1. Rationing: An unhelpful term for the broader issue of prioritisation

    (Guest blogger)
    18 Feb 2015
    Comments

    Clinical commissioning places general practitioners at the heart of local health planning. As clinicians, we want to ensure that we provide every service our patients want, and that every health intervention comes with the necessary aftercare and support. There are, however, two important additional factors.

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  2. Level up: new responsibilities for CCGs

    23 Jan 2015
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    Clinical Commissioning Groups (CCGs) – now approaching their second birthday – are having to grow up fast. They have cut their teeth on community and acute services, and now have the option to take up further responsibilities.

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  3. 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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  4. Could health and wellbeing boards really work as a single commissioner?

    3 Oct 2014
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    When Health and Wellbeing Boards (HWBs) were introduced in local authorities (LAs) in 2012, their original purpose was to improve the health and wellbeing of local communities and reduce inequalities by promoting integration across health, care and other services.

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  5. More NHS charges? Lessons from history

    (Guest blogger)
    8 Aug 2014
    Comments

    The Health Secretary has quite a difficult job. He is charged with encouraging quality improvements in the NHS while it is, as the Nuffield Trust’s report Into the Red? shows, under considerable – perhaps unsustainable – financial pressure.

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  6. The Better Care Fund: no easy way out

    16 Jul 2014
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    Nokia CEO Stephen Elop found a place in the vocabulary of austerity-beset civil servants everywhere when he told his struggling company’s staff they stood on a “burning platform”. The phrase suggests that, like a man jumping from a blazing oil rig, managers and organisations can expand the range of what they see as possible if times get tough enough.

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  7. Only half the picture: understanding the impact of the social care squeeze

    11 Jul 2014
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    Yesterday our Into the Red? report revealed worrying signs about the future funding of the NHS in England. This was echoed in the results of our first survey of leading figures from the field of health and social care, with around half of respondents saying they felt it was unlikely that the NHS would be free at the point of use in ten years’ time.

     

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  8. Financial Crystal Ball Gazing

    10 Jul 2014
    Comments

    Our report, Into the red? The State of the NHS’ financessets out the facts on NHS expenditure between 2010 and 2014. It is clear on figures for 2013/14 from Monitor and The NHS Trust Development Authority, that, subject to audit, NHS providers will post a small overall deficit of £100 million. Equivalent figures from NHS England show that the commissioning side will produce a small surplus.

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  9. Making hospitals fit for the frail older people who actually use them

    (Guest blogger)
    19 Jun 2014
    Comments

    On June 9, I finished my ward round of 24 inpatients – median age 80-plus, legged it to the station and got into London just in time to set up my workshop on models of care for frail older people at the Nuffield Trust Future Hospitals conference.

    At the event, I presented some challenging ‘home truths’ alongside an animation and some practical solutions.

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  10. The £billion question: funding the Welsh NHS for the future

    17 Jun 2014
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    If the next two years look tough for NHS Wales finances, the long-term could be dire – and not just for the health service.

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  11. The future of the hospital: some useful lessons

    13 Jun 2014
    Comments

    NHS England Chief Executive Simon Stevens issued his challenge to rethink the role of the hospital in more imaginative ways after this week’s Nuffield Trust’s conference on the future of the hospital was already in the diary.

    There were some clear lessons from our audience of hospital leaders – many on the theme that simple answers of hot-cold splits (separating emergency from elective care), centralisation, mergers etc are not working. I took away a number of lessons. 

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  12. Local leaders unleashed? What to expect from Simon Stevens’ reign

    4 Jun 2014
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    The response to NHS England Chief Executive Simon Stevens’ first interview says as much about the challenges facing the NHS as the content of the interviews themselves.

    Mr Stevens’ message – to be pragmatic, to decide what’s right locally, to be bold, and to look beyond current bricks-and-mortar configurations – quickly transmuted under the media spotlight into one of harking back to a bygone age of cottage hospitals...

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  13. General practice needs more than money

    3 Jun 2014
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    It seems that hardly a week goes by without another report of workload pressure, lack of funding and general imminent doom in general practice. As a response to this, the Royal College of General Practitioners (RCGP) has its Put Patients First: Back General Practice campaign, and the British Medical Association have Your GP Cares. Both focus on the need for more money to ease the pressures faced by GPs and their teams.

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  14. NHS and social care funding: speaking truth to piety

    30 May 2014
    Comments

    As the noise generated by last week’s local and European elections fades, political energy will now be directed towards defining the policy battlegrounds on which next year’s General Election will be fought, which will have to be much wider than immigration and the European Union.

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  15. The Better Care Fund: do the sums add up?

    8 May 2014
    Comments

    Yesterday's Guardian reports that the Government’s plans for the Better Care Fund have been put on hold as the Cabinet Office demand that the Department of Health do more to explain how the savings needed to pay for it will be secured. Government sources have been quick to dampen speculation that this signals trouble for the plans.

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  16. Primary care: will Stevens drop the 'cookie cutter'?

    30 Apr 2014
    Comments

    Simon Stevens’ first appearance in front of the Health Select Committee has produced some interesting changes in tone.

    He is less inclined to see competition as a barrier to change than his predecessor, hinting at a more pragmatic approach to how it is used.

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  17. Beyond the politics: the truth behind the UK health systems

    11 Apr 2014
    Comments

    Criticism of the Welsh NHS is a popular sport for English ministers. David Cameron takes regular pot shots at longer waiting times and failure to hit A&E targets.

    To the politically cynical, it looks like a straightforward attempt to brand Labour, who governs in Wales, as a party that cannot manage the NHS.

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  18. Houston we need a solution: time to stop describing the problem

    3 Apr 2014
    Comments

    My start at the Nuffield Trust coincides with the anniversary of the new system and Simon Stevens’ first week in charge of NHS England.

    I’ve been spending time on international work for the last two years and have been somewhat concerned by the nature of the debate on health and social care recently.

    The first reason is that there is too little public discussion about the solutions to the financial challenges facing social care and the NHS.

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  19. Influencing GPs and the expanding role of Clinical Commissioning Groups

    1 Apr 2014
    Comments

    Since clinical commissioning groups (CCGs) moved into the driving seat of the commissioning system 12 months ago, the breadth of the job they are expected to do has become apparent.

    Responsibility for each of the big changes we are increasingly told that the NHS needs – better joint working with social care, further efficiency savings in hospitals, and radical change in the scale and scope of general practice – rests largely on the shoulders of CCG leaders as the key drivers of change.

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  20. The other care crisis: disabled people are also feeling the squeeze

    (Guest blogger)
    26 Mar 2014
    Comments

    The new report from QualityWatch (a joint research programme from the Nuffield Trust and Health Foundation) is another reminder that the social care system is on its knees.

    The number of people receiving care – working age disabled people and their carers, as well as older people whose case is so powerfully made in this report – is being rationed, leaving thousands of people previously eligible without any local support.

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