A report described a new approach to setting target allocations for hospital care to commissioning general practices – 'person-based resource allocation'. The approach used complex data sets to build up estimated budgets at family doctor practice level, based on the needs of people registered on practice lists.
Source: Martin Bardsley and Jennifer Dixon, Person-Based Resource Allocation: New approaches to estimating commissioning budgets for GP practices, Nuffield Trust
Links: Report
Date: 2011-Dec
An article set out an operational framework for assessing the completeness and consistency of the stewardship function of national health ministries in Europe.
Source: Jeremy Henri Maurice Veillard, Adalsteinn Davidson Brown, Enis Baris, Govin Permanand, and Niek Sebastian Klazinga, 'Health system stewardship of national health ministries in the WHO European region: concepts, functions and assessment framework', Health Policy, Volume 103 Issue 2-3
Links: Abstract
Date: 2011-Dec
The fair trading watchdog said that it had provisionally decided to refer the market for privately funded healthcare services to the competition watchdog for further investigation. It had found a number of features that prevented, restricted or distorted competition in the private healthcare market – including a lack of easily comparable information available to patients, family doctors, and health insurance providers on the quality and costs of private healthcare services.
Source: Private Healthcare Market Study: Report on the market study and proposed decision to make a market investigation reference, Office of Fair Trading
Links: Report | OFT press release | BBC report | Guardian report
Date: 2011-Dec
A report said that the coalition government needed to act quickly to minimize the risks for children and child health as it proceeded with its reforms to the National Health Service. Insufficient attention had been paid to what the reforms would mean for child health. The government should clarify and simplify the way in which services would work together, and produce a cross-government strategy.
Source: Children and Young People's Health: Where Next?, NHS Confederation/Royal College of Paediatrics and Child Health
Links: Report | NHS Confederation press release | Public Finance report
Date: 2011-Dec
An article examined the relevance of strategy in health and social care. Strategy in the context of recent reforms in health and social care was more likely to be characterized as 'emergent and processual'.
Source: Steve Willcocks, 'Understanding strategy, change and leadership in UK health and social care', Journal of Integrated Care, Volume 19 Number 6
Links: Abstract
Date: 2011-Dec
An article examined the effects of choice and competition policies in healthcare in England by using subjective well-being as an indicator of welfare and equity. The results indicated overall positive welfare effects of choice and competition, but with marked differences between social groups: the positive welfare effects were felt most strongly by high-income and high-education groups.
Source: Valentina Zigante, 'Subjective well-being as a measure of welfare and equity: the case of choice policies in health care', CESifo Economic Studies, Volume 57 Issue 4
Links: Abstract
Date: 2011-Dec
An article examined the overall readiness of joint strategic needs assessment (JSNA) to respond to the new functions proposed by the Health and Social Care Bill 2011. Despite significant progress in the quality of JSNA during the period 2008-2010, raised expectations posed a serious challenge. It was possible to identify a number of key issues that needed to be directly addressed if the process were to fulfil the new expectations.
Source: Ed Harding and Michelle Kane, 'Joint strategic needs assessment: reconciling new expectations with reality', Journal of Integrated Care, Volume 19 Number 6
Links: Abstract
Date: 2011-Dec
A report examined the strategies adopted in European Union countries to improve the health of patients through better co-ordination between different levels of healthcare.
Source: Better Health: A Shared Challenge for Hospitals and Primary Health Care, European Hospital and Healthcare Federation
Date: 2011-Dec
A report examined major developments in the governance of public hospitals in Europe, and their implications for national and European health policy.
Source: Richard Saltman, Antonio Duran, and Hans Dubois (eds.), Governing Public Hospitals. Reform strategies and the movement towards institutional autonomy, World Health Organisation (Regional Office for Europe)
Links: Report
Date: 2011-Dec
The report was published of a review (led by John Compton) into health and social care in Northern Ireland. It said that there was an 'unassailable case for change': pressures arising from a growing and ageing population, and from poorer health and a growth in chronic conditions, threatened the stability of the existing services. The review set out a new model that should drive the future shape and direction of services. The model included: placing the individual at the centre, by promoting a better outcome for the service user, their carer, and their family; using outcomes and quality evidence to shape services; a focus on prevention and tackling inequalities; integrated care; realizing value for money; and maximizing the use of technology.
Source: Transforming Your Care: A review of health and social care in Northern Ireland, Northern Ireland Executive
Links: Report | Ministerial Statement | NIE press release | RCPsych press release
Date: 2011-Dec
A report set out a delivery agenda for spreading innovation throughout the National Health Service.
Source: Innovation, Health and Wealth: Accelerating adoption and diffusion in the NHS, Department of Health
Links: Report | Responses to call for evidence
Date: 2011-Dec
A new book examined the healthcare experiences of the most developed countries in Asia (Japan, South Korea, Taiwan, and Singapore) and compared these with four of the most important healthcare systems in Europe (United Kingdom, France, Germany, and Italy). It looked at the increasing need for reforms in healthcare and health insurance administration, delivery systems, financing, and overall healthcare policy strategies – particularly in fast-aging societies in Asia, and highly aged societies in Europe.
Source: Christian Aspalter, Yasuo Uchida, and Robin Gauld (eds.), Health Care Systems in Europe and Asia, Routledge
Links: Summary
Date: 2011-Dec
An article examined the ways in which the position of patients had been reinforced under the 2011 Directive on cross-border healthcare.
Source: Frans Pennings, 'The cross-border health care Directive: more free movement for citizens and more coherent EU law?', European Journal of Social Security, 2011 Volume 4
Links: Abstract
Date: 2011-Dec
A report highlighted the key findings and recommendations from a conference (held in September 2011) to discuss the key priorities for child health. Significant progress had been made in improving the health and well-being of children and young people over the previous 5 years: but some children and young people still failed to receive the highest standards of healthcare attainable. Children and young people needed to be engaged early in the design of new health organizations and structures, in order to ensure that their views were included right from the start and regularly in the future.
Source: Involving Children and Young People in Health Services, NHS Confederation
Links: Report
Date: 2011-Dec
A report said that patients faced such a confusing mix of places to seek urgent healthcare or advice in England that their safety could be at risk. The services that had proliferated between family doctor surgeries and hospital departments made it difficult to define who was responsible for care as patients moved across organizational boundaries within the National Health Service. The report called for the system of 24/7 care outside hospital to be simplified.
Source: David Carson, Henry Clay, and Rick Stern, Breaking the Mould Without Breaking the System: New ideas and resources for clinical commissioners on the journey towards integrated 24/7 urgent care, Primary Care Foundation
Links: Report | NHS Alliance press release | Guardian report
Date: 2011-Nov
A new operating framework was published for the National Health Service in England in 2012-13. It described how NHS organizations could maintain and improve the quality of services provided, while delivering transformational change and maintaining financial stability.
Source: The Operating Framework for the NHS in England 2012/13, Department of Health
Links: Framework | Hansard | CMH press release | MHN press release | NHS Confederation press release | Nuffield Trust press release | RCP press release
Date: 2011-Nov
An article examined the different integrated approaches to healthcare services supporting older people in care homes, and identified barriers and facilitators to integrated working. There was limited evidence about what the outcomes of different approaches to integrated care between health services and care homes might be.
Source: Sue Davies, Claire Goodman, Frances Bunn, Christina Victor, Angela Dickinson, Steve Iliffe, Heather Gage, Wendy Martin, and Katherine Froggatt, 'A systematic review of integrated working between care homes and health care services', BMC Health Services Research, Volume 11
Date: 2011-Nov
The coalition government was reported to have climbed down over its opposition to waiting time targets in the National Health Service. It had introduced a treatment directive aimed at stemming the increase in the number of patients in England not treated within 18 weeks of referral.
Source: BBC report, 17 November 2011
Links: BBC report | Labour Party press release | UNISON press release | Guardian report
Date: 2011-Nov
A report summarized contributions at a seminar (held in October 2011) to discuss the implementation of the coalition government's reforms to commissioning in the National Health Service.
Source: An NHS for Patients: Making clinical commissioning work, Reform
Links: Report
Date: 2011-Nov
An audit briefing said that there were significant geographical variations in the types of care received by people aged 65 and over. Despite the strong focus for many years on improving joint working across the National Health Service and social care, progress remained 'patchy'.
Source: Joining up Health and Social Care: Improving value for money across the interface, Audit Commission
Links: Briefing | Audit Commission press release
Date: 2011-Nov
An independent forum of health experts published its interim advice to the government on integrated care, patient information, and public health. It said that information about health and social care services needed to be published in a transparent and usable form, and that patients needed to have better access to healthcare records. It called for a 'national partnership' across the National Health Service and public health. The government should allow local flexibility in NHS tariffs to help 'align incentives' for integration.
Source: Letter 17 November 2011, NHS Future Forum
Links: Letter | DH press release
Date: 2011-Nov
A district general hospital in Huntingdon (England) became the first hospital in the National Health Service to have its management handed over to a private company, under a 10-year agreement.
Source: The Guardian, 10 November 2011
Links: Guardian report (1) | Guardian report (2) | Green Party press release | Labour Party press release | Unite press release
Date: 2011-Nov
The Welsh Government published a new 5-year plan for the National Health Service, based around an emphasis on community services and placing prevention, quality, and transparency at the heart of healthcare. Doctors, nurses, and other health professionals would be brought together to form 'clinical networks' aimed at treating more patients in the community. At the same time 'centres of excellence' would be created to make sure that patients had quick and easy access to specialist care.
Source: Together for Health: A five year vision for the NHS in Wales, Welsh Government
Links: Plan | Welsh Government press release | BBC report | Guardian report
Date: 2011-Nov
A paper examined plans for establishing a new NHS Commissioning Board (due to start work in shadow form on 31 October 2011). It considered some of the key issues facing the Board, in areas such as accountability, values, culture, and behaviour.
Source: Building a Successful NHS Commissioning Board: A perspective from the NHS, NHS Confederation
Links: Paper | NHS Confederation press release
Date: 2011-Oct
An article said that a research paper that had claimed to show that the introduction of patient choice in the National Health Service had reduced deaths from heart attacks was 'flawed and misleading'.
Source: Allyson Pollock, Alison Macfarlane, Graham Kirkwood, F Azeem Majeed, Ian Greener, Carlo Morelli, Sean Boyle, Howard Mellett, Sylvia Godden, David Price, and Petra Brhlikova, ' No evidence that patient choice in the NHS saves lives', The Lancet 10 October 2011 (online first)
Links: Article | City University press release | Dundee University press release
Date: 2011-Oct
Researchers examined the early experiences of a small sample of personal health budget holders and their representatives. Some interviewees had already experienced positive outcomes.
Source: Annie Irvine, Jacqueline Davidson, Caroline Glendinning, Karen Jones, Julien Forder, James Caiels, Elizabeth Welch, Karen Windle, Paul Dolan, and Dominic King, Personal Health Budgets: Early experiences of budget holders – Fourth interim report, Department of Health
Date: 2011-Oct
A think-tank report examined how personalization needed to be adapted to fit the specific context of healthcare services. Personalization could produce many significant benefits if implemented well, including enabling the National Health Service to meet its efficiency targets. But the report highlighted the dangers posed by poor implementation and a failure to adapt personalization technologies to the healthcare environment.
Source: Vidhya Alakeson and Simon Duffy, Health Efficiencies: The possible impact of personalisation in healthcare, Centre for Welfare Reform
Date: 2011-Oct
An article examined whether the framework for healthcare integration set out by the coalition government was likely to be more successful than previous frameworks. There was a relatively good fit between the principles and proposals: but gaps were identified, and implementation difficulties were already becoming evident – especially in respect of the tension between localism and national accountability.
Source: Gerald Wistow, ' Integration and the NHS reforms', Journal of Integrated Care, Volume 19 Number 4
Links: Abstract
Date: 2011-Oct
A paper set out a series of principles for how the members of new local boards for health and well-being should work together. They included: strong collective leadership, proper engagement with local people, a clear sense of shared priorities, and joint working to tackle key issues such as health inequalities.
Source: Operating Principles for Health and Wellbeing Boards: Laying the foundations for healthier places, NHS Confederation (with six other organizations)
Links: Paper | NHS Confederation press release
Date: 2011-Oct
An article examined evidence on the effects of hospital competition on quality of care within the English National Health Service, and considered whether it supported coalition government proposals to extend competition. More research was needed before conclusions could be drawn.
Source: Gwyn Bevan and Matthew Skellern, ' Does competition between hospitals improve clinical quality? A review of evidence from two eras of competition in the English NHS', British Medical Journal, 9 October 2011
Links: Extract
Date: 2011-Oct
A paper examined the 'independent' healthcare sector's engagement with the National Health Service in England. The independent sector and the NHS were 'symbiotic' and had had a close relationship for many years: this had benefited patients and saved the NHS significant cost. Most of the public did not mind who provided care, as long as it continued to be free at the point of use and of high quality.
Source: A Positive Partnership: The independent sector and the NHS, NHS Confederation
Links: Briefing
Date: 2011-Oct
The coalition government announced (following consultation) that from April 2012 National Health Service patients in England would have the right to stipulate which hospital consultant treated them. All NHS providers would have to accept all clinically appropriate referrals to named hospital consultant-led teams.
Source: Written Ministerial Statement 11 October 2011, columns 20-21WS, House of Commons Hansard, TSO
Links: Hansard | Response to consultation | DH press release
Date: 2011-Oct
The coalition government published a 'strategic vision' (following consultation) for promoting the use of volunteers in health and social care services. It highlighted the potential of volunteering in terms of improving health and well-being and addressing health inequalities.
Source: Social Action for Health and Well-Being: Building co-operative communities, Department of Health
Date: 2011-Oct
A new book examined priority-setting methods in healthcare.
Source: Iestyn Williams, Suzanne Robinson, and Helen Dickinson, Rationing in Health Care: The theory and practice of priority setting, Policy Press
Links: Summary
Date: 2011-Oct
The coalition government announced that it would accelerate the process of dismantling the information technology programme for the National Health Service in England. An internal review had concluded that the programme was not fit for purpose.
Source: Press release 22 September 2011, Department of Health
Links: DH press release | Letter | Review report | BBC report | Public Finance report
Date: 2011-Sep
A study examined how primary care trusts made decisions about funding priorities. Although most commissioners had established robust systems in relation to funding new services and exceptional treatments, they generally struggled to apply the same rigour to 'core' spending.
Source: Suzanne Robinson, Helen Dickinson, Iestyn Williams, Tim Freeman, Benedict Rumbold, and Katie Spence, Setting Priorities in Health: A study of English primary care trusts, Nuffield Trust
Links: Report | Nuffield Trust press release
Date: 2011-Sep
A report sought to identify examples of commissioners achieving greater integration of healthcare services in England. It highlighted a number of barriers to more joined-up services, and recommended ways in which the coalition government could address these as part of the next stage of National Health Service reform.
Source: Chris Ham, Judith Smith, and Elizabeth Eastmure, Commissioning Integrated Care in a Liberated NHS, Nuffield Trust
Date: 2011-Sep
A think-tank report called for radical changes to improve the process for reorganizing hospital services, and to prevent politicians from blocking essential changes. The existing decision-making process for hospital reconfigurations was 'complex and bureaucratic', posing significant risks to the delivery of safe services.
Source: Candace Imison, Reconfiguring Hospital Services, King?s Fund
Links: Report | Kings Fund press release | RCP press release | Guardian report
Date: 2011-Sep
An article examined examples of competition, freedom of choice,, and personalized care in health and social services in England and Sweden. It considered the type of relationships emerging between users/consumers, market-driven providers, and various agencies of the state under a marketized welfare system.
Source: Marianna Fotaki, 'Towards developing new partnerships in public services: users as consumers, citizens and/or co-producers in health and social care in England and Sweden', Public Administration, Volume 89 Issue 3
Links: Abstract
Date: 2011-Sep
A think-tank report provided a comprehensive analysis of the impact of introducing competition to the National Health Service in England under the former Labour governments (1997-2010). The new coalition government's proposals for increasing competition represented an evolution of Labour's reforms: but Labour's reforms had been implemented in a 'vastly different' context. 'Almost nothing' was known about the costs of competition or its relative effect compared with other approaches such as targets and performance management.
Source: Nicholas Mays, Anna Dixon, and Lorelei Jones (eds.), Understanding New Labour's Market Reforms of the English NHS, King?s Fund
Links: Report | Kings Fund press release
Date: 2011-Sep
A report by a committee of MPs called on the government to urgently review whether it was worth continuing with the remaining elements of the electronic care records system in the National Health Service. The £4.3 billion spending that was planned on the project might be better used to buy systems that were proven to work, that were good value for money, and that delivered demonstrable benefits.
Source: The National Programme for IT in the NHS: An update on the delivery of detailed care records systems, Forty-fifth Report (Session 2010-12), HC 1070, House of Commons Public Accounts Select Committee, TSO
Links: Report | NHS Confederation press release | BBC report | Guardian report | Public Finance report
Date: 2011-Aug
A report examined information governance regulations in healthcare, and the social values that underpinned them.
Source: Sarah Clark and Albert Weale, Information Governance in Health, Nuffield Trust
Date: 2011-Aug
A think-tank report said that there were significant risks for social enterprise organizations in the coalition government's plans for greater competition in the provision of healthcare services.
Source: Rachael Addicott, Social Enterprise in Health Care: Promoting organisational autonomy and staff engagement, King s Fund
Links: Report | Kings Fund press release | Public Finance report
Date: 2011-Aug
The coalition government published a summary of responses to a consultation on the information strategy for health and social care in England. It said that respondents broadly supported the strategy: but there was concern that the strategy did not increase inequalities in access to services.
Source: Liberating the NHS: An Information Revolution – A Summary of Consultation Responses, Department of Health
Links: Consultation responses
Notes: Consultation document (October 2010)
Date: 2011-Aug
The coalition government announced (following consultation) that it would open more than £1 billion of National Health Service community services (including wheelchair services for children) to competition from private companies and charities.
Source: Liberating the NHS: Greater Choice and Control – Government Response: Extending Patient Choice of Provider (Any qualified provider), Department of Health
Links: Response to consultation | Impact assessment | Equality impact assessment | DH press release | CSP press release | Unison press release | BBC report | Guardian report
Date: 2011-Jul
A paper examined which factors mattered to patients and their family doctors when they chose a hospital for treatment. Many patients had a good choice of hospitals within a reasonable distance of where they lived, and nearly 4 in 10 patients chose not to receive treatment at their nearest hospital and instead travelled to a hospital further afield. Patients were more likely to choose a hospital if it provided higher-quality care; and they preferred hospitals with shorter waiting times, lower hospital-acquired infection rates, and lower overall mortality rates. The paper highlighted the importance of the family doctor in helping patients to choose the most appropriate hospital for treatment.
Source: Walter Beckert, Mette Christensen, and Kate Collyer, Working Paper – Volume 1 Number 4, Choice of NHS Funded Hospital Services in England, Co-Operation and Competition Panel for NHS-Funded Services
Links: Paper
Date: 2011-Jul
The Department of Health published a 'business plan' covering the period 2011-2015. The cost of the coalition government's reform plans for the National Health Service was estimated at £1.49 billion – £160 million more than the previous estimate.
Source: Business Plan 2011-2015, Department of Health
Links: Plan | Guardian report
Date: 2011-Jul
An article examined the potential implications of the coalition government's proposed National Health Service reforms for the third sector.
Source: Helen Dickinson and Robin Miller, 'GP commissioning: implications for the third sector', Voluntary Sector Review, Volume 2 Number 2
Links: Abstract
Date: 2011-Jul
An article examined preparations by local authorities and primary care trusts in England for the duty to conduct a joint strategic needs assessment of the health and well-being of their local community. Respondents felt that the assessment had the potential to raise the profile of jointly agreed approaches to needs assessment, and to partnership working more generally.
Source: Jo Ellins and Jon Glasby, 'Together we are better? Strategic needs assessment as a tool to improve joint working in England', Journal of Integrated Care, Volume 19 Number 3
Links: Abstract
Date: 2011-Jul
The competition watchdog for the National Health Service said that some patients were losing out as a result of restrictions on their choice of provider of National Health Service care. Although some commissioners were successfully balancing the many requirements on them and still delivering patient choice, others were restricting choice excessively. If these variations were not addressed there was a serious risk that the expected benefits of patient choice – both to patients and taxpayers – would not be realized to their full potential.
Source: Review of the Operation of Any Willing Provider for the Provision of Routine Elective Care: Final Report, Co-Operation and Competition Panel for NHS-Funded Services
Links: Report | CCP press release | DH press release | NHS Confederation press release | BBC report
Date: 2011-Jul
Researchers examined the financial costs of implementing personal health budgets – including systems design, workforce training, and 'managing the market'.
Source: Karen Jones, Julien Forder, James Caiels, Elizabeth Welch, Karen Windle, Jacqueline Davidson, Paul Dolan, Caroline Glendinning, Annie Irvine, and Dominic King, The Cost of Implementing Personal Health Budgets, Department of Health
Links: Report | DH press release
Date: 2011-Jul
A think-tank report examined whether competition and integration could coexist in the National Health Service, and considered the role that different bodies – especially the NHS Commissioning Board and Monitor – would play within a new system. In order to create effective integrated care pathways for particular conditions or individual patients, key bodies would need to have a shared vision for 'payment currencies' and clear measures of efficiency, quality, and outcomes.
Source: Loraine Hawkins, Can Competition and Integration Co-Exist in a Reformed NHS?, King s Fund
Date: 2011-Jul
A report said that the delivery of maternity care in the existing configuration 'could not be sustained'. It recommended that services should be provided in managed clinical networks that linked primary, community, secondary, and tertiary services. A life-course approach to women's healthcare should be adopted, utilizing every interaction a woman had with the health service, irrespective of age, to promote health and lifestyle rather than the constant 'firefight' against disease and ill-health The variation in health service provision needed to be resolved by universally adopting clinical standards and guidelines, and mandating the reporting of outcomes.
Source: High Quality Women s Health Care: A proposal for change, Royal College of Obstetricians and Gynaecologists
Links: Report | RCOG press release | NHS Confederation press release | RCM press release | Guardian report
Date: 2011-Jul
A report investigated what was meant by integrated care in the National Health Service, and explained the distinction between the terms 'integrated care' and 'integration'. It explored integration from an NHS perspective, identified the concepts that underpinned integrated care, and suggested how these could be used to inform practical integration efforts both within and beyond the NHS.
Source: Sara Shaw, Rebecca Rosen, and Benedict Rumbold, What Is Integrated Care? An overview of integrated care in the NHS, Nuffield Trust
Links: Report
Date: 2011-Jul
A report described the outcome of a simulation exercise that examined how the National Health Service and its local government partners could deliver better outcomes in health and social care with fewer resources. It highlighted the 'immense challenge' of moving beyond short-term efficiency savings to a longer-term transformational redesign of services; the tension between 'top-down' approaches to change and devolved models based on personalised care, choice, and provider incentives; and the potential of health and well-being boards to offer system leadership in moving towards different models of care.
Source: Sarah Harvey, Laurie McMahon, and Richard Humphries, Routes for Social and Health Care: A simulation exercise, King s Fund
Links: Report
Date: 2011-Jun
A report made a series of recommendations (based on experiences in the United States of America) in relation to plans by the coalition government to give greater commissioning powers to consortiums of family doctors. In order to succeed, consortiums would have to invest heavily in leadership, management, and infrastructure. Consortium objectives should be balanced between quality, patient experience, and cost incentives. Incentives for consortiums to generate cost savings should not be excessively strong. Hospitals and specialist physicians should be encouraged, and supported, to co-operate with consortiums.
Source: Lawrence Casalino, GP Commissioning in the NHS in England: Ten Suggestions from the United States, Nuffield Trust
Links: Report
Date: 2011-Jun
A think-tank report examined what the coalition government's National Health Service reforms could mean for voluntary organizations providing health services. It raised particular concerns that larger providers could end up dominating the market, and stressed that the sector needed support in the transition to the new arrangements.
Source: Natasha Curry, Claire Mundle, Fiona Sheil, and Lisa Weaks, The Voluntary and Community Sector in Health: Implications of the proposed NHS reforms, King s Fund
Links: Report | NCVO press release
Date: 2011-Jun
An article examined the strategies that health scrutiny committees in 8 English local authorities adopted in order to influence decision-makers.
Source: Alan Boyd and Anna Coleman, 'Strategies used by health scrutiny committees to influence decision-makers', Local Government Studies, Volume 37 Issue 3
Links: Abstract
Date: 2011-Jun
A study found that at least one-half of the board members of some family doctor consortiums (the new bodies that would take over healthcare commissioning under coalition government plans) had links with a single private healthcare company.
Source: Press release 15 June 2011, Bureau of Investigative Journalism
Links: BIJ press release | Telegraph report
Date: 2011-Jun
An audit report highlighted the risks to value for money associated with the coalition government's programme aimed at enabling staff to set up health social enterprises outside the National Health Service. The Department of Health had not set measurable objectives against which to evaluate the programme's success. Primary care trusts expected social enterprises to deliver more benefits than other providers: but they did not generally contract for them to deliver savings or any other additional benefits.
Source: Establishing Social Enterprises Under the Right to Request Programme, HC 1088 (Session 2010-2012), National Audit Office, TSO
Links: Report | NAO press release | Community Care report | Public Finance report
Date: 2011-Jun
A report examined recent policy changes across housing, health, and social care; and investigated how these might provide new opportunities for integrating local services for the benefit of communities and individuals.
Source: Sarah Davis, Localism: Delivering integration across housing, health and care, Chartered Institute of Housing
Links: Report
Date: 2011-Jun
Researchers examined the benefits, drawbacks, and cost implications of a shift to providing healthcare for ill children closer to their home.
Source: Gillian Parker et al., Evaluating Models of Care Closer to Home for Children and Young People Who Are Ill: Final Report, Service Delivery and Organisation programme, National Institute for Health Research
Date: 2011-May
An audit report said that the rate at which electronic care records systems were being put in place across the National Health Service under the national programme for information technology was falling far below expectations. The core aim that every patient should have an electronic care record under the programme would not now be achieved.
Source: The National Programme for IT in the NHS: An Update on the Delivery of Detailed Care Records Systems, HC 888 (Session 2010-2012), National Audit Office, TSO
Links: Report | NAO press release | DH press release | BMA press release | Conservative Party press release | NHS Confederation press release | BBC report | Public Finance report
Date: 2011-May
A report examined how National Health Service foundation trusts were run, and what difference new governance arrangements had made – both in terms of their internal structures and how they were regulated. The trusts had become more business focused: but at the same time centralized 'command and control' aspects of the NHS continued to be very powerful influences.
Source: Pauline Allen et al., Investigating the Governance of NHS Foundation Trusts, Service Delivery and Organisation programme, National Institute for Health Research
Date: 2011-May
A think-tank report identified 10 priorities for action by healthcare commissioners under the coalition government's plans for reform. The proposed National Health Service Commissioning Board needed to work collaboratively with family doctors and commissioners to influence and develop the provision of local primary care services. In particular, it needed to help drive a more systematic and proactive management of chronic disease, the empowerment of patients, a population-based approach to commissioning, and more integrated models of care.
Source: Candace Imison et al., Transforming Our Health Care System: Ten priorities for commissioners, King s Fund
Links: Report
Date: 2011-May
A report summarized findings from an historical overview of arrangements and experiences of joint working between local government and the National Health Service since 1948. It generated 10 'principles of integration', which were then used as a framework for analyzing the relevant provisions of the coalition government's latest proposals.
Source: Gerald Wistow, Integration This Time? Liberating the NHS and the role of local government, Local Government Association
Links: Report
Date: 2011-May
A commission report highlighted the crucial role that excellent general and clinical managers could play in delivering the productivity improvements and service transformation required in the National Health Service.
Source: Commission on Leadership and Management in the NHS, The Future of Leadership and Management in the NHS: No more heroes, King s Fund
Links: Report | Kings Fund press release | CMI press release | NHS Confederation press release
Date: 2011-May
The government announced that responsibility for commissioning health services in England for children and young people in secure children's homes and secure training centres was to pass to the National Health Service (in line with arrangements for young offender institutions). It said that the change was designed to ensure that those concerned, who often had complex needs, benefited from high-quality healthcare.
Source: Press release 27 May 2011, Department of Health
Links: DH press release
Date: 2011-May
A paper examined 'choice' policies in European public services, focusing on the case of choice in healthcare in the United Kingdom. The UK had a highly developed consumerist policy, and had served as a role model for other European countries implementing choice policies. There were positive effects of choice, particularly for middle-class individuals.
Source: Valentina Zigante, Assessing Welfare Effects of the European Choice Agenda: The case of health care in the United Kingdom, LEQS Paper 35, European Institute (London School of Economics)
Links: Paper
Date: 2011-May
A paper examined the relationship between the quality of family doctor practices in England and the degree of competition that they faced (as indicated by the number of nearby rival practices). Those practices that were located close to other rival practices provided a higher quality of care than that provided by practices that lacked competitors.
Source: Chris Pike, An Empirical Analysis of the Effects of GP Competition, Co-Operation and Competition Panel for NHS-Funded Services
Links: Paper
Date: 2011-May
A report summarized qualitative research into how expectant and new parents experienced maternity and early years care. Parents did not perceive the health service as a service, but rather as a set of prescribed interactions at key stages: they needed to be encouraged to be more 'proactive' in accessing the help available to them.
Source: Parents Views on the Maternity Journey and Early Parenthood, Department of Health
Links: Report
Date: 2011-Apr
A new book examined the development of National Health Service treatment centres. It described the centres as a 'top-down' innovation that had become 'subverted' into a multiplicity of solutions to different local problems.
Source: John Gabbay et al., Organisational Innovation in Health Services: Lessons from the NHS treatment centres, Policy Press
Links: Summary
Date: 2011-Apr
An article examined the extent to which co-ordination between health and social care agencies had been achieved, following the introduction of a policy initiative (the 'single assessment process') that aimed to integrate assessment of older people through the use of shared tools and procedures.
Source: Michele Abendstern, Jane Hughes, Paul Clarkson, Caroline Sutcliffe, and David Challis, 'The pursuit of integration in the assessment of older people with health and social care needs', British Journal of Social Work, Volume 41 Number 3
Links: Abstract
Date: 2011-Apr
An article examined the introduction (under the terms of the coalition government's White Paper) of a greater role for local government in running health services in England.
Source: Bob Hudson, 'All that glisters: are the NHS reforms good for local government?', Journal of Integrated Care, Volume 19 Number 2
Links: Abstract
Date: 2011-Apr
The government published a 'working document' that described the proposed statutory functions of family doctor (GP) commissioning consortia.
Source: The Functions of GP Commissioning Consortia: A Working Document, Department of Health
Links: Working document
Date: 2011-Mar
A paper examined the 2011-12 operating framework for the National Health Service in England, together with guidance on the operation of payment by results. It set out the key challenges associated with managing the transition to a reformed NHS, as envisaged in the coalition government's White Paper, and proposed ways in which the risks associated with transition might be mitigated.
Source: Judith Smith and Anita Charlesworth, NHS Reforms in England: Managing the Transition, Nuffield Trust
Links: Report | Nuffield Trust press release | Public Finance report
Date: 2011-Mar
The first report was published of a two-phase review of how to maintain and improve quality during the process of National Health Service 'modernization'. It described the key roles and responsibilities of organizations and individuals, and practical steps to safeguard quality during the transition. It emphasized the importance of effective handover of knowledge about quality between old and new organizations.
Source: National Quality Board, Maintaining and Improving Quality During the Transition: Safety, effectiveness, experience – Part one 2011-12, Department of Health
Links: Report | Summary | Telegraph report
Date: 2011-Mar
An article examined the 'destabilizing' effects of European Union law in relation to patient mobility. Health service organizations and governments in member states had opted for very limited compliance.
Source: Scott Greer and Simone Rauscher, 'Destabilization rights and restabilization politics: policy and political reactions to European Union healthcare services law', Journal of European Public Policy, Volume 18 Issue 2
Links: Abstract
Date: 2011-Mar
A report examined cross-border healthcare in the European Union, and the legal uncertainties surrounding rights, access, reimbursement, quality, and safety. It looked at different approaches to these concerns and the methodologies to use to ease or resolve them.
Source: Matthias Wismar, Willy Palm, Josep Figueras, Kelly Ernst, and Ewout van Ginneken (eds.), Cross-Border Health Care in the European Union: Mapping and analysing practices and policies, European Observatory on Health Systems and Policies
Date: 2011-Mar
A report examined 8 carefully selected interventions that formed part of the wider 'Partnership for Older People Projects' initiative (aimed partly at reducing hospital admissions). No evidence was found of a reduction in emergency hospital admissions associated with any of the interventions studied.
Source: Adam Steventon, Martin Bardsley, John Billings, Theo Georghiou, and Geraint Lewis, An Evaluation of the Impact of Community-Based Interventions on Hospital Use, Nuffield Trust
Date: 2011-Mar
An article examined different models for estimating the future healthcare costs to an organization of an ageing population. Making over-simplistic assumptions and not using well-established principles led to greatly different outcomes, with potentially massive organizational consequences in terms of short- to medium-term strategic planning.
Source: Michael Caley and Khesh Sidhu, 'Estimating the future healthcare costs of an aging population in the UK: expansion of morbidity and the need for preventative care', Journal of Public Health, Volume 33 Number 1
Links: Abstract
Date: 2011-Mar
A survey found that National Health Service professionals supported the idea of personal health budgets, but that they had little enthusiasm for their implementation. Clinicians especially were not yet convinced that personal health budgets would benefit patients.
Source: Facing Up to the Challenge of Personal Health Budgets: The view of frontline professionals, NHS Confederation/National Mental Health Development Unit
Links: Report | NHS Confederation press release
Date: 2011-Mar
An audit report said that a government scheme that 'incentivized' family doctors to improve their services to patients might not be having the impact it should, because of poor oversight of the payments being made.
Source: Paying GPs to Improve Quality: Auditing payments under the Quality and Outcomes Framework, Audit Commission
Links: Report | Audit Commission press release
Date: 2011-Feb
The Scottish Government outlined a proposal to integrate health and social care for adults. The plan was designed to give quicker access to care and staff, and reduce delayed discharges. Local councils and health boards would be expected to work more closely together under a 'lead commissioning' model.
Source: Press release 2 February 2011, Scottish Government
Links: Scottish Government press release | SNP press release | Community Care report | BBC report
Date: 2011-Feb
The Scottish Parliament approved a Bill designed to improve patients' experience of the National Health Service. It included a 12-week treatment time guarantee, and a charter of patient rights and responsibilities.
Source: Patient Rights (Scotland) Bill, Scottish Government, TSO | Scottish Parliament Debate 24 February 2011, Official Report, TSO
Links: Bill | Explanatory notes | Policy memorandum | Official Report | Scottish Government press release | BBC report
Date: 2011-Feb
An article examined the idea of integrated priority setting as a key element of health and social care commissioning. There were significant barriers in terms of financing, accessibility, evidence, and politics: although these barriers were not insurmountable, the solution lay in engagement with a range of stakeholders, rather than simply a technical process.
Source: Iestyn Williams, Helen Dickinson, and Suzanne Robinson, 'Joined-up rationing? An analysis of priority setting in health and social care commissioning', Journal of Integrated Care, Volume 19 Number 1
Date: 2011-Feb
The competition watchdog for the National Health Service said that attempts by primary care trusts to cap referrals to private providers, in order to control costs, breached National Health Service competition rules.
Source: Review of the Operation of 'Any Willing Provider' for the Provision of Routine Elective Care: Interim assessment, Co-Operation and Competition Panel for NHS-Funded Services
Links: Report | CCP press release
Date: 2011-Feb
A study examined the opportunities for co-operatives and mutuals as service providers under personal budgets in social care and health. The market for personalized services was found to be underdeveloped: but co-operatives were not well understood by gatekeepers to social care and health services.
Source: Jenny Fisher, Mary Rayner, and Sue Baines, Personalisation of Social Care and Health: A Co-operative Solution, Co-operatives UK/Manchester Metropolitan University
Links: Report | MMU press release
Date: 2011-Feb
A paper said that individual budgets could create a more patient-centred and integrated health and social care system – one that recognized individuals as 'experts by experience', and engaged them as partners alongside professionals in decisions about their own care. This would improve health outcomes, prevent individuals becoming dependent on specialist services, and make the National Health Service more efficient.
Source: Vidhya Alakeson, Active Patient: The case for self-direction in healthcare, Health Services Management Centre (University of Birmingham)/Centre for Welfare Reform
Links: Paper
Date: 2011-Jan
A think-tank report (based on a study of experiences in the United States of America) said that substantial investment in leadership, management, and information technology – combined with a focus on helping family doctors to work in new ways, and collaborate more closely with their specialist colleagues – was vital if the government's plan to give control of National Health Service budgets to groups of family doctors were to succeed.
Source: Ruth Thorlby, Rebecca Rosen and Judith Smith, GP Commissioning: Insights from Medical Groups in the United States, Nuffield Trust
Links: Report | Nuffield Trust press release | Guardian report
Date: 2011-Jan
An article examined the new coalition government's vision for health and social care. Despite risks of increased fragmentation, there were new opportunities for integration in both commissioning and provider functions. Local authorities should move quickly to influence and lead the new partnerships.
Source: Ray Jones, 'A "liberated" NHS: intentions, impact and implications for local government', Journal of Integrated Care, Volume 18 Number 6
Links: Abstract
Date: 2011-Jan
A briefing paper examined the commissioning function in the National Health Service in England. It briefly defined commissioning, set out how it currently operated, and outlined the coalition government's policy for reform.
Source: David Turner and Thomas Powell, NHS Commissioning, Standard Note SN/SP/5607, House of Commons Library
Links: Briefing paper
Date: 2011-Jan
The government responded to a report by a committee of MPs on its plans for wholesale reform of commissioning in the National Health Service. It said that although the proposal to abolish primary care trusts had not been in the Conservative or Liberal Democrat election manifestos, or even in the coalition government's agreed programme, it was simply a 'logical consequence' of other proposals – that is, to transfer the trusts' main responsibilities to other bodies including local government.
Source: Government Response to the House of Commons Health Select Committee Third Report of Session 2010-11: Commissioning, Cm 8009, Department of Health, TSO
Notes: The MPs' report had said that the proposal represented a 'high-risk' strategy.
Date: 2011-Jan
An article examined options for the functional and structural integration of health and social care for older people.
Source: Colin Currie, 'Health and social care of older people: could policy generalise good practice?', Journal of Integrated Care, Volume 18 Number 6
Links: Abstract
Date: 2011-Jan
A paper examined how to use health and social care resources to achieve the best possible outcomes, in the context of difficult financial circumstances. Existing approaches would be insufficient to respond to the range of financial, demographic, and social challenges. The traditional response of simply changing structures tended to damage local relationships, give only a false impression of change, and actually make some staff more resistant to change.
Source: Jon Glasby, Helen Dickinson, and Robin Miller, All in This Together? Making best use of health and social care resources in an era of austerity, Health Services Management Centre (University of Birmingham)
Links: Paper
Date: 2011-Jan
The European Parliament voted to adopt a Directive that sought to clarify the rights of patients to receive healthcare in another member state.
Source: Debate 19 January 2011, European Parliament
Links: Text | European Parliament press release | European Commission press release | European Patients Forum press release | Green Party press release | NHS Confederation press release
Date: 2011-Jan
