An article examined the experiences of voluntary sector organizations involved in public sector commissioning. The research suggested that the public sector was limiting the voluntary sector's engagement in service design and performance monitoring.
Source: Susanne Martikke and Claire Moxham, 'Public sector commissioning: experiences of voluntary organizations delivering health and social services', International Journal of Public Administration, Volume 33 Issue 14
Links: Abstract
Date: 2010-Dec
The government began consultation on proposals (in its July 2010 White Paper) in respect of funding and commissioning routes for public health in England, including a ring-fenced budget provided to local authorities.
Source: Healthy Lives, Healthy People: Consultation on the Funding and Commissioning Routes for Public Health, Department of Health
Links: Consultation document | Hansard
Date: 2010-Dec
The government published the operating framework for the National Health Service in England for 2011-12. An NHS Commissioning Board would be created in shadow form during the year, and the programme of pathfinder family doctor consortia would be extended.
Source: The Operating Framework for the NHS in England 2011/12, Department of Health
Links: Framework | Hansard | DH press release | NAPC press release | NHS Employers press release
Date: 2010-Dec
A new book examined future research challenges for social scientists concerning population ageing, pensions, health, and social care in Europe.
Source: Lans Bovenberg, Arthur Van Soest and Asghar Zaidi (eds.), Ageing, Health and Pensions in Europe: An economic and social policy perspective, Palgrave Macmillan
Links: Summary
Date: 2010-Dec
A think-tank report said that the wholesale abolition of primary care trusts proposed in the National Health Service White Paper (July 2010) could have a negative impact on patient care, and should be halted in favour of a more incremental approach to commissioning reform.
Source: James Gubb, A Risky Business: The White Paper and the NHS, Civitas
Links: Report | Civitas press release
Date: 2010-Dec
The second interim evaluation report was published on the personal health budgets pilot programme. There was an 'overwhelming' view among organizational representatives that personal health budgets would have a positive impact on both budget holders and carers.
Source: Karen Jones et al., Experiences of Implementing Personal Health Budgets: 2nd interim report, Department of Health
Links: Report | Community Care report
Date: 2010-Nov
A think-tank report said that most people would die in hospitals and care homes, often cut off from friends and family – dependent on systems and procedures that felt impersonal, and too often robbed them of control and dignity. It set out proposals designed to improve people's experiences of the end of life.
Source: Jake Garber and Charles Leadbeater, Dying for Change, Demos
Links: Report | Summary | Dignity in Dying press release | Guardian report
Date: 2010-Nov
A think-tank report said that the 'business model' used by the National Health Service for managing long-term conditions was wrong – with the resources, processes, and financial incentives of both family doctor practices and hospitals designed to manage acute events, not prolonged periods of care. It recommended that new business models that incentivized 'wellness', rather than treating sickness, should be introduced instead.
Source: Henry Featherstone and Lilly Whitham, Incentivising Wellness: Improving the treatment of long-term conditions, Policy Exchange
Links: Report | Policy Exchange press release
Date: 2010-Nov
A progress report was published on the 16 integrated care pilots in the National Health Service.
Source: RAND Europe/Ernst & Young, Progress Report: Evaluation of the National Integrated Care Pilots, Department of Health
Links: Report
Date: 2010-Nov
An article said that the effectiveness of boards of directors in National Health Service trusts was compromised by a range of issues. The focus of governance needed to shift from structural concerns to the multiple collective aspects of a board's behaviour.
Source: Gianluca Veronesi and Kevin Keasey, 'NHS boards: knowing the "what" but not the "how"', Public Money and Management, Volume 30 Issue 6
Links: Abstract
Date: 2010-Nov
A think-tank report said that clinical and service integration should be at the heart of moves to reform the health service: but the changes needed to ensure that the new structures, funding, and regulatory framework allowed integrated services to grow, rather than stand in the way of their evolution. Family doctor consortia could form the vanguard of moves to integrate services.
Source: Natasha Curry and Chris Ham, Clinical and Service Integration: The route to improved outcomes, King's Fund
Links: Report | King's Fund press release
Date: 2010-Nov
A report by a committee of MSPs said that it 'remained to be convinced' of the need for new primary legislation to strengthen patient rights in Scotland.
Source: Patient Rights (Scotland) Bill, 9th Report 2010, SP Paper 512, Scottish Parliament Health and Sport Committee
Links: Report | Scottish Parliament press release
Date: 2010-Nov
A report examined the potential role of the third sector in improving the way in which Scotland's health and care needs were met.
Source: The Third Sector: A Key Role in Delivering a Healthier Scotland, Scottish Council for Voluntary Organisations
Date: 2010-Nov
A think-tank report said that much more needed to be done to give patients and carers real choices about their care at the end of life.
Source: Rachael Addicott and Shilpa Ross, Implementing the End of Life Care Strategy: Lessons for good practice, King's Fund
Links: Report | King's Fund press release | Community Care report
Date: 2010-Oct
An audit report in Scotland examined the governance arrangements of National Health Service and other public sector bodies. Accountability could be complex, with chief executives and boards reporting in different ways to the Scottish Government, ministers, and the Scottish Parliament. This risked causing confusion about who led an organization and was responsible for its decisions.
Source: The Role Of Boards, Audit Scotland for Accounts Commission and Auditor General
Links: Report | Audit Scotland press release
Date: 2010-Oct
An article examined the evidence for the policy of promoting third sector organizations as providers of National Health Service-funded health and social care. The literature did not support the policy of a larger role for the third sector in healthcare, let alone a switch to a market-based system.
Source: Elke Heins et al., 'A review of the evidence of third sector performance and its relevance for a universal comprehensive health system', Social Policy and Society, Volume 9 Issue 4
Links: Abstract
Date: 2010-Oct
A think-tank report summarized the results of a public engagement exercise on the subject of electronic patient records in the National Health Service. It made recommendations about how to ensure that electronic records were used in a way that protected privacy and confidentiality.
Source: Stephen Whitehead, Who Sees What? Exploring public views on personal electronic health records, New Economics Foundation
Date: 2010-Oct
An article examined the quality of assessment of older people in England with complex health and social care needs. Policy initiatives to address the difficulties in assessment needed to be more prescriptive if they were to produce the intended outcomes.
Source: David Challis, Michele Abendstern, Paul Clarkson, Jane Hughes and Caroline Sutcliffe, 'Comprehensive assessment of older people with complex care needs: the multi-disciplinarity of the single assessment process in England', Ageing and Society, Volume 30 Issue 7
Links: Abstract
Date: 2010-Oct
A paper summarized the research evidence on the role of foundation trusts in the National Health Service. There was limited research evidence, and comparative research was made difficult through lack of a counter-factual. Foundations trusts generally scored more highly in quality dimensions than other trusts: but this was likely to be more a function of the self-selection of the best-performing trusts for foundation trust status, rather than a function of foundation trust status itself.
Source: Chris Bojke and Maria Goddard, Foundation Trusts: A Retrospective Review, Research Paper 58, Centre for Health Economics/University of York
Links: Paper
Date: 2010-Oct
A think-tank report said that National Health Service patients were being denied potentially better, more timely treatment because of a 'closed shop' culture that demanded loyalty to the 'family' of NHS hospital providers. Existing providers used their muscle and connexions to keep providing services even when faster, higher-quality care was on offer elsewhere.
Source: Laura Brereton and James Gubb, Refusing Treatment: The NHS and market-based reform, Civitas
Links: Civitas press release | Telegraph report | BBC report
Date: 2010-Oct
A report said that there was little, if any, evidence that smaller organizations were better at commissioning healthcare services than larger ones. The government's plans for devolving commissioning to family doctors would be costly, almost certainly resulting in a dip in performance in the short to medium term.
Source: Sebastian Baird, James Gubby and Kieran Walshe, NHS White Paper Proposals for GP Commissioning: Does Size Matter?, Civitas
Links: Report | Civitas press release | MBS press release
Date: 2010-Oct
A think-tank report examined a case study of healthcare commissioning led by family doctors. It concluded that the system would increase efficiency and the quality of service in the National Health Service.
Source: Paul Corrigan, Practice Makes Perfect, Demos
Date: 2010-Oct
The government began consultation on proposals (originally outlined in a July 2010 White Paper) for creating greater choice and control over healthcare and treatment.
Source: Liberating the NHS: Greater choice and control, Department of Health
Links: Consultation document | Summary | DH press release | Kings Fund press release
Date: 2010-Oct
An article examined the proposal that waiting times for elective treatment should be reduced to the point where the costs of doing so exceeded the benefits. It concluded that the 'apparently simple' criterion proposed for defining the point where waiting times were optimal was hard to establish. The criterion chosen needed to reflect the overall values that a given healthcare system was intended to promote.
Source: Anthony Harrison and John Appleby, 'Optimising waiting: a view from the English National Health Service', Health Economics, Policy and Law, Volume 5 Issue 4
Links: Abstract
Date: 2010-Oct
An article examined how sexual orientation might impact on concerns about, and experiences of, end-of-life care and bereavement within same-sex relationships.
Source: Kathryn Almack, Jane Seymour and Gary Bellamy, 'Exploring the impact of sexual orientation on experiences and concerns about end of life care and on bereavement for lesbian, gay and bisexual older people', Sociology, Volume 44 Issue 5
Links: Abstract
Date: 2010-Oct
An article examined the role of choice and competition in healthcare. There was a potential conflict between choice and equity, in terms of both the values and the outcomes each policy was likely to produce. It highlighted the importance of socio-economic and psycho-social factors, which were left out of existing policy considerations.
Source: Marianna Fotaki, 'Patient choice and equity in the British National Health Service: towards developing an alternative framework', Sociology of Health & Illness, Volume 32 Issue 6
Links: Abstract
Date: 2010-Oct
A paper said that the reforms outlined in the new coalition government's White Paper on the National Health Service in England, such as handing commissioning responsibilities to groups of family doctors, could deliver more seamless care for patients. However, policy in areas such as commissioning, competition, incentives, and regulation needed to be developed to better support moves towards integration. There was also a need to involve both clinicians and members of the public in service redesign.
Source: Chris Ham and Judith Smith, Removing the Policy Barriers to Integrated Care in England, Nuffield Trust
Links: Summary
Date: 2010-Sep
A new book examined new governance arrangements in the National Health Service, how they were working in practice, and how practitioners were responding.
Source: John Storey, John Bullivant and Andrew Corbett-Nolan, Governing the New NHS: Issues and tensions in health service management, Routledge
Links: Summary
Date: 2010-Sep
A new textbook provided an overview of key issues and core themes in the field of health and social care.
Source: Adam Barnard (ed.), Key Themes in Health and Social Care: A companion to learning, Routledge
Links: Summary
Date: 2010-Sep
A report examined what was meant by sustainable development in the context of adult social care and health.
Source: Gemma Bradshaw, Janet Sillett and Amelia Walker, Independence, Community and Environment: Final report of the Sustainable Social Care Learning Network, Social Care Institute for Excellence
Links: Report
Date: 2010-Sep
An official advisory body called for the reorganization of maternity services in order to improve access to, and uptake of, antenatal care. Too many women in difficult social circumstances were not using maternity services, with potentially negative consequences for their own health and for that of their baby.
Source: Pregnancy and Complex Social Factors: A model for service provision for pregnant women with complex social factors, National Institute for Health and Clinical Excellence
Links: Guidelines | NIHCE press release | BBC report | Guardian report
Date: 2010-Sep
An official review of the national programme for information technology in the National Health Service in England concluded that a centralized, national approach was no longer required. The government said that a national infrastructure would be retained: but decision-making and responsibility would in future be localized.
Source: Written Ministerial Statement 9 September 2010, columns 21-22WS, House of Commons Hansard/TSO
Links: Hansard | DH press release | Conservative Party press release | BMA press release | Telegraph report | BBC report
Date: 2010-Sep
A discussion paper examined the new coalition government's proposals for commissioning health services at a very local level through general practice consortia. It made suggestions about how commissioning could develop in a transparent, inclusive, and accountable way.
Source: Towards Transparent, Inclusive and Accountable GP Commissioning, Centre for Public Scrutiny/NHS Alliance
Links: Paper | CfPS press release
Date: 2010-Sep
An article examined why attempts to restructure public services were not always successful, with particular reference to the English National Health Service.
Source: Robert McMurray, 'Tracing experiences of NHS change in England: a process philosophy perspective', Public Administration, Volume 88 Issue 3
Links: Abstract
Date: 2010-Sep
An article compared National Health Service providers with private treatment centres, in terms of the quality of data coding and patient complexity. The NHS was treating more complex patients than private providers: if complexity drove costs, a fair reimbursement system would require higher payments for NHS providers.
Source: Anne Mason, Andrew Street and Rossella Verzulli, 'Private sector treatment centres are treating less complex patients than the NHS', Journal of the Royal Society of Medicine, Volume 103 Number 8
Links: Article
Date: 2010-Aug
A think-tank report examined how external support was being used by primary care trusts and strategic health authorities, and whether it was helping them to develop more effective commissioning. In many cases external organizations had improved commissioning processes and could provide support in key areas such as data analysis and commercial skills: but external support was not always used effectively.
Source: Chris Naylor and Nick Goodwin, Building High-Quality Commissioning: What role can external organisations play?, King s Fund
Date: 2010-Jul
The new coalition government announced plans (following a review) to reduce the number of arm's-length bodies in the National Health Service. The Health Protection Agency, together with the National Treatment Agency for Substance Misuse, would be abolished and their functions transferred to the Secretary of State as part of a new 'Public Health Service'. The Human Fertilisation and Embryology Authority would be abolished, and its functions transferred to other bodies. The work of the General Social Care Council in regulating social workers in England would be transferred to the Health Professions Council.
Source: Liberating the NHS: Report of the Arms-Length Bodies Review, Department of Health
Links: Report | DH press release | ADASS/ADCS press release | CQC press release | CWDC press release | DrugScope press release | HFEA press release | HPC press release | NTA press release | BBC report | Guardian report | Personnel Today report | Community Care report | Children & Young People Now report | Christian Institute report
Date: 2010-Jul
The government began consultation on the implementation of proposals (contained in its July 2010 White Paper) that would put local consortia of family doctor practices in charge of commissioning National Health Service services in England.
Source: Liberating the NHS: Commissioning for Patients, Department of Health
Links: Consultation document | Hansard | DH press release | BMA press release | NHS Employers press release | NHS Confederation press release
Date: 2010-Jul
A new book examined ageing, health, and care.
Source: Christina Victor, Ageing, Health and Care, Policy Press
Links: Summary
Date: 2010-Jul
A paper examined the early experiences of implementing personal health budgets. Pilot leads in primary care trusts said that they were struggling both to calculate the value of budgets and to find money to resource them.
Source: Karen Jones et al., Early Experiences of Implementing Personal Health Budgets, Discussion Paper 2726/2, Personal Social Services Research Unit/London School of Economics
Links: Paper | Pulse report | Community Care report
Date: 2010-Jul
The government began consultation on proposals to give greater financial and management freedom to National Health Service foundation trusts, and to make Monitor the economic regulator for the NHS (including giving it powers to set tariff prices for NHS services, and to promote competition).
Source: Liberating the NHS: Regulating Healthcare Providers, Department of Health
Links: Consultation document | DH press release | Monitor press release
Date: 2010-Jul
The government began consultation on the implementation of proposals (contained in its July 2010 White Paper) that would give local authorities a greater role in the running of the National Health Service in England – including a stronger role in supporting patient choice, and in promoting public health.
Source: Liberating the NHS: Local Democratic Legitimacy in Health, Department of Health
Links: Consultation document | Hansard | DH press release | NHS Employers press release | NHS Confederation press release
Date: 2010-Jul
The new coalition government responded to a report by a committee of MPs (published under the previous Labour government) on healthcare commissioning. It said that the weaknesses identified in commissioning were symptomatic of a system that did not emphasize the importance of clinical involvement in decisions about how National Health Service resources should be spent.
Source: Government Response to the Health Select Committee on Commissioning, Cm 7877, Department of Health/TSO Links: Response | Hansard | MPs report
Date: 2010-Jul
A report examined Welsh policy responses to a rapidly ageing society.
Source: John Osmond, Adding Life to Years: Welsh policy approaches to ageing, Institute of Welsh Affairs
Links: Summary
Date: 2010-Jun
The evidence base was published for a five-year strategy for the National Health Service in Wales.
Source: Delivering a Five-Year Service, Workforce and Financial Strategic Framework for NHS Wales, NHS Wales
Links: Report | NHS Wales press release
Date: 2010-Jun
An audit report said that most private finance initiative (PFI) hospital contracts were well-managed, and that the evidence indicated they were achieving the value for money expected when the contracts were signed. There continued to be risks, however, to the long-term value for money of these contracts.
Source: The Performance and Management of Hospital PFI Contracts, HC 68 (Session 2010-11), National Audit Office/TSO
Links: Report | NAO press release | BMA press release | Guardian report
Date: 2010-Jun
A report by a committee of MSPs said that 'fundamental weaknesses' in National Health Service management might be influencing decisions on spending, budgeting, and staff resources.
Source: NHS Board Revenue Allocations, 8th Report 2010, SP Paper 477, Scottish Parliament Health and Sport Committee
Links: Report | Scottish Parliament press release
Date: 2010-Jun
The new Conservative-Liberal Democrat coalition government published a revision to the operating framework for the National Health Service in England for 2010-11. The changes included: removal of targets around access to primary care; removal of the 18 weeks referral-to-treatment target; and a reduction of the 4-hour accident and emergency target threshold from 98 per cent to 95 per cent.
Source: Revision to the Operating Framework for the NHS in England 2010/11, Department of Health
Links: Framework | DH press release | Hansard | NHS Confederation press release | Kings Fund press release | BMA press release | Patients Association press release | RCN press release | Alzheimers Society press release | Guardian report | BBC report | Pulse report (1) | Pulse report (2)
Date: 2010-Jun
A briefing paper examined the integration of health and social care services. It said that a new model based on 'neighbourhood' and involving a 'Total Place' approach could enable health and social care integration to develop further.
Source: Where Next for Health and Social Care Integration?, NHS Confederation
Links: Briefing
Date: 2010-Jun
A report said that plans by the new coalition government to give family doctors responsibility for holding budgets and commissioning health services on behalf of their local communities had the potential to help improve care: but they would need time and careful design if they were to be successful.
Source: Judith Smith and Ruth Thorlby, Giving GPs Budgets for Commissioning: What Needs to Be Done?, Nuffield Trust
Links: Report | Nuffield Trust press release | Kings Fund press release
Date: 2010-Jun
A report said that restructurings and reorganizations usually took longer, cost more, and produced less than they promised; and that they were therefore not an easy solution to the difficulties facing the National Health Service.
Source: Nigel Edwards, The Triumph of Hope Over Experience: Lessons from the history of reorganisation, NHS Confederation
Links: Report | NHS Confederation press release
Date: 2010-Jun
A think-tank report said that having a choice of hospitals was valued by the majority of patients: but the scheme was not yet operating as intended, and had not yet acted as a lever to improve quality and increase competition.
Source: Anna Dixon et al., Patient Choice: How patients choose and how providers respond, King's Fund
Links: Report | King's Fund press release | Telegraph report
Date: 2010-Jun
A briefing paper examined how a publicly funded health service could be preserved in the economic downturn. It outlined a number of tools that could help to keep National Health Service spending down. Radical reform of the health sector was required in the medium term in order to reduce ill-health, dependency on the NHS, and inefficiencies in care resulting from avoidable use of costly hospital care (mainly among older people and those with chronic conditions).
Source: Jennifer Dixon, NHS in England: Options for System Reform, Nuffield Trust
Links: Paper
Date: 2010-Jun
A report said that government plans to give family doctors greater control of National Health Service budgets were a step in the right direction, but needed to be implemented carefully if they were to deliver benefits for patients.
Source: Chris Ham, GP Budget Holding: Lessons from Across the Pond and from the NHS, Health Services Management Centre/University of Birmingham
Links: Report | HSMC press release
Date: 2010-Jun
The new Conservative-Liberal Democrat coalition government announced that hospitals would be subject to a financial penalty in cases of emergency readmission following treatment. It said that this would improve quality and performance, and shift the focus to the outcome for the patient, rather than the volume of activity paid to the hospital.
Source: Speech by Andrew Lansley MP (Secretary of State for Health), 8 June 2010
Links: Text of speech | DH press release | Kings Fund press release | NHS Confederation press release | BMA press release | RCN press release | Patients Association press release | Turning Point press release | Alzheimers Society press release | Nursing Times report | BBC report | Guardian report | Pulse report | Community Care report
Date: 2010-Jun
A joint inspectorate report called for improvements in healthcare for adults in the prison system. It said that primary care trusts needed to improve efforts to centre care on patients' needs; arrangements for healthcare around transfer and release; and the provision of drug treatment systems.
Source: Commissioning Health Care In Prisons 2008/09: Key findings from our analysis of primary care trusts as commissioners of prison health care, Care Quality Commission/HM Prisons Inspectorate
Links: Report | CQC press release
Date: 2010-May
An article criticized as 'undesirable and flawed practically' attempts to encourage practitioners in a range of settings – such as school, healthcare, and children's centres – to 'engage' fathers.
Source: Brid Featherstone, 'Writing fathers in but mothers out!!!', Critical Social Policy, Volume 30 Issue 2
Links: Abstract
Date: 2010-May
An article examined policy arguments surrounding the Richards' Review (in 1998) of patient co-payments (or 'top-up' payments) – in particular, patients paying privately for additional medicines as part of an episode of care in the National Health Service.
Source: Albert Weale and Sarah Clark, 'Co-payments in the NHS: an analysis of the normative arguments', Health Economics, Policy and Law, Volume 5 Issue 2
Links: Abstract
Date: 2010-Apr
A report examined the key policy changes required to ensure that private healthcare providers adhered to the values and principles of the National Health Service.
Source: Harnessing the Benefits of the Independent Sector: Priorities for the next government, NHS Confederation
Links: Report
Date: 2010-Apr
An article examined the organization and leadership of the Department of Health, and weighed its suitability to meet the challenges posed by public spending restraint. The organization was culturally split between public servants and managers, highly reliant on the ability of its key personnel to bridge these divides, and extremely responsive to the political goals of government ministers.
Source: Holly Jarman and Scott Greer, 'In the eye of the storm: civil servants and managers in the UK Department of Health', Social Policy and Administration, Volume 44 Number 2
Links: Abstract
Date: 2010-Apr
A report summarized the evaluation of a pathfinder programme designed to improve the understanding of the role that social enterprise could play in health and social care. It said that the ethos and values of the social enterprise model were a catalyst for improving choice, equality, and access to services; and that it enabled services to be delivered in an innovative and efficient manner.
Source: Tribal Newchurch, Leading the Way Through Social Enterprise: The Social Enterprise Pathfinder Programme evaluation, Department of Health
Links: Report
Date: 2010-Mar
A think-tank report called for a reconfiguration of National Health Service services, away from hospitals and towards community service, in order to improve care and reduce costs.
Source: Nick Bosanquet, Thomas Cawston, Andrew Haldenby, Patrick Nolan and Nick Seddon, Fewer Hospitals, More Competition, Reform
Links: Report | Reform press release | BMA press release | RCN press release | Telegraph report | BBC report | Nursing Times report
Date: 2010-Mar
A report examined the economic savings available from integrating a broad range of health, housing, and social care services. It found 'significant evidence' that integration created efficiencies and savings, with early intervention services potentially saving the National Health Service up to £2.65 for every £1 spent.
Source: Benefits Realisation: Assessing the evidence for the cost benefit and cost effectiveness of integrated health and social care, Turning Point
Links: Report | Turning Point press release
Date: 2010-Mar
A report examined the potential for significant changes to the delivery of care through a new generation of clinically led organizations that both provided and commissioned patient care. Although the evidence base for the effectiveness of these organizations was as yet underdeveloped, this form of integration offered the potential for improving the efficiency and effectiveness of patient care across a range of providers.
Source: Richard Lewis, Rebecca Rosen, Nick Goodwin and Jennifer Dixon, Where Next for Integrated Care Organisations in the English NHS?, Nuffield Foundation/Kings Fund
Links: Report | Kings Fund press release
Date: 2010-Mar
A report set out a detailed rescue plan for the national programme for information technology in the National Health Service. It said that at least £1 billion could be saved by 'realigning' the programme and boosting its performance.
Source: John Cruickshank, Fixing NHS IT: A plan of action for a new government, 2020health
Links: Report
Date: 2010-Mar
The government published (following consultation) a revised National Health Service constitution for England, which included (from April 2010) a new right to start non-urgent treatment within 18 weeks; and a right to see a specialist where cancer was suspected within 2 weeks of referral, or for the NHS to take all reasonable steps to offer a range of alternative providers where this was not possible.
Source: The NHS Constitution, Department of Health
Links: Constitution | Handbook to Constitution | Government response to consultation | Hansard | DH press release
Date: 2010-Mar
A report examined why local commissioners of care and healthcare in the National Health Service had been unable to successfully challenge powerful hospitals. Commissioning was a difficult and challenging task, and local commissioners had few effective levers for improving the quality of care and reducing the costs of providing it.
Source: Judith Smith, Nicholas Mays, Natasha Curry and Jennifer Dixon, Where Next for Commissioning in the English NHS?, Nuffield Foundation/Kings Fund
Links: Report | Kings Fund press release
Date: 2010-Mar
A new book examined leadership as part of a wider frame of organizational issues in healthcare.
Source: Jean Hartley and John Benington, Leadership for Healthcare, Policy Press
Links: Summary
Date: 2010-Mar
A study examined the relationship between decentralization, governance, incentives, and performance in local health economies in England. Recent health policy had aimed to increase local autonomy and enhance organizational performance. Decentralization, it was often claimed, could solve multiple organizational and policy dilemmas: but it was not a panacea for these shortcomings.
Source: Mark Exworthy et al., Decentralisation and Performance: Autonomy and incentives in local health economies, National Institute for Health Research
Links: Report
Date: 2010-Mar
The Scottish Government published a Bill designed to improve patients' rights, including a legal waiting time guarantee and a legal right to complain.
Source: Patient Rights (Scotland) Bill, Scottish Government/TSO
Links: Text of Bill | Explanatory notes | Policy memorandum | Scottish Government press release | BBC report
Date: 2010-Mar
A think-tank report examined research literature on the effectiveness of policies (over the previous 20 years) designed to promote 'internal' or 'quasi' markets in National Health Service provision in England. It concluded that the introduction of competition had developed a system-wide awareness of costs, efficiency, and accountability: but it had not been proven to bring about the beneficial outcomes expected in other areas, including provider responsiveness to patients and purchasers, large-scale cost reduction, and innovation in service provision.
Source: Laura Brereton and Vilashiny Vasoodaven, The Impact of the NHS Market: An overview of the literature, Civitas
Links: Report | Civitas press release | Pulse report
Date: 2010-Mar
The government published a strategy for promoting the role of volunteering in the health and social care system, including addressing health inequalities.
Source: Volunteering: Involving People and Communities in Delivering and Developing Health and Social Care Services, Department of Health
Date: 2010-Mar
The government set out revised principles and rules for co-operation and competition in the commissioning and provision of National Health Service services. Commissioners needed to commission services from the providers who were best placed to deliver the needs of their patients and populations. Commissioners and providers should promote patient choice.
Source: Principles and Rules for Cooperation and Competition, Department of Health
Links: Report
Date: 2010-Mar
The Scottish Government began consultation on a strategy for self-directed support, developed in order to help take forward the 'personalization' of health and social care services. The strategy promoted the use of individual budgets, under which users were allocated a sum of money to meet their assessed needs which they could take as a direct payment or leave to their local council or a third party to administer.
Source: Self-Directed Support: A national strategy for Scotland, Scottish Government
Links: Consultation document | Community Care report
Date: 2010-Feb
A report said that the National Health Service could save more than £1 billion each year by increasing the number of patients it treated at home rather than in hospital.
Source: Hospital Care at Home: Supporting independent and healthy lives, Hospital Care at Home/Dr Foster Intelligence
Links: Report | Nursing Times report
Date: 2010-Feb
The competition watchdog for the National Health Service said that a 'significant number' of commissioners took procurement decisions at risk of challenge under its rules. Problems included: using different criteria to evaluate bidders from those initially described in the bid documents; excluding potential bidders on grounds unrelated to their ability to deliver the services tendered; and failing to select the best-performing service provider as the preferred bidder.
Source: Progress Report, Co-Operation and Competition Panel for NHS-Funded Services
Links: Report
Date: 2010-Feb
A report by a committee of MPs said that the National Health Service should stop funding the use of homeopathic 'remedies' until there was credible scientific evidence that they were effective.
Source: Evidence Check 2: Homeopathy, Fourth Report (Session 2009-10), HC 45, House of Commons Science and Technology Select Committee/TSO
Links: Report | Pulse report | BBC report | Guardian report | Telegraph report
Date: 2010-Feb
An employers' organization called for a major shift in the way healthcare was delivered to provide more convenient services for patients at home and on the high street, and to make better use of National Health Service resources. The NHS was targeting resources in the wrong places, with too many people treated in hospitals because of a lack of suitable alternatives.
Source: Best of Health: Improving lives through smarter care, Confederation of British Industry
Links: Report | CBI press release | Guardian report | Pulse report
Date: 2010-Feb
A study raised concerns over any move to broaden the range of costs and economic benefits considered in the analysis of new National Health Service treatments. Taking into account effects outside the NHS would require trade-offs to be made between the overall impact on the health of NHS patients, other social concerns, and wider costs and economic benefits.
Source: Karl Claxton, Simon Walker, Steven Palmer and Mark Sculpher, Appropriate Perspectives for Health Care Decisions, Research Paper 54, Centre for Health Economics/University of York
Links: Paper | York University press release
Date: 2010-Jan
An article examined the inherent problems and limitations of managing risk and uncertainty in the context of the National Health Service.
Source: Patrick Brown and Michael Calnan, 'The risks of managing uncertainty: the limitations of governance and choice, and the potential for trust', Social Policy and Society, Volume 9 Issue 1
Links: Abstract
Date: 2010-Jan
