1. Commission Impossible? Why a royal review might struggle to solve the NHS funding crisis

    28 Jan 2016
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    Later today, Members of Parliament will debate a backbench motion calling for a cross-party Royal Commission into long-term funding for health and social care. Mark Dayan examines where a royal commission really is the answer for our struggling NHS. 

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  2. 'Transformation fund' or deficit mop-up? Time for an honest conversation

    20 Jan 2016
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    Sally Gainsbury calls for honesty and transparency from politicians, as new analysis reveals that the majority of the NHS 'Transformation and Sustainability Fund' announced last week will go toward plugging hospital deficits.

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  3. Social care: still unresolved

    27 Nov 2015
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    Mark Dayan argues that, even with new council-tax-funded money promised in the Spending Review, we should all still be deeply concerned for the future of adult social care. 

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  4. What the Spending Review really means for the NHS

    27 Nov 2015
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    Sally Gainsbury examines the numbers behind the Spending Review and what they really mean for the NHS.

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  5. Hanging on to hospital fines could hit patients hardest

    10 Nov 2015
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    In this blog, Sally Gainsbury, looks more closely at a proposed money-saving scheme by the Department of Health in the run-up to the spending review: having commissioners hold onto penalty fines for hospitals that fail to meet key targets.

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

    (Guest blogger)
    29 Sep 2015
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    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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  7. Prudent progress in the Welsh NHS

    (Guest blogger)
    29 Jul 2015
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    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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  8. Facing future challenges: do changes in skill mix offer some solutions?

    25 Jun 2015
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    Candace Imison explores whether changes in skill mix offers some solutions to the challenges faced across the spectrum of the NHS. 

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  9. Time for tough decisions: Northern Ireland’s great health challenge

    (Guest blogger)
    23 Jun 2015
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    Hugh McCaughey, Chief Executive of the South Eastern Health and Social Care Trust in Northern Ireland blogs about the great health challenges facing the country, and examines the options. 

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  10. NHS agency staff costs: treating the symptom not the cause

    9 Jun 2015
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    Candace Imison explores the Secretary of State for Health's recent campaign against agency staff costs and considers whether this approach might well be treating the symptom, but not the cause. 

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  11. The NHS bidding war

    21 Apr 2015
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    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.

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  12. 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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  13. 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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  14. The way the NHS manages A&E problems is not fit for purpose

    6 Mar 2015
    Comments

    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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  15. 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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  16. MPs will always be part of the rationing equation

    (Guest blogger)
    18 Feb 2015
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    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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  17. 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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  18. The Cancer Drugs Fund: An important stopgap

    (Guest blogger)
    14 Jan 2015
    Comments

     At a time when the CDF is under the public spotlight, it’s useful to remind ourselves about the problems that the Fund was set up to address, and recognise that while it is by no means the finished article, it has gone some way to plugging a gap. 

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  19. We are in a hole with the Cancer Drugs Fund – why do we keep on digging?

    (Guest blogger)
    14 Jan 2015
    Comments

    The news that the Fund was to be extended into 2016 brought equal amounts of delight and concern. The proponents of the Fund, who had hailed its introduction, were delighted, however, it raised huge concerns for those that could see its obvious flaws.

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  20. The Cancer Drugs Fund: a question of value(s)

    13 Jan 2015
    Comments

    NHS England’s announcement yesterday on the future of the Cancer Drugs Fund has reignited an important debate about how to understand ‘value’ in relation to NHS services. This blog provides an overview of the issues, and suggests what we at the Nuffield Trust think is a good way forward.

     

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