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King’s fund

Richard Humphries: A year is a long time in the politics of integrated care

10 Mar, 14 | by BMJ

richard-humphriesWhen Andy Burnham set out his vision for “whole person care” at The King’s Fund last year, few would have disagreed with his crisp summation of the need to move towards one service that meets people’s needs as opposed to the three very different existing services—the NHS, mental health services, and social care.

The Labour Party went on to establish an independent commission led by Sir John Oldham to consider how this vision of whole person care could be achieved. Following this, the government set out its own stall with a new national collaboration framework for integrated care, featuring a programme of 14 co-ordinated care pioneers, and a £3.8 billion Better Care Fund—a pooled budget to be spent locally to provide better support at home and earlier treatment in the community. more…

David Buck: Tackling health inequalities: we need a national conversation

26 Feb, 14 | by BMJ

david_buckIn one of The King’s Fund’s most popular and commented on Time to Think Differently blogs last year, Gabriel Scally questioned whether we had lost the battle to tackle health inequalities. In December last year, NHS England released a document on their approach to reducing inequalities and now Public Health England has launched, rather quietly it has to be said, a national conversation on health inequalities. But why has this all taken so long? more…

Chris Ham: Making general practice fit for the future

21 Feb, 14 | by BMJ

General practice represents a paradox. On the one hand, it is widely and rightly viewed around the world as a model of primary care to be studied and emulated. On the other hand, it is based on small, independently minded units, unable to operate on the scale needed to meet changing population needs.

GPs in some areas recognise that practices have to change to rise to the challenges of an ageing population and shifting disease burden. We have studied four of these areas in our new report, Commissioning and funding general practice: making the case for family care networks, which describes how federations and networks of practices are working to deliver extended services and raise standards of care. These innovations in care are valuable, but much more is needed to ensure general practice really is fit for the future. more…

John Appleby: Care.data—your bits in their hands

13 Feb, 14 | by BMJ

Over the past few months there has been considerable debate and argument about plans by the NHS to collect and centrally collate details of individual patient records from general practice for the first time. Many have expressed worries about the care.data initiative and how potentially sensitive patient information will be used, who will have access to it (and for what reasons), and not least its security. Such fears are perhaps not just hypothetical given past examples of lost patient notes and what appear to be the misuse of sensitive patient information (even for the best of intentions). more…

Catherine Foot: Can the Care Quality Commission live up to expectations?

7 Feb, 14 | by BMJ

catherine_footThis week marks one year since Robert Francis published his second report into failures of care at Mid Staffordshire Foundation Trust.

Mid Staffs director of quality and patient experience, Julie Hendry, gave a moving presentation at a conference at the King’s Fund in November summarising the journey that the trust have been on since 2009, and the progress they have made and continue to make.

But what developments have there been more broadly across the system? more…

Vijaya Nath: Making revalidation work—what have we learnt so far?

16 Oct, 13 | by BMJ

Revalidation—the process by which licensed doctors demonstrate that they are up to date and fit to practise—was greeted with cynicism by some in the medical profession when it was introduced last year. But what have responsible officers—those who make recommendations to the General Medical Council (GMC) about doctors’ fitness to practise—thought about the process during its first six months? Our recent survey of responsible officers in London provided some interesting answers.

Responding to questions on what would improve the experience of revalidation in future, the responsible officers we interviewed broadly agreed on four areas. more…

Chris Naylor: Why we cannot afford to be pessimistic about CCGs

29 Jul, 13 | by BMJ

Clinical commissioning groups (CCGs) have a lot stacked against them. They have taken control of the majority of the NHS budget at a time when financial pressures are mounting and there is little hope of relief in the next few years. Some GPs have gone as far as to say they are being set up to fail.

The future of CCGs hinges to a large extent on the support they receive from local GPs. Clinical commissioning does not necessarily require substantial direct involvement from all or even most GPs. What it does need is widespread “buy in,” so that members feel a sense of collective ownership of their CCG and shared responsibility for its success. more…

Nigel Edwards: Can we keep up with the demand for urgent and emergency care?

3 May, 13 | by BMJ

nigel_edwardsThe urgent and emergency care system is under severe pressure. Performance on a number of important indicators, including the four hour wait and ambulance handover targets, is heading in the wrong direction. Demand is growing and calls for work to be shifted out of hospital look oddly out of line with a system that cannot even constrain, let alone reduce, the rate of increase in many places. Our recent study for NHS South of England raises some questions about the management of urgent and emergency care and identifies some important lessons. more…

Chris Ham: Medical leadership must move from the margins to the mainstream

2 May, 13 | by BMJ

A new report from the health services management centre at the University of Birmingham and The King’s Fund, funded by the National Institute for Health Research, provides a comprehensive and up to date picture of the state of medical leadership in NHS trusts today.

Thirty years after the Griffiths report set out a vision of doctors taking control of budgets and services, our report finds that much remains to be done to realise this vision. In most of the trusts we studied, a small minority of doctors were involved in leadership, and most of those committed only one day a week to these roles. It is hard to escape the conclusion that medical leadership remains a minority interest on the margins of the NHS. more…

Partha Kar: The consultant of the future

21 Feb, 13 | by BMJ

Type “define an NHS consultant” into Google and you’ll get more than 5 million results—none of which actually crystallises what the role involves. It’s a term that’s ever more shrouded in ambiguity as the NHS morphs and changes while moving into the unknown future. more…

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