1. NHS reforms: what now for health service managers?

    5 Apr 2012
    Comments

    The introduction of the Health and Social Care Act 2012 was trumpeted in some quarters (including, apparently, the Cabinet room) as a hard-won victory for Andrew Lansley and his plans to ‘liberate the NHS’.

    For the battalion of health service managers, however, the campaign has now begun in earnest. It is they who have to take the legislation, translate its complex clauses into practical plans, and determine how far Lansley's hopes will be realised and the fears of his detractors proven or not.

    NHS...

    Continue reading
  2. NHS reform, wherever next?

    14 Feb 2012
    Comments

    Andrew Lansley's woes are multiplying by the hour this week as efforts mount to block the Health and Social Care Bill.

    Resistance might be expected from the British Medical Association (BMA) and the Royal College of Nursing (RCN) and other unions, but it is now more widespread and even reported from deep in his own party, among cabinet colleagues. The public are bewildered and staff in the service doing a difficult job while debate rages and the...

    Continue reading
  3. The Health and Social Care Bill gets a second opinion

    4 Jul 2011
    Comments

    When the NHS White Paper was published a year ago, it diagnosed three main pathologies for which major reform was the prescribed solution: weak commissioning; insufficient competition and choice; and excessive micro-management from the political centre. 

    The prescription set out an array of medicines to deal with these ailments including: GP commissioning ‘consortia’ in place of primary care trusts; an economic regulator to promote competition among ‘any qualified provider’ of NHS-funded services; and a new more strategic role for the Secretary of State, with more power and...

    Continue reading
  4. Andrew Lansley: competition, NICE and payment reform

    14 Apr 2011
    Comments

    Andrew Lansley, the Secretary of State for Health, arrived at the Nuffield Trust summit intending to announce some new developments in Payment by Results.  But the questions and debate following his speech came to be dominated with other questions, including whether the government really plans to introduce competition on price and abolish mandatory NICE guidance in the future.

    The audience was rewarded with clarity on the first question. There would be no competition on price, he explained. There...

    Continue reading
  5. The data laboratory: predicting future health care needs

    25 Mar 2011
    Comments

    Most interactions you might have with any organisation leave behind a trail of data. In health care, these datasets have many uses and the Nuffield Trust is interested in ways that we can exploit them to inform health policy.

    We are particularly interested in how linkage between data sets can reveal a fuller picture of what is happening to people as they use services.  We refer to this as a “data laboratory”, and use this in evaluation and in developing models that predict the likelihood of future events. 

    Session three of the Nuffield Trust’s 2011 Health Strategy...

    Continue reading
  6. Unleashing dynamism: reflections from the 2011 summit

    4 Mar 2011
    Comments

    The quest for better, more efficient health services requires innovation, new ways of working and new behaviours across every area of care. The message from the summit was that innovation and change will flow from everywhere – patients, individual clinicians, managers and large organisations.  

    We were challenged at the start of the conference by two proponents of the Big Society, Phillip Blond of ResPublica and Geoff Mulgan of the Young Foundation. Phillip Blond argued that innovation would flow if the NHS can avoid capture by the private sector and instead actively foster...

    Continue reading
  7. Summit comes at crucial time in reform agenda

    1 Mar 2011
    Comments

    The third annual Nuffield Trust Health Strategy Summit takes place this week, bringing together senior health leaders, academics and clinicians for two days of reflection and debate on the NHS.

    The imminent reforms to the English NHS and the challenge of delivering £20bn efficiency savings form an imposing backdrop to the discussions, and will no doubt provoke much debate and comment, but the summit’s ambition is to look past the headlines and grapple with some of the bigger issues that lie beyond. 

    The tangle of ideas that make up ’The Big Society’ will be unravelled and...

    Continue reading
  8. Legislative and Operating Frameworks: the unanswered questions

    16 Dec 2010
    Comments

    Tis the festive season but no let up is apparent in the health reform agenda.  Yesterday saw the publication by the Department of Health of the 167 page Liberating the NHS: Legislative framework and next steps and the Operating Framework for the NHS in England 2011/12.

    The first is thoughtful and detailed, taking care to weave in responses from as many as possible and explain the rationale for decisions. The messages are clear – radical change, no going soft on the pace of reform, and decentralise. These are meant to be one-off reforms after which local...

    Continue reading
  9. Handing real budgets to GPs: is this really the right approach?

    21 Sep 2010
    Comments

    Will GP consortia be able to achieve better value care and control costs in the NHS in England? This policy is the centrepiece of health secretary Andrew Lansley’s NHS reforms, and as we go into the autumn it remains the key point of debate (read our briefing on the health White Paper).
     
    Already Stephen Dorrell, former Secretary of State for Health (1995-7) and newly elected chair of the Health Select Committee, is asking the obvious: what is the evidence that GP commissioning will work after 20 years of being largely ineffective? The...

    Continue reading
  10. White Paper proposals for GP commissioning: home thoughts from abroad

    14 Jul 2010
    Comments

    As details emerge about the new Coalition Government’s plans to reform the NHS by handing GPs more commissioning power, one thing is certain: this reform is high risk and will need very careful implementation if it is to deliver where others in the UK and overseas have failed.
     
    At the point where NHS funding is about to be squeezed, and commissioners need to drive rapid improvements in efficiency and quality, there is little evidence that GP commissioning can deliver to the extent implied in the White Paper.
     
    Most notably, while a handful of GPs around the country...

    Continue reading