1. A good idea? Wait and see

    4 Aug 2014
    Comments

    I'd heard over the weekend that Jeremy Hunt would make an announcement on NHS waiting times today. My sort of thing (see Buzzfeed for details). I was intrigued.

    Continue reading
  2. We won! The World Cup of health care systems

    27 Jun 2014
    Comments

    According to the Commonwealth Fund’s latest report Mirror, Mirror on the Wall: How the Performance of the US Health Care System Compares Internationally which compares 11 industrialised countries, the UK has won the ‘World Cup’ of health care systems.

    Continue reading
  3. A new start for the Care Quality Commission?

    12 Aug 2013
    Comments

    Today we publish our response to the Care Quality Commission’s (CQC) consultation on changes to the way it inspects, regulates and monitors care services: A New Start.

    Our response builds on the findings from our review of provider ratings, commissioned by the Secretary of State for Health, as well as drawing on the expertise of various members of our team with a past in regulation.

    ...

    Continue reading
  4. NHS @ 65: the NHS cannot do it alone

    (Guest blogger)
    12 Jul 2013
    Comments

    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...

    Continue reading
  5. NHS @ 65: tender, fragile, fragmented, strained, vulnerable

    (Guest blogger)
    4 Jul 2013
    Comments

    Tender, fragile, fragmented, strained, vulnerable. In disarray. At a cross-roads. These are just some of the words used by key contributors to the Nuffield Trust’s latest publication: The wisdom of the crowd: 65 views of the NHS at 65.

    The service has never been particularly good at celebrating its big anniversaries. The tenth, in 1958, was pretty much all sweetness and light. But most of the others – from the 20th through to the 50th – were overshadowed by one crisis or another, by a sense of foreboding, or by both.

    By contrast, the 60th, back...

    Continue reading
  6. NHS @ 65: views of patients must be heard

    3 Jul 2013
    Comments

    It appears that the founding principles and aspirations of the NHS remain largely intact, but they are under great and increasing strain. This relates in part – but only in part – to increasing demands and costs brought about by demographic change, high expectations and new therapeutic opportunities offered by technological advance.

    But these factors are not the sole cause, nor in the views of patients, public and staff are they the most important.

    As the Francis Inquiry – the latest of several into shameful events – has so painfully shown, unless...

    Continue reading
  7. Reconfiguration versus re-election: public expectations and health reform

    (Guest blogger)
    24 Jun 2013
    Comments

    Clinicians and health service administrators can often identify ways of reconfiguring services, particularly hospital services. These reconfigurations usually appear to deliver improved outcomes but prove hard to sell to a sceptical public. On these occasions, local politicians are urged to be brave and support such moves.

    All too often though, the politician is found fanning the flames of popular discontent and those inside the NHS look upon them with varying degrees of sympathy, bewilderment, despair or contempt. The situation is actually made worse if health insiders believe that...

    Continue reading
  8. Should there be 'Ofsted-style' ratings for health and social care providers?

    22 Mar 2013
    Comments

    This was the question set by the Secretary of State.

    We’ve been there before, and the added value of previous ratings relative to the costs is not clear either way. Nor indeed is the potential for ratings to have an impact in the future if there were improvements in its design and use.

    So what might ratings add today? There are two obvious gaps.

    First, there is currently no independent comprehensive assessment of quality across all providers and across the full spectrum of performance. Second, there is nothing...

    Continue reading
  9. What role can patients play in improving quality?

    (Guest blogger)
    7 Mar 2013
    Comments

    Back in 2002, I learned a valuable lesson: The patient’s view is paramount.

    Building user involvement in Motor Neurone Disease was a service improvement project at King’s College Hospital that included an in-person support group, newsletter, dedicated telephone group, and an online asynchronous message board or ‘forum’.

    As the lead researcher wound down the project, the team found there were two young patients, diagnosed in their early 20s, still using the forum to communicate.

    That’s when I...

    Continue reading
  10. Snapshot survey on the NHS: is confidence faltering?

    6 Mar 2013
    Comments

    For the third year running, we have carried out a small, snapshot survey of the NHS amongst the policy makers, senior managers, academics and clinicians who are attending our forthcoming Health Policy Summit, which takes place on 7 and 8 March.

    This survey does not pretend to be representative in any way, but nevertheless provides a flavour of opinion amongst the 53 people who responded, in the wake of a year which has brought prolonged gloom about the prospects of improvement in the state of public finances and the passing and...

    Continue reading
  11. Mid Staffordshire Public Inquiry: will the public and patient voice be heard?

    6 Feb 2013
    Comments

    Amidst all the shocking evidence about failures of staff, regulators and managers, there's a subplot to the Mid Staffordshire Inquiry that's received less attention. This is the failure of the vehicles supposed to convey patients' voices beyond the hospital, to the local public, patient and representative bodies.

    Evidence to the Inquiry exposed how the arrangements for responding to complaints within the hospitals failed to deliver: many patients complained to PALS (the Patient Advice and...

    Continue reading
  12. Mergers, 24/7 working and ratings – mind the gaps

    30 Jan 2013
    Comments

    The queasily thin amount of experienced medical cover in some hospitals at nights and weekends was the subject of BBC Radio 4's File on 4 last week. Juniors missing key symptoms and signs, not wanting to bother a consultant out of hours, with occasional tragic results or at best near misses.

    Suggestions for remedy included making consultants work 24/7 rotas. I sympathised with the experienced paediatrician who predicted that would be the last straw for many who have given their all for the NHS over many years.

    The...

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

    28 Jun 2012
    Comments

    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...

    Continue reading
  14. Beyond the headlines: what is happening with NHS satisfaction rates?

    (Guest blogger)
    21 Jun 2012
    Comments

    Last week saw the release of three surveys looking at patient satisfaction with the NHS, prompting a flurry of comment and opinion.

    The British Social Attitudes (BSA) survey, sponsored by The King’s Fund, saw a drop in overall satisfaction with the NHS from 70 per cent to 58 per cent. The Public Perceptions of the NHS research...

    Continue reading