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

    10 Apr 2015
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    What is the truth about where decisions in funding are taken, and what difference could the election make? Mark Dayan looks at the facts. 

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  2. 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?

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  3. 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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  4. Getting the most from evaluation

    31 Mar 2015
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    How can we get the most out of evaluation in health? Dr Alisha Davies explores. 

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

    25 Mar 2015
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    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 community will help resolve these pressures.

    But how realistic is this belief? What does the evidence tell us?

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  6. 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?

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  7. 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?

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  8. The voluntary sector: ready, willing and able

    (Guest blogger)
    18 Mar 2015
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    People also often talk about services provided by the voluntary sector as a ‘nice-to-have’ but less important than the core business of the NHS, which is usually thought to involve hospitals and the GP surgery. This ignores the fact that the NHS is actually already wholly dependent on the support of the voluntary sector in many areas.

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  9. 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.

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

    13 Mar 2015
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    It’s inherent in our system that hospitals are individually punished for poor performance in some way. Indeed, since the early 2000s, performance management and a financial drive has continued to push for achievements on access targets. But can the recent decline in national average performance be explained by a minority of failing hospitals?

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  11. 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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  12. 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? And why is this type of activity thought to be an important part of the response? 

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  13. ‘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.

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

    3 Mar 2015
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    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.

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  15. A patient perspective on self-care

    (Guest blogger)
    25 Feb 2015
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    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 with the man I met at university.

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  16. The NHS is in an era of opportunity; let’s not lose sight

    24 Feb 2015
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    Would you go out on a hazardous journey, with barely enough food to survive on, and with no map or compass? It could be argued that this is precisely what has been asked of the NHS since funding stopped keeping pace with our country’s rising health and social care needs and the Health and Social Care Act undermined the strategic leadership of the NHS. 

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  17. Fact or Fiction? The NHS has too many managers

    19 Feb 2015
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    It’s election season, and NHS managers and 'bureaucracy' are once again in the firing line. The Coalition boast of putting “more money on to the front line and less into management”; Labour and its supportive press accuse them of the opposite. So who's right? 

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  18. MPs will always be part of the rationing equation

    (Guest blogger)
    18 Feb 2015
    Comments

    Most people can accept that, in any cash-limited system, there will be some things that cannot be funded. However, translating this relatively simple, if abstract, concept into a practical and defensible process is challenging.

    Rationing is probably not a very helpful term to describe the difficult decisions health services face about potentially denying people care that their doctors think they need. In the UK when we think of rationing we tend to think of the World Wars.

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  19. Rationing: An unhelpful term for the broader issue of prioritisation

    (Guest blogger)
    18 Feb 2015
    Comments

    Clinical commissioning places general practitioners at the heart of local health planning. As clinicians, we want to ensure that we provide every service our patients want, and that every health intervention comes with the necessary aftercare and support. There are, however, two important additional factors.

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  20. Fact or Fiction? Targets improve quality in the NHS

    13 Feb 2015
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    Views on targets are highly polarised, and recently there has been much anguish and headlines that the NHS is "dying" and "third world". But are targets good or bad for the NHS? Ian Blunt looks at the facts. 

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