1. Improving health care quality: An opportunity, a challenge and an enduring question

    30 Jul 2015
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    The enduring question of how to improve care for people with complex health and care needs was the central theme of the 15th International Meeting on the Quality of Health Care jointly held by the Nuffield Trust and Commonwealth Fund. In this blog, Dr Rebecca Rosen reflects on the discussions among participants, focusing on the potential role for technology, the challenge of workforce development and how we achieve that needed...

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  2. Prudent progress in the Welsh NHS

    (Guest blogger)
    29 Jul 2015
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    What’s Wales’ approach to the NHS? What drives painful change west of Offa’s Dyke? That famous Scot, Adam Smith, has no legacy here. Markets have gone from Welsh healthcare, and will probably never return given the predominance of left-of-centre politics. Similarly, we have eschewed a simple command-and-control where ministers and their civil servants make appointments and decisions across Wales directly. Yet there will be a temptation for future Health Ministers to revert to this in their frustration at the slow pace of development. Because the most common criticism of the NHS in Wales,...

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  3. Will Scotland stop the squeeze on pay again?

    (Guest blogger)
    23 Jul 2015
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    Four more years. The Chancellor's budget announcement that NHS staff will face another round of pay constraint will likely take us through to the next Westminster election. The timing gives the UK government further fiscal breathing space to contain cost in the NHS. 

    Timing is all in politics, and what might suit Westminster looks more problematic for the SNP government at Holyrood. With an election due next year,...

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  4. Equipping the NHS with the staff it needs

    23 Jul 2015
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    Currently, 1.4 million people work in the NHS and a further 1.6 million in social care; together this accounts for one in ten of the working population. In this essay, Candace Imison notes that successful workforce planning should ensure that we have the right number of staff with the right skills in the right place at the right time. However, she argues that this is not currently the case in the health and social care sectors.

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  5. The view from local government: Reconsidering accountability in an age of integrated care

    (Guest blogger)
    20 Jul 2015
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    There is cross-party consensus both within the Local Government Association and nationally that integration of health and social care is the right approach, particularly for improving outcomes for citizens, but also for improving value for money in the long term. But how this move towards integration works in practice is up for debate, as mentioned in Ben Jupp's viewpoint paper recently published by the Nuffield Trust.

    Jeremy Hunt is clear that a strong NHS depends on a strong...

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  6. The view from commissioners: Reconsidering accountability in an age of integrated care

    (Guest blogger)
    17 Jul 2015
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    Steve Kell, Co-Chair of NHS Clinical Commissioners, argues that concerns that conflicts of interest between GPs as commissioners and GPs as providers of care would hinder decision making have so far proved unfounded. CCGs and their governing bodies are recognising where conflicts of interest might arise and are managing them, rather than seeing them as a barrier to commissioning high-quality care in a local context.

    Therefore, he argues that we already have the structures in place to deliver improvements to population health and that we should focus first on improving health...

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  7. The view from Healthwatch: Reconsidering accountability in an age of integrated care

    (Guest blogger)
    16 Jul 2015
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    Responding to Ben Jupp's paper 'Reconsidering accountability in an age of integrated care', Jan Sensier argues that the most important factor for real accountability in the face of changing services is the voice of the public and patient.

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  8. The view from Westminster: Reconsidering accountability in an age of integrated care

    (Guest blogger)
    15 Jul 2015
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    All too often, discussions about accountability focus on structures and processes, emphasising the importance of reconciling different interests. All of that is important, but it is in danger of confusing method with purpose, argues Stephen Dorrell in a blog responding to a recent paper by Ben Jupp.

    He adds that accountability structures don’t exist to justify the status quo – they exist to facilitate change. Measured against that test, Ben is right to question whether current commissioning structures are fit for purpose. 

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  9. How can England’s experience of integrated care help Finland?

    9 Jul 2015
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    Rapidly merging municipalities in Finland have led to budget fragmentation of health budgets and accountability, but there is a desire for greater integration. A delegation from Finland recently visited the Nuffield Trust to listen to representatives from pioneer and early adopter sites, academics and NHS England officials describe the challenges that the Finns might face as they begin to integrate health and social care services.

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  10. Will technology save the NHS £10 billion?

    30 Jun 2015
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    Sophie Castle-Clarke muses on digital plans for the NHS and considers whether they can really lead to savings of £10billion by 2020. 

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  11. Evaluation: rigour, relevance and naivety

    (Guest blogger)
    29 Jun 2015
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    Professor Martin Marshall and Laura Eyre from UCL explore the challenging questions often asked of evaluation experts. 

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  12. Facing future challenges: do changes in skill mix offer some solutions?

    25 Jun 2015
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    Candace Imison explores whether changes in skill mix offers some solutions to the challenges faced across the spectrum of the NHS. 

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  13. Time for tough decisions: Northern Ireland’s great health challenge

    (Guest blogger)
    23 Jun 2015
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    Hugh McCaughey, Chief Executive of the South Eastern Health and Social Care Trust in Northern Ireland blogs about the great health challenges facing the country, and examines the options. 

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  14. Setting the scene for a new era in general practice?

    19 Jun 2015
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    Natasha Curry considers the announcement of a 'new deal' for general practice from the Secretary of State for Health. 

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  15. Beyond the carrot and stick: transforming general practice

    17 Jun 2015
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    With announcements on general practice expected soon Dr Rebecca Rosen, Senior Fellow at the Trust, examines why contractual changes and financial incentives alone will not be enough to drive the transformation that general practice so urgently needs.

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  16. £200m cuts to public health: the situation is getting serious

    16 Jun 2015
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    Dr Alisha Davies examines why the recent announcement from the Treasury of £200m in cuts to non-NHS funding has provoked serious cause for concern among public health organisations. 

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  17. Don’t look back in anger – retrospective matching when an RCT won’t do

    15 Jun 2015
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    Evaluation is on everyone’s lips these days as the plethora of new and existing initiatives, such as Integrated Care Pilots, the Better Care Fund and most recently the Vanguard sites are under scrutiny to show that these new models are actually delivering on their promise. Like the attendees coming to our Evaluation of complex care 2015 conference you may well be grappling with the question of whether a Randomised Controlled Trial (RCT) is a possible way to evaluate the complex, community based...

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  18. NHS agency staff costs: treating the symptom not the cause

    9 Jun 2015
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    Candace Imison explores the Secretary of State for Health's recent campaign against agency staff costs and considers whether this approach might well be treating the symptom, but not the cause. 

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  19. The NHS and the General Election: a false sense of security?

    7 May 2015
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    Are we at risk of being lulled into a false sense of security with the NHS party pledges? Ruth Thorlby examines how the NHS has fared during the election campaign. 

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  20. Political cross-dressing and the NHS

    27 Apr 2015
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    Daniel Reynold's recaps the Health and Care Debate and presents his conclusions. 

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