1. The NHS: no more levers left to pull?

    21 Oct 2015
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    This Friday marks the first year anniversary of NHS England’s Five Year Forward View. But one year on and the outlook looks increasingly bleak: the policy ’levers’ beloved of generations of civil servants and politicians look increasingly ineffectual. The process of remodelling the NHS into a better integrated set of services will need local leaders to work out bespoke solutions and experiment with them.

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  2. Doing justice to patient involvement in research

    19 Oct 2015
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    Dr Miranda Davies examines the benefits of involving patients and other stakeholders in the design and delivery of research. 

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  3. Will over-promising mean the NHS under-delivers?

    16 Oct 2015
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    Rebecca Rosen blogs on the worrying disconnect between the reality of austerity funding for the NHS and the boom expectations of the public. 

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  4. Blanket financial incentives to reduce referrals could harm patients

    13 Oct 2015
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    Candace Imison blogs about the recent investigation from Pulse which found that GPs were being offered financial incentives by CCGs in order to reduce referral rates. 

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  5. What will be the real cost of poor NHS staff wellbeing?

    5 Oct 2015
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    If the NHS wants to become a ‘well-being service’, and not a ‘sickness service’, what better place to start than its own staff?

     
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  6. Learning from an intrepid pioneer: integrated care in North West London

    1 Oct 2015
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    Gerald Wistow and Judith Smith report on their evaluation of the North West London Whole Systems Integrated Care (WSIC) programme. 

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  7. What do leaders want from NHS Improvement? The view from Westminster

    (Guest blogger)
    30 Sep 2015
    Comments

    Jeremy Hunt’s announcement that he would appoint a single management team to take responsibility for Monitor and the Trust Development Authority set the ball rolling. But it left all the difficult questions unanswered.

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  8. Between a rock and a hard place?

    25 Sep 2015
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    If the results of our latest Health Leaders’ Panel survey are anything to go by, senior managers are facing uncomfortable times at the moment.

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  9. Consequences for carers: reduced social care funding

    23 Sep 2015
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    The decline in government funding for people with social care needs continues. Recent warnings have worried about a failure in the social care provider market. But, in this blog, Holly Holder asks how are these same pressures are impacting on less visible and less vocal groups: those in need of support and their carers.

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  10. New models of care: opportunities to get it right for children

    (Guest blogger)
    21 Sep 2015
    Comments

    Time and again children are missed off the national health policy agenda. So, in this blog recapping a recent event held by the Nuffield Trust, Bob Klaber asks: how do we transform the paediatric workforce around the needs of children?

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  11. Is clearance for hospital mergers about to get easier?

    (Guest blogger)
    10 Sep 2015
    Comments

    With the Competition and Markets Authority provisionally clearing the way for the merger of the Ashford & St Peter’s Hospitals NHS FT and the Royal Surrey County Hospital NHS FT, navigating the merger process might become a lot quicker. Andrew Taylor, co-founder of Aldwych Partners and an advisor on this merger, explains why.

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  12. The Devolution Bill and the NHS: what will it mean?

    2 Sep 2015
    Comments

    The Cities and Local Government Devolution Bill is moving quickly through parliament, but its implications for the NHS remain unclear. In a guest blog for the Nuffield Trust, our Senior Associate Sharon Lamb, Partner at Capsticks Solicitors LLP, examines some of the important issues and unanswered questions that need to be considered.

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  13. How are GPs adopting digital innovation?

    24 Aug 2015
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    Kushal Barai examines three ways that GPs are working with digital innovation to create better care for their patients.

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  14. #WhyGP: Should it be #WhyPrimaryCare?

    4 Aug 2015
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    In this blog, Candace Imison highlights the #WhyGP campaign on Twitter, which seeks to create "an island of positivity in a sea of negativity" with regard to the current state of General Practice, in the hope that it encourages future GPs to take up the role. However, she argues that it is a pity that the hashtag is not #WhyPrimaryCare. The shortages of GPs are matched by equally serious but less well publicised shortages in primary care nursing. Like their medical counterparts, nurses in primary care can have...

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  15. 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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  16. Prudent progress in the Welsh NHS

    (Guest blogger)
    29 Jul 2015
    Comments

    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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  17. Will Scotland stop the squeeze on pay again?

    (Guest blogger)
    23 Jul 2015
    Comments

    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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  18. Equipping the NHS with the staff it needs

    23 Jul 2015
    Comments

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

    (Guest blogger)
    20 Jul 2015
    Comments

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

    (Guest blogger)
    17 Jul 2015
    Comments

    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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