1. Will Scotland stop the squeeze on pay again?

    (Guest blogger)
    23 Jul 2015
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    Professor James Buchan, Adjunct Professor, at the WHO Collaborating Centre, ponders whether Scotland can continue to defy Westminster by protecting staff pay increments in the Scottish NHS. 

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  2. US healthcare reform: Lessons for the UK

    (Guest blogger)
    16 Mar 2015
    Comments

    As we near the fifth anniversary of the signing of the Affordable Care Act (ACA), it is an important moment to reflect on what the ACA has accomplished, which challenges remain and how we might move forward. The lessons of the ACA, especially from the Accountable Care Organizations programs, have important implications for the UK NHS and their efforts to improve integration, delivery, and quality of care provided.

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  3. What can we learn from clinical leadership in the US?

    (Guest blogger)
    3 Feb 2015
    Comments

    In 2015 Kaiser Permanente wants to be the “best place to start and grow your family.” Leading this vision is a doctor. With over nine million members, spread across eight regions and six states, Kaiser is one of the US’s largest health management organisations, but inevitable tensions exist across its three separate entities. This requires leadership; a great deal of which comes from the medical profession.

    Why does doctor leadership work in the US?

    Doctors in the US do enjoy a respect –...

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  4. America’s primary care revolutionaries

    (Guest blogger)
    16 Dec 2014
    Comments

    A new breed of healthcare provider is subverting the model of American healthcare for its most needy patients, whilst improving care and reducing costs.

    Need a lift to the doctor? If you’re a patient of CareMore in the American southwest, they may well chauffeur you there. Worried about falling over in your sitting room? They’ll fit you a new carpet. Not sure when to pop your next pill? Don’t worry – your medicine box will sing you a tune when the time comes.

    Casual observers might...

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  5. If only we could focus on the end rather than the means

    1 Oct 2014
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    My heart sank when we got a glimpse of Labour’s thinking about post-election health policy, with hints that hospitals would be expected to evolve into integrated care organisations providing...

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  6. 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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  7. A risk worth taking?

    24 Jul 2014
    Comments

    The concept of predictive risk, or using linked person-level data to identify the patients most likely to have future unplanned hospital admissions, is now firmly embedded in the NHS. Here at the Nuffield Trust we recently held our fifth annual conference on the topic.

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  8. 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.

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  9. 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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  10. 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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  11. General practice needs more than money

    3 Jun 2014
    Comments

    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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  12. 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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  13. Summit’s up: issues for the 2015 election

    26 Feb 2014
    Comments

    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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  14. Under pressure: hospital organisation in Europe

    (Guest blogger)
    29 Jan 2014
    Comments

    Hospitals across Europe are under pressure. They all tend to have business models which rely on growing income and payers that are increasingly trying to contain them.

    Big questions are being asked about future strategy but there is surprisingly little public debate about this important part of the health system and there is insufficient policy analysis.

    Our recent European Summit brought together leaders and analysts from across 16 countries to compare notes. This revealed some interesting differences...

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  15. Common challenges, common solutions: lessons from primary care in Europe

    12 Dec 2013
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    The Nuffield Trust’s 2013 European Summit on primary health care brought together primary care leaders from 16 countries to discuss the common challenges facing primary care organisations across Europe.

    The key findings, published today, should make GPs in England feel encouraged. They are not alone in the pressure they experience and the need to develop new ways of working, and Europe is full of ideas and examples about how to develop and change to meet the challenges of an uncertain future.

    A cluster...

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  16. Reforming social care – the Japanese experience

    (Guest blogger)
    27 Nov 2013
    Comments

    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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  17. Houston, we have a problem

    12 Nov 2013
    Comments

    Next year (2014/15) is an important year – if all had gone to plan the structural current deficit would be eliminated and it would be the last year of austerity. It was also supposed to be the year in which almost all NHS trusts became foundation trusts (FT).

    As it is, the Government is not expecting to close the current account deficit until 2017 and 100 NHS trusts are still not foundation trusts.

    The combination of deteriorating finances and the new Care Quality Commission (CQC) inspection regime mean that very few will make it to FT status this side of the election.

    ...

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  18. New century, new hospital

    30 Sep 2013
    Comments

    Since the money stopped flowing freely into the NHS, there has been a relentless focus on the hospital. Recent concerns about quality are matched by continuing concern about money.

    They come together in the increasing professional and managerial clamour for reconfiguration as the solution to quality and financial issues, targeting smaller hospitals in the way stranded explorers might look hungrily at their weakest comrade.

    The recent Royal College of...

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  19. Personal health budgets: potential and challenges

    (Guest blogger)
    28 Aug 2013
    Comments

    Starting in April 2014 the 56,000 people eligible for NHS continuing health care will be offered a personal health budget. Positive results from an independent evaluation of a three-year pilot programme provided sufficient evidence to take the approach forward.

    However, while the pilot programme has generated a lot of knowledge about how best to implement personal health budgets, important questions about how they can be sustained in the wider NHS are raised by next year’s roll out. These will need careful consideration as the roll...

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  20. Back to first principles: primary care for the future

    18 Jul 2013
    Comments

    Looking back over recent blogs about primary care written by Jonathan Tomlinson, Clare Gerada, John Macaskill-Smith and Helen Parker, three things stand out.

    First, there is consensus that general practice is under significant pressure, struggling to meet demand from patients, blamed for contributing to the alleged crisis in accident and emergency care, and exhorted to reassume responsibility for out-of-hours patient care.

    Second, the ‘special sauce’ of general practice – the relationship between a patient and their family...

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