MPs report
Date: 2009-Mar
An article examined whether larger family doctor practices produced a higher volume and greater diversity of enhanced services. Existing average-sized practices were found to provide similar volume and diversity of enhanced services to those in the largest quartile: there was apparently little merit, therefore, in creating polyclinics or 'supersurgeries' if the aim was to transfer work from secondary to primary care. There did not seem to be an upper threshold above which practice size created spare capacity and expertise to deliver a significantly greater volume or greater diversity of services.
Source: Claire Morgan and Hendrik Beerstecher, 'Practice size and service provision in primary care: an observational study', British Journal of General Practice, Volume 59 Number 560 Links: Abstract | BBC report | Telegraph report | Pulse report
Date: 2009-Mar
The healthcare inspectorate said that National Health Service trusts in England were increasing their efforts to listen to patients and the public: but they needed to go further and ensure that these views were used to bring about change and improvement.
Source: Listening, Learning, Working Together? A national study of how well healthcare organisations engage local people in planning and improving their services, Commission for Healthcare Audit and Inspection (020 7448 9200)
Links: Report | CHAI press release | Pulse report
Date: 2009-Mar
A report examined how clinicians and health service managers could combine their expertise to bring about improvements in local health services. It set out a series of clear entitlements underlining the support that practice-based commissioners could expect to receive.
Source: Clinical Commissioning: Our vision for practice-based commissioning, Department of Health (08701 555455)
Links: Report | DH press release | Kings Fund press release | NHS Alliance press release
Date: 2009-Mar
The government published a strategy for improving the health of children and young people. There would be stronger and better joined-up support during the crucial early years of life, including more health visitors; and a strengthened role for Sure Start children's centres with, for the first time, each centre having access to a named health visitor.
Source: Healthy Lives, Brighter Futures: The strategy for children and young people's health, Department of Health (08701 555455) and Department for Children, Schools and Families
Links: Strategy | Summary | Impact assessment | Hansard | DH press release | DCSF press release | RCN press release | Action for Children press release | CPAG press release | NCT press release | CDC press release | NCB press release | Scope press release | Conservative Party press release | Community Care report | New Start report | Guardian report | Pulse report
Date: 2009-Feb
An article examined the views of primary care personnel on their relationship with hospital services providers. The relationship was regarded as being unbalanced in favour of the latter, despite a shared framework of central government policy. Commissioners were seen as generally weak, and providers were judged to be generally unresponsive to the wishes of primary care organizations. Top-down pressure by government was more important than commissioning power in shaping hospital services.
Source: Stephen Abbott, Susan Procter and Nicci Iacovou, 'NHS purchaser-provider relationships in England and Wales: the view from primary care', Social Policy and Administration, Volume 43 Number 1
Links: Abstract
Date: 2009-Feb
A report by a committee of peers said that a proposed right to access healthcare across the European Union could worsen health inequalities if fair funding and information systems were not put in place.
Source: Healthcare Across EU Borders: A safe framework, 4th Report (Session 2008-09), HL 30, House of Lords European Union Select Committee, TSO (0870 600 5522)
Links: Report | BBC report
Date: 2009-Feb
The government launched a national dementia strategy for England, designed to increase awareness of dementia, ensure early diagnosis and intervention, and radically improve the quality of care that people with the condition received.
Source: Living Well with Dementia: A National Dementia Strategy, Department of Health (08701 555455)
Links: Strategy | Summary | Impact assessment | DH press release | Alzheimers Society press release | LGA press release | RCN press release | PRTC press release | UKHCA press release | Carers UK press release | Counsel and Care press release | NCF press release | RNHA press release | Help the Aged press release | MHF press release | BBC report | Community Care report | Guardian report | Telegraph report | Pulse report
Date: 2009-Feb
An annual compendium of health statistics was published. It highlighted a steady decline since 1999 in the number of available hospital beds per 100,000 population in all countries of the United Kingdom. Since devolution the rate of decline had been fastest in Scotland, with the other three countries experiencing more modest rates of bed loss. Since 2003-04 there seemed to have been an acceleration in the reduction of available beds in England.
Source: Compendium of Health Statistics (20th Edition), Office of Health Economics (020 7930 9203)
Links: OHE press release
Date: 2009-Feb
The government responded to a report by a committee of MPs on foundation trusts in the National Health Service. It said that the trusts had 'proven strengths' and were performing well.
Source: The Government Response to the Health Committee Report into Foundation Trusts and Monitor, Cm 7528, Department of Health, TSO (0870 600 5522)
Links: Response | MPs report | Hansard
Date: 2009-Jan
An article said that since 2002 reforms to National Health Service purchasing in England had begun to transform a quasi-market into a 'real' market – with greater diversity of suppliers, including from the private sector; a payment regime designed to reward additional hospital activity; and new rights for patients to choose their provider. Evidence from the quasi-market era suggested that the purchasing function had had little significant impact on services for patients or shifts in the pattern of hospital provision. The new market reforms, in theory, provided an opportunity to overcome prior weaknesses in the purchasing function.
Source: Richard Lewis, Judith Smith and Anthony Harrison, 'From quasi-market to market in the National Health Service in England: what does this mean for the purchasing of health services?', Journal of Health Services Research and Policy, Volume 14 Number 1
Links: Abstract
Date: 2009-Jan
The government responded to a report by a committee of MPs on cross-border health services for Wales. It said that it agreed with the committee that the border between England and Wales should not represent a barrier to the provision of healthcare.
Source: The Government Response to the Welsh Affairs Committee Interim Report on the Provision of Cross-border Health Services for Wales, Cm 7531, Department of Health, TSO (0870 600 5522)
Links: Response | MPs report | Hansard
Date: 2009-Jan
A report highlighted the problems local clinicians were experiencing with the operation of the electronic 'Choose and Book' system for hospital appointments.
Source: Choose and Book: Learning lessons from local experience, British Medical Association (020 7387 4499)
Links: Report | BMA press release | Pulse report | Telegraph report
Date: 2009-Jan
An article said that an economics centred on subjective utility-maximization was unsuitable for the analysis and policy grounding of healthcare provision.
Source: Geoffrey Hodgson, 'Towards an alternative economics of health care', Health Economics, Policy and Law, Volume 4 Issue 1
Links: Abstract
Date: 2009-Jan
The Welsh Assembly Government began consultation on proposals for a unified public health system comprising a new National Health Service Trust, designated the Public Health Wales National Health Service Trust.
Source: Unification of Public Health Services in Wales, Welsh Assembly Government (029 2082 5111)
Links: Consultation document | Consultation document (Welsh)
Date: 2009-Jan
An audit report said that about one-third of the National Health Service estate in Scotland might require 'major upgrading' work in the near future.
Source: Asset Management in the NHS in Scotland, Audit Scotland for Accounts Commission and Auditor General (0131 477 1234)
Links: Report | Summary | Audit Scotland press release | BBC report
Date: 2009-Jan
An article examined attempts to reduce the number of patients whose discharge from hospital was delayed, using financial incentives. There was 'little evidence' to support the policy. There were a number of pressures to reduce the time patients spent in hospital, including fewer beds and increasing numbers of admissions. There were few good data available to monitor the impact of earlier discharge, such as on the quality and availability of post-discharge care.
Source: Sylvia Godden, David McCoy and Allyson Pollock, 'Policy on the rebound: trends and causes of delayed discharges in the NHS', Journal of the Royal Society of Medicine, Volume 102 Issue 1
Links: Article
Date: 2009-Jan
A report by a committee of MPs said that key parts of a £12.7 billion programme to upgrade the National Health Service's information technology were on the brink of failure.
Source: The National Programme for IT in the NHS: Progress since 2006, Second Report (Session 2008-09), HC 153, House of Commons Public Accounts Select Committee, TSO (0870 600 5522)
Links: Report | NHS Confederation press release | BMA press release | Guardian report | BBC report
Date: 2009-Jan
The government announced a package of measures designed to 'virtually eliminate' mixed-sex hospital accommodation. From 2010, hospitals that treated patients in mixed-sex accommodation would not be paid for their care.
Source: Press release 28 January 2009, Department of Health (020 7210 4850)
Links: DH press release | Patients Association press release | RCN press release | Help the Aged press release | Mind press release | Conservative Party press release | Guardian report | Telegraph report | Community Care report
Date: 2009-Jan
A report said that personal health budgets could improve personal control, empowerment, and cost-effectiveness; and could also provide better co-ordinated services, greater choice, and new ways of redesigning services.
Source: Personal Health Budgets The shape of things to come?, NHS Confederation (020 7959 7272)
Links: Report | NHS Confederation press release
Date: 2009-Jan
