1. Local leaders and MPs must embrace NHS England vision

    23 Oct 2014
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    It’s the report the NHS has been waiting for. 

    Simon Stevens’ vision for the future of how care will be organised and delivered in England is set out in the Five Year Forward View – the first time the arm’s length bodies in the NHS have come together to produce such a report. 

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  2. Social care and cancer: tracking care across service boundaries

    (Guest blogger)
    2 Jun 2014
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    A recently published Nuffield trust report offers a fascinating insight into the routes that cancer patients take through the care system. In an era that promotes integrated care we all accept that caring for a person extends beyond one organisation; and treatment for cancer may include primary, community and social care on top of acute hospital activities.

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  3. The nitty gritty detail of integrating complex systems

    17 Apr 2014
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    Recently, on one of my clinical general practice days, I made 21 phone calls to a London hospital trying to leave a message asking a consultant to call me urgently. A patient I had seen at 9am had decided not to have a disfiguring operation for a cancer that was planned for 10 days later.

    I needed urgent advice about the options for reconstructive surgery so that I could have an informed discussion with her during the following week about the choice she had made.

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  4. Can telephone health coaching prevent hospital admission?

    7 Aug 2013
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    Health services around the world are attempting to improve care for people with long-term conditions, as currently it is often fragmented and expensive. Many interventions have been tried and tested. To the long list of evaluations another can now be added – that of Birmingham OwnHealth (published today in the BMJ).

    Birmingham OwnHealth was England’s largest example of telephone health coaching, established in 2006. Operating as part of...

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  5. NHS @ 65: transparency is the future of the people’s NHS

    (Guest blogger)
    26 Jul 2013
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    You attend a hospital with your disabled daughter. You do this pretty much every day because your daughter has regular seizures and emergencies. Every time, you have to start all over again because the hospital doesn’t know who your daughter is. More paperwork.

    Then you wait and wait because the staff have to find a hoist to lift your child out of her wheelchair onto a bed. Why couldn’t you have called in advance to tell them she was coming? Hours and hours of waiting.

    This is the NHS in the experience of one mother I met recently: everyday indignities and inhumanities and, in...

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  6. NHS @ 65: the NHS cannot do it alone

    (Guest blogger)
    12 Jul 2013
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    We are in danger of losing our collective nerve over the future of the NHS. In 1948, in the midst of austerity and post-war national exhaustion, Britain created a comprehensive health service which offered care to those who needed it regardless of their means.

    It was a courageous idea whose time had come and it made compelling economic, political and social sense. It still does.

    In 2013 our far richer country can and should continue to embrace Aneurin Bevan’s vision. Of course we face very different...

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  7. Community-based interventions: how do we know what works?

    26 Jun 2013
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    Over the past four years the Nuffield Trust have been asked to look at a range of service innovations and assess whether they lead to a change in service use – most typically a reduction in inpatient hospital activity, which is something that seems to have become the holy grail of health service planning.

    Our new report summarises observations from our studies and efforts that might help those planning and evaluating new services in the future. In particular, the report should provide useful learning for the new...

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  8. Long-term care reform in the United States

    (Guest blogger)
    19 Jun 2013
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    Long-term services and support (LTSS) primarily refers to personal care services that include home help, care in nursing homes and assisted living, as well as day care.

    Of the 13 million Americans that need long-term care, only 13 per cent have received help in paying for these services. The situation is set to become even more challenging, as the proportion of Americans over the age of 65 is...

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  9. How primary care providers can rise to the challenges of the public health agenda

    (Guest blogger)
    25 Apr 2013
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    The release today of a crucial report written by the Nuffield Trust, commissioned by the National Association of Primary Care (NAPC) sets out the challenges that face primary care and general practice.

    In particular, the report looks at moving from a purely curative and reactive based approach to patient care, to one that is balanced against making significant inroads into the reduction of the rise in chronic ill health set against the backdrop of an ageing population.

    As the NHS struggles to meet unprecedented financial efficiency...

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  10. Clinical commissioning groups: ready for take off?

    1 Mar 2013
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    As clinical commissioning groups (CCGs) prepare for 1 April, one has to wonder how ready they really are to take full responsibility for local strategic planning and purchasing of health care.

    The coming year will be one of immense challenge in terms of the quality and safety of health care, particularly in light of the Francis Inquiry’s call for a fundamental change in NHS culture.

    And all of this at a time when NHS funding is flat and the NHS Commissioning...

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  11. Should clinical commissioning groups invest in telehealth?

    8 Oct 2012
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    Telehealth is increasingly being advocated as a way to monitor patients remotely and better manage long-term health conditions. The Nuffield Trust was part of the largest randomised controlled trial in this area, “the Whole System Demonstrator” (WSD) – the initial results were published earlier in the summer.

    We held a seminar with practitioners, researchers and funders to discuss the remaining research that needs to be done, post WSD. Priorities were identified as;...

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  12. How useful are randomised controlled trials in evaluating new ways of delivering care?

    24 Aug 2012
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    In the Whole System Demonstrator (WSD) trial, a team of researchers studied the impact of installing telehealth technologies in patients’ homes to monitor their vital signs such as blood sugar levels. 

    Debate continues over whether the findings justify the Government’s policy of encouraging the NHS to invest more in telehealth. At the same time, the trial has raised a potentially even more significant discussion. 

    How useful are randomised controlled trials...

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  13. Does telehealth reduce hospital costs? Six points to ponder

    28 Jun 2012
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    The first results of the largest randomised controlled trial on telehealth were published in the British Medical Journal last week. Of the five arms of the Department of Health-funded 'whole system demonstrator' (WSD) trial, the first (conducted by a team here at the Nuffield Trust) examined the impact on hospital admissions and costs.

    The headline results so far: patients receiving telehealth care had just 0.14 fewer emergency admissions in the one year of follow up; and...

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  14. What is the impact of telehealth on hospital use?

    22 Jun 2012
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    This week, the British Medical Journal published the first results from one of the world’s most complex randomised controlled trials. Researchers at the Nuffield Trust led this analysis, which relied on collecting over a billion records of administrative data from more than 250 health and social care organisations.

    The trial’s aim was to evaluate “telehealth” – a way of using technology to support people with long-term health conditions such as diabetes, heart failure or chronic obstructive pulmonary disease....

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  15. Portuguese lessons: don’t forget the chronic diseases with high planned costs

    1 Dec 2010
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    I was in Lisbon last week to speak at a chronic disease workshop run by the National School of Public Health.  Both the English and the Portuguese health services currently face a significant funding squeeze, and policymakers in the two countries see chronic diseases as an area ripe for potential cost savings.  However, in Portugal the focus is on different chronic diseases from those on which we concentrate in this country. Moreover, the emphasis in Portugal is on reducing the expected costs of these chronic diseases, whereas in the UK we tend to focus on preventing the...

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  16. Health care reform: lessons from international experience

    22 Nov 2010
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    The Nuffield Trust recently joined forces with Salzburg Global Seminar and the British Medical Journal to host a global meeting on health system reform. Housed in the magnificent surroundings of Schloss Leopoldskron, Salzburg Global Seminar has been a refuge for thinking and reflection since the Second World War. On this occasion, emerging leaders from 29 countries spanning every stage of economic development, met to discuss the challenges of achieving universal access to high quality health care that is both affordable...

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  17. Broccoli branding, 23-hour clinics, and the bone phone: new lessons from Kaiser Permanente

    2 Aug 2010
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    On 22 July, The Nuffield Trust held the first in our series of seminars focussing on ‘High Value Health Care’, in partnership with the Royal College of Physicians and the Cambridge Health Network.

    Before the seminar began I heard a few mutterings from audience members about how comparisons between Kaiser Permanente and the NHS are so well known that they’re becoming a bit trite. 
     
    However, by the end of Bernard Tyson and Jed Weissberg’s presentations, nobody could be in doubt that the NHS still has...

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