Of the 13 million Americans that need long-term care, only 13 per cent have received help in paying for these services. The situation is set to become even more challenging, as the proportion of Americans over the age of 65 is...
I once worked with a consultant who had an uncanny ability to extract the truth from his junior staff. When he suspected dubious information (such as “I’m sure the patient had a high erythrocyte sedimentation rate (ESR)”) he’d say, “Is that a guess, rumour, fact or lie?”
Of course, he did it in such an intimidating manner that the answer was clear by the blood draining from the face of the poor, unfortunate wretch who didn’t have all the information to hand.
The current debate about the absolute need to reorganise and improve the NHS often reminds me of that consultant’s total...
General practice seems to be considered by politicians and the media as both the cause of and solution to the current crisis in demand for urgent and emergency care.
At the same time, the primary care community is recognising that the current business model of general practice is under threat due to increased demand by patients, growing regulatory workload and, for some this year, significantly less income.
From discussions with GPs and policy makers, there appears to be some consensus that the current ‘small scale’...
The impact of immigration on the NHS has long been a contentious topic and the Queen's Speech last week, which outlined plans to restrict migrants' access to NHS care, has thrust it into the headlines once again. Yet hard data on the issue have sometimes been thin on the ground.
Odd isn't it that after ten years of policies to encourage competition and choice and ten years of an increasing share of NHS cash spent on non-NHS providers, the evidence base supporting the benefits of competition in health care is too thin to make a sound judgement.
In particular, the report looks at moving from a purely curative and reactive based approach to patient care, to one that is balanced against making significant inroads into the reduction of the rise in chronic ill health set against the backdrop of an ageing population.
This is a critical time for the NHS, with many key themes to discuss. But my start to the year is dominated by emergency care – a very practical challenge but one that raises important questions about culture too.
Our new series of interactive charts: The NHS in numbers pulls together some key data on health care spending, activity, resources and performance. These charts broadly cover the boom years for health care in the UK, from the late 1990s to the early 2010s, reflecting the latest data publicly available from official sources.
When I arrived in Boston as one of the 2012-13 Harkness Fellows I had no idea what learning I would want to bring back from the US health system to the UK. The Fellowship provides a wonderful opportunity to stand outside the UK as well as the US system and look at the strengths and weaknesses of both.
The greatest strength that I have so far seen in the US system is a genuine commitment to innovation.
Never in the field of NHS re-organisations can so many have left so few. Well, not literally. But April 1 sees some 160 NHS organisations, including all primary care trusts and strategic health authorities, abolished as hundreds more – 211 clinical commissioning groups plus a clutch of new national bodies and their regional arms – come formally into existence.
The result is what must be an unprecedented turnover of NHS chief executives. Some retiring, some moving on to other jobs, some taking redundancy, some leaving the direct employment of the service, some willingly, some not....
The Budget 2013 confirms that funding for health in England will be frozen in real terms for a further year – up to 2015-16 – and the requirement to under-spend allocations is here to stay. The Government has also extended the one per cent cap on pay awards for a further year and is talking about limiting pay progression.
This is hard for NHS workers but will be a big help to NHS organisations trying to match the money with the pressures on services.
After 2015-16 the Office for Budget Responsibility’s...
We’ve been there before, and the added value of previous ratings relative to the costs is not clear either way. Nor indeed is the potential for ratings to have an impact in the future if there were improvements in its design and use.
So what might ratings add today? There are two obvious gaps.
First, there is currently no independent comprehensive assessment of quality across all providers and across the full spectrum of performance. Second, there is nothing...
It’s clear we are going to have to improve the amount of the former whilst having less of the latter.
I will return to that issue, but throughout my time at the Summit I couldn’t get away from the idea nagging at me that here we are in the spring of 2013 and now, right now, would have been a great time to launch an NHS reform programme from the Government.
In a speech to the Nuffield Trust a few years ago, the then-Secretary of State for Health, Andrew Lansley, turned to the failings of care at Mid-Staffordshire to motivate his argument for reform.
In defending the cause of clinically-led commissioning, Lansley said: ‘where were the GPs? I’ll tell you: the GPs were there, they sent the patients to the hospital’ but too often they had a culture of ‘refer and forget’.
For the third year running, we have carried out a small, snapshot survey of the NHS amongst the policy makers, senior managers, academics and clinicians who are attending our forthcoming Health Policy Summit, which takes place on 7 and 8 March.
This survey does not pretend to be representative in any way, but nevertheless provides a flavour of opinion amongst the 53 people who responded, in the wake of a year which has brought prolonged gloom about the prospects of improvement in the state of public finances and the passing and...
The Francis report has pushed money well down the pecking order as quality takes first, second and third place.
But as we come to the end of the financial year some eyes will again turn to how well the service is maintaining financial balance, meeting the Nicholson challenge of £20 billion savings and raising quality.
We know that the NHS needs to increase productivity to make savings, raise quality and balance the books. The consensus is that NHS productivity flat-lined over much of the last...
The Inquiry was however about the wider NHS system and its ability or otherwise to spot and address failure. Indeed the list of witnesses to the Inquiry underlines the extent to which this wider system includes commissioners, regulators, policy-makers and local general practices.
Robert Francis' analysis of the events at Mid Staffordshire includes...