1. Political cross-dressing and the NHS

    27 Apr 2015
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    This election campaign has turned long-standing political perceptions on their head, prompting political commentators to make frequent use of the phrase ‘political cross-dressing’. The Labour party, keen to banish perceptions of profligacy, has emphasised its fiscal rectitude throughout the campaign. The Conservatives, by contrast, have sought to cash in on their handling of the economy by promising seemingly unfunded goodies, made possible by achieving the levels of economic growth that they claim only they can deliver.

    ...

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  2. 10 NHS myths to watch out for

    27 Apr 2015
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    Debate about the NHS has intensified as the election draws closer, and many of the same myths are being recycled by politicians of all persuasions.  Here we examine 10 of the most commonly heard untruths you might hear about our health service in the run up to the election. 

    1. “There’s been massive privatisation under this government” 

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    In the most recent figures, £10.2 billion was being spent on non-NHS providers (which...

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  3. Children’s health: seen but not heard?

    23 Apr 2015
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    We know that measuring quality of care is difficult. It is an even bigger challenge with children, since prevalence of paediatric conditions is low and indicators often need to be age and development stage specific.

    We also cannot monitor quality because data is not available or collected. The National Child and Maternal Health Intelligence Network has done an excellent job in compiling available child health indicators but there are...

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  4. The NHS bidding war

    21 Apr 2015
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    Last week, all the major parties in England laid out their bids to be trusted with the future of the NHS. The bids were partly denominated in hard cash as each pledged higher spending. But observers could be forgiven for still having quite a few questions.

    Why this amount? Is it enough?

    There was a time when politicians did their best to ignore warnings about the financial squeeze facing the health service. When the Nuffield Trust warned of an emerging funding gap back in July 2014, Government minister Dan Poulter confidently said...

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  5. Facts, figures and views on health and social care: A resource for reporters of the 2015 general election

    14 Apr 2015
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    Download full PDF >

    As the General Election approaches, the NHS is in the spotlight. Facts, figures, claims and counter claims are flying back and forth as each party seeks to shore up their position as the party that can be trusted to run the National Health Service.

    At times like this, it can be hard to...

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  6. Health spending across the UK nations: Who decides how much?

    10 Apr 2015
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    The health services of Scotland, Wales and Northern Ireland are governed by those countries’ respective governments, not by Westminster or Whitehall. The tricky task of comparing the systems is an important case study in how this kind of change in responsibility changes how health systems work – or doesn’t.

    Yet the health...

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  7. Fact or fiction? Politicians make a difference to health system performance

    2 Apr 2015
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    As the longest election campaign in living memory moves into its closing stages, the main political parties are working harder than ever to emphasise the differences between themselves and their competitors. This is especially noticeable when it comes to the NHS, which has been one of the key battlegrounds of this election. But does the choice of political party really make that much of a difference to health system performance?

    Fortunately, we have a natural experiment with which to test this hypothesis. The UK has operated four health systems since devolution in the late 1990s and...

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  8. Will co-commissioning deliver on its promises?

    1 Apr 2015
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    Today marks the launch of primary care co-commissioning between NHS England and the majority of CCGs. These plans support the current direction of travel that aims to see more care being provided in the community as well as services and (perhaps) commissioners integrated. However, for the CCG leaders trying to turn these policy intentions into reality, the pressures facing both commissioners and general practice providers suggest that life is going to get harder before it gets easier.

    What does this mean for how likely it is that co-commissioning will deliver on its promises?

    ...

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  9. Getting the most from evaluation

    31 Mar 2015
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    There is an awful lot of interest in evaluation at the moment – no bad thing for us at the Nuffield Trust, given that we have a long track record in certain types of evaluation.

    Most recently, NHS England have said that the new Vanguard sites, new models of care described in the Five Year Forward View, will need to show “a commitment to co-design local and national metrics and to demonstrate progress against them, including...

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  10. Fact or Fiction? Reconfiguring hospital services will deliver significant savings

    25 Mar 2015
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    This blog is part of a series called ‘Fact or fiction?’, where experts from the Nuffield Trust give their take on the data and evidence behind some of the current perceptions of what is happening with the NHS.

    NHS hospitals are under mounting financial pressure. A common belief is that the reconfiguration of hospital services, primarily through rationalising services across sites and shifting services into the...

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  11. Can the NHS help tackle the UK’s obesity epidemic?

    20 Mar 2015
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    “Obesity is the new smoking”, said Simon Stevens, Chief Executive of NHS England. “It is a slow-motion car crash in terms of avoidable illness and rising health care costs.”

    Is he right? And if so, can the NHS help work towards solutions, or only tackle the associated health need?

    How big a problem is the obesity epidemic?

    According to estimates from Public Health England, two thirds of adults...

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  12. A starting gun or shot in the dark?

    (Guest blogger)
    19 Mar 2015
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    In a sequence of events, that could only be dreamt of (up) by election pundits, Simon Stevens announced the day before NHS Change day that his Vanguard programme will support “radical care redesign….for patients across England”. But did he really ‘fire the starting gun' or is this simply another shot in the dark?

    Let us be in no doubt. The health and social care system has never faced such critically challenging times. The usual way of delivering...

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  13. The voluntary sector: ready, willing and able

    (Guest blogger)
    18 Mar 2015
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    Ahead of the launch of our fourth Health Leaders Survey tomorrow, Dr Jane Collins, Chief Executive at Marie Curie and member of the panel blogs on the role of the voluntary sector in the NHS.

    People often talk about the role of the voluntary sector in the NHS as though this is somehow a new or unusual thing, but actually Marie Curie and many other voluntary sector organisations have been around for as long as the NHS – some longer – and have proven expertise in delivering high quality care and support.

    People also often talk about services provided by...

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  14. US healthcare reform: Lessons for the UK

    (Guest blogger)
    16 Mar 2015
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    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.

    What does the Affordable Care Act aim to do, and how?

    The ACA is two laws in one: an act to improve access to...

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  15. Fact or Fiction? Declining hospital performance is down to a few ‘bad apples’

    13 Mar 2015
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    This blog is part of a series called ‘Fact or fiction?’, where experts from the Nuffield Trust give their take on the data and evidence behind some of the current perceptions of what is happening with the NHS.

    We know national performance in many key NHS hospital targets has been declining for a while – indeed it’s nearly impossible to go a day without hearing about the pressures facing A&E and its ‘four-hour target’. Recently, this apparent deterioration has spread beyond...

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  16. NHS research ethics approval: Open to interpretation?

    10 Mar 2015
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    Research is key to providing evidence for best practice in healthcare. The current system of approvals and permissions for conducting research in the NHS presents a number of practical challenges, most noticeably navigating the complexities of the system and overcoming the inconsistencies that can be encountered.

    Few would argue with the need for some sort of ethical review of research in the NHS – protection of patients under NHS care is paramount. There is a clear duty of care that exists, particularly when research involves potentially vulnerable populations like children.

    ...

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  17. The way the NHS manages A&E problems is not fit for purpose

    6 Mar 2015
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    In researching the recent problems in accident and emergency performance, I was struck by the way the NHS is managing the situation: there appears to be a large amount of activity across the system – conference calls, emails, phones calls – to check progress and request detailed information.

    Is this adding value or causing problems? What were those involved hoping to achieve? And why is this type of activity thought to be an important...

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  18. ‘Devo Manc’: Small steps, great leaps

    5 Mar 2015
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    The bold proposals to transfer responsibility for Greater Manchester’s health and social care needs to accountable bodies in the region were the talk of our annual Health Policy Summit.

    This reflected two very contrasting themes that were evident at the Summit. At one end of the spectrum, there was a focus on micro-level improvements that have the potential to add up to major change. At the other end, were discussions of big structural changes needed within the NHS.

    Micro-focus, major impact

    One change approach...

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  19. Fact or fiction? Demand for GP appointments is driving the ‘crisis’ in general practice

    3 Mar 2015
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    This blog is part of a series called ‘Fact or fiction?’, where experts from the Nuffield Trust give their take on the data and evidence behind some of the current perceptions of what is happening with the NHS.

    Headlines and stories about the ‘crisis’ in general practice have become commonplace over the last year or so. A demoralised and squeezed workforce is struggling to meet the needs of increasing numbers of patients demanding immediate appointments. Or so the narrative goes.

    There are mounting concerns that patients unable to get an appointment...

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  20. A patient perspective on self-care

    (Guest blogger)
    25 Feb 2015
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    Having Parkinson's since I was 13 has made me an expert in self-care

    When I was 13 years old, I experienced the first symptoms of what almost 20 years later would be diagnosed as Parkinson’s disease. Getting Parkinson’s in your teens is pretty unusual, if not rare. Nevertheless, I am happy that I wasn’t diagnosed with an “old person’s disease” in my teens. I am convinced that if I had known when I was 16 that the problems I experienced with movement, gait and balance were due to Parkinson’s, I would not have gone to university, got my driver’s licence or dared to start a family...

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