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King’s fund

Matthew Honeyman: Saving paper, saving money, or transforming care?

27 Sep, 16 | by BMJ

Yesterday we published a briefing on the digital agenda that has been pursued by the NHS since 2013 – the year Secretary of State for health Jeremy Hunt challenged the NHS to “go paperless.” We chart progress made to date and look at some of the barriers and opportunities presented.

This comes two weeks after the Wachter review of health IT was published. Much of the commentary on Wachter’s review has been focused on its messages about unrealistic timetables and insufficient funding. But it also calls for a re-launch of the government’s digital agenda with a new name by the end of this year. Could the “paperless” branding finally end up in the bin? more…

Richard Smith: What if everyone over 55 was offered a pill to prevent heart attacks and strokes?

4 Aug, 16 | by BMJ

richard_smith_2014The NHS, like other health systems, is facing huge financial pressure. Bold thinking is needed, and the King’s Fund, a British health think tank, has commissioned a series of articles asking authors to explore radical questions of “What if . . .” All of the articles can be accessed at The NHS if—essays on the future of health and care and this is one of them.

Cardiovascular disease accounts for just over a quarter of deaths (27%) in Britain and costs the economy £15 billion a year, £11 billion of which are the costs of healthcare. Each year 41 000 people die prematurely (under 75) from cardiovascular disease. We know how to prevent half, and possibly three quarters, of these deaths, but at the moment we are failing to do so. more…

Helen McKenna: The consequences of living within your means

2 Aug, 16 | by BMJ

HELEN_MCKENNA,The technicality (or “administrative error” as the National Audit Office described it) that enabled the Department of Health to avoid breaching expenditure controls set by parliament may have spared it from the full wrath of the National Audit Office, MPs, and the Public Accounts Committee; but it did little to hide the bottom line—a serious financial crisis engulfing the NHS.

In 2015/16, NHS providers overspent by an eye-watering £2.8 billion (reduced to £2.5 billion by one-off measures). Although a commissioning underspend of £700 million helped to offset this figure, the NHS (commissioners and providers in aggregate) still ended 2015/16 with the largest deficit in its history. more…

Marcus Powell: A new and powerful relationship with patients

5 Jul, 16 | by BMJ

marcus-powell-portraitThe NHS five year forward view talks about harnessing the “renewable energy represented by patients and communities” and the need to “engage with communities and citizens in new ways, involving them directly in decisions about the future of health and care services.” We know that one of the founding principles that underpins the NHS at its best is that it’s “of the people, by the people and for the people.”

Now more than ever this is becoming true not because the Five year forward view says it but because it’s demanded by patients, communities and the population the NHS serves. Simon Stevens recognised this changing relationship when he talked about the NHS as a social movement. This can’t be controlled or mandated – it’s happening and it should be embraced and celebrated as a force for good and renewal. more…

Chris Ham: What can the NHS in England learn from Scotland?

28 Jun, 16 | by BMJ

I was in Glasgow recently speaking at the annual NHS Scotland conference. I took the opportunity to meet national and local leaders to discuss areas of common concern. Three programmes of work in Scotland hold particular interest for the NHS in England.

The first is work to improve patient safety and the quality of care. Leadership is provided by Healthcare Improvement Scotland which brings together in one organisation some of the functions that in England are dispersed between the Care Quality Commission, NHS Improvement and the National Institute for Health and Care Excellence. Healthcare Improvement Scotland also houses the Scottish Health Council and is currently placing particular emphasis on supporting person centred care and a greater voice for citizens and communities. The impressive range of work undertaken by Healthcare Improvement Scotland is outlined on its website and it has recently hosted a visit by national leaders from England keen to learn about how it operates. more…

Edward Wernick and Steve Manley: Meaningful patient collaboration—the end of the beginning . . .

1 Jun, 16 | by BMJ

ed_wernick_2steve_manley_2The delay between this blog and the last one in November on the new King’s Fund Collaborative Pairs Programme reflects the level of work that we have been dealing with over the past few months. We write this after our final session on the Collaborative Pairs course at the King’s Fund headquarters in Cavendish Square. We have written before about the nature of the course, but now that it has come to an end it is time to reflect on what we have learned.

By way of a brief update, the course brought us together as patient representative and clinician to work on a “shared issue” facing our local community. more…

John Appleby: New NHS inflation figures underline funding pressures facing the NHS

20 May, 16 | by BMJ

john-applebyThe latest Quarterly Monitoring Report from the King’s Fund surveying NHS trust finance directors reveals deepening pessimism about local finances and concern about the outturn for the current financial year. New NHS inflation figures from NHS Improvement reveal the true extent of the financial pressures facing the NHS this year and up to 2020/21.

How much money the NHS has been allocated over the next few years is a somewhat contested fact. It shouldn’t be of course; how much the government has decided to spend on healthcare should be —in one sense at least—an uncontroversial figure. more…

How do the healthcare systems in the UK compare with others internationally?

3 May, 16 | by BMJ

sarah-gregoryTwo years ago I wrote about how health systems in other countries were grappling with the problems of how to support an ageing population with high rates of comorbidities. I was interested in the fact that the same policy problem can generate different solutions depending on the context in which it sits—so while it may appear that there is a sort of “free will” in decisions about policy, in reality decisions will always depend on the limitations of funding and political structures. more…

Chris Ham: Statesmanship among medical leaders could help resolve the junior doctors’ dispute

18 Apr, 16 | by BMJ

Whatever the rights and wrongs of the standoff between the government and junior doctors, failure to reach agreement on a new contract is bad for patients and for staff. The all out strike planned for the end of the month will cause disruption and delay for patients, and add to the pressures on staff who cover for absent colleagues. It will also create dilemmas for junior doctors torn between loyalty to their peers and their primary—and strongly felt—duty to patients.

The dispute may also affect recruitment into medicine and the willingness of newly qualified doctors to practise in England. It will have an impact too on the discretionary effort of junior doctors who form the backbone of patient care throughout the NHS. more…

What are the consequences of recent caps on NHS agency staff spending?

4 Apr, 16 | by BMJ

phoebe-dunn-portraitFour months since the first caps on agency spending were introduced by NHS Improvement—and after new framework agreements came into force last week—what do we know about the impact of these measures so far?

Unfortunately, not a huge amount. Although NHS providers are submitting weekly data returns to NHS Improvement, no official figures have yet been published. Without this we are, to some extent, in the dark about the effects of the measures, instead relying on piecing together other sources of information—such as Freedom of Information requests and individual trust and agency experiences—to try and gauge early indications of impact. more…

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