A survey examined the ways of working that were emerging between clinical commissioning groups and NHS England. The results would be used as a baseline, to stimulate discussion on how to develop relationships, and the survey would be repeated in 2014.
Source: Ways of Working Survey, Ipsos MORI
Links: Report
Date: 2013-Dec
A new book examined partnership working and governance under the New Labour government in the United Kingdom. It said that, despite substantial investment in the partnership agenda, there was little evidence that this had significantly improved outcomes. It examined three areas of policy (child safeguarding, urban regeneration, and the modernization of health and social care), applying a new framework to the analysis before making recommendations about effective collaboration.
Source: Helen Dickinson, Performing Governance: Partnerships, culture and New Labour, Palgrave Macmillan (Publication date: May 2014)
Links: Summary
Date: 2013-Dec
An article examined whether policy initiatives driving the development of health and social care partnerships were delivering improved outcomes, particularly the outcomes valued by people who used services. It identified features of partnership that particularly contributed to improved outcomes. These included continuity of staff, and sufficient staff and resources – including the availability of long-term and preventative services.
Source: Alison Petch, Ailsa Cook, and Emma Miller, 'Partnership working and outcomes: do health and social care partnerships deliver for users and carers?', Health and Social Care in the Community, Volume 21 Issue 6
Links: Abstract
Date: 2013-Dec
A report examined the financial implications of introducing seven day services for acute and emergency care, and supporting diagnostics, in the National Health Service.
Source: NHS Services, Seven Days a Week Forum, Costing Seven Day Services: The financial implications of seven day services for acute emergency and urgent services and supporting diagnostics, Healthcare Financial Management Association
Links: Report | NHS England press release
Date: 2013-Dec
The Welsh Government began consultation on arrangements to support the effective delivery of Continuing NHS Healthcare by the National Health Service. The consultation would close on 13 March 2014.
Source: Continuing NHS Healthcare (CHC) Consultation on the 2014 National Framework, Welsh Government
Links: Consultation document
Date: 2013-Dec
An article examined the factors that might have influenced the public-private mix of health expenditure in 13 developed countries (including the United Kingdom) from 1981 to 2007. Greater income inequality and population ageing were associated with a smaller share of public health expenditure in the total. Private health insurance tended to erode the political support for the public healthcare systems in countries with private duplicate health insurance, but not in countries with private primary health insurance.
Source: Haizhen Mou, 'The political economy of the public-private mix in heath expenditure: an empirical review of thirteen OECD countries', Health Policy, Volume 113 Issue 3
Links: Abstract
Date: 2013-Dec
A report examined the prioritization of children and young people in existing mental health services commissioning processes. Key findings were that: two thirds of joint strategic needs assessments did not specifically include a section on children and young people and one third did not include an estimated or actual level of need for this group; JSNAs often used outdated or incomplete data; and one third of joint health and well-being strategies did not prioritize children and young people's mental health. The report made recommendations to the Department of Health, health and well-being boards, and Public Health England.
Source: Laurie Oliva and Paula Lavis, Overlooked and Forgotten: A review of how well children and young people s mental health is being prioritised in the current commissioning landscape, Children & Young People s Mental Health Coalition
Links: Report | | Summary | CYPMHC press release | Mental Health Foundation press release
Date: 2013-Dec
An article classified 30 OECD healthcare systems according to three core dimensions (regulation, financing, and service provision) and three types of actors (state, societal, and private). There was a hierarchical relationship between the three dimensions, whereby the superior dimension restricted the nature of the subordinate dimensions. This hierarchy limited the number of theoretically plausible types. Five system types were identified: national health service, national health insurance, social health insurance, 'etatist' social health insurance, and private health.
Source: Katharina Bohm, Achim Schmid, Ralf Gotze, Claudia Landwehr, and Heinz Rothgang, 'Five types of OECD healthcare systems: empirical results of a deductive classification', Health Policy, Volume 113 Issue 3
Links: Abstract
See also: Katharina Bohm, Achim Schmid, Ralf Gotze, Claudia Landwehr, and Heinz Rothgang, Classifying OECD Healthcare Systems: A deductive approach, TranState Working Paper 165, University of Bremen (Germany)
Date: 2013-Dec
An article examined how ready or vulnerable each primary care organization in England was in 2010 to the National Health Service reforms proposed by the coalition government, which were enacted by the Health and Social Care Act 2012. Areas with higher concentrations of older people were not correlated with vulnerability except where there was also deprivation. This contrasted with widespread qualitative and quantitative evidence of sub-optimal care of older people – suggesting that there might be an over-reliance on using activity, which was proportionately higher in the least vulnerable areas, to determine funding and quality markers rather than outcomes. A risk of the reform process could be a negative impact on deprived areas that appeared to be financially less secure and more likely to have long-established health inequalities.
Source: Jose Iparraguirre, Tom Gentry, and Diego Pena, 'Vulnerability of primary care organizations to the National Health Service reform in England', Applied Economic Perspectives and Policy, Volume 35 Issue 4
Links: Abstract
Date: 2013-Dec
A report said that liaison psychiatry services should be available all acute hospitals in the United Kingdom, to integrate mental and physical healthcare for people whose mental health problems arise in, or have an impact on management of, physical illness and symptoms. The report examined the existing evidence for liaison services, considered the services required, outlined service design and standards, and considered governance issues.
Source: Liaison Psychiatry for Every Acute Hospital: Integrated mental and physical healthcare, College Report CR183, Royal College of Psychiatrists
Links: Report | RCPsych press release
Date: 2013-Dec
A survey examined the impact of National Health Service reforms for children and young people. The report said that two thirds of people working in the system thought that prevention and early intervention did not have the same status as acute care, and the majority thought that barriers remained to integrating commissioning and service delivery. Recommendations included: improvements in joint working across agencies; and greater priority for early intervention and prevention services.
Source: Child Health in the New NHS: Results of a survey by the National Children s Bureau and the NHS Confederation, National Children s Bureau/NHS Confederation
Links: Report | NCB press release | NHS Confederation press release
Date: 2013-Dec
A new book examined inter-agency working in health and social care.
Source: Jon Glasby and Helen Dickinson, A-Z of Interagency Working, Palgrave Macmillan
Links: Summary
Date: 2013-Dec
The government announced fourteen initiatives in delivering more coordinated health care. Building on recent initiatives in areas such as Greenwich and Devon, the aim was for health and social care services to work together to provide better support at home and earlier treatment in the community.
Source: Integration Pioneers Leading the Way for Health and Care Reform, Press release 1 November 2013, Department of Health
Links: DH press release | King's Fund press release | NHS England press release
Date: 2013-Nov
A report examined the role of the pharmacy profession in the reformed National Health Service in England. The report outlined existing roles and good practice and made recommendations.
Source: Judith Smith, Catherine Picton, and Mark Dayan, Now or Never: Shaping pharmacy for the future, Royal Pharmaceutical Society of Great Britain
Links: Report | Summary | RPS comment | NHS England press release
Date: 2013-Nov
A report provided an atlas of diagnostic services within the National Health Service in England. It highlighted geographical variation in the provision of services.
Source: The NHS Atlas of Variation in Diagnostic Services: Reducing unwarranted variation to increase value and improve quality, RightCare
Links: Report | RightCare press release
Date: 2013-Nov
The Northern Ireland Executive began consultation on the future development and enhancement of healthcare services for children and young people (from 0-18 years) from 2014. The consultation would close on 31 January 2014.
Source: Enhancing Healthcare Services for Children and Young People in Northern Ireland (from Birth to 18 Years): A review of paediatric healthcare services provided in hospitals and in the community, Department of Health, Social Services and Public Safety
Links: Consultation document
Date: 2013-Nov
An article examined the impact of the urgent care telephone service NHS 111 on the emergency and urgent care system. It concluded that, in its first year of operation, NHS 111 did not deliver the expected reduction of calls to the 999 ambulance service, nor did it shift patients to urgent rather than emergency care. The article noted the potential for this type of service to increase overall demand for urgent care.
Source: Joanne Turner, Alicia O'Cathain, Emma Knowles, and Jon Nicholl, 'Impact of the urgent care telephone service NHS 111 pilot sites: a controlled before and after study', BMJ Open, Volume 3 Issue 11
Links: Abstract | NHS England press release | Guardian report
Date: 2013-Nov
A report examined care integration and acute care management in the National Health Service. It said that structural change alone would not achieve integration and that behavioural change was needed.
Source: Alex Khaldi, A Question of Behaviours: Why delivering care integration and managing acute demand depends as much on changing behaviour as new systems and structures, iMPOWER
Links: Report | iMPOWER press release
Date: 2013-Nov
A report examined the implementation of seven day consultant present care in the National Health Service across the United Kingdom. It said that changing practices would have resource implications in hospital, primary care and community settings that would require services to be reshaped and reallocated. It said that workforce flexibility and optimal value could be gained by employing more generalist consultants to lead multi-disciplinary teams. It called for in-depth financial modelling of the resource implications.
Source: Seven Day Consultant Present Care: Implementation considerations, Academy of Medical Royal Colleges
Links: Report | AMRC press release
Date: 2013-Nov
An article examined the exercise of rationality in the work of Individual Funding Request panels in the National Health Service in England. It said there was a delicate balance between being human and being rational that created a dilemma for panels. It suggested placing greater value on narrative ethics as an aid to understanding resource allocation.
Source: Jill Russell and Trisha Greenhalgh, 'Being rational and being human : how National Health Service rationing decisions are constructed as rational by resource allocation panels', Health, Online first
Links: Abstract
Date: 2013-Nov
An article examined how young people with life-limiting conditions and their parents experienced the transition into adult palliative care services. It said that transition planning was absent or poorly co-ordinated, with a lack of equivalent adult health/social services. Moving to a young adult unit recognized adult status, but there were unmet needs for emotional support and information/services and staff identified training needs. The article called for a new model of support that promotes independence and provides emotional support while continuing to support wider family. It noted a role for hospices in transition support and co-ordination.
Source: Susan Kirk and Claire Fraser, 'Hospice support and the transition to adult services and adulthood for young people with life-limiting conditions and their families: a qualitative study', Palliative Care, Online First
Links: Abstract
Date: 2013-Nov
A report outlined the first stage of the review of urgent and emergency care in England. It called for a fundamental shift in provision, with more extensive services delivered outside of hospital, and with more serious or life threatening conditions being treated in centres with appropriate expertise and facilities. The report said that the Urgent and Emergency Care Review Team would now work with National Health Service commissioners towards trialling new delivery models, work with Monitor to develop new payment mechanisms, and complete the service specification for the new NHS 111 service. In the longer term, further work would be needed on costing, clinical standards, performance measures, contracting issues, and workforce development.
Source: Transforming Urgent and Emergency Care Services in England: Urgent and emergency care review end of Phase 1 report – high quality care for all, now and for future generations, NHS England
Links: Report | Appendix 1 | Appendix 2 | Appendix 3 | NHS England press release | King's Fund press release | RCN press release | BBC report
Date: 2013-Nov
A report highlighted concerns about existing and anticipated shortages of nursing staff in the National Health Service in England. It said there were nearly 20,000 nursing vacancies currently unfilled, with a likely shortage of 47,545 registered nurses by 2016. It said there had been a 15 per cent cut in the number of nursing student places commissioned since 2010-11 and that the true level of staff shortage was higher than the official figures suggested. The report called for: mandatory safe staffing levels; mandatory use of workforce planning tools; longer term planning for workforce needs, informed by workforce reviews; and investment in the existing workforce's professional development.
Source: Frontline First: Running the red light – November 2013 special report, Royal College of Nursing
Links: Report | RCN press release | Guardian report | BBC report
Date: 2013-Nov
The regulator for National Health Service foundation trusts said that almost one in four National Health Service walk-in centres had closed in recent years, despite being popular with patients. Commissioners who had closed centres cited concerns that included: that the centres were generating unwarranted demand; that they led to duplication when patients self-referred to multiple services; and that they caused confusion among patients about where to go for care. Commissioners also commonly said they felt they were 'paying twice' for patients who attend walk-in centres, since most users were registered with a family doctor practice elsewhere. The report invited further evidence to be submitted.
Source: Walk-in Centre Review: Preliminary report, Monitor
Links: Report | Survey | DOH press release | Monitor press release | NHS Partners press release | Guardian report
Date: 2013-Nov
A government minister said that agreement had been reached on changes to contracts with family doctors in England. The new contract would: reduce the number of quality indicators; introduce a new 'enhanced service' for patients with complex health needs; assign a named, accountable family doctor to everyone over the age of 75 to co-ordinate care; commit practices to monitoring the quality of out-of-hours services; and introduce new information technology systems that would enable patients to book appointments online and access their records.
Source: , Press release 15 November 2013, Department of Health
Links: DH press release | Summary of changes | NHS Employers press release | Alzheimer's Society press release | BBC report | Guardian report | Telegraph report
Date: 2013-Nov
The government published an agreement which both set out how NHS England was accountable for the delivery of certain public health services, and described the expert support role for Public Health England. Individual service specifications, published alongside the agreement, provided details of the public health evidence and advice that was needed to support effective commissioning.
Source: NHS Public Health Functions Agreement 2014-15: Public health functions to be exercised by NHS England, Department of Health
Links: Agreement | Service specifications
Date: 2013-Nov
A report examined the degree of financial resilience in National Health Service trusts in England. It said that many trusts had adequate governance and monitoring in place, but highlighted areas of concern, particularly over the degree of some trusts' reliance on non-recurrent support funding.
Source: Alternative Therapy: Strengthening NHS financial resilience – summary findings from our financial health checks of English NHS trusts and foundation trusts, Grant Thornton
Links: Report | Grant Thornton press release
Date: 2013-Nov
A report examined the role of the voluntary sector in providing support to commissioners in the National Health Service in England. It said that the sector could offer particular expertise, such as needs assessment, business intelligence, service re-design, and public and patient engagement. The report said that organizations needed to demonstrate how they could support wider commissioning agendas, such as efficiency gains and integration, alongside improving patient outcomes and experience. Geographical variation had left the voluntary sector in some areas unsure of what opportunities were available. Much work was offered free of charge, but there were opportunities for this to become an income generator for the sector. A support role was identified for umbrella organizations. The report made recommendations for the voluntary sector, clinical commissioning groups, commissioning support units, and National Health Service England.
Source: Holly Holder, Role of the Voluntary Sector in Providing Commissioning Support, Nuffield Trust
Links: Report
Date: 2013-Nov
The government published its early years and childcare plan, setting out its direction of travel for the following ten years. The plan included actions on early education and childcare, supporting families, and child health.
Source: Building a Brighter Future: Early years and childcare plan, Welsh Government
Links: Report
Date: 2013-Nov
A study examined the scale and value of volunteering in National Health Service acute trusts in England. It estimated that there were around 78,000 volunteers across all acute trusts, but the numbers varied between trusts. The report said that the volunteer profile had changed over the past five years, with volunteers having a younger and more ethnically diverse profile. The report made recommendations.
Source: Amy Galea, Chris Naylor, David Buck, and Lisa Weaks, Volunteering in Acute Trusts in England: Understanding the impact, King s Fund
Links: Report | Kings Fund press release
Date: 2013-Nov
An article examined different stakeholder perspectives of 'privatization' in the English National Health Service. It examined the political, public, clinical provider, and campaigning groups' perspectives of privatization using a 'three-dimensional' approach (ownership, finance, and regulation). It said that privatization was multi-dimensional, stakeholders had differing interests, and a lack of distinction around use and meaning of the term had led to differing accounts of privatization.
Source: Martin Powell and Robin Miller, 'Privatizing the English National Health Service: an irregular verb?', Journal of Health Politics, Policy and Law, Volume 38 Number 5
Links: Abstract
Date: 2013-Nov
A study examined the impact of 'virtual wards' on hospital admissions and other, community based, health and social care services. 'Virtual wards' were designed to use the staffing and systems of a hospital ward to deliver preventive care to patients in their own homes. The study found no evidence of a reduction in emergency hospital admissions, and no evidence of impact on mortality, compared with matched cases from a national sample. There was a reduction in elective hospital admissions and in outpatient attendances in the six months after starting the intervention. The study noted that the three participating sites used different models of 'virtual wards' and raised methodological questions.
Source: Geraint Lewis, Theo Georghiou, Adam Steventon, Rhema Vaithianathan, Xavier Chitnis, John Billings, Ian Blunt, Lorraine Wright, Adam Roberts, and Martin Bardsley, Impact of Virtual Wards on Hospital Use: A research study using propensity matched controls and a cost analysis, National Institute for Health Research
Links: Report
Date: 2013-Nov
A report examined the the activities of health and wellbeing boards during their first year, what they had achieved, and whether they were providing effective leadership across local systems of care. The report discussed policy implications.
Source: Richard Humphries and Amy Galea, Health and Wellbeing Boards: One year on, King s Fund
Links: Report | Kings Fund press release
Date: 2013-Oct
The Welsh Government published a Bill designed to allow local health boards to focus their service planning, workforce, and financial decisions; and to implement them over a longer, more manageable, period. The Bill would achieve this by removing the existing annual financial duty in the National Health Service (Wales) Act 2006, replacing this with a 3-year rolling financial duty. Stage 1 of the Bill (debate in plenary on general principles) was scheduled for 8 October 2013.
Source: National Health Service Finance (Wales) Bill, Welsh Government, TSO
Links: Bill | Explanatory memorandum | Welsh Government press release
Date: 2013-Oct
The government published guidance on the implementation of a European Union Directive on patients' rights in cross-border healthcare.
Source: Cross Border Healthcare and Patient Mobility in Europe: Information to accompany the implementation of Directive 2011/24/EU – on patients rights in cross-border healthcare, Department of Health
Links: Report | Regulations
Date: 2013-Oct
The government began consultation on proposals for new constitutional requirements for National Health Service Trusts and clinical commissioning groups. The consultation would close on 31 December 2013.
Source: Health Service Bodies Audit Committees: Consultation about proposed new constitutional requirements for NHS Trusts and Clinical Commissioning Groups, Department of Health
Links: Consultation document
Date: 2013-Oct
A report examined why some health economies managed better than others in times of financial constraint. Drawing on the experiences of health organizations in 'turnaround', the report concluded that there was a balancing act between short-term policy and strategic planning; between collaborative working and challenge; and between internally focused work and economy-wide considerations. The report noted the importance of support from policymakers and NHS England in enabling organizations to implement change.
Source: Natasha Curry, Benedict Rumbold, Richard Edwards, and Sandeepa Arora, Managing Financial Difficulties in Health Economies: Lessons for clinical commissioning groups, Nuffield Trust
Date: 2013-Oct
A quantitative study examined visitor and migrant use of the National Health Service in England.
Source: Prederi, Quantitative Assessment of Visitor and Migrant Use of the NHS in England: Exploring the data, Department of Health
Links: Report | Summary | DH press release (1) | DH press release (2) | Guardian report | AMRC press release
Date: 2013-Oct
A report examined how acute paediatric and local authority statutory child protection services in England worked together in cases of suspected child maltreatment.
Source: Jane Lewis, Partnership Working in Child Protection: Improving liaison between acute paediatric and child protection services, Social Care Institute for Excellence
Links: Report | SCIE press release
Date: 2013-Oct
A report examined the current role and practice of hospice care, and the issues faced by the sector, making recommendations for change.
Source: Commission into the Future of Hospice Care, Future Ambitions for Hospice Care: Our mission and our opportunity – the final report of the Commission into the Future of Hospice Care, Help the Hospices
Links: Report | NCPC press release | Age UK press release | BBC report
Date: 2013-Oct
A think-tank report examined a case study of community virtual wards based in family doctor practices within a clinical commissioning group in the west of England. It outlined the model and identified key lessons.
Source: Lara Sonola, Veronika Thiel, Nick Goodwin, and Dennis Kodner, South Devon and Torbay: Proactive case management using the community virtual ward and the Devon Predictive Model, King s Fund
Links: Report
Date: 2013-Oct
A report described the working practices of consultants and other senior decision-makers in emergency departments, the pressures they faced, and the impact on their working lives.
Source: Tajek Hassan, Ben Walker, Magnus Harrison, and Fiona Rae, Stretched to the Limit: A survey of Emergency Medicine consultants in the UK, College of Emergency Medicine
Links: Report | CEM press release | Guardian report | Telegraph report | BBC report | Work Foundation comment | BMA press release
Date: 2013-Oct
The government announced that people in England would be able to see their family doctor seven days a week from 8am to 8pm. A first wave of family doctor groups offering extended opening hours would be piloted in every region, covering up to half a million patients. Innovative practices would be able to apply to a new £50 million Challenge Fund to set up a pioneer programme. The new pioneer family doctor groups would also test a variety of new services, including greater use of Skype, email, and phone consultations.
Source: Press release 1 October 2013, Department of Health
Links: DH press release | Guardian comment | RCN press release | Kings Fund press release | BMA press release | NHS England comment | BBC report | NCB press release
Date: 2013-Oct
The hospitals regulator for England examined options available to the National Health Service to enable the delivery of better care while closing the 'financial gap'. Suggested options included: improving productivity; delivering the 'right care in the right setting'; developing new ways to deliver care; making 'one-off' reductions in capital expenditure and staffing costs; and changing the resource allocation system.
Source: Closing the NHS Funding Gap: How to get better value health care for patients, Monitor
Links: Report | Monitor press release | Guardian report
Date: 2013-Oct
A report examined approaches in Scotland to providing care for people living with dementia at home, recommending an '8 Pillars' model of support.
Source: Lindsay Kinnaird, Delivering Integrated Dementia Care: The 8 Pillars model of community, Alzheimer Scotland
Links: Report
Date: 2013-Oct
A report examined the barriers that prevented people from having choice at the end of life, and made recommendations for improvements.
Source: Time to Choose: Making choice at the end of life a reality, Macmillan Cancer Support
Links: Report | Macmillan press release | Guardian report
Date: 2013-Oct
The government published the results of its consultation on proposed new legislation to require temporary migrants to make a financial contribution towards the cost of healthcare in the United Kingdom.
Source: Controlling Immigration: Regulating migrant access to health services in the UK – results of the public consultation, Home Office
Links: Report | Home Office press release | Department of Health press release | Guardian report
Date: 2013-Oct
A qualitative study examined visitor and migrant use of the National Health Service in England.
Source: Creative Research, Qualitative Assessment of Visitor and Migrant use of the NHS in England: Observations from the front line, Department of Health
Links: Full report | Diary report | Summary | DH press release (1) | DH press release (2) | Guardian report | AMRC press release
Date: 2013-Oct
An article examined the findings from a study of disinvestment in the National Health Service. It reported that organizations had taken varied approaches, determined by both health system features and organizational characteristics. Interviewees reported that the easier disinvestment options had already been implemented, with more complex work now to be undertaken.
Source: Tom Daniels, Iestyn Williams, Suzanne Robinson, and Katie Spence, 'Tackling disinvestment in health care services: the views of resource allocators in the English NHS', Journal of Health Organization and Management, Volume 27 Number 6
Links: Abstract
Date: 2013-Oct
An audit report said that more people who attended accident and emergency departments were now being admitted to hospital. It said that there was a range of explanations for this, but that the trend needed to be actively managed. It said that the Department of Health, NHS England, and the hospitals regulator should work to align incentives and remove barriers across the health system.
Source: Emergency Admissions to Hospital: Managing the demand, HC 739 (Session 2013-14), National Audit Office, TSO
Links: Report | NAO press release | Alzheimer's Society comment
Date: 2013-Oct
A report examined the challenges facing healthcare services in London and recommended an 'open and honest debate' with the public, health and care professionals, and other stakeholders to inform the way forward.
Source: London: A call to action, NHS England
Links: Report | NHS England press release
Date: 2013-Oct
A think-tank report proposed that 'patient-led commissioning groups' be allowed to set up alongside existing clinical commissioning groups.
Source: Anton Howes, A National Health Service for Patients, Civitas
Links: Report
Date: 2013-Oct
A think-tank study examined strategies and approaches to care co-ordination for people with age-related chronic and complex needs and made observations on policy translation.
Source: Nick Goodwin, Lara Sonola, Veronika Thiel, and Dennis Kodner, Co-ordinated Care for People with Complex Chronic Conditions: Key lessons and markers for success, King s Fund
Links: Report | Kings Fund press release
Date: 2013-Oct
The coalition government published its response to a review (led by Fiona Caldicott) on information governance in the National Health Service in England. It said that it accepted the recommendations of the review report: although information sharing was essential to provide good care for everyone, only the minimum amount of information should be shared, and there needed to be strict rules to govern it.
Source: Information: To Share or Not to Share – Government response to the Caldicott Review, Department of Health
Links: Response | Hansard | DH press release | AMRC press release
See also: Review report (March 2013)
Date: 2013-Sep
A think-tank report examined recent moves toward a more localist health system in England, and opinions on this from people in local government. It also took stock of how local councils had adapted to the return of public health to their portfolio, and the dismantling of barriers between health and social care.
Source: Gwilym Tudor Jones, In Sickness and in Health: Assessing the transition to a more localist health system – The first step towards marriage between the NHS and local government?, Localis
Links: Report | Localis press release | Guardian report (1) | Guardian report (2) | Public Finance report
Date: 2013-Sep
A commission report made 50 recommendations aimed at improving care for acute medical patients. It called for a radical restructuring of the hospital wards where acutely ill patients were treated, together with a new organizational and management structure whose responsibilities for acutely ill medical patients would stretch out from the hospital into the wider community, developing the idea of a local healthcare system.
Source: Future Hospital Commission, Future Hospital: Caring for medical patients, Royal College of Physicians
Links: Report | RCP press release (1) | RCP press release (2) | AMRC press release | FTN press release | Kings Fund press release | NHS Confederation press release | NHS Employers press release | NHS England press release | RCGP press release | RPS press release | BBC report | Guardian report | Telegraph report
Date: 2013-Sep
A report examined ways of improving leadership and participatory governance in healthcare, with a view to supporting the implementation of the European Union's 'Health 2020' framework.
Source: Ilona Kickbusch and Thorsten Behrendt, Implementing a Health 2020 Vision: Governance for health in the 21st century – Making it happen, World Health Organisation (Regional Office for Europe)
Links: Report | Summary | WHO press release
Date: 2013-Sep
A think-tank report examined the role of governors in National Health Service foundation trusts. It considered how they fitted within the overall governance of the Trusts, and how effective and representative councils of governors were.
Source: Effective and Representative? A review of NHS foundation trusts councils of governors, Smith Institute
Links: Report
Date: 2013-Sep
An article said that draft guidance from the Department of Health fell short of providing a robust, comprehensive, and practical guide to the challenges of 'joining up' healthcare provision and land use or spatial planning in England.
Source: Paul Tomlinson, Stephen Hewitt, and Neil Blackshaw, 'Joining up health and planning: how joint strategic needs assessment (JSNA) can inform health and wellbeing strategies and spatial planning', Perspectives in Public Health, Volume 133 Number 5
Links: Abstract
Date: 2013-Sep
An article examined the theoretical and policy antecedents of provisions in the 2012 Health and Social Care Act transferring responsibility for public health in England from primary care trusts to local authorities. The development of health and well-being boards and their objectives could best be understood by viewing them through the theoretical prism of public value or new public service theory.
Source: Peter Murphy, 'Public health and health and wellbeing boards: antecedents, theory and development', Perspectives in Public Health, Volume 133 Number 5
Links: Abstract
Date: 2013-Sep
An article said that moves to introduce greater competition in the National Health Service in England sharpened the need for attention to be paid to the ethical operation of healthcare organizations. The use of commercial companies could create new relationships and ethical tensions. It suggested the development of organizational ethics programmes.
Source: Lucy Frith, 'The NHS and market forces in healthcare: the need for organisational ethics', Journal of Medical Ethics, Volume 39 Number 1
Links: Abstract
Date: 2013-Sep
A report by a committee of MPs said that the final cost of the abandoned national programme for information technology in the National Health Service was still unknown. The latest official estimate, of £9.8 billion, was likely to be an underestimate.
Source: The Dismantled National Programme for IT in the NHS, Nineteenth Report (Session 2013-14), HC 294, House of Commons Public Accounts Select Committee, TSO
Links: Report | Committee press release | BBC report | Guardian report | Telegraph report
Date: 2013-Sep
An article examined how middle management roles in acute healthcare settings were changing; how reforms were managed following serious incidents; and how clinical and organizational outcomes were influenced by management practice. Middle managers faced increasing workloads with reduced resources, creating 'extreme jobs' with long hours, high intensity, and a fast pace. Such roles could be rewarding, but carried implications for work-life balance and stress. Other pressures on middle management included: rising patient and public expectations; financial challenges; burdensome regulation (external and internal); staffing problems; incompatible and dated information systems; resource and professional barriers to implementing change; and problematic relationships with external agencies. Action was required to maintain an enabling environment to support the contribution of middle managers: this would involve individual, divisional, and organizational steps, most of which would be cost-neutral.
Source: David Buchanan, David Denyer, Joe Jaina, Clare Kelliher, Ciara Moore, Emma Parry, and Colin Pilbeam, 'How do they manage? A qualitative study of the realities of middle and front-line management work in health care', Health Services and Delivery Research, Volume 1 Issue 4
Date: 2013-Aug
An article examined early evidence from the development of clinical commissioning groups in the English National Health Service, against the background of what was known from previous studies of family doctor involvement in commissioning.
Source: Kath Checkland, Ann Coleman, Imeld McDermott, Juli Segar, Rosalind Miller, Christin Petsoulas, Andrew Wallace, Stephen Harrison, and Stephen Peckham, 'Primary care-led commissioning: applying lessons from the past to the early development of clinical commissioning groups in England', British Journal of General Practice, Volume 63 Number 614
Links: Abstract
Date: 2013-Aug
The report was published of an independent review (led by Don Berwick) of patient safety in the National Health Service in England. It said that: the quality of patient care, especially patient safety, should be paramount; patients and carers needed to be empowered, engaged, and heard; staff should be supported to develop and improve; and there should be complete transparency of data. Recommendations included:
• Staffing levels needed to be adequate: but decisions should be taken locally based on evidence.
• The NHS should continue to use mortality rate indicators to detect potentially severe problems: but these should not be used to generate league tables.
• New criminal offences should be created around recklessness or wilful neglect or mistreatment by organizations or individuals, and for healthcare organizations that withheld or obstructed the release of relevant information: but the use of criminal sanctions should be extremely rare, and unintended errors should not be criminalized.
The report did not recommend that a statutory duty of candour for healthcare workers be introduced, saying that this duty was adequately addressed in professional codes of conduct and guidance.
Source: A Promise to Learn – A Commitment to Act: Improving the safety of patients in England, Department of Health
Links: Report | DH press release | Alzheimers Society press release | BMA press release | GMC press release | Kings Fund press release | National Voices press release | NHS Alliance press release | NHS Confederation press release | NHS England press release | RCGP press release | RCN press release | RCP press release | RCS press release | RPS press release | Scottish Government press release | Unison press release | BBC report | Guardian report | Telegraph report
Date: 2013-Aug
An article said that action was needed to empower National Health Service foundation trust governors in England to undertake their statutory duties more effectively – particularly through clarification of their role in the governance of patient safety, and the provision of targeted training and support.
Source: Josephine Ocloo, Ali O'Shea, and Naomi Fulop, 'Empowerment or rhetoric? Investigating the role of NHS foundation trust governors in the governance of patient safety', Health Policy, Volume 111 Issue 3
Links: Abstract
Date: 2013-Aug
A think-tank report examined personal health budgets – how they would work in practice, and the issues that they raised. For policy-makers, the areas of concern included: the scope of personal health budgets; the impact on care quality; the longer-term financial sustainability of personal health budgets; and the risk of a postcode lottery emerging in access to personal health budgets.
Source: Vidhya Alakeson and Benedict Rumbold, Personal Health Budgets: Challenges for commissioners and policy-makers, Nuffield Trust
Notes: A personal health budget is an allocation of National Health Service money to someone with an identified health need so that they can buy the services they think will improve certain aspects of their health and well-being. They will be introduced in 2014.
Date: 2013-Aug
An article illustrated the potential for service integration through the experience of the personal health budgets pilot programme. Personal health budgets supported integration in two distinct ways. First, they could support the delivery of more holistic, whole-person care in line with the principles of shared decision-making. Second, by bringing personal budgets in social care and personal health budgets together, they could provide a vehicle for integration across health and social care systems.
Source: Vidhya Alakeson, 'The individual as service integrator: experience from the personal health budget pilot in the English NHS', Journal of Integrated Care, Volume 21 Number 4
Links: Abstract
Date: 2013-Jul
The government responded to a report by a committee of MPs on the role of English local authorities in health issues. It said that local authorities were best placed to handle responsibility for public health issues – not the National Health Service or central government.
Source: Government Response to the House of Commons Communities and Local Government Committee Eighth Report of Session 2012-13: The Role of Local Authorities in Health Issues, Cm 8638, Department of Health, TSO
Links: Response
Notes: MPs report (March 2013)
Date: 2013-Jul
An article examined the limited influence of cost-effectiveness analysis in healthcare decisions in England, particularly at local levels. Explanations tended to overlook the role played by institutions, which was critical to understanding the technology coverage function and the role of evidence, analysis, and deliberation in this.
Source: Iestyn Williams, 'Institutions, cost-effectiveness analysis and healthcare rationing: the example of healthcare coverage in the English National Health Service', Policy & Politics, Volume 41 Number 2
Links: Abstract
Date: 2013-Jul
A report said that many family doctors did not yet have a strong sense of ownership of their local clinical commissioning groups (CCGs). Although there was a great deal of support for what CCGs were trying to achieve, many family doctors felt that decisions being taken by their CCG did not always reflect their views.
Source: Chris Naylor, Natasha Curry, Holly Holder, Shilpa Ross, Louise Marshall, and Ellie Tait, Clinical Commissioning Groups: Supporting Improvement in General Practice?, King s Fund/
Links: Report | Appendix | Kings Fund press release | Nuffield Trust press release
Date: 2013-Jul
A think-tank report said that family doctor practices should be put in charge of administering direct payments to patients as part of the personal health budget scheme.
Source: Gail Beer, Jon Paxman, and Charlotte Morris, Personal Health Budgets: A Revolution in Personalisation, 2020health
Links: Report | 2020 press release
Date: 2013-Jul
The Welsh Government began consultation on proposals to promote more integrated health and social care for older people with complex needs.
Source: A Framework for Delivering Integrated Health and Social Care for Older People with Complex Needs, Welsh Government
Links: Consultation document | Welsh Government press release
Date: 2013-Jul
A report said that a complete overhaul of the healthcare operating model was needed if the National Health Service were to deliver better patient outcomes and care at lower cost. Key to this transformation would be the life sciences sector partnering to share costs, data, and risk – in order to improve the value and effectiveness of the therapies offered to patients.
Source: More than Medicine, KPMG
Links: Report | KPMG press release
Date: 2013-Jul
A report said that the next phase of development in social care and health services needed to be towards integration. Integrated services were much more likely to improve people's health and well-being in ways that treated them with dignity and respect; and it also made financial sense to get rid of duplication and waste.
Source: Rewiring Public Services: Adult Social Care and Health, Local Government Association
Links: Report
Date: 2013-Jul
An article examined the practices, processes, and outcomes of joint commissioning of health and social care at five English localities. Very little of what was found seemed to relate directly to issues of joint commissioning. Respondents often conflated joint commissioning with issues of commissioning or joint working more generally. There was a variety of different definitions and meanings of joint commissioning in practice, suggesting that this was not a coherent model but varied across localities. Little evidence of improved outcomes was found, due to practical and technical difficulties.
Source: Helen Dickinson and Jon Glasby, 'How effective is joint commissioning? A study of five English localities', Journal of Integrated Care, Volume 21 Number 4
Links: Abstract
Date: 2013-Jul
An audit report said that the transition to a reformed health system in England had been successfully implemented, in the sense that the 240 new organizations were ready to start functioning on 1 April 2013 – although not all were operating as intended. Some parts of the system were less ready than others, and much remained to be done to complete the transition. The reforms were reported to have cost £1.1 billion up to 31 March 2013, 15 per cent more than expected at that point.
Source: Managing the Transition to the Reformed Health System, HC 537 (Session 2013-14), National Audit Office, TSO
Links: Report | NAO press release | RCGP press release | Public Finance report
Date: 2013-Jul
A think-tank report examined what the health and social care system in England could learn from the experiences of the other countries of the United Kingdom. It considered the context in which health and social care were provided; identified policy initiatives that promoted integrated care and the impact of these initiatives; and considered the barriers and challenges to achieving integrated care. The structural integration of the health and social care system in England would bring few benefits unless it was accompanied by other changes, including: a willingness to challenge and overcome professional, cultural, and behavioural barriers; action to share information both within the National Health Service and between health and social care; organizational stability to avoid the distractions and delays that occurred when structures were altered frequently; and a willingness to provide financial support and flexibilities to enable the introduction of new models of care.
Source: Chris Ham, Deirdre Heenan, Marcus Longley, and David Steel, Integrated Care in Northern Ireland, Scotland and Wales: Lessons for England, King s Fund
Links: Report | Kings Fund press release
Date: 2013-Jul
A report by a committee of MPs said that plans put in place to relieve the pressure on accident and emergency units in England were not good enough, and that 'confusing' and 'contradictory' information had been given to MPs about the action being taken.
Source: Urgent and Emergency Services, Second Report (Session 2013-14), HC 171, House of Commons Health Select Committee, TSO
Links: Report | Additional written evidence | Committee press release | Carers UK press release | NHS Confederation press release | RCGP press release | RCN press release | RCP press release | Unison press release | Unite press release | BBC report | Daily Mail report | Guardian report | Public Finance report | Telegraph report
Date: 2013-Jul
A report examined United Kingdom and international models of primary care, focusing on those that could increase capacity and help primary care meet the pressures that it faced. If policy-makers and commissioners wanted to develop the scope and scale of primary care services, they would need to put in place imaginative measures that made the most of the strong history of independence and innovation within general practice. This would include support and incentives, as well as permission for family doctors and other primary care practitioners to test out new approaches to the delivery and organization of care.
Source: Judith Smith, Holly Holder, Nigel Edwards, Jo Maybin, Helen Parker, Rebecca Rosen, and Nicola Walsh, Securing the Future of General Practice: New models of primary care, Nuffield Trust
Links: Report | Summary | Nuffield Trust press release
Date: 2013-Jul
A report said that, despite the achievements of the National Health Service since its foundation, the United Kingdom still lagged behind internationally in some important areas, such as cancer survival rates. There was still too much unwarranted variation in care across the country, exacerbating health inequalities. And in some places the NHS was letting patients down badly. Future trends threatened the sustainability of the health and care system: an ageing population, an epidemic of long-term conditions, lifestyle risk factors in the young, and greater public expectations. Combined with rising costs and constrained financial resources, these trends posed the greatest challenge in the NHS's history. The NHS needed to change to survive: this meant a reshaping of services to put patients at the centre. There was scope to improve the quality of services while reducing costs – by refocusing on prevention, putting people in charge of their own health and healthcare, and matching services more closely to individuals' risks and specific characteristics.
Source: The NHS Belongs to the People: A call to action, NHS England
Links: Report | AMRC press release | Kings Fund press release | NHS Confederation press release | RCGP press release
Date: 2013-Jul
The High Court ruled that the Health Secretary's decision to reduce services at a major hospital was unlawful. It said that the minister had acted outside his powers when he announced that casualty and maternity units at Lewisham Hospital would be downgraded. Under the National Health Services Act 2006, the minister had to have regard to, or be supported by, family doctor commissioners: but the Lewisham commissioners had not given their support to the proposals.
Source: R (on the application of LB of Lewisham and others) v Secretary of State for Health and the TSA for South London Hospitals NHS Trust, High Court 31 July 2013
Links: Judgement | Summary | BMA press release | FTN press release | GMB press release | Labour Party press release | NHS Confederation press release | Unison press release | Unite press release | BBC report | Daily Mail report | Public Finance report
Date: 2013-Jul
A report said that major investment was needed in general practice in order to keep the National Health Service sustainable, and to ensure that it provided value for money while ensuring safe patient care. There needed to be a major shift in spending into general practice to address the existing imbalance in funding, which saw family doctors providing 90 per cent of NHS care for only 9 per cent of the budget. This included increasing the number of family doctors by at least 10,000, and investment in practice premises to allow more care to be provided in the community.
Source: The 2022 GP: A vision for general practice in the future NHS, Royal College of General Practitioners
Links: Report | RCGP press release
Date: 2013-Jun
A discussion paper examined the issues involved in designing a comprehensive long-term payment system for National Health Service services. It focused on the questions of how the system could support innovation in patterns of care, and positively influence provider and commissioner behaviour; how the system could include different payment approaches for the different types of patient needs and care; and how to strengthen the foundations of the existing payment system in the meantime.
Source: How Can the NHS Payment System Do More for Patients?, NHS England/Monitor
Links: Paper
Date: 2013-Jun
A report said that rising demand and limited resources meant that the reorganization of National Health Service services was essential for its sustainability. But the term 'reconfiguration' had become loaded with negative meaning, associated with making cuts and downgrading services, and service changes were frequently viewed by the public as a threat rather than as positive and necessary reforms. Making the case for change needed to happen earlier, and public and patients needed to be fully involved from the outset. Communities needed to understand how reinvestment in community-based services would deliver the quality and access that they prioritized. The report set out five recommendations designed to ensure that essential reconfigurations – underpinned by sound clinical reasons – could proceed with the understanding and support of relevant stakeholders.
Source: Changing Care, Improving Quality: Reframing the debate on reconfiguration, Academy of Medical Royal Colleges/NHS Confederation/National Voices
Links: Report | RCN press release | BBC report | Public Finance report
Date: 2013-Jun
A report said that even though health and well-being boards in England had only had statutory responsibilities since April 2013, many had already made substantial progress towards delivering on the high expectations set for them on issues such as integration and health inequalities.
Source: Making a Local Difference: State of play and challenges ahead for health and wellbeing boards, NHS Confederation
Links: Report | NHS Confederation press release
Date: 2013-Jun
A report called for fundamental change in the design, funding, and running of emergency care systems. It said that emergency care was facing its biggest challenge in well over a decade as a result of 'unsustainable' workloads and a lack of sufficient numbers of middle-grade doctors and consultants. It recommended urgent action to redesign workloads, improve funding, and reform performance measurement.
Source: Taj Hassan, Philip McMillan, Chris Walsh, and Ian Higginson, The Drive for Quality: How to achieve safe, sustainable care in our emergency departments?, College of Emergency Medicine
Links: Report | CEM press release | FTN press release | NHS Confederation press release | RCP press release | RCPsych press release | RCS press release | 2020health press release | BBC report | Guardian report | Public Finance report | Telegraph report
Date: 2013-May
An article offered an alternative paradigm to healthcare delivery by introducing the concept of mutuality and empowerment into the existing health-wealth model (against the background of Scottish Government health policy). It examined what was meant by mutuality, public interest, and community empowerment, and introduced a model that linked them together.
Source: Brian Howieson, 'Mutuality, empowerment and the health-wealth model: the Scottish context', Health Care Analysis, Volume 21 Number 2
Links: Abstract
Date: 2013-May
A report summarized the main findings of the Francis inquiry (into the failings of care at the Mid Staffordshire NHS foundation trust) in relation to National Health Service leadership and culture. It set out what needed to be done to avoid similar failures in future, focusing on the role of three key 'lines of defence' against poor-quality care: frontline clinical teams; the boards leading NHS organizations; and national organizations responsible for overseeing the commissioning, regulation, and provision of care. The report also presented survey findings showing that almost three-quarters (73 per cent) of NHS professionals did not think that quality of care in the NHS was given enough priority.
Source: Kathryn O Neill (ed.), Patient-Centred Leadership: Rediscovering our purpose, King s Fund
Links: Report | Kings Fund press release | NHS Confederation press release | RCP press release | Public Finance report
Date: 2013-May
The government, together with key provider and regulatory organizations, published plans designed to promote greater integration in health and social care services. The plans included:
• An ambition to make joined-up and co-ordinated health and care the norm by 2018 – with projects in every part of the country by 2015.
• The first-ever agreed definition of what people said good integrated care and support looked and felt like.
• New 'pioneer' areas to test innovative approaches.
• New measures of people's experience of joined-up care and support, designed to test whether people were feeling the benefits of change.
Source: Integrated Care and Support: Our Shared Commitment, National Collaboration for Integrated Care and Support
Links: Plan | DH press release | Civitas press release | Kings Fund press release | Labour Party press release | LGA press release | NHSCB press release | NHS Confederation press release | RCN press release | Scope press release | Turning Point press release | BBC report | Guardian report | Public Finance report
Date: 2013-May
The Scottish Government published a Bill designed to ensure that the health and social care systems worked together effectively to improve the provision of community care – by reducing unnecessary delays that kept older people in hospital longer than needed, and increasing the amount of care that could be provided at home.
Source: Public Bodies (Joint Working) (Scotland) Bill, Scottish Government, TSO
Links: Bill | Explanatory notes | Policy memorandum | Scottish Government press release | PRTC press release
Date: 2013-May
A new book examined recent developments in healthcare delivery. It said that reforms under the former Labour governments (1997-2010) had included an important network element consistent with underlying network governance ideas, specifying conditions of 'success' for these managed networks. It went on to discuss the concept of 'wicked problems' – problematic situations with no obvious solutions, whose scope went beyond any one agency, often with conflicting stakeholder interests, where there were major social and behavioural dimensions to be considered alongside clinical considerations.
Source: Ewan Ferlie, Louise Fitzgerald, Gerry McGivern, Sue Dopson, and Chris Bennett, Making Wicked Problems Governable? The case of managed networks in health care, Oxford University Press
Links: Summary
Date: 2013-Apr
A report said that shared decision-making could lead to positive change within health systems and for individual patients.
Source: Ewan King, Jean Taylor, Rebecca Williams, and Tim Vanson, The MAGIC Programme: Evaluation – An independent evaluation of the MAGIC (Making good decisions in collaboration) improvement programme, Health Foundation
Notes: Shared decision-making is a process in which clinicians and patients work together to choose tests, treatments, and support packages, based on clinical evidence and patients informed preferences.
Date: 2013-Apr
An article examined the different approaches to integrated care taken by separate proposed care services legislation for England and Wales. Although there was much common ground between the two pieces of legislation, in other respects the approach taken to integrated care legislation differed.
Source: Ed Mitchell, 'Reforming care legislation in England and Wales: different legislative approaches to promoting integrated care', Journal of Integrated Care, Volume 21 Number 3
Links: Abstract
Date: 2013-Apr
A report called for changes to the existing system of healthcare in order to make better use of patient involvement. Consultations should combine clinical expertise with patient-driven goals of well-being, and connect to interventions that changed behaviour and built networks of support. New services should be commissioned that complemented clinical care by supporting long-term behaviour change, improving well-being, and building social networks of support. Care pathways should be jointly designed by patients and professionals to focus on long-term outcomes, recovery, and prevention. A linked report set out the business case for this approach.
Source: Matthew Horne, Halima Khan, and Paul Corrigan, Health for People, by People and with People, National Endowment for Science, Technology and the Arts | Simon Morioka, Stephen Farrington, Phil Hope, and Kieran Brett, The Business Case for People Powered Health, National Endowment for Science, Technology and the Arts
Links: Report | Summary | Business case
Date: 2013-Apr
A report provided an overview of recent changes in national governments' role in the governance of health systems in 11 European countries (including England), focusing on: efforts to reconfigure responsibilities for health policy, regulation, and management; the resultant policy priorities; and the initial impact. The shift in responsibilities showed little uniform direction. A number of countries had centralized certain areas of decision-making or regulation but decentralized others.
Source: Elke Jakubowski and Richard Saltman (eds), The Changing National Role in Health System Governance: A case-based study of 11 European countries and Australia, World Health Organisation (Regional Office for Europe)
Links: Report
Date: 2013-Apr
An article examined whether hospital ownership affected the level of quality reported by patients whose care was funded by the National Health Service in areas other than clinical quality. It was found that the experience reported by patients in public and private hospitals was different. Most dimensions of quality were delivered differently by the two types of hospitals, with each sector offering greater quality in certain specialties or to certain groups of patients. However, in overall terms hospital ownership by itself did not affect the level of quality of the average patient's reported experience.
Source: Virginie Perotin, Bernarda Zamora, Rachel Reeves, Will Bartlett, and Pauline Allen, 'Does hospital ownership affect patient experience? An investigation into public-private sector differences in England', Journal of Health Economics, Volume 32 Issue 3
Links: Abstract
Date: 2013-Apr
An investigation found that more than one-third of family doctors on the boards of the new clinical commissioning groups (CCGs) in England had a conflict of interest resulting from directorships or shares held in private companies.
Source: British Medical Journal, 13 March 2013
Links: BMA press release | BBC report | Guardian report
Date: 2013-Mar
A report said that advances in information technology opened up the potential for a 'knowledge commons' in healthcare – an open system of knowledge within which researchers, clinicians, patients, and communities could be involved in capturing, refining, and utilizing a common body of knowledge in real time.
Source: John Loder, Laura Bunt, and Jeremy Wyatt, Doctor Know: A knowledge commons in health, National Endowment for Science, Technology and the Arts
Links: Report
Date: 2013-Mar
A report said that the National Health Service and the public needed to shift their 'default setting' for delivering healthcare from hospitals to the community and the home, where it was in patients' best interests. Reserving in-patient care in major hospitals for people with life-threatening conditions or those needing complex surgery could be more clinically effective and make better use of NHS resources.
Source: Transforming Local Care: Community healthcare rises to the challenge, NHS Confederation
Links: Report | NHS Confederation press release | Public Finance report
Date: 2013-Mar
A think-tank report called for a strategic approach to volunteering throughout the health and social care system in England. 3 million volunteers added significant value to the work of paid professionals, and were a critical but often under-appreciated part of the workforce. Volunteers played an important role in improving people's experience of care, building stronger relationships between services and communities, supporting integrated care, improving public health, and reducing health inequalities. The support that volunteers provided could be of particular value to those who relied most heavily on services, such as people with multiple long-term conditions or mental health problems.
Source: Chris Naylor, Claire Mundle, Lisa Weaks, and David Buck, Volunteering in Health and Care: Securing a sustainable future, King s Fund
Links: Report | Kings Fund press release | Community Care report
Date: 2013-Mar
The coalition government published (following consultation) a revised NHS constitution in England. It said that the revisions strengthened areas including: patient involvement; complaints; and staff rights.
Source: The NHS Constitution, Department of Health
Links: Constitution | Handbook | Hansard | DH press release
Date: 2013-Mar
A new book examined federalism and decentralization in the health and social care systems of a range of European countries (including the United Kingdom).
Source: Joan Costa-Font and Scott Greer (eds), Federalism and Decentralization in European Health and Social Care, Palgrave Macmillan
Links: Summary
Notes: Chapters included: Scott Greer, 'The rise and fall of territory in United Kingdom health politics'.
Date: 2013-Mar
A study examined commissioning practice in three high-performing primary care trust areas. It said that new clinical commissioning groups would, in a climate of financial austerity, need to make sure that, alongside collaborative discussion and service planning, they left space for transactional work such as contract specification, service review, and decommissioning.
Source: Judith Smith, Sara Shaw, Alison Porter, Rebecca Rosen, Ian Blunt, Alisha Davies, Elizabeth Eastmure, and Nicholas Mays, Commissioning High Quality Care for People with Long-Term Conditions, National Institute for Health Research
Links: Report | Nuffield Trust press release
Date: 2013-Mar
The coalition government withdrew proposed regulations on the procurement of health services in England, following criticism (by a committee of peers, among others) that they would have allowed the 'back door' privatization of a range of services. It said that the wording of the regulations had 'inadvertently created confusion'. Revised regulations were subsequently issued, which the coalition government said made clear that there was no requirement to put all contracts out to competitive tender, and that the healthcare regulator had no power to force the competitive tendering of services.
Source: Debate 5 March 2013, columns 835-844, House of Commons Hansard, TSO | National Health Service (Procurement, Patient Choice and Competition) Regulations 2013, 30th Report (Session 2012–13), HL 136, House of Lords Science and Technology Select Committee, TSO
Links: Hansard | DH press release | Original regulations | Revised regulations | Peers report | AMRC press release | Labour Party press release | OHE press release | RCGP press release | RCN press release (1) | RCN press release (2) | BBC report | Public Finance report
Date: 2013-Mar
An article examined the potential for health and social care service integration in Wales, drawing on experience from the United Kingdom, Europe, and Canada.
Source: Gareth Morgan, 'Integration of health and social care – what can Wales learn and contribute?', Quality in Ageing and Older Adults, Volume 14 Number 1
Links: Abstract
Date: 2013-Mar
A manifesto for primary care in England called for a fundamental shift from acute to primary settings. Every patient should be given the opportunity to create a personal health and well-being plan. Consultants' contracts in certain specialties should be held by the National Health Service Commissioning Board or local clinical commissioning groups, enabling these specialists to take a community-wide responsibility for groups of patients and to become an expert resource for primary care clinicians. There should be a review of the existing financial systems under which general practice was paid per head of population but hospitals were paid for activity.
Source: Breaking Boundaries, NHS Alliance
Links: Manifesto | NHS Alliance press release
Date: 2013-Mar
A report by a committee of MPs welcomed the return to local government in England of the responsibility to improve the health and well-being of local people. But it also raised concerns over the complex accountability mechanisms of the reformed system. In particular, it was not clear who would be in charge in the event of a health emergency. The committee also called for 'perverse' incentives in the funding formula be reviewed.
Source: The Role of Local Authorities in Health Issues, Eighth Report (Session 2012–13), HC 694, House of Commons Communities and Local Government Select Committee, TSO
Links: Report | Additional written evidence | Committee press release | LGA press release | BBC report
Date: 2013-Mar
A report for the children's watchdog for England said that health bodies needed to do more to involve children and young people in strategic decision-making. Children and young people tended to be asked to comment on decisions that adults had already made, or consulted on their own health needs and service planning, rather than on the wider commissioning, delivery, or evaluation of services. There was no coherent national programme of activity to encourage local bodies to include children and young people in strategic health service commissioning or other vital decision-making about National Health Service provision.
Source: Rachel Blades, Zoe Renton, and Ivana La Valle (with Keith Clements, Jennifer Gibb, and Joanna Lea), We Would Like to Make a Change: Children and young people's participation in strategic health decision-making, Office of the Children's Commissioner
Links: Report | OCC press release
Date: 2013-Mar
A report called for a radical shift away from reactive, hospital-based care towards greater use of preventative services to keep people healthy and allow them to manage their conditions at home and in the community.
Source: The Prevention Revolution: Transforming health and social care, Association of Chief Executives of Voluntary Organisations
Links: Report
Date: 2013-Mar
A new book examined the legal regulation of new health technologies in Europe. It considered the roles of risk, ethics, rights, and markets. New health technologies promised improved quality of life for patients suffering from a range of diseases, and the potential for the prevention of incidence of disease in the future. At the same time, new health technologies posed significant challenges for governments, particularly in relation to ensuring that the technologies were safe and effective, and provided appropriate value for (public) money.
Source: Mark Flear, Anne-Maree Farrell, Tamara Hervey, and Therese Murphy (eds), European Law and New Health Technologies, Oxford University Press
Links: Summary
Date: 2013-Feb
An article examined how public-private partnerships (PPPs) shaped service and workforce organization in the English National Health Service.
Source: Justin Waring, Graeme Currie, and Simon Bishop, 'A contingent approach to the organization and management of public-private partnerships: an empirical study of English health care', Public Administration Review, Volume 73 Number 2
Links: Abstract
Date: 2013-Feb
A series of articles examined the role of the new health and well-being boards, and the challenges facing them.
Source: Journal of Integrated Care, Volume 21 Number 1
Links: Table of contents
Notes: Articles included:
Richard Humphries, 'Health and wellbeing boards: policy and prospects'
Simon Allen and Janet Rowse, 'Health and well being boards – developing transformational relationships'
Bill Mumford, 'Making health and wellbeing boards a success: engaging providers'
John Wilderspin, 'Health and wellbeing boards and service transformation'
Sian Lockwood, 'Micro-enterprise:: community assets helping to deliver health and well-being and tackle health inequalities'
Date: 2013-Feb
A review presented evidence on the role of clinical engagement in primary care-led commissioning, and how this had contributed to the delivery of healthcare services.
Source: Rosalind Miller, Stephen Peckham, Kath Checkland, Anna Coleman, Imelda McDermott, Stephen Harrison, and Julia Segar, Clinical Engagement in Primary Care-Led Commissioning: A review of the evidence, Policy Research Unit in Commissioning and the Healthcare System
Links: Report
Date: 2013-Jan
An article said that European healthcare systems had not been particularly hit by retrenchment; and that convergence was absent in key healthcare dimensions, namely coverage and provision. Convergence appeared mainly in terms of the increased reliance on private healthcare financing.
Source: Ingalill Montanari and Kenneth Nelson, 'Social service decline and convergence: how does healthcare fare?', Journal of European Social Policy, Volume 23 Number 1
Links: Abstract
Date: 2013-Jan
A report said that the National Health Service could save £4.4 billion per year by making more extensive use of information and technology such as text messages for negative test results, electronic prescribing, and electronic patient records.
Source: PricewaterhouseCoopers LLP, A Review of the Potential Benefits from the Better Use of Information and Technology in Health and Social Care, Department of Health
Links: Report | DH press release
Date: 2013-Jan
A report said that the perceived benefits of joint commissioning in health and social care, such as efficiency savings and improvements to services, often lagged behind the reality. New financial pressures would make joint commissioning and joint working even harder in the future.
Source: Helen Dickinson, Jon Glasby, Alyson Nicholds, Stephen Jeffares, Suzanne Robinson, and Helen Sullivan, Joint Commissioning in Health and Social Care: An exploration of definitions, processes, services and outcomes, National Institute for Health Research
Links: Report | Summary | Birmingham University press release
Date: 2013-Jan
An interim report presented research findings on how healthcare commissioners negotiated, specified, monitored, and managed contractual mechanisms to improve services and allocate financial risk in their local health economies, looking at both acute services and community healthcare.
Source: Pauline Allen, Christina Petsoulas, and Ben Ritchie, Study of the Use of Contractual Mechanisms in Commissioning, Policy Research Unit in Commissioning and the Healthcare System
Links: Report
Date: 2013-Jan
A paper examined the effects of healthcare decentralization in Europe. Whether efficiency improved after a process of decentralization depended heavily on the incentives that fiscal design exerted on cost containment, inter-jurisdictional competition, and policy innovation and diffusion. Decentralization gave rise to important concerns associated with vertical imbalances and limited horizontal imbalances. Decentralization could give rise to a new regional political cycle where citizens could reward or penalize the performance of health policy.
Source: Joan Costa-i-Font, Fiscal Federalism and European Health System Decentralization: A perspective, LEQS Paper 55, European Institute (London School of Economics)
Links: Paper
Date: 2013-Jan
A report said that unless the 'bureaucratic burden' on National Health Service organizations were reduced, there was a risk that frontline staff time would be diverted from patient care to form filling and 'box ticking'.
Source: Information Overload: Tackling bureaucracy in the NHS, NHS Confederation
Links: Report | NHS Confederation press release
Date: 2013-Jan
An article examined the increasing use by European governments of partnerships with the private sector in healthcare. Experience with these partnerships had been 'mixed' thus far. Early partnership models – for example, in which a private firm built a hospital and carried out building maintenance – had arguably not met expectations for achieving greater efficiencies at lower costs. Newer models offered greater opportunities for efficiency gains, but were administratively harder to set up and manage.
Source: James Barlow, Jens Roehrich, and Steve Wright, 'Europe sees mixed results from public-private partnerships for building and managing health care facilities and services', Health Affairs, Volume 32 Number 1
Links: Abstract
Date: 2013-Jan
A report said that the new health and well-being boards should take advantage of the experience and connexions of established providers of health and care-related services, as well as be open to innovative contributions from new ones, if they wanted to be successful at improving the health outcomes of their communities.
Source: Stronger Together: How health and wellbeing boards can work effectively with local providers, NHS Confederation
Links: Report
Date: 2013-Jan
An article examined the role of health and well-being boards. Early experience indicated considerable optimism about their prospects to achieve greater success in achieving integrated services: but they faced formidable challenges arising from a hostile financial climate, and from unchanged national policy fault lines that had hindered effective integration to date.
Source: Richard Humphries, 'Health and wellbeing boards: policy and prospects', Journal of Integrated Care, Volume 21 Number 1
Links: Abstract
Date: 2013-Jan
A report examined how to incorporate women's health needs into joint strategic needs assessments and joint health and well-being strategies.
Source: Better Health for Women, Women s Health and Equality Consortium
Date: 2013-Jan
A think-tank report said that the formula used to recommend which drugs should be funded by the National Health Service was 'flawed'. The threshold range used – £20,000 to £30,000 per quality-adjusted life year (QALY) – was not based on evidence, and should be no more than £18,317 per QALY (based on 2008 expenditure).
Source: Karl Claxton, Steve Martin, Marta Soares, Nigel Rice, Eldon Spackman, Sebastian Hinde, Nancy Devlin, Peter Smith, and Mark Sculpher, Methods for the Estimation of the NICE Cost Effectiveness Threshold, Research Paper 81, Centre for Health Economics (University of York)
Links: Paper | York University press release | BBC report
Date: 2013-Jan
A report examined what action could be taken at a local level in England to improve the health outcomes for children and young people, and how this action could be supported at a national level. It said that the government needed to take action to address the lack of policy co-ordination between different government departments and national bodies.
Source: Children and Young People's Health and Wellbeing in Changing Times: Shaping the future and improving outcomes, NHS Confederation
Links: Report | NHS Confederation press release
Date: 2013-Jan
