A report evaluated the social and economic impact of the Rotherham Social Prescribing Pilot, which linked patients in primary care and their carers with non-medical sources of support within the community. The report said that there had been reductions in patients' use of hospital resources, improvements in their well-being, and progress towards better self-management of their conditions. The evaluation had found positive economic benefits to commissioners, with cost reductions for the National Health Service, and benefits to organizations in the voluntary and community sector, which had been involved in providing support services. The report also valued of a range of social benefits of the scheme.
Source: Chris Dayson and Nadia Bashir, The Social and Economic Impact of the Rotherham Social Prescribing Pilot: Main evaluation report, Centre for Regional, Economic and Social Research (Sheffield Hallam University)
Date: 2014-Sep
An article examined the implementation of one service provider's developments in integrated and personalized care. Drawing on structuration theory, the article explored how policy and legislation were translated into local perspectives and operational practice. It said the evidence suggested a need for better understanding of policy interpretation and translation, as well as the role of information and information services in front line delivery.
Source: Penelope Hill, 'Supporting personalisation: the challenges in translating the expectations of national policy into developments in local services and their underpinning information systems', Social Policy and Society, Volume 13 Issue 4
Links: Abstract
Date: 2014-Sep
A report said that there was now a significant cohort of people in the United Kingdom who were living with HIV and were aged over 50, and that this presented new challenges to the way in which HIV care and treatment were designed, managed, and delivered. Recommendations included: for a national patient experience survey of people living with HIV, to be funded by NHS England; for mandatory basic training in HIV for all those working in health and social care; for ongoing support for peer networks; for the development of personal health budgets among HIV patients; and for groups and charities working with the elderly to be brought together with those supporting people living with HIV to help meet the needs of the ageing cohort.
Source: Gail Beer, Matt James, and Sean Summers, Growing Older Positively: The challenge of ageing with HIV, 2020health
Links: Report | 2020 press release
Date: 2014-Sep
A report examined the estimated costs for care at the end of life through family doctor contacts, community nursing, local authority-funded social care, hospices, and hospital care. It said that cost savings might be possible by making community-based support more widely available to those who preferred to receive care at home. The work had tested a number of models using a range of available anonymised data, and noted the difficulties in acquiring good quality data on palliative care, since it was being provided across a wide range of providers.
Source: Theo Georghiou and Martin Bardsley, Exploring the Cost of Care at the End of Life, Nuffield Trust
Links: Report | Summary | Nuffield Trust press release | NCPC press release
Date: 2014-Sep
An article examined the development of 'whole-system' integrated health and social care in England, and the key lessons learned.
Source: Claire Kennedy and Simon Morioka, 'The development of whole-system integrated care in England', Journal of Integrated Care, Volume 22 Number 4
Links: Abstract
Date: 2014-Sep
An article examined the delivery of, and outcomes from, a feasibility study of using case management as a means of overcoming service fragmentation by co-ordinating services along the care pathway for people with dementia in England.
Source: Steve Iliffe, Amy Waugh, Marie Poole, Claire Bamford, Katie Brittain, Carolyn Chew-Graham, Chris Fox, Cornelius Katona, Gill Livingston, Jill Manthorpe, Nick Steen, Barbara Stephens, Vanessa Hogan, and Louise Robinson, 'The effectiveness of collaborative care for people with memory problems in primary care: results of the CAREDEM case management modelling and feasibility study', Health Technology Assessment, Volume 18 Number 52
Date: 2014-Sep
An article examined awareness and use of NHS 111, a telephone service set up to improve and simplify access to non-emergency National Health Service healthcare in England. Drawing on a telephone survey, it said that fifty nine percent of respondents had heard of NHS 111 and 9 per cent reported ever using it. People less likely to use the service were older, male, did not have a disability/limiting long-term illness, or were home owners. The article concluded that reliance on the use of a telephone service to access urgent care could be problematic if some groups were less likely to use it, and that there might be a need to offer alternative access, or deliver targeted publicity campaigns.
Source: Emma Knowles, Alicia O'Cathain, Janette Turner, and Jon Nicholl, 'Awareness and use of a new urgent care telephone service, NHS 111: cross-sectional population survey', Journal of Health Services Research and Policy, Volume 19 Number 4
Links: Abstract
Date: 2014-Sep
A report examined what was known about the extent and quality of care and services delivered by allied health professionals (AHPs – including such services as chiropodists/podiatrists, dieticians, occupational therapists, paramedics, physiotherapists, and radiographers). It said that AHPs made up 6 per cent of the National Health Service workforce in 2013, but the numbers varied across areas of care and geographical areas. The report said that there was very little systematic information at a national level about the quality of care delivered by AHPs, and discussed the importance of developing information systems that would collect consistent and comparable data.
Source: Holly Dorning and Martin Bardsley, Focus On: Allied health professionals – can we measure quality of care?, Health Foundation/Nuffield Trust
Links: Report | Nuffield Trust press release | CSP press release
Date: 2014-Sep
A think-tank report presented findings from a survey of people with long-term health conditions, which asked their views on self-managing their conditions and having more of a say over their services. The report called for: people to be given a named contact for day-to-day queries about their health, healthcare, and care co-ordination; patients to have legal ownership of medical records, and better information and advice; peer support, facilitated by organizations within the local health economy; comprehensive healthcare plans, drawn up in partnership with patients; and personal, integrated health and social care budgets, based on healthcare plans.
Source: Catherine McDonald, Patients in Control: Why people with long-term conditions must be empowered, Institute for Public Policy Research
Links: Report | Summary | Alzheimers Society press release
Date: 2014-Sep
An article examined the effectiveness and cost consequences of family doctor-led and nurse-led telephone triage, compared with usual care, for patients seeking same-day consultations in primary care in the United Kingdom. It said that triage interventions were associated with increased numbers of patient contacts, although the estimated costs over a period of 28 days were similar between all three groups.
Source: John Campbell, Emily Fletcher, Nicky Britten, Colin Green, Tim Holt, Valerie Lattimer, David Richards, Suzanne Richards, Chris Salisbury, Raff Calitri, Vicky Bowyer, Katherine Chaplin, Rebecca Kandiyali, Jamie Murdoch, Julia Roscoe, Anna Varley, Fiona Warren, and Rod Taylor, 'Telephone triage for management of same-day consultation requests in general practice (the ESTEEM trial): a cluster-randomised controlled trial and cost-consequence analysis', The Lancet 4 August 2014
Links: Article | University of Bristol press release | BBC report | NHS Choices article | Telegraph report
Date: 2014-Sep
A report provided findings from a survey of the voluntary and community sector (VCS) in England about how it was engaging with health and well-being boards (HWBs). It said that some good practice was emerging, although reports suggested that the VCS was being under-utilized by local partners in health and care. The report made recommendations to improve links between the VCS and the activity of HWBs.
Source: Supporting Influence on Health and Wellbeing Boards: Report from survey Spring 2014, Regional Voices
Links: Report | Summary | Regional Voices press release
Date: 2014-Sep
A report examined the state of cancer services in England, in the context of recent and ongoing changes within the National Health Service. It said that recent change, combined with a lack of spare capacity, was seen as holding back the development of cancer services. The report said that the research had highlighted a number of perceived challenges, including: increasing demand for services and insufficient capacity to respond; a loss of national and local leadership and infrastructure; fragmentation of commissioning across services; and variation in the roles and responsibilities of new organizations, as well as a need to rebuild relationships and expertise across the new structures. The report made recommendations, including a call for increased investment.
Source: Hilary Brown, Jo Ellins, James Kearney, Kelly Singh, Oliver Jackson, Holly Krelle, and Iain Snelling, Measuring Up? The health of NHS cancer services, Health Services Management Centre, University of Birmingham/ICF GHK Consulting
Links: Report | Cancer Research press release | BBC report | Guardian report
Date: 2014-Sep
An article examined the impact on patient outcomes (mortality and length of hospital stay) of the centralization of acute stroke services, drawing on a study in two metropolitan areas of England (London in the south east and Manchester in the north). It concluded that a centralized model of care, in which hyperacute care was provided to all patients with stroke across an entire metropolitan area, could reduce mortality and length of hospital stay.
Source: Stephen Morris, Rachael Hunter, Angus Ramsay, Ruth Boaden, Christopher McKevitt, Catherine Perry, Nanik Pursani, Anthony Rudd, Lee Schwamm, Simon Turner, Pippa Tyrrell, Charles Wolfe, and Naomi Fulop, 'Impact of centralising acute stroke services in English metropolitan areas on mortality and length of hospital stay: difference-in-differences analysis', British Medical Journal, 5 August 2014
Links: Article | Abstract | Guardian report
Date: 2014-Sep
A report said that the financial challenge facing the National Health Service posed risks to the quality of care it provided, because the estimated potential savings from productivity improvements were insufficient to meet shortfalls in funding (projected to reach £30 billion by 2021). The report outlined three forms of support that were now needed: support in implementing improvements to services and to deliver integrated care (skills such as basic management, change management, improvement skills, and analysis); targeted resources, in the form of a 'transformation fund' and additional ongoing operational funding; and political openness and support for change.
Source: Richard Taunt, Alecia Lockwood, and Natalie Berry, More than Money: Closing the NHS quality gap, Health Foundation
Links: Report | Health Foundation press release
Date: 2014-Sep
The government responded to a report by a committee of MPs on the care, treatment, and support of people with long-term health conditions.
Source: Government Response to the House of Commons Health Select Committee Report into Long-Term Conditions, Cm 8937, Department of Health, TSO
Links: Response | MPs report
Date: 2014-Sep
A report by a committee of the Northern Ireland Assembly reviewed the Department's approach to managing waiting times for elective health care.
Source: Review of Waiting Times Report, Northern Ireland Assembly Committee for Health, Social Services and Public Safety
Links: Report
Date: 2014-Sep
An article examined a case study of a public healthcare enterprise, the Queen Elizabeth Hospital in Greenwich, England. It said that the hospital, which was developed under the private finance initiative, became the first to be placed 'in administration', and considered the impact of changes in legislation and policy on the hospital.
Source: Jane Lethbridge, 'Public enterprises in the healthcare sector a case study of Queen Elizabeth Hospital, Greenwich, England', Journal of Economic Policy Reform, Volume 17 Number 3
Links: Abstract
Date: 2014-Aug
A report examined breast cancer care services in Europe, based on a survey in 25 countries (including the United Kingdom). The report examined healthcare organization, cancer screening, breast cancer care organization, safety and quality, accreditation and certification schemes, and competence requirements for professionals.
Source: Donata Lerda, Silvia Deandrea, Crystal Freeman, Jesus Lopez-Alcalde, Luciana Neamtiu, Ciaran Nicholl, Nicholas Nicholson, Asli Uluturk, and Silvia Villanueva, Report of a European Survey on the Organisation of Breast Cancer Care Services, European Commission
Links: Report | European Commission press release
Date: 2014-Aug
A paper examined the extent to which a higher supply of nursing/care home beds, or lower prices, might reduce hospital bed blocking (when hospital patients could not be discharged to a nursing or care home because no place was available). It said that delayed discharges responded to the availability of beds but the effect was modest, with a 10 per cent increase in beds found to reduce delayed discharges by about 4-7 per cent. The paper also described strong evidence of spillover effects across local authorities, where spare capacity in neighbouring authorities reduced delays, and with higher levels of delays in local authorities with higher prices for long term care.
Source: James Gaughan, Hugh Gravelle, and Luigi Siciliani, Testing the Bed-Blocking Hypothesis: Does higher supply of nursing and care homes reduce delayed hospital discharges?, Research Paper 102, Centre for Health Economics (University of York)
Links: Paper
Date: 2014-Aug
Date: 2014-Aug
NHS England began consultation on proposals for a new information standard for health and social care organizations in England, aimed at ensuring that patients and service users, and their carers and parents, could understand the information they were given. The consultation would close on 9 November 2014.
Source: Making Health and Social Care Information Accessible: Consultation document summer/autumn 2014, NHS England
Links: Consultation document | NHS England press release
Date: 2014-Aug
A report examined issues relating to the extension of pharmacy services in hospitals to a seven day per week service, outlining four emerging themes for consideration: joining up hospital and community services; the pharmacy workforce and ways of working; targeted delivery of seven day services; and the business case for extending services.
Source: Seven Day Services in Hospital Pharmacy: Giving patients the care they deserve, Royal Pharmaceutical Society
Links: Report
Date: 2014-Aug
The Welsh Government began consultation on draft guidance for healthcare practitioners to assist effective working with Gypsies and Travellers. The guidance included a summary analysis of the research and evidence base, together with advice on, and examples of, effective practice with these communities. The consultation would close on 30 October 2014.
Source: Travelling to Better Health: Guidance for healthcare practitioners on working effectively with Gypsies and Travellers, WG22725, Welsh Government
Links: Consultation document | Annexes | Outcome measures
Date: 2014-Aug
A special issue of a journal examined privatization of provision across a range of policy areas.
Source: Economic Affairs, Volume 34 Issue 2
Links: Table of contents
Notes: Articles included:
Peter Zweifel, 'Does privatisation contribute to the performance of a health care system?'
Richard Wellings, 'The privatisation of the UK railway industry: an experiment in railway structure'
Guy Opperman, 'Change your prison, change your outcomes, change your community'
Date: 2014-Jul
An article examined the extent of privatization in the English National Health Service over three periods of government and through the lens of three approaches: mixed economy of welfare; wheels of welfare; and publicness.
Source: Martin Powell and Robin Miller, 'Framing privatisation in the English National Health Service', Journal of Social Policy, Volume 43 Issue 3
Links: Abstract
Date: 2014-Jul
A report said that more National Health Service organizations should be encouraged to become public service mutuals, as such organizations delivered higher levels of staff engagement, which in turn had been shown to deliver better quality care. The report called on the government to launch a programme of pathfinders to gather further evidence about the benefits of mutuals and whether they could be adopted on a larger scale across the National Health Service. It also called for greater devolution of responsibility to National Health Service organizations.
Source: Improving NHS Care by Engaging Staff and Devolving Decision-Making: Report of the Review of Staff Engagement and Empowerment in the NHS, King's Fund
Links: Report | Kings Fund press release
Date: 2014-Jul
An article examined the implementation of market reforms within the National Health Service. It considered how consumer culture had influenced attitudes towards health and dying, and the 'creeping commodification' of healthcare users.
Source: David Sturgeon, 'The business of the NHS: the rise and rise of consumer culture and commodification in the provision of healthcare services', Critical Social Policy, Volume 34 Issue 3
Links: Abstract
Date: 2014-Jul
A report examined cancer services in the United Kingdom, comparing existing provision and outcomes against nine elements that people affected by cancer found important to them, including early diagnosis, information, quality of life, and end of life care. It discussed a range of reported problems, including delayed diagnosis, and shortcomings in end of life care. The report called for adaptations to ways of working in health and social care, and for funding for well evidenced treatments and services, with a greater focus on community-based provision, free social care at the end of life, and a cancer plan for each United Kingdom country.
Source: Cancer in the UK 2014: State of the nation report, Macmillan Cancer Support
Links: Report | Macmillan press release
Date: 2014-Jun
The government began consultation on proposals to change the system for contracting National Health dental services, with a focus on improving oral health through prevention and increased access. The consultation would close on 31 July 2014.
Source: Department of Health
Links: Consultation documents
Date: 2014-Jun
The regulator for National Health Service foundation trusts said that there was no systematic evidence of poorer quality of clinical services in small hospitals (often described as district general hospitals), compared to larger ones, and only a limited effect of size on financial performance. However, it said that this was likely to become more relevant as a result of ongoing policy change.
Source: Facing the Future: Smaller acute providers, Monitor
Links: Report | Monitor press release
Date: 2014-Jun
An article examined integration in health care in the United States and England. The article applied concepts of economic integration to examine why integration did or did not occur in health settings, and whether expectations of integrating different kinds of providers and health and social services were realistic.
Source: Miriam Laugesen and George France, 'Integration: the firm and the health care sector', Health Economics, Policy and Law, Volume 9 Issue 3
Links: Abstract
Date: 2014-Jun
A report examined the transitions of young people with complex physical health needs as they moved between children's and adults' health services. It said that there were examples of good practice, including consistency in staffing, the provision of adolescent clinics, good communication between the respective parties, and good information about the process. However, the report said that young people did not always receive the necessary care and support during the transition, and that it was made more difficult by issues such as a lack of early planning, insufficient consideration of the needs of carers, and failures to agree over responsibilities for funding. The report made recommendations.
Source: From the Pond into the Sea: Children's transition to adult health services, Care Quality Commission
Links: Report | Summary | CQC press release
Date: 2014-Jun
A report said that integrated strategic thinking and planning was needed within the National Health Service to help address issues caused by increased demand for primary care and emergency hospital services over the winter period. It also called for more self-care education to empower people to self-manage common winter ailments and use services appropriately.
Source: Inquiry Report into Winter Pressures, All Party Parliamentary Group on Primary Care and Public Health
Links: Report | APPG press release
Date: 2014-Jun
A report examined different approaches to reforming the National Health Service in England. It said that politics and policy worked on different cycles, which resulted in short-term political initiatives that undermined vital long-term policy commitments to change. It said that a new political settlement was needed for the NHS that clarified the strategic role of ministers in determining funding, establishing priorities, and providing accountability to parliament, drawing on lessons learned from the experience of recent health reforms. It said that reform had so far relied too much on external stimuli such as targets, performance management, inspection, regulation, competition, and choice, and too little on bringing about improvement 'from within'. It discussed the role of leadership and noted the importance of engaging health service staff in improvement programmes.
Source: Chris Ham, Reforming the NHS from Within: Beyond hierarchy, inspection and markets, King's Fund
Links: Report | Kings Fund press release | Alzheimers Society press release
Date: 2014-Jun
A report examined how the delivery of National Health Service care in England could be made more sustainable and help to improve outcomes for people living with long-term conditions. It made recommendations around three themes: embedding a patient-centred approach and treating the individual, rather than focusing on their condition; aiding patients' navigation of the healthcare system and coaching people to manage their health; and using technology to improve the delivery of services and support self-management.
Source: Patient, Manager, Expert: Individual – improving the sustainability of the healthcare system by removing barriers for people with long-term conditions, Abbvie/College of Medicine
Links: Report
Date: 2014-Jun
An article examined the early development of health and well-being boards in England, arising from the Health and Social Care Act in 2012. It said that developing boards differed in their structure and approach, but also identified a number of significant and familiar issues that had arisen in earlier attempts at health and social care integration, such as: reliance on voluntary agreements to align the strategic plans of multiple statutory bodies; mundane organizational processes in determining the extent of effective co-operation; and issues arising from factors such as organizational size and local boundaries.
Source: Anna Coleman, Kath Checkland, Julia Segar, Imelda Mcdermott, Stephen Harrison, and Stephen Peckham, 'Joining it up? Health and Wellbeing Boards in English local governance: evidence from clinical commissioning groups and shadow health and wellbeing boards', Local Government Studies, Volume 40 Issue 4
Links: Abstract
Date: 2014-Jun
A report provided a summary of published reviews on the economic impacts of integrated care approaches, drawing on a systematic search of existing literature. It said that there was a lack of definitional clarity over what constituted integrated care, and over the intended outcomes, that needed to be overcome in order to assess impact. However, it did find evidence that suggested a positive impact of integrated care programmes on the quality of patient care and improved health or patient satisfaction outcomes, and said that some evidence was found of cost-effectiveness of selected integrated approaches.
Source: Ellen Nolte and Emma Pitchforth, What Is the Evidence on the Economic Impacts of Integrated Care?, European Observatory on Health Systems and Policies
Links: Report | EOHSP press release
Date: 2014-Jun
An article examined the literature around joint working in health and social care for older people and people with mental health problems in the United Kingdom. Updating an earlier literature review, it said there were signs that some joint working or integration initiatives could deliver outcomes desired by government, and some evidence to suggest benefits to service users or carers. However, the authors concluded that the available evidence did not support the current or previous government's faith in the strategy of health and social care integration.
Source: Ailsa Cameron, Lisa Bostock, and Rachel Lart, 'Service user and carers perspectives of joint and integrated working between health and social care', Journal of Integrated Care, Volume 22 Number 2
Links: Abstract
Date: 2014-May
An article examined the relationship between general practitioners (family doctors) and social care professionals. Reflecting on the Home Truths project, that sought to improve joint working between general practice and social care though an action research process, it said that family doctors' knowledge of social care services was poor, they rated their relationship with social workers as poor, and they perceived that social care services were of poor quality. It said that family doctors had expressed a desire to work more closely with social care, but interventions to improve relationships were found to focus on daily practice, rather than introducing new initiatives. The article noted the low response rate of family doctors (10 per cent) and difficulties in outcome measurement.
Source: Catherine Mangan and Robin Miller, 'Time for some home truths – exploring the relationship between GPs and social workers', Journal of Integrated Care, Volume 22 Number 2
Links: Abstract
Date: 2014-May
A think-tank report said that the National Health Service in England was at a critical juncture, where reduced funding and increasing service demands meant that the existing system was unsustainable. It said that neither greater privatization nor further state control alone would be a practical solution, and argued that health mutuals, owned exclusively by patients, would be able to provide whole-person, joined up care, and would improve the patient experience, improve health outcomes, and be more cost effective. The report made a range of recommendations, including: for an independent review of patient engagement; for a pilot scheme for the proposed model of healthcare commissioning; for a revised role for Monitor and the health service regulator; for engagement of the health sector with friendly societies; and for a new patient right to holistic care.
Source: Mo Girach, Karol Sikora, and Adam Wildman, Power to the People: The mutual future of our National Health Service, ResPublica
Links: Report | ResPublica press release
Date: 2014-May
A report said that deficiencies had been found in routine asthma care that sometimes led to preventable deaths. The report called for: every hospital and family doctor practice to have a designated, named clinician for asthma services; better monitoring of asthma control, and immediate action on loss of control; better education on risk awareness for doctors, nurses, patients, and carers; and all patients to be provided with a personal asthma action plan.
Source: Mark Levy, Rachael Andrews, Rhona Buckingham, Hannah Evans, Caia Francis, Rosie Houston, Derek Lowe, Shuaib Nasser, James Paton, Navin Puri, Kevin Stewart, and Mike Thomas, Why Asthma Still Kills: The National Review of Asthma Deaths (NRAD) – Confidential Enquiry report, Royal College of Physicians
Links: Report | Summary | Appendices | RCP press release | RCN press release
Date: 2014-May
A think-tank paper summarized themes of the existing debates regarding change in the National Health Service in England. It discussed the ways in which change could be taken forward, how solutions could be related to public behaviour, and the nature of communications and public debate about the National Health Service. The paper argued for the de-politicization of the debate, for greater public involvement in decision-making, and for a range of recommendations that included 'payment by results' for people's behavioural change and a strategic network of specialized and general hospitals.
Source: Julia Manning and Gail Beer, Healthcare and the Economy 2: Going with the flow, 2020health
Links: Paper | 2020health press release
Date: 2014-May
A report set out recommendations made to government ministers on the health services to be directly commissioned by NHS England. It said that ministers had accepted the recommendations but, following formal consultation, certain of the recommended changes would not be implemented until NHS England had completed ongoing work to ensure that the detailed definitions of its commissioning responsibilities were applied consistently across the country.
Source: Prescribed Specialised Services Advisory Group Recommendations to Ministers, Department of Health
Links: Report
Date: 2014-May
A report examined the integration of health and social care, the Better Care Fund, and the role of county councils in shaping the future of care in England. The report drew on the findings of a survey of county councils.
Source: Delivering the Better Care Fund in Counties, County Councils Network
Links: Report | Public Finance report
Date: 2014-May
A report said that a recent audit of end of life care had found significant variations in standards across hospitals in England. It said that major improvements were needed to ensure better care for dying people, and better support for family, carers, and friends. Recommendations included: for the provision of a face-to-face specialist palliative care service, 7 days per week; for mandatory training for all staff caring for dying patients; for regular pain monitoring; and for the decision that the patient was in the last hours or days of life to be made by a multidisciplinary team, discussed with the patient where possible, and documented by the senior responsible doctor.
Source: National Care of the Dying Audit for Hospitals, England, Royal College of Physicians
Links: Report | Summary | RCP press release | Alzheimers Society press release | BBC report | NHS Choices report
Date: 2014-May
An article examined a project in Tower Hamlets, a disadvantaged area in East London, that grouped family doctor practices into local networks for cardiovascular care. The 34 practices were allocated to geographical networks of four to five practices, to deliver financially-incentivized attainment targets in four care packages, of which cardiovascular disease (CVD) comprised one. The article concluded that the managed geographical practice networks delivered a 'step-change' in improvements in key CVD performance indicators, compared with England, London, or similar PCT/CCGs.
Source: John Robson, Sally Hull, Rohini Mathur, and Kambiz Boomla, 'Improving cardiovascular disease using managed networks in general practice: an observational study in inner London', British Journal of General Practice, Volume 64 Number 622
Links: Abstract | GP Online article
Date: 2014-May
A report examined productivity improvements in the National Health Service, and considered ways in which to avoid an anticipated 'major crisis' in NHS and social care. It said that: the existing productivity challenge was uniquely different, and difficult, because of the severity and duration of funding restraints that had coincided with major reorganization; that NHS spending would fall from its peak level in 2009 to just over 6 per cent of gross domestic product by 2021; and that some providers now planned to cut emergency and elective work as a result of funding being diverted from NHS allocations to consolidate the Better Care Fund. The report discussed policy implications and areas for further efficiency savings. It called for funding to cover the costs of change and to provide temporary support for otherwise sound organizations that were experiencing budget difficulties.
Source: John Appleby, Amy Galea, and Richard Murray, The NHS Productivity Challenge: Experience from the front line, King's Fund
Links: Report | Kings Fund press release | RCN press release
Date: 2014-May
A report examined the use of, and outcomes from, integrated care funding transfers for 2012-13 and 2013-14, which were granted to support adult social care services that also had a health benefit, encourage health and social care integration, support existing services facing budget pressures, or deliver new services through transformation programmes. Based on freedom of information requests sent to local authorities in England, the report said that funding was used primarily as a means to support existing services, rather than to transform and more closely integrate health and social care services. It said that there was a wide variation in how funding was invested and reported, but it was not sufficient to meet increasing health and social care needs of local populations, there was a lack of robust outcomes data, and less than 4 per cent of funding had gone to local mental health services. The report concluded that, while there had been much support for the integration of health and social care, service change remained subject to significant local variation and the results had important implications for the introduction of the Better Care Fund from 2015.
Source: All in this Together? An analysis of spending on integrated care by commissioners in the new health and social care system, MHP Health
Links: Report | National Care Forum report
Date: 2014-May
The Scottish Government published its response to a consultation on proposals for services for the management of chronic pain. The report outlined ongoing proposals and next steps in the development of the Scottish National Chronic Pain Management Programme.
Source: Future Provision of Specialist Residential Chronic Pain Management Services in Scotland: Consultation report, Scottish Government
Links: Report | Summary | Independent report | Consultation document | Scottish Government press release
Date: 2014-Apr
The Welsh Government began consultation on proposals to introduce new arrangements for multi-agency adult practice reviews, to replace the current serious case review policy and procedure. The consultation document was accompanied by draft guidance. The consultation would close on 27 June 2014.
Source: Protecting Adults at Risk in Wales: Arrangements for Multi-Agency Adult Practice Reviews, WG21166, Welsh Government
Links: Consultation document | Draft guidance | Welsh Government press release
Date: 2014-Apr
The Public Bodies (Joint Working) (Scotland) Act 2014 was given Royal assent. The Act provided a framework to support the improvement of the quality and consistency of health and social care services, permitting the integration of local authority services with health services, and providing for other joint working arrangements.
Source: Public Bodies (Joint Working) (Scotland) Act 2014, Scottish Parliament, TSO
Links: Act | Explanatory notes
Date: 2014-Apr
An article examined the policy of personalization within adult social care, focusing on the implications for social work. Both governments and the disability movement associated personalization with the concept of social citizenship: but it could also be analyzed in terms of neo-liberalism and consumerism. It said that, either way, budget cuts were limiting the opportunities for social workers to practise it.
Source: Mark Lymbery, 'Understanding personalisation: implications for social work', Journal of Social Work, Volume 14 Number 3
Links: Abstract
Date: 2014-Apr
A report provided an outline of the government's plans for changes to primary care in England. This would include some surgeries opening longer hours and greater use of technology, as well as the Proactive Care Programme, which would provide patients with the most complex health and care needs with a personal care and support plan, a named family doctor, a professional to co-ordinate their care, and same-day telephone consultations. The plan outlined in general terms how the relevant organizations were working to implement the changes, which would be introduced from mid 2014.
Source: Transforming Primary Care: Safe, proactive, personalised care for those who need it most, Department of Health
Links: Report | Equality analysis | DH press release | Age UK press release | Independent Age press release | RCGP press release | RCPsych press release | BBC report | Guardian report | Telegraph report
Date: 2014-Apr
Public Health England published a range of data and other information on end of life and end of life care needs in England. The reports highlighted the variance in data across the country and provided resources on which clinical commissioning groups could draw when planning services.
Source: Public Health England
Links: End of life care profiles | PHE press release
Source: Electronic Palliative Care Co-ordination Systems (EPaCCS) in England: Survey of clinical commissioning groups (2013) by the National End of Life Care Intelligence Network, Public Health England
Links: Report | PHE press release
Source: Patterns of End of Life Care in England, 2008 to 2010: Analysis of the National End of Life Care Intelligence Network local authority profiles by PHE region and centre, Public Health England
Links: Report | PHE press release
Date: 2014-Apr
A report discussed the health and social care system in England and said that it was no longer fit for purpose in the context of an ageing demography and the current funding environment. It called for health and social care provision to be integrated into a single system, with a ring-fenced, singly commissioned budget, and more closely aligned entitlements. The work of the Commission would continue, and a further call for evidence was issued alongside this interim report.
Source: Commission on the Future of Health and Social Care in England, A New Settlement for Health and Social Care: Interim report, King's Fund
Links: Report | Summary and backgound papers | Call for evidence | Kings Fund press release | Age UK press release | Care and Support Alliance press release | CSP press release | BBC report | Guardian report
Date: 2014-Apr
An article examined research evidence related to joint working in the field of adult health and social care services, and whether recent reforms to joint working had met the objectives set by policy-makers. There was some indication that recent developments, in particular the drive to greater integration of services, might have positive benefits for organizations as well as for users and carers of services. However, the evidence consistently reported a lack of understanding about the aims and objectives of integration, suggesting that more work needed to be done if the full potential of the renewed policy agenda on integration were to be realized.
Source: Ailsa Cameron, Rachel Lart, Lisa Bostock, and Caroline Coomber, 'Factors that promote and hinder joint and integrated working between health and social care services: a review of research literature', Health and Social Care in the Community, Volume 22 Issue 3
Links: Abstract
Date: 2014-Apr
An article examined the findings from a research project that examined the operation of Alongside Midwifery Units (AMUs) in England. AMUs provided midwife-led care to low-risk women, adjacent to maternity units run by obstetricians, aiming to provide a homely environment to support normal childbirth. The project examined how AMUs were organized, staffed and managed, the experiences of women receiving maternity care in an AMU, and the views and experiences of maternity staff.
Source: Christine McCourt, Juliet Rayment, Susanna Rance, and Jane Sandall, 'An ethnographic organisational study of alongside midwifery units: a follow-on study from the Birthplace in England programme', Health Services and Delivery Research, Volume 2 Issue 7
Date: 2014-Mar
A report examined the role of integrated financial mechanisms in supporting and incentivizing integrated health and social care. The report was based on a literature review, which found 38 studies across eight countries (including England). It said that schemes that integrated funds and resources seldom led to improved health outcomes and, if schemes were successful in assessing patient needs, they would be likely to identify previously unmet need, thus increasing overall cost. The report said that the evidence from England revealed that outcome evaluation was challenging, as new schemes often emerged in the context of other evolving policy initiatives, and that future policy should bear this in mind.
Source: Anne Mason, Maria Goddard, and Helen Weatherly, Financial Mechanisms for Integrating Funds for Health and Social Care: An evidence review, Centre for Health Economics (University of York)
Links: Report | CHE press release
Date: 2014-Mar
A report examined the evidence regarding the effective and cost-effective provision of health services for young people aged 5-19 in England.
Source: Geoff Bates and Jodie Freeman, Evidence Briefing: Delivering effective health services to children and young people, Centre for Public Health (Liverpool John Moores University)
Links: Report
Date: 2014-Mar
Three research briefings examined outcomes from research on charities' and voluntary organizations' attitudes and experiences of local health organizations in England. The briefings drew on a survey conducted by NAVCA and discussed the extent to which respondents felt able to influence joint strategic needs assessments, the nature of their relationships with local clinical commissioning groups, and local Healthwatch.
Source 1: Local Need and the Joint Strategic Needs Assessment, National Association for Voluntary and Community Action
Links: Briefing | NAVCA press release
Source 2: Working with Clinical Commissioning Groups, National Association for Voluntary and Community Action
Links: Briefing | NAVCA press release
Source 3: Healthwatch and Voluntary and Community Organisations, National Association for Voluntary and Community Action
Links: Briefing | NAVCA press release
Date: 2014-Mar
A report said that care for terminally ill people needed to be reviewed and improved, to ensure that they had access to around the clock care when needed. It said that people found the current system difficult to understand and navigate, and that there was a need for: greater availability of hospice care (in-patient and day services), palliative and specialist end of life care for people with non-cancer diagnoses; more effective pain relief at home; and better out-of-hours services.
Source: Difficult Conversations with Dying People and their Families, Marie Curie Cancer Care
Links: Report | Marie Curie press release | NCPC press release
Date: 2014-Mar
A report outlined the view of NHS England on the role to be played by general practice (family doctors) in wider local systems of primary care, and progress made to date.
Source: Improving General Practice: A call to action Phase One report, NHS England
Links: Report | NHS England press release
Date: 2014-Mar
A paper examined the development of accountable care organizations (ACOs) in the United States and considered the implications for integrated care initiatives for England. It said that an ACO generally consisted of a group of providers that agreed with commissioners to provide all care for a certain population for a defined period of time, being held accountable to pre-agreed quality outcomes within a given budget or expenditure target. The paper said that the transfer from the United States to the United Kingdom context was not straightforward, however, and recommended caution in transferring the concept to the English National Health Service.
Source: Stephen Shortell, Rachael Addicott, Nicola Walsh, and Chris Ham, Accountable Care Organisations in the United States and England: Testing, evaluating and learning what works, King's Fund
Links: Paper
Date: 2014-Mar
A report provided the findings of the Independent Commission on Whole-Person Care. The commission was established by the Labour Party to make recommendations about how to integrate health and social care services in England, within existing resources and without further reorganization. The report would feed into the ongoing development of party policy.
Source: One Person, One Team, One System, Independent Commission on Whole Person Care
Links: Report | Alzheimers Society press release | Independent Age press release | Kings Fund press release
Date: 2014-Mar
A study examined patterns of health and social care use and costs, to establish which groups of people might benefit from better integration of services. The study drew on data from the South Somerset Symphony project, which was designed to establish greater collaboration between primary, community, acute, and social care, particularly for people with complex conditions.
Source: Panos Kasteridis, Andrew Street, Matthew Dolman, Lesley Gallier, Kevin Hudson, Jeremy Martin, and Ian Wyer, The Importance of Multimorbidity in Explaining Utilisation and Costs Across Health and Social Care Settings: Evidence from South Somerset s Symphony Project, Centre for Health Economics (University of York)
Links: Report
Date: 2014-Mar
A report examined health and care services for older people in England, in the context of an ageing population. It said that a fundamental shift was required, moving towards co-ordinating care around individual needs rather than single diseases, alongside the prioritization of prevention and support for maintaining independence. The report outlined areas of good practice, identified aspects of care that required improvement, and highlighted the need for integrated working across teams to ensure that sufficient and appropriate services would be available in the right locations.
Source: David Oliver, Catherine Foot, and Richard Humphries, Making Our Health and Care Systems Fit for an Ageing Population, King's Fund
Links: Report | Kings Fund press release | CSP press release
Date: 2014-Mar
A report examined whether lessons could be learned for existing health policy from the transformation of mental health provision from institutional to community based care over the past thirty years. Drawing on workshops and a literature review, it said that a combination of factors served to drive the transformation in mental healthcare, and outlined a range of implications for existing change, including: a need to redesign, rather than merely relocate, services; the need for high quality, stable leadership; the importance of understanding professional resistance to change; the role of family doctors; and that the choice of care models should be driven by local need, and supported by national mechanisms/policies.
Source: Helen Gilburt, Edward Peck, Beccy Ashton, Nigel Edwards, and Chris Naylor, Service Transformation: Lessons from mental health, King s Fund
Date: 2014-Feb
A report examined funding for family doctor practices in England and called for a new approach to combine funding for general practice with that for other services, to create integrated 'family care networks'. It said that this would require new forms of commissioning and that practices would need new skills in areas such as: understanding risk stratification of the population; quality improvement; collaborative working; and managing financial and clinical risks.
Source: Rachael Addicott and Chris Ham, Commissioning and Funding General Practice: Making the case for family care networks, King s Fund
Links: Report | Summary | Kings Fund press release | 4Children press release | CSP press release
Date: 2014-Feb
A report examined the impact of the introduction of a market system (Any Qualified Provider) for the provision of psychological therapies in primary care in England. The AQP programme was introduced to allow for patient choice, and aimed to raise both service quality and efficiency through competition between providers. The report said that some waiting lists had been reduced, but raised a number of concerns, including the use of payment by results, the emergence of perverse incentives, levels of payment, the use of zero value contracts, concerns about the method and impact of outcome measurement, and concerns over the impact on smaller organizations. The report made recommendations for policy-makers, commissioners, and ongoing research.
Source: Steve Griffiths, Joan Foster, Scott Steen, and Patrick Pietroni, Mental Health's Market Experiment: Commissioning psychological therapies through Any Qualified Provider, Centre for Psychological Therapies in Primary Care, University of Chester
Links: Report
Date: 2014-Feb
A report examined the operation and impacts of National Health Service dental contract pilots. The pilots looked at ways to shift the focus of dentistry away from reactive treatment and repair towards prevention and oral health. This was the second report on the operation of the pilots, focusing on how practices had adapted and the impact on risk and disease.
Source: Jimmy Steele, NHS Dental Contract Pilots: Learning after first two years of piloting, Department of Health
Links: Report | 2012 report
Date: 2014-Feb
The regulator for National Health Service services in England published a report that summarized issues raised following a call for evidence in July 2013. The call had sought to understand how well the arrangements for commissioning and providing general practice (family doctor) services were working for patients. The report summarized responses under three headings: access and quality; the ability of new or existing providers to develop the scope of their offer to the National Health Service; and providers' ability and incentives to work together to benefit patients. It outlined work currently being undertaken in the sector to address those issues and identified areas where the regulator could provide support to improve services for patients.
Source: Discussion Document Following Monitor's Call for Evidence on GP Services, Monitor
Links: Report | Call for evidence
Date: 2014-Feb
An audit report in Scotland said that progress on the Scottish government's ten-year project to improve health and social services for older people had been slow, and monitoring of its implementation and impact needed to improve. It said that the government needed to: work with its partners to plan the movement of resources from institutions such as hospitals into the community; gain greater understanding of the geographical variations in activity and spending on services; and improve and maintain data on costs, activity and outcomes for health and care services.
Source: Reshaping Care for Older People, Audit Scotland
Links: Report | Summary | Audit Scotland press release
Date: 2014-Feb
A report examined the changes needed to realize the full potential of community services, based on contributions from a working group of community providers. The report said that: services should be simplified, to remove unnecessary complexity; there should be larger multidisciplinary teams based around primary care and natural geographies, offering rapid and accessible response and better outreach; new ways were needed to contract and pay for services; and changes were needed to the infrastructure and workforce, with community services more closely connected to other parts of the health and social care system.
Source: Nigel Edwards, Community Services: How they can transform care, King s Fund
Links: Report | Kings Fund press release
Date: 2014-Feb
An article examined the types of choices available to patients in the English National Health Service when being referred for acute hospital care, in the light of the divergence of patient choice policy in the four countries of the United Kingdom. There were challenges in implementing pro-choice policy in healthcare systems where it had not traditionally existed. Differences between England and the other UK countries were limited in the way choice was offered to patients. A cultural shift was needed to ensure that patients were fully informed by family doctors of the choices available to them.
Source: Marie Sanderson, Pauline Allen, Stephen Peckham, David Hughes, Menna Brown, Grace Kelly, Debbie Baldie, Nicholas Mays, Alison Linyard, and Anne Duguid, 'Divergence of NHS choice policy in the UK: what difference has patient choice policy in England made?', Journal of Health Services Research and Policy, Volume 18 Number 4
Links: Abstract
Date: 2014-Feb
A report provided the findings from a policy commission on healthy ageing. It said that the experience of ageing was complex, bore little relationship to age, and was viewed in a variety of ways by people from the wide range of nationalities, ethnicities, languages, faiths, and cultures that resided in the United Kingdom. The report said that health inequalities associated with socio-economic disadvantage were also found in the older population, and that longer term planning was needed to provide services that respected older people's desire for control and independence alongside meeting their need for security, care, and support. The report made recommendations for commissioners and providers of health and social care, as well as for ongoing research.
Source: Birmingham Policy Commission, Healthy Ageing in the 21st Century: The best is yet to come, University of Birmingham
Links: Report | Summary | University of Birmingham press release
Date: 2014-Feb
A report evaluated the Shrewsbury Safer Nights scheme, a multiagency co-ordinated treatment response designed to reduce the impact of the night time economy (NTE) on health services in Shrewsbury (a town in England) over the Christmas and new year period, through providing a temporary St John Ambulance minor injuries treatment unit within the town centre. The report concluded that local partners had successfully worked together to deliver a co-ordinated response, negating the need for attendance at accident and emergency departments, while supporting the police and staff within the NTE. Although the scheme did not have a quantifiable impact on accident and emergency department attendances, it was reported to reduce the pressure on the ambulance service. The report made recommendations for the further development of the scheme.
Source: Katie Hardcastle, Karen Hughes, and Zara Quigg, Perceptions and Impact of the Shrewsbury Safer Nights Minor Injury Unit, Centre for Public Health (Liverpool John Moores University)
Links: Report
Date: 2014-Feb
A report by a committee of MPs said that the National Health Service had made savings, but there was a question mark about the sustainability of savings (particularly related to pay restraint) and it was not clear how the money saved had then been spent. The report noted the challenges surrounding the integration of the health and social care sectors, where one budget was static and the other reduced at a time of rising demand, and recommended that the existing level of real terms funding for social care should be ring-fenced. The committee noted the consequences of integration for commissioning and repeated its earlier recommendations for health and well-being boards to develop an overarching role across health and social care, and for a review to establish the best method of consolidating commissioning through the boards.
Source: Public Expenditure on Health and Social Care, Seventh Report (Session 2013–14), HC 793, House of Commons Health Select Committee, TSO
Links: Report | Foundation Trust Network press release | NHS Confederation press release | King's Fund press release | BBC report
Date: 2014-Feb
A concordat was signed by organizations from the health, social services, emergency services, and local government sectors in England. The concordat was a shared, agreed statement of intent and common purpose regarding policy-making and spending decisions for services to anticipate and meet the needs of people who had mental health crises. It covered: access to services that prevent crisis; urgent and emergency access to crisis care; the quality of treatment and care while in crisis; and recovery and ongoing prevention. It discussed commissioning and set out a timed action plan.
Source: Mental Health Crisis Care Concordat: Improving outcomes for people experiencing mental health crisis, Department of Health
Links: Concordat | Summary | DH press release | ACPO press release | CMH press release | MHF press release | NHS Confederation press release | NHS England press release | RCN press release | Turning Point press release | Guardian report
Date: 2014-Feb
A consultation was launched to examine opportunities for health inequalities to be addressed at the local level through the work of local authorities. The consultation would inform evidence reviews on behalf of Public Health England and would close on 21 February 2014.
Source: Overview of Consultation: Implementing the Marmot Review locally, Institute of Health Equity (University College, London)
Links: Consultation document | Associated paper
Date: 2014-Feb
A report examined the implications of child sexual exploitation on the provision of health services. Noting a range of potential long-term effects for those affected, the report made recommendations for health services to help develop prevention techniques and to improve health and well-being outcomes for children and young people.
Source: Health Working Group Report on Child Sexual Exploitation, Health Working Group, Department of Health
Links: Report
Date: 2014-Jan
A sustainable development strategy was published for the health and social care sectors in England. It outlined a vision of how organizations could continue to improve health and well-being and deliver high quality care within available social and environmental resources. It called for implementation at the local level, recommending that local health and well-being boards should have regard to the strategy in their needs assessments and strategies.
Source: Sustainable, Resilient, Healthy People & Places: A sustainable development strategy for the NHS, public health and social care system, Sustainable Development Unit, NHS England/Public Health England
Links: Strategy | SDU press release
Date: 2014-Jan
An article examined current health service development practices, through an examination of eleven service development projects in a large mental health service. It discussed areas of good practice and suggested areas for improvement, including evaluation prior to implementation, and using partnership working with design experts and researchers to improve management training.
Source: Gyuchan Thomas Jun, Cecily Morrison, and P John Clarkson, 'Articulating current service development practices: a qualitative analysis of eleven mental health projects', BMC Health Services Research, Volume 14
Links: Abstract
Date: 2014-Jan
A paper summarized the evidence on 'what works' in a number of areas such as: primary prevention; self-care; and case management. Aimed at assisting decisions relating to the Better Care fund (a reallocation of £3.8 billion for integrated health and social care provision), the paper said that commissioning decisions needed to interpret and use the evidence alongside a sound understanding of local challenges and underlying issues.
Source: Laura Bennett and Richard Humphries, Making Best Use of the Better Care Fund: Spending to save?, King s Fund
Links: Paper | Kings Fund comment
Date: 2014-Jan
A report examined approaches to staffing levels in the National Health Service in England. Focussing on nursing staff, it examined the existing approaches, the potential benefits from improved workforce data, and the barriers to the adoption of digital technology for rosters, payment, and quality assurance. It said that significant potential safety and financial gains could be made, but implementation would require a cohesive approach, with strong leadership and broad support.
Source: Tony Hockley and Sean Boyle, NHS Safe Staffing: Not just a number, London School of Economics
Links: Report
Date: 2014-Jan
A report presented articles providing expert views on a range of ways in which local authorities in the United Kingdom could improve health and reduce health inequalities. Subjects covered by the contributions included: living wage (Kate Pickett); early childhood education (Edward Melhuish); speed limits (Danny Dorling); health-related 'worklessness' (Clare Bambra); 'age-friendly' communities (Hal Kendig and Chris Phillipson); participatory budgeting (Kwame McKenzie); employment conditions of public sector workers (James Nazroo); adult and further education (Tarani Chandola and Andrew Jenkins); and policy evaluation and cost effectiveness (Alan Maynard).
Source: If You Could Do One Thing... : Nine local actions to reduce health inequalities, British Academy
Links: Report | Summary | British Academy press release
Date: 2014-Jan
The Northern Ireland Executive began consultation on proposals to review the palliative and end-of-life care of children and young people, and how bereaved families were helped to cope with the loss of their child. The consultation would close on 28 March 2014.
Source: A Review of Children's Palliative and End of Life Care in Northern Ireland, Northern Ireland Executive
Links: Consultation document | Summary | NIE press release
Date: 2014-Jan
A report evaluated the early operation of the Rotherham Social Prescribing Model, a health and social care commissioning model piloted in Rotherham, a town in the north of England. The pilot project aimed to prevent worsening health and reduce specialist interventions for people with existing long-term conditions, through linking patients in primary care and their carers with non-medical sources of support within the community. The report outlined progress to date and made immediate and longer term recommendations.
Source: Chris Dayson, Nadia Bashir, and Sarah Pearson, From Dependence to Independence: Emerging lessons from the Rotherham Social Prescribing pilot – summary report, Centre for Regional, Economic and Social Research (Sheffield Hallam University)
Date: 2014-Jan
