You don't need to be signed in to read BMJ Blogs, but you can register here to receive updates about other BMJ products and services via our site.

King’s fund

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…

Chris Ham: The proposed NHS and social care commission should report quickly and engage with staff and the public

8 Feb, 16 | by BMJ

After the government’s spending review, the NHS has just over two years at best to stabilise rapidly deteriorating finances and declining standards of patient care. At that point the harsh reality of planned real growth in funding of only 0.2 per cent in 2018/19 (and even less the following year) will have to be confronted.

It is inconceivable that the NHS will be able to balance its books and maintain current standards, let alone implement new commitments such as seven day working, with such a small increase in its budget. And even if councils take advantage of new powers to increase council tax, social care faces a funding shortfall of approaching £3 billion by the end of the parliament. Something will have to give. more…

Chris Ham: Learning from others—devolved governance in the Australian state of Victoria

30 Nov, 15 | by BMJ

I spent a week working in Australia earlier this month and it made me reflect on similarities and differences with the NHS in England.

The funding context feels quite different, with healthcare spending in Australia having risen by 5% per year in real terms over the past decade. On the day I departed, a report in The Australian warned that this level of spending increase was unsustainable at a time of reduced economic growth and falling government revenues (the Chinese downturn being a key factor here). more…

Edward Wernick and Steve Manley: Meaningful patient collaboration—a mountain to climb?

15 Oct, 15 | by BMJ


In early September we arrived at the King’s Fund HQ in Cavendish Square to be welcomed to their new Collaborative Pairs Programme, designed to bring together 12 pairs from across the country—each made up of a healthcare professional and a patient or patient representative—to work on a shared challenge facing their local health system. The NHS Five Year Forward View and the current national programme for system change have focussed on developing a new relationship between citizens, communities and the health and social care system. From our respective positions, with clinical, strategic and community development experience between us, we know the challenges in turning this aspiration into a reality.

steve_manleyEach pair were asked to bring with them a “real” challenge that is a genuine current issue in their area. We will have five days over the next six months to utilise the support offered by the Kings Fund and the shared knowledge of other participating pairs. Our facilitators introduced the concept of the programme clearly…”To develop the skills and practices which enable collaborative relationships and offer a constructive, reflective space to learn about how to do this work well.” more…

BMJ blogs homepage


Helping doctors make better decisions. Visit site

Creative Comms logo

Latest from The BMJ

Latest from The BMJ

Latest from BMJ podcasts

Latest from BMJ podcasts

Blogs linking here

Blogs linking here