Today, Jeremy Hunt announced a ‘new deal’ for general practice, promising to boost numbers in the workforce and to invest in new services and surgeries. But only if GPs keep their side of the bargain – to provide seven day services and to increase preventive and proactive care. Alongside this will be financial incentives to attract GPs to areas of greatest need.

The extra investment and commitment to more staff will be welcome, but will this ‘new deal’ really...

Speaking on the Andrew Marr show about Cameron’s Europe negotiations last week, Michael Heseltine described the complexity and difficulty inherent in structural change and merging small organisations into larger ones. Drawing parallels with the merging of ten discrete Kingdoms into a united England in the middle ages and merging 1,400 local authorities into 400 in the 1970s, he emphasised the difficulty of overcoming deeply held beliefs about how things should be organised. Although at a much reduced scale, it brought to mind contemporary challenges of coaxing standalone GP practices into...

As voters head to the polls, many people will be hoping that their vote, regardless of who they vote for, will do something to help secure the future of their local NHS services. This time, more than any previous campaign, it seems to have been the ‘it’s the NHS, stupid’ election.

The NHS has topped the list of voters’ concerns in Mori’s polls fairly consistently since January,...

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.

...

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...

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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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...

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...

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...

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...

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...

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...

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...

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.

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...

This blog is the third in a new 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.

Views on targets are highly polarised. Special interest groups are keen to get a target for their priority area while detractors question their clinical validity and assert that care has become 'all about meeting targets'; a sense of achievement abstracted from meaning. Yet in the past targets have been associated with dramatic improvements in...

This blog is the second in a new 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.

Despite being a devolved issue whose political fate will not be next determined until Welsh Assembly elections in 2016, the NHS in Wales has become a key battleground in the UK general election.

Claims about the Welsh NHS fly back and forth between politicians in Westminster and Cardiff Bay: Labour politicians can barely appear on...

This blog is the first in a new 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.

Rising demand for urgent and emergency care is not a new challenge. But in recent months, there’s been a scramble to find explanations for the overheating hospital sector.

These include (in descending...

Clinical Commissioning Groups (CCGs) – now approaching their second birthday – are having to grow up fast. They have cut their teeth on community and acute services, and now have the option to take up further responsibilities.

Up to half of the country's CCGs have applied for full delegated responsibility for commissioning primary care (Level 3). An estimated 10 per cent are likely to opt for '...

Risk or reward? The changing role of CCGs in general practice

sarah.wilson 13 January 2015
Research report
Nuffield Trust
26 Jan 2015
Ruth Robertson
Shilpa Ross
Laura Bennett
Jeni Gosling

As clinical commissioning groups (CCGs) settle into their central role in the reformed NHS, the full scale of the challenges they face is becoming clear. This report, part of a joint project by the Nuffield Trust and The King’s Fund, aims to understand the development of CCGs, and to support them by spreading good practice and learning.

It tracks the development of six CCGs, selected to broadly represent CCGs across England. The report, which is based on a survey, interviews, observations and reviews of board papers, considers two research questions: how CCGs are functioning as membership organisations and how they are supporting the development of primary care in their local area.

“Our research shows that the future of the clinical role in commissioning healthcare remains fragile. While CCG leaders overall are still highly engaged in their work, our fieldwork and survey revealed this is waning and there are some worrying signs emerging over strained resources – both time and money. CCGs are set to be stretched yet further as they adapt to new and expanded roles.”

Holly Holder, Fellow in Health Policy, Nuffield Trust and report co-author

The report authors found that:

  • CCG leaders questioned whether they had sufficient capacity to expand into primary care commissioning.
  • While the majority of CCG leaders felt that conflicts of interest were being managed adequately, researchers highlighted examples of decisions where there was the potential for conflict.
  • Few GPs felt that managing GP performance – something that contract management responsibilities under co-commissioning may lead to – was an appropriate role for CCGs.

The study outlines a number of key recommendations to CCG leaders and NHS England to assist CCGs in making the transition to co-commissioning and ensure the sustainability of CCGs. 

 

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