1. Three key factors for making NHS England’s Forward View a success on the frontline

    31 Oct 2014
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    In my clinic last Friday I was shocked: four out of sixteen appointments were taken by patients who were unable to gain access to the hospital services they had been told they needed. Having each tried to contact the hospital several times, they came to me to ask for help in navigating hospital booking systems, for interim pain relief, and reassurance. GP appointments that should have been available for clinical problems were used for administrative support, alongside clinical advice on the symptoms that arose from delays in care.

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  2. Over-stretched hospitals: let's improve how patients are met on arrival, not block the front door.

    (Guest blogger)
    30 Oct 2014
    Comments

    Jeremy Hunt this morning pledged that £5bn worth of Better Care Fund allocations, founded on targets for reducing urgent hospital admissions, will 'change the basic NHS model'.

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  3. Local leaders and MPs must embrace NHS England vision

    23 Oct 2014
    Comments

    It’s the report the NHS has been waiting for. 

    Simon Stevens’ vision for the future of how care will be organised and delivered in England is set out in the Five Year Forward View – the first time the arm’s length bodies in the NHS have come together to produce such a report. 

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  4. Is a transformation fund really the answer for the NHS?

    20 Oct 2014
    Comments

    A number of organisations have been arguing that there needs to be a transformation fund to support change in the NHS.  

    What they are picking up is something that is very noticeable when comparing the NHS to other sectors and to health systems in many other countries – the absence of a banking function or mechanisms to support organisations while they restructure. This is how the asylums were closed and community mental health services developed. 

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  5. Party conference commitments on NHS spending: the unanswered questions

    15 Oct 2014
    Comments

    I am writing this from my hospital isolation room having just had a stem cell transplant that will I hope cure my dysfunctional bone marrow. The transplant and the care that goes with it is a tremendous fusion of compassion, research, pharmaceutical development, attention to detail, dedicated caring professionalism from the unit director through to the receptionists, significant voluntary sector input largely from the Anthony Nolan Trust but also in funding of hospital facilities, and international cooperation.

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  6. Those worrying about the transatlantic trade deal should look closer to home

    6 Oct 2014
    Comments

    There has been a lot of concern expressed about the planned free trade deal between the European Union and the US, the Transatlantic Trade and Investment Partnership, and the impact it will have on the NHS.

    TTIP seems to combine a number of popular demons in health circles: privatisation, US healthcare, competition and Europe. The fact that the Department for Business, Innovation and Skills is leading UK negotiations on behalf of the NHS might also make those who remember the Working Time Directive nervous.

    So just how big a threat is TTIP to the way the NHS works?

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  7. Could health and wellbeing boards really work as a single commissioner?

    3 Oct 2014
    Comments

    When Health and Wellbeing Boards (HWBs) were introduced in local authorities (LAs) in 2012, their original purpose was to improve the health and wellbeing of local communities and reduce inequalities by promoting integration across health, care and other services.

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

    1 Oct 2014
    Comments

    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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  9. Facing the funding conundrum

    25 Sep 2014
    Comments

    The future funding of health and social care is arguably the big public policy conundrum of our age. Yet, until now, politicians have been reluctant to address the unprecedented financial squeeze facing both the NHS and social care. 

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  10. Counting the cost of end of life care

    25 Sep 2014
    Comments

    Our health services are not just about our health. They are also heavily involved in our deaths.

    This year, for every 1,000 people in England, nine will die. Eight of those nine will have some hospital care during their final year of life. For four or five, a hospital bed will be their last.

    Unsurprisingly, people who are near to the end of their lives are disproportionately high users of hospital services. We estimate, that approximately 15% of all emergency hospital admissions in England belong to the 1% of people in their final year of life.

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  11. 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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  12. The ‘wicked’ problem of access: is the telephone a solution?

    6 Aug 2014
    Comments

    This week a study in the Lancet concluded that phone consultations with patients who request same-day appointments generate additional work for GPs when compared to face–to-face encounters. In some ways, the study provides further evidence for the existence of induced demand – the phenomenon that widening access for health care fuels use – that we highlighted in a recent Nuffield Trust report (June 2014).

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  13. 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.

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  14. Improving cancer diagnosis: is there a better way than naming and shaming?

    30 Jul 2014
    Comments

    In a drive to improve England’s record on cancer survival, Jeremy Hunt recently announced that he will 'name and shame' low-referring GPs. It’s clear that improving early diagnosis of cancer could improve survival. But it’s not clear how shaming GPs into referring more patients will solve the problem of delayed diagnosis.

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  15. 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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  16. The Better Care Fund: no easy way out

    16 Jul 2014
    Comments

    Nokia CEO Stephen Elop found a place in the vocabulary of austerity-beset civil servants everywhere when he told his struggling company’s staff they stood on a “burning platform”. The phrase suggests that, like a man jumping from a blazing oil rig, managers and organisations can expand the range of what they see as possible if times get tough enough.

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  17. Only half the picture: understanding the impact of the social care squeeze

    11 Jul 2014
    Comments

    Yesterday our Into the Red? report revealed worrying signs about the future funding of the NHS in England. This was echoed in the results of our first survey of leading figures from the field of health and social care, with around half of respondents saying they felt it was unlikely that the NHS would be free at the point of use in ten years’ time.

     

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  18. Financial Crystal Ball Gazing

    10 Jul 2014
    Comments

    Our report, Into the red? The State of the NHS’ financessets out the facts on NHS expenditure between 2010 and 2014. It is clear on figures for 2013/14 from Monitor and The NHS Trust Development Authority, that, subject to audit, NHS providers will post a small overall deficit of £100 million. Equivalent figures from NHS England show that the commissioning side will produce a small surplus.

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  19. 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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  20. The benefits to patients? Shining a light on the NHS merger regime

    (Guest blogger)
    24 Jun 2014
    Comments

    Last week was a landmark: a new competition authority (the Competition and Markets Authority (CMA) – itself the consequence of a merger) approved the first full merger of two NHS acute trusts. Their decision will allow the merger between Frimley Park Hospital NHS Foundation Trust and Heatherwood and Wexham Park Hospitals NHS Foundation Trust to proceed.

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