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. Is a transformation fund really the answer for the NHS?

    20 Oct 2014
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    A number of organisations have been arguing that there needs to be a transformation fund to support change in the NHS.  

    What they are picking up is something that is very noticeable when comparing the NHS to other sectors and to health systems in many other countries – the absence of a banking function or mechanisms to support organisations while they restructure. This is how the asylums were closed and community mental health services developed. 

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  3. Party conference commitments on NHS spending: the unanswered questions

    15 Oct 2014
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    I am writing this from my hospital isolation room having just had a stem cell transplant that will I hope cure my dysfunctional bone marrow. The transplant and the care that goes with it is a tremendous fusion of compassion, research, pharmaceutical development, attention to detail, dedicated caring professionalism from the unit director through to the receptionists, significant voluntary sector input largely from the Anthony Nolan Trust but also in funding of hospital facilities, and international cooperation.

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  4. Facing the funding conundrum

    25 Sep 2014
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    The future funding of health and social care is arguably the big public policy conundrum of our age. Yet, until now, politicians have been reluctant to address the unprecedented financial squeeze facing both the NHS and social care. 

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  5. Counting the cost of end of life care

    25 Sep 2014
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    Our health services are not just about our health. They are also heavily involved in our deaths.

    This year, for every 1,000 people in England, nine will die. Eight of those nine will have some hospital care during their final year of life. For four or five, a hospital bed will be their last.

    Unsurprisingly, people who are near to the end of their lives are disproportionately high users of hospital services. We estimate, that approximately 15% of all emergency hospital admissions in England belong to the 1% of people in their final year of life.

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  6. More NHS charges? Lessons from history

    (Guest blogger)
    8 Aug 2014
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    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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  7. 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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  8. 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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  9. Financial Crystal Ball Gazing

    10 Jul 2014
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    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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  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 Better Care Fund: do the sums add up?

    8 May 2014
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    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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  12. Houston we need a solution: time to stop describing the problem

    3 Apr 2014
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    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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  13. The other care crisis: disabled people are also feeling the squeeze

    (Guest blogger)
    26 Mar 2014
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    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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  14. Are the wheels finally coming off the NHS' finances?

    20 Mar 2014
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    While this week’s Budget contained no new announcements on health spending, it shone a harsh light on just how tough the financial challenge is proving for the English NHS.

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  15. The big freeze: is the NHS pay deal fair?

    19 Mar 2014
    Comments

    Today’s Budget contained no new announcements when it comes to health and social care. While the continuation of austerity beyond the next election will almost certainly mean more tough decisions on public spending in the next spending review, today was all about warming up to electorate for the election with eye-catching policies on tax and pensions.

    The big news as far as the NHS is concerned had already been announced: last week the Government set out its decision on NHS pay over the next two years.

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  16. Summit’s up: issues for the 2015 election

    26 Feb 2014
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    Just over a year to go to the next election and we are all in for a prolonged bout of campaigning. Come next March we will probably all be bored, waiting for it to be over having made up our minds. So now is the best time to get a sense of what will be coming – and our annual Health Policy Summit next week will offer some clues.

    Call me a wonk if you like, but I’m looking forward to Philip Collins reviewing the political scene and Jeremy Hunt and Andy Burnham strutting their stuff, along with further debate from Rt Hon Stephen Dorrell...

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  17. Can payment reform promote better care?

    (Guest blogger)
    20 Feb 2014
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    The NHS payment system defines the mechanisms through which NHS-funded care is paid for, and the prices paid. These mechanisms and prices are levers available to commissioners to incentivise providers to achieve health care objectives, such as better health outcomes, activity targets, greater efficiency, and reduced waiting times.

    For example, the “Payment by Results” system, through which hospitals are paid according to how much treatment they provide, was introduced to incentivise more hospital activity, at a time of long and growing...

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  18. Hard truths or home truths?

    28 Nov 2013
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    It has been a very busy November for the NHS. Hospitals, general practice, community and other services have been battling to deal with the apparently incessant demand for emergency advice and care – a warning sign of how difficult it will be for the service to make it through the winter unscathed.

    How far this pressure is due to constrained funding, the effects of the recession on people’s health and access to social care, growing numbers of frail elderly...

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  19. Reforming social care – the Japanese experience

    (Guest blogger)
    27 Nov 2013
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    How is the oldest population in the world – Japan – coping with the long-term health and social care needs of its population?

    That is the question that a new report published by the Nuffield Trust attempts to answer:Caring for an ageing population: points to consider from reform in Japan.

    I was one of a group who visited Japan as part of this project. In the report we describe how Japan introduced compulsory social care insurance to pay for care in older age.

    Briefly, everyone over the age...

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  20. What does the new drugs deal mean for the NHS?

    18 Nov 2013
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    The new Pharmaceutical Price Regulation Scheme (PPRS) agreement looks like a good deal for the NHS.

    Getting the budget fixed for the next five years for a sizeable chunk of spend is good news. It also matches the expected trend of spending and immediate pressures on the NHS with zero increases in the branded drugs budget in 2014 and 2015 and thereafter only a two per cent increase (i.e. more or less in line with expected inflation) in each of the remaining...

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