Health Policy

Economic crisis, health systems and health in Europe: impact and implications for policy – European Observatory on Health Systems and Policies – 4 September 2014

Posted on September 9, 2014. Filed under: Health Mgmt Policy Planning, Health Policy |

Economic crisis, health systems and health in Europe: impact and implications for policy – European Observatory on Health Systems and Policies – 4 September 2014

“How have health systems in Europe responded to the crisis? How have these responses affected health system performance and population health? And what are the implications of this experience for health systems facing economic and other forms of shock in the future?

This new document summarizes the findings of a joint study by WHO Europe and the Observatory analyzing the impact of health policy responses to the crisis in Europe from 2008 to 2013. It is a key part of a wider initiative to monitor the effects of the crisis on health systems and health, to identify the policies most likely to sustain the performance of health systems facing fiscal pressure and to gain insight into the political economy of implementing reforms in a crisis.

The study was supported by the Norwegian Directorate of Health and the UK Department for International Development. It will be published by the Open University Press in January 2015 and will be downloadable from this site soon afterwards.”

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Improving NHS Care by Engaging Staff and Devolving Decision-Making: Report of the Review of Staff Engagement and Empowerment in the NHS – The King’s Fund – 15 July 2014

Posted on July 22, 2014. Filed under: Health Mgmt Policy Planning, Health Policy, Workforce | Tags: |

Improving NHS Care by Engaging Staff and Devolving Decision-Making: Report of the Review of Staff Engagement and Empowerment in the NHS – The King’s Fund – 15 July 2014

Enable more NHS organisations to become mutuals and devolve decision-making, says independent review – The King’s Fund – 15 July 2014

“An independent review for the government has concluded that more NHS organisations should be encouraged to become public service mutuals.

The review, led by Chris Ham, Chief Executive of The King’s Fund, found compelling evidence that NHS organisations with high levels of staff engagement – where staff are strongly committed to their work and involved in decision-making – deliver better quality care. Organisations with high levels of staff engagement report:

lower mortality rates
better patient experience
lower rates of sickness absence and staff turnover.

Organisations with low levels of staff engagement are more likely to provide poor-quality care – the failures in care at Mid Staffordshire NHS Foundation Trust are one high-profile example of this.

While staff engagement levels have increased across the NHS in recent years, the review found significant variations between organisations. It calls on all NHS organisations to make staff engagement a key priority in order to improve care at a time of unprecedented financial and service pressures.

The review found emerging evidence that, by giving employees a stronger stake in their organisation, public service mutuals deliver higher levels of staff engagement. This was reinforced by testimony from leaders and staff working for mutual organisations that they feel a strong sense of ownership and empowerment, leading to better organisational performance.”

… continues on the site

 

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Obesity: perception and policy – multi-country review and survey of policymakers – C3 Collaborating for Health – launched 29 May 2014

Posted on June 24, 2014. Filed under: Health Policy, Public Hlth & Hlth Promotion | Tags: |

Obesity: perception and policy – multi-country review and survey of policymakers – C3 Collaborating for Health – launched 29 May 2014

“Over the last few decades, rates of obesity have been rapidly rising, first across the developed world and, more recently, in developing countries. The health impacts can be myriad and serious, and the implications for individuals and for governments – including increasing health-care costs and falling economic output – are clear. Policymakers will be faced with the financial consequences of obesity – and they are well placed to take action to control the epidemic and its health repercussions. However, are their perceptions of obesity and obesity policy accurate? Do they appreciate the extent of the epidemic, the drivers of obesity, and the tools and actions that need to be taken to make a difference?

To address these questions, the European Association for the Study of Obesity, with C3 Collaborating for Health, commissioned a survey of policymakers’ attitudes towards and knowledge of obesity issues. It built on a successful survey of policymakers carried out in three countries in 2013 (England, Spain and the United States), extending it to a further eight (Brazil, Bulgaria, Canada, Denmark, France, Germany, Italy and Mexico). The survey found that policymakers would benefit from greater awareness of the extent of obesity and overweight (and particularly the latter) in their countries, with a better appreciation of ‘what works’ and the impact of obesity-prevention and -management programmes. If policymakers have solid knowledge of the extent of the problem and the existing evidence on successful interventions, national policies are more likely to be put in place that adequately address the reality of tackling obesity in the population.”

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Reforming the NHS from within: beyond hierarchy, inspection and markets – King’s Fund – 11 June 2014

Posted on June 12, 2014. Filed under: Health Mgmt Policy Planning, Health Policy, Health Systems Improvement | Tags: |

Reforming the NHS from within: beyond hierarchy, inspection and markets – King’s Fund – 11 June 2014

Media release: It’s time to end top-down reform of the NHS – King’s Fund – 11 June 2014

“Politicians’ role in the running of the National Health Service (NHS) needs to be better defined to counter interventionist and centralising tendencies that have hampered effective reform to date, says a new report published today by The King’s Fund.

The report, Reforming the NHS from within: beyond hierarchy, inspection and markets, argues that a new political settlement is needed that clarifies the strategic role of ministers in determining funding, establishing priorities and providing accountability to Parliament, and leaves local NHS leaders with the space to innovate and lead service change. This settlement should reflect lessons learnt from the experience of the present government’s health reforms, which have failed to distance ministers from the operational management of the NHS as originally intended.

The report challenges the dominant approaches to NHS reform over the past 20 years – targets and performance management; inspection and regulation; and competition and choice. It argues for a fundamental shift in how the NHS is reformed. The NHS needs to move on from prescriptive, top-down approaches to change by progressing from:”

… continues on the site

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Priority-setting/prioritisation: A Reading List produced by NHS Right Care – May 2014

Posted on June 11, 2014. Filed under: Health Mgmt Policy Planning, Health Policy | Tags: , |

Priority-setting/prioritisation: A Reading List produced by NHS Right Care – May 2014

Nicola Pearce-Smith, Information Scientist
Sir Muir Gray, Joint Lead for Right Care

 

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Sir Humphrey and the professors: What does Whitehall want from academics? – University of Manchester – April 2014

Posted on June 3, 2014. Filed under: Evidence Based Practice, Health Policy, Knowledge Translation |

Sir Humphrey and the professors: What does Whitehall want from academics? – University of Manchester – April 2014

A survey of senior civil servants’ views on the accessibility and utility of academic research and expertise

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Making fair choices on the path to universal health coverage: Final report of the WHO Consultative Group on Equity and Universal Health Coverage – launched 1 May 2014

Posted on May 21, 2014. Filed under: Health Mgmt Policy Planning, Health Policy, Public Hlth & Hlth Promotion | Tags: |

Making fair choices on the path to universal health coverage: Final report of the WHO Consultative Group on Equity and Universal Health Coverage – launched 1 May 2014

ISBN 978 92 4 150715 8

Extract from the Executive Summary:

“Universal health coverage (UHC) is defined as all people receiving quality health services that meet their needs without being exposed to financial hardship in paying for the services. Given resource constraints, this does not entail all possible services, but a comprehensive range of key services that is well aligned with other social goals. UHC was firmly endorsed by the World Health Assembly in 2005 and further supported in the World Health Report 2010. Since then, more than seventy countries have requested policy support and technical advice for UHC reform from the World Health Organization (WHO). In response, WHO developed a plan of action that included providing guidance on how countries can manage the central issues of fairness and equity that arise on the path to UHC. The WHO Consultative Group on Equity and Universal Health Coverage was set up to develop this guidance.

This document is the Consultative Group’s final report. The report addresses the key issues of fairness and equity by clarifying these issues and offering recommendations for how countries can manage them. The report is relevant for a wide range of actors and particularly for governments in charge of overseeing and guiding the progress toward UHC.

To achieve UHC, countries must advance in at least three dimensions. Countries must expand priority services, include more people, and reduce out-of-pocket payments. However, in each of these dimensions, countries are faced with a critical choice: Which services to expand first, whom to include first, and how to shift from out-of-pocket payment toward prepayment? A commitment to fairness—and the overlapping concern for equity—and a commitment to respecting individuals’ rights to health care must guide countries in making these choices. For fair progressive realization of UHC, the three critical choices and the trade-offs between the dimensions must be carefully addressed. ”

 

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Guide to Implementation Planning – Department of the Prime Minister and Cabinet – 2014

Posted on April 23, 2014. Filed under: Health Mgmt Policy Planning, Health Policy |

Guide to Implementation Planning – Department of the Prime Minister and Cabinet – 2014

Extract from the introduction.

“This guide is designed to help departments and agencies formulate robust implementation plans that clearly articulate how new policies, programs, and services will be delivered on time, on budget and to expectations. It supports the Australian Government’s approach to strengthening Cabinet decision-making and improving program governance and implementation.

This guide aims to assist those involved in implementation planning to understand how they should formulate an implementation plan.”

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The four health systems of the UK: How do they compare? – Nuffield Trust – 11 April 2014

Posted on April 14, 2014. Filed under: Comparative Effectiveness Research, Health Mgmt Policy Planning, Health Policy, Health Systems Improvement | Tags: |

The four health systems of the UK: How do they compare? – Nuffield Trust – 11 April 2014

“This report, published by the Nuffield Trust and the Health Foundation, assesses the performance of the NHS on the quality of patient care in all four UK countries since devolution.

Summary

Since political devolution in 1999, there has been increasing policy divergence between the health systems of the four countries of the United Kingdom (UK). This report attempts to update earlier comparisons of the publicly financed health systems of England, Scotland, Wales and Northern Ireland in terms of funding, inputs and performance before and since devolution.

It also includes comparisons with the North East of England, which has been chosen as a better comparator with the three devolved nations than England as a whole.”

… continues on the site

 

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A new settlement for health and social care: interim report – King’s Fund – 3 April 2014

Posted on April 4, 2014. Filed under: Health Mgmt Policy Planning, Health Policy | Tags: , , |

A new settlement for health and social care: interim report – King’s Fund – 3 April 2014

“This is the interim report from the independent Commission on the Future of Health and Social Care in England. In it, the commission explains why it believes England needs a single health and social care system, with a ring-fenced, singly commissioned budget, and more closely aligned entitlements. Drawing on accounts from patients and their families, the commission argues that the current system is no longer fit for purpose.

At the root of the problem is a lack of alignment in funding, organisation and entitlement. The report analyses the historical divides between the two systems, the effects of our ageing society, and issues of affordability, before exploring options for change in meeting the costs ahead. It concludes with a call for responses to these options.”

… continues on the site

 

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Applying a Health Lens to Decision Making in Non-Health Sectors: Workshop Summary – National Research Council – 2014

Posted on March 28, 2014. Filed under: Health Policy, Public Hlth & Hlth Promotion | Tags: |

Applying a Health Lens to Decision Making in Non-Health Sectors: Workshop Summary – National Research Council – 2014

National Research Council. Applying a Health Lens to Decision Making in Non-Health Sectors: Workshop Summary. Washington, DC: The National Academies Press, 2014.

“Description

Health is influenced by a wide range of factors, many of which fall outside of the health care delivery sector. These determinants of health include, for example, the characteristics of how people live, work, learn, and play. Decision and policy making in areas such as transportation, housing, and education at different levels of government, and in the private sector, can have far-reaching impacts on health. Throughout the United States there has been increasing dialogue on incorporating a health perspective into policies, programs, and projects outside the health field.

Applying a Health Lens to Decision Making in Non-Health Sectors is the summary of a workshop convened in September 2013 by the Institute of Medicine Roundtable on Population Health Improvement to foster cross-sectoral dialogue and consider the opportunities for and barriers to improving the conditions for health in the course of achieving other societal objectives (e.g., economic development, efficient public transit). The roundtable engaged members, outside experts, and stakeholders on three core issues: supporting fruitful interaction between primary care and public health; strengthening governmental public health; and exploring community action in transforming the conditions that influence the public’s health. This report is a discussion of health in all policies approaches to promote consideration for potential health effects in policy making in many relevant domains, such as education, transportation, and housing.”

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One person, supported by people acting as One Team, from organisations behaving as One System: Report of the Independent Commission on Whole Person Care for the Labour Party launched 4 March 2014

Posted on March 13, 2014. Filed under: Health Mgmt Policy Planning, Health Policy |

One person, supported by people acting as One Team, from organisations behaving as One System: Report of the Independent Commission on Whole Person Care for the Labour Party launched 4 March 2014

One Person, One Team, One System – Chairman Sir John Oldham, Independent Commission on Whole Person Care

NHS Clinical Commissioners media release: NHSCC welcome and support Sir John Oldham report

“Today sees the launch of “One Person, One Team, One System” a report by John Oldham’s Independent Commission for the Labour party into health and social care policy.”

Commission members:
Sir John Oldham (Chair)
Sally Brearley
Hilary Chapman
Angela Coulter
Marion Dinwoodie
Peter Hay
Jeremy Hughes
Donal Hynes
Ian Philp
Richard Smith
Jay Stickland

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How do government agencies use evidence? – Socialstyrelsen: the National Board of Health and Welfare, Sweden – 1 June 2013

Posted on February 25, 2014. Filed under: Evidence Based Practice, Health Mgmt Policy Planning, Health Policy |

How do government agencies use evidence? – Socialstyrelsen: the National Board of Health and Welfare, Sweden – 1 June 2013

Extract from the executive summary:

“Significant research gaps remain in our understanding about what happens inside government agencies in relation to the production, commissioning, assessment and incorporation of research-based evidence into their policy advice and their program delivery and review activities. Practices and capabilities vary enormously across types of public agencies, levels of government, and policy areas. Understanding these patterns and potentialities better would help focus attention on effective methods for improving the quality of decision-making through evidence-informed processes.”

… continues on the site

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Many to many: How the relational state will transform public services – IPPR – 12 February 2014

Posted on February 18, 2014. Filed under: Health Mgmt Policy Planning, Health Policy, Health Systems Improvement, Patient Participation | Tags: |

Many to many: How the relational state will transform public services – IPPR – 12 February 2014

“This landmark report sets out a new ‘relational state’ agenda for public service reform that would address complex problems holistically, provide more intensive and personalised engagement at the frontline of service delivery, and empower and engage citizens.

We need a radical reconfiguration of our public services to make them better able to tackle the complex challenges – such as antisocial behaviour, chronic ill-health, and long-term unemployment – that are consuming a growing proportion of public expenditure. In the past, public service reform has relied too heavily on bureaucratic and market-based tools that are ill-equipped to deal with these problems.

In this publication, the authors set out how we can build a more relational state in practice, and consider how the lessons offered by some cutting-edge initiatives could help reshape mainstream services. By managing public services as interconnected and decentralised systems, promoting deep relationships and neighbourhood-based approaches in key services, and designing institutions that enable citizens to tackle shared problems together, we can make those services fit for the more complex times that we live in.”

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Capacity development in health systems and policy research: a survey of the Canadian context – Health Research Policy and Systems 7 February 2014

Posted on February 18, 2014. Filed under: Health Policy, Health Systems Improvement, Research, Workforce |

Capacity development in health systems and policy research: a survey of the Canadian context – Health Research Policy and Systems 7 February 2014

Health Research Policy and Systems 2014, 12:9 doi:10.1186/1478-4505-12-9

“Background
Over the past decade, substantial global investment has been made to support health systems and policy research (HSPR), with considerable resources allocated to training. In Canada, signs point to a larger and more highly skilled HSPR workforce, but little is known about whether growth in HSPR human resource capacity is aligned with investments in other research infrastructure, or what happens to HSPR graduates following training.

Methods
We collected data from the Canadian Institutes of Health Research, Canada’s national health research funding agency, and the Canadian Association for Health Services and Policy Research on recent graduates in the HSPR workforce. We also surveyed 45 Canadian HSPR training programs to determine what information they collect on the career experiences of graduates.

Results
No university programs are currently engaged in systematic follow-up. Collaborative training programs funded by the national health research funding agency report performing short-term mandated tracking activities, but whether and how data are used is unclear. No programs collected information about whether graduates were using skills obtained in training, though information collected by the national funding agency suggests a minority (<30%) of doctoral-level trainees moving on to academic careers.

Conclusions
Significant investments have been made to increase HSPR capacity in Canada and around the world but no systematic attempts to evaluate the impact of these investments have been made. As a research community, we have the expertise and responsibility to evaluate our health research human resources and should strive to build a stronger knowledge base to inform future investment in HSPR research capacity.”

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Strengthening national health systems capacity to respond to future global pandemics – McMaster University Health Forum Issue Brief – 4 November 2013

Posted on January 30, 2014. Filed under: Health Mgmt Policy Planning, Health Policy, Infectious Diseases | Tags: , |

Strengthening national health systems capacity to respond to future global pandemics – McMaster University Health Forum Issue Brief – 4 November 2013

Edge J, Gauvin FP, Hoffman SJ, Lavis JN. Issue Brief: Strengthening National Health Systems’ Capacity to Respond to Future Global Pandemics. Hamilton, Canada: McMaster Health Forum, 4 November 2013.

Extract from the Key Messages

“What’s the problem?
The challenges to strengthening national health systems’ capacity to respond to future global pandemics of infectious disease can be understood by considering six manifestations of, or contributors to, the problem:
1) pandemics challenge conventional systems of governance;
2) timely information sharing and evidence-informed decision-making is difficult;
3) domestic and international partners often encounter coordination problems;
4) public health and animal health perspectives can be difficult to reconcile when addressing emerging zoonoses;
5) antimicrobial resistance represents a growing threat; and
6) risk and protective factors for pandemics are changing.

Moreover, existing programs, health system arrangements and implementation strategies may not be optimal:
o programs and plans may limit capacity to respond to future pandemics;
o health system arrangements complicate matters; and
o some previously agreed upon courses of action have not been fully implemented.

What do we know about three elements of a comprehensive approach to address the problem?”

… continues on the site

 

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Learning from research: systematic reviews for informing policy decisions. A quick guide – Alliance for Useful Evidence – December 2013

Posted on December 17, 2013. Filed under: Evidence Based Practice, Health Policy | Tags: |

Learning from research: systematic reviews for informing policy decisions. A quick guide – Alliance for Useful Evidence – December 2013

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The influence of cost-effectiveness and other factors on NICE decisions – Centre for Health Economics, University of York – November 2013

Posted on December 10, 2013. Filed under: Evidence Based Practice, Health Economics, Health Mgmt Policy Planning, Health Policy | Tags: , |

The influence of cost-effectiveness and other factors on NICE decisions – Centre for Health Economics, University of York – November 2013

“Abstract

Background: The National Institute for Health and Care Excellence (NICE) emphasises that costeffectiveness is not the only consideration in health technology appraisal and is increasingly explicit about other factors considered relevant. Observing NICE decisions and the evidence considered in each appraisal allows us to ‘reveal’ its implicit weights.

Objectives: This study aims to investigate the influence of cost-effectiveness and other factors on NICE decisions and to investigate whether NICE’s decision-making has changed through time.

Methods: We build on and extend the modelling approaches in Devlin and Parkin (2004) and Dakin et al (2006). We model NICE’s decisions as binary choices: i.e. recommendations for or against use of a healthcare technology in a specific patient group. Independent variables comprised: the clinical and economic evidence regarding that technology; the characteristics of the patients, disease or treatment; and contextual factors affecting the conduct of health technology appraisal. Data on all NICE decisions published by December 2011 were obtained from HTAinSite [www.htainsite.com].

Results: Cost-effectiveness alone correctly predicted 82% of decisions; few other variables were significant and alternative model specifications led to very small variations in model performance. The odds of a positive NICE recommendation differed significantly between musculoskeletal disease, respiratory disease, cancer and other conditions. The accuracy with which the model predicted NICE recommendations was slightly improved by allowing for end of life criteria, uncertainty, publication date, clinical evidence, only treatment, paediatric population, patient group evidence, appraisal process, orphan status, innovation and use of probabilistic sensitivity analysis, although these variables were not statistically significant. Although there was a non-significant trend towards more recent decisions having a higher chance of a positive recommendation, there is currently no evidence that the threshold has changed over time. The model with highest prediction accuracy suggested that a technology costing £40,000 per quality-adjusted life-year (QALY) would have a 50% chance of NICE rejection (75% at £52,000/QALY; 25% at £27,000/QALY).

Discussion: Past NICE decisions appear to have been based on a higher threshold than the £20,000 – £30,000/QALY range that is explicitly stated. However, this finding may reflect consideration of other factors that drive a small number of NICE decisions or cannot be easily quantified.”

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Reassessing existing funded health services and products to support appropriate care – Canadian Foundation for Healthcare Improvement – 29 November 2013

Posted on December 4, 2013. Filed under: Health Economics, Health Mgmt Policy Planning, Health Policy, Health Systems Improvement | Tags: |

Reassessing existing funded health services and products to support appropriate care – Canadian Foundation for Healthcare Improvement – 29 November 2013

“In Ontario, new healthcare services and technologies coming into the system must undergo a rigorous evidence-based assessment. But what about existing services and technologies that are already in use? Which of those should be subjected to new evidence-based analyses to determine if they add value and are appropriate? Without a framework to identify priorities for reassessment from the thousands of existing funded services and products, the prospect of determining which services to scale back, focus or discontinue would be problematic at best.”

 

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Caring for an ageing population: points to consider from reform in Japan – Nuffield Trust – 27 November 2013

Posted on November 28, 2013. Filed under: Aged Care / Geriatrics, Health Policy | Tags: , |

Caring for an ageing population: points to consider from reform in Japan – Nuffield Trust – 27 November 2013

“Summary

Changing demography and the rising prevalence of long-term conditions has meant that finding a sustainable and fair model of funding social care for our growing older population is a matter of significant policy attention in England.

Japan has the oldest population in the world with 23 per cent of its population aged over 65; this is set to rise to 40 per cent by 2050. In order to address the shortage of social care, to ease burdens on informal carers and to relieve pressure on health services, a new insurance system for long-term care was introduced in Japan in 2000.”

… continues on the site

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International Profiles of Health Care Systems, 2013 – The Commonwealth Fund – 14 November 2013

Posted on November 27, 2013. Filed under: Evidence Based Practice, Health Economics, Health Informatics, Health Mgmt Policy Planning, Health Policy | Tags: |

International Profiles of Health Care Systems, 2013 – The Commonwealth Fund – 14 November 2013

S. Thomson, R. Osborn, D. Squires, and M. Jun, International Profiles of Health Care Systems, 2013, The Commonwealth Fund, November 2013.

“This publication presents overviews of the health care systems of Australia, Canada, Denmark, England, France, Germany, Japan, Italy, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United States. Each overview covers health insurance, public and private financing, health system organization and governance, health care quality and coordination, disparities, efficiency and integration, use of information technology and evidence-based practice, cost containment, and recent reforms and innovations. In addition, summary tables provide data on a number of key health system characteristics and performance indicators, including overall health care spending, hospital spending and utilization, health care access, patient safety, care coordination, chronic care management, disease prevention, capacity for quality improvement, and public views.”

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An Ageing Australia: Preparing for the Future – Productivity Commission – 22 November 2013

Posted on November 27, 2013. Filed under: Aged Care / Geriatrics, Health Policy | Tags: |

An Ageing Australia: Preparing for the Future – Productivity Commission – 22 November 2013

“The report focuses on the effects of ageing on economic output (underpinned by changes in population, participation and productivity) and the resulting implications for government budgets were current policy settings to be maintained. In that context, it will help inform the forthcoming Intergenerational Report (IGR).”

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The Recife Political Declaration on Human Resources for Health: renewed commitments towards universal health coverage – WHO – 13 November 2013

Posted on November 18, 2013. Filed under: Health Policy, Workforce | Tags: , |

The Recife Political Declaration on Human Resources for Health: renewed commitments towards universal health coverage – WHO – 13 November 2013

Full text of the Recife Declaration

“Renewed commitments towards universal health coverage

The largest ever forum focussing on health workers and global health has concluded with a series of renewed commitments that will ensure more countries move with greater speed towards the goal of universal health coverage.

The commitments, both at the global and national level, harness political leadership on human resources for health – an area of public health often left sidelined on international development agendas – to the extent that real and lasting impact will be felt both by those on the frontline of delivering health care, as well as those on the receiving end.”

… continues on the site

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Expertise and public policy: a conceptual guide – Parliamentary Library – 21 October 2013

Posted on October 29, 2013. Filed under: Health Policy |

Expertise and public policy: a conceptual guide – Parliamentary Library – 21 October 2013

“Executive summary

In developing policy and assessing program effectiveness, policy makers are required to make decisions on complex issues in areas that involve significant public risks.

In this context, policy makers are becoming more reliant on the advice of experts and the institution of expertise. Expert knowledge and advice in fields as diverse as science, engineering, the law and economics is required to assist policy makers in their deliberations on complex matters of public policy and to provide them with an authoritative basis for legitimate decision making.

However, at the same time that reliance on expertise and the demands made of it are increasing, expert claims have never been subject to greater levels of questioning and criticism. This problem is compounded by the growing public demand that non-experts should be able to participate in debates over issues that impact on their lives. However their capacity to understand and contribute to the technical aspects of these debates may be either limited or non-existent.

This paper provides a guide to assessing who is and who is not an expert in the technical aspects of public policy debates, by providing a framework of levels of expertise. It also notes the importance of identifying the specific fields of expertise relevant to the issue in question. The main focus is on scientific and technical areas, but the issues raised also apply in other domains.

It then examines the problem of how non-experts can evaluate expert claims in complex, technical domains. The paper argues that, in the absence of the necessary technical expertise, the only way that non-experts are able to appraise expertise and expert claims is through the use of social expertise. This is expertise using everyday social judgements that enables them to determine who to believe when they are not in a position to judge what to believe.
In this context, the paper suggests policy makers ask a series of questions:”

… continues on the site

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Social Media and Public Policy: what is the evidence? – Alliance for Useful Evidence – September 2013

Posted on October 1, 2013. Filed under: Evidence Based Practice, Health Policy | Tags: , |

Social Media and Public Policy: what is the evidence? – Alliance for Useful Evidence – September 2013

“This report considers whether social media data can improve the quality and timeliness of the evidence base that informs public policy. Can the myriad of human connections and interactions on the web provide insight to enable government to develop better policy, understand its subsequent impact and inform the many different organisations that deliver public services?”

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The role of evidence in policy formation and implementation. A report from the Prime Minister’s Chief Science Advisor [NZ] – September 2013

Posted on September 17, 2013. Filed under: Evidence Based Practice, Health Policy |

The role of evidence in policy formation and implementation. A report from the Prime Minister’s Chief Science Advisor [NZ] – September 2013

ISBN 978-0-477-10404-3 (paperback)
ISBN 978-0-477-10405-0 (PDF)

“At the request of the Prime Minister, this report has been designed to explore in greater detail the issues that were brought to light in an earlier discussion paper, Towards better use of evidence in policy formation (2011). This paper extends that discussion and makes some specific suggestions as to how to improve the use of robust evidence in policy formation and evaluation.”

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What Is Evidence-Based Policy? – Melbourne Institute of Applied Economic and Social Research – August 2013

Posted on September 17, 2013. Filed under: Evidence Based Practice, Health Policy | Tags: |

What Is Evidence-Based Policy? – Melbourne Institute of Applied Economic and Social Research – August 2013

Paul H. Jensen, Melbourne Institute Policy Brief No. 4/13
ISSN 2201-5477 (Print)
ISSN 2201-5485 (Online)
ISBN 978-0-7340-4321-4

“In this Policy Brief, the rationale underpinning the ‘evidence-based’ approach to public policy is carefully explained, as are the pros and cons of the different methods used to construct the evidence base. “

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Health 2020. A European policy framework and strategy for the 21st century – WHO – 2013

Posted on August 30, 2013. Filed under: Health Policy | Tags: |

Health 2020. A European policy framework and strategy for the 21st century – WHO – 2013

ISBN 978 92 890 0279 0

“In 2012, the WHO Regional Committee for Europe approved Health 2020 in two forms. This publication gives both. The shorter policy framework provides European politicians and policy-makers with Health 2020’s main values and principles, and key strategic advice to support action for health and well-being. The longer policy framework and strategy give more detail in terms of evidence and practice.

It has two strategic objectives, constructed around equity, gender and human rights and improved governance for health. It is aimed at those committed to improving health, well-being and health equity, in a way that is sensitive to each country’s situation and political and organizational circumstances. It is a “living” guide to policies and strategies.

Addressing these questions is as much a political as a scientific endeavour and Health 2020 puts strong emphasis on political commitment, as well as professional expertise and the engagement of civil society. Focused on “solutions”, it offers practical and achievable, yet flexible, policy options capable politically of being successfully implemented in the individual context of each country.”

 

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Health Literacy: Improving Health, Health Systems, and Health Policy Around the World – Workshop Summary – released 12 July 2013

Posted on August 26, 2013. Filed under: Health Policy, Public Hlth & Hlth Promotion | Tags: , , |

Health Literacy: Improving Health, Health Systems, and Health Policy Around the World – Workshop Summary – released 12 July 2013

“From the first use of the term health literacy in 1974 – described as “health education meeting minimal standards for all school grade levels” – the definition of health literacy has evolved into a common idea that involves both the need for people to understand information that helps them maintain good health and the need for health systems to reduce their complexity . Since the 1990s, health literacy has taken two different approaches; one oriented to clinical care and the other to public health. The public health approach is more prominent in developing nations, where organizations not only work to improve health for large groups of people but also provide educational opportunities. There are many opportunities for international research collaboration between the United States, European countries, and developing nations.

In September 2012, the IOM Roundtable on Health Literacy hosted a workshop focused on international health literacy efforts. The workshop featured presentations and discussions about health literacy interventions from various countries as well as other topics related to international health literacy. This document summarizes the workshop.”

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Obsessive Hope Disorder – ConNetica – 6 August 2013

Posted on August 6, 2013. Filed under: Health Mgmt Policy Planning, Health Policy, Mental Health Psychi Psychol |

Obsessive Hope Disorder – ConNetica – 6 August 2013

“Obsessive Hope Disorder examines mental health reform in Australia since the Richmond Report and Inquiry into Health Services for the Psychiatrically Ill and Developmentally Disabled in 1983 and the report by the then Federal Human Rights Commissioner, Brian Burdekin in 1993.”

… continues

Other links on the report

News report

Project update

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The view from Westminster: Parliamentarians on the future of health and social care – Nuffield Trust – June 2013

Posted on June 21, 2013. Filed under: Health Policy | Tags: |

The view from Westminster: Parliamentarians on the future of health and social care – Nuffield Trust – June 2013

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The four UK health systems: Learning from each other – The King’s Fund – 13 June 2013

Posted on June 14, 2013. Filed under: Health Mgmt Policy Planning, Health Policy | Tags: |

The four UK health systems: Learning from each other – The King’s Fund – 13 June 2013

” This paper aims to probe what it sees as a woefully under-explored area: the differences between the United Kingdom’s four separate health systems. These systems, it argues, are diverging in terms of structures, management approaches, and the way social care relates to health.

In theory, this divergence should offer a unique opportunity to establish ‘what works’ in these different approaches. In practice, the exercise is hampered by hard-to-compare data and a political reluctance to back comparative studies.

Much more could be done to facilitate such studies. To this end, the paper explores devolution, finance and politics, documenting areas that diverge and those where cross-border transfer of policy has occurred. It concludes by listing opportunities for cross-border learning that are being ignored.”

… continues

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Duty to care: In defence of universal health care – Centre for Labour and Social Studies – May 2013

Posted on May 16, 2013. Filed under: Health Mgmt Policy Planning, Health Policy | Tags: |

Duty to care: In defence of universal health care – Centre for Labour and Social Studies – May 2013

Policy paper by Prof Allyson M Pollock and David Price

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Development of nationally consistent subacute and non-acute admitted patient care data definitions and guidelines – AIHW – 2 May 2013

Posted on May 8, 2013. Filed under: Chronic Disease Mgmt, Health Informatics, Health Mgmt Policy Planning, Health Policy | Tags: , , , |

Development of nationally consistent subacute and non-acute admitted patient care data definitions and guidelines – AIHW – 2 May 2013

“In August 2012, the Independent Hospital Pricing Authority engaged the Australian Institute of Health and Welfare to develop nationally consistent definitions and business rules for subacute and non-acute admitted patient care and care types for implementation in national hospital datasets. The data element for ‘care type’ was revised to include a definition of subacute care. It also clarified that subacute care: is delivered under the management of or informed by a clinician with specialised expertise in the care type; be evidenced by an individualised multidisciplinary management plan that is documented in the patient’s medical record; and reflect both the characteristics of the patient and the expertise of the treating clinician.”

ISBN 978-1-74249-422-7; Cat. no. HSE 135; 84pp

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Healthy Lives, Healthy People: A Public Workforce Strategy – Department of Health [England] – 3 May 2013

Posted on May 7, 2013. Filed under: Health Policy, Public Hlth & Hlth Promotion, Workforce |

Healthy Lives, Healthy People: A Public Workforce Strategy – Department of Health [England] – 3 May 2013

“The government’s response to the consultation on developing a public health workforce strategy in the new public health system.

The strategy sets out actions for various partners in the new public health system to support and develop the public health workforce. It will help embed public health capacity within the wider workforce to support delivery of the public health outcomes framework.

The commitments will be delivered by a range of organisations including Public Health England, the Department of Health, Health Education England and local authorities. The strategy will be reviewed in 2015.”

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The changing national role in health system governance. A case-based study of 11 European countries and Australia – WHO – April 2013

Posted on April 22, 2013. Filed under: Health Mgmt Policy Planning, Health Policy | Tags: |

The changing national role in health system governance. A case-based study of 11 European countries and Australia – WHO – April 2013

“This study of 12 countries provides an overview of recent changes in national governments’ role in the governance of health systems, focusing on efforts to reconfigure responsibilities for health policy, regulation and management; the resultant policy priorities; and the initial impact. The shift in responsibilities shows little uniform direction: a number of countries have centralized certain areas of decision-making or regulation but decentralized others. The study reviews common trends, based on the country cases, and assesses potential future developments.”

ISBN 978 92 890 0003 1

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Patient power: what it takes for patient associations to help shape public policy – Stockholm Network Research Team – 2013

Posted on April 9, 2013. Filed under: Health Policy, Patient Participation | Tags: |

Patient power: what it takes for patient associations to help shape public policy – Stockholm Network Research Team – 2013

“This paper seeks to understand the environment in which patient associations emerge and play an active part in healthcare policy making, both theoretically and in practice, in a number of emerging markets.”

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Putting Patients First: The NHS England Business Plan for 2013/14 – 2015/16 – NHS England

Posted on April 8, 2013. Filed under: Health Mgmt Policy Planning, Health Policy | Tags: , |

Putting Patients First: The NHS England Business Plan for 2013/14 – 2015/16 – NHS England

NHS England’s business plan for 2013/14 – 2015/16, called Putting Patients First, explains how its commitment to transparency and increasing patients’ voice are fundamental to improving patient care.

The plan describes an 11 point scorecard which NHS England will introduce for measuring performance of key priorities, focused on receiving direct feedback from patients, their families and NHS staff.

This supports the cultural change needed to put people at the centre of the NHS, a key theme in the report by Robert Francis QC, by making sure that patients’ voices are heard and used to deliver better services.

This plan builds on Everyone Counts: Planning for Patients 2013/14, our earlier planning guidance for commissioners which was published in December 2012.

There is also a summary document available – Putting Patients First: The summary NHS England business plan for 2013/14 – 2015/16.”

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What Works: evidence centres for social policy – London, Cabinet Office – March 2013

Posted on March 19, 2013. Filed under: Evidence Based Practice, Health Mgmt Policy Planning, Health Policy |

What Works: evidence centres for social policy – London, Cabinet Office – March 2013

What Works Centres [UK]

“The What Works Network, a key action in the Civil Service reform plan, will consist of two existing centres of excellence – the National Institute for Health and Clinical Excellence (NICE) and the Educational Endowment Foundation – plus four new independent institutions responsible for gathering, assessing and sharing the most robust evidence to inform policy and service delivery in tackling crime, promoting active and independent ageing, effective early intervention, and fostering local economic growth.

 
This initiative will build upon existing evidence-based policy making. These independent specialist centres will produce and disseminate research to local decision makers, supporting them in investing in services that deliver the best outcomes for citizens and value for money for taxpayers. The centres will also feed insights into the heart of government to inform national decision-making. It is the first time a government anywhere has set up such a model at a national level.”

… continues

the four new ones
What Works Centre for Local Economic Growth
What Works Centre for Ageing Better
What Works Centre for Crime Reduction
What Works Centre for Early Intervention

Alliance for Useful Evidence

“The Alliance for Useful Evidence champions the use of evidence in social policy and practice. We are an open–access network of individuals from across government, universities, charities, business and local authorities in the UK and internationally.”

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Sustainable Health Systems: Visions, Strategies, Critical Uncertainties and Scenarios – A report from the World Economic Forum Prepared in collaboration with McKinsey & Company – January 2013

Posted on February 5, 2013. Filed under: Health Economics, Health Mgmt Policy Planning, Health Policy | Tags: , |

Sustainable Health Systems: Visions, Strategies, Critical Uncertainties and Scenarios – A report from the World Economic Forum Prepared in collaboration with McKinsey & Company – January 2013

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Everyone counts: Planning for Patients 2013/14 – NHS – December 2012

Posted on January 9, 2013. Filed under: Health Mgmt Policy Planning, Health Policy | Tags: |

Everyone counts: Planning for Patients 2013/14 – NHS – December 2012

“Everyone Counts: Planning for Patients 2013/14 outlines the incentives and levers that will be used to improve services from April 2013, the first year of the new NHS, where improvement is driven by clinical commissioners.

The guidance is published alongside financial allocations to clinical commissioning groups and is accompanied by other documents intended to help local clinicians deliver more responsive health services, focused on improving outcomes for patients, addressing local priorities and meeting the rights people have under the NHS Constitution.”

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United Kingdom (Northern Ireland). Health system review – European Observatory on Health Systems and Policies – November 2012

Posted on November 29, 2012. Filed under: Health Mgmt Policy Planning, Health Policy |

United Kingdom (Northern Ireland). Health system review – European Observatory on Health Systems and Policies – November 2012

O’Neill C, McGregor P, Merkur S. United Kingdom (Northern Ireland): Health system review. Health Systems in Transition, 2012; 14(10): 1– 91.  ISSN 1817–6127

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Health Authorities and the Built Environment: Actions to Influence Public Policies – National Collaborating Centre for Healthy Public Policy [Canada] – November 2012

Posted on November 21, 2012. Filed under: Health Policy, Public Hlth & Hlth Promotion | Tags: |

Health Authorities and the Built Environment: Actions to Influence Public Policies – National Collaborating Centre for Healthy Public Policy [Canada] – November 2012

“This document, structured around interviews, presents the experiences of six Canadian health authorities (Vancouver Coastal Health, Vancouver Island Health, Fraser Health, Peel Public Health, Toronto Public Health, and Direction de santé publique de Montréal), regarding political actions to foster healthy built environments.

Actions undertaken by the health authorities include:

•Active involvement in developing Official Community Plans;
•Inclusion of healthy built environment principles in the planning and construction of a new health facility;
•Inclusion and integration of a health perspective into a regional growth strategy, a regional sustainable development plan and a long-term regional transportation plan;
•Development of tools to foster the integration of a health perspective in planning and engineering processes;
•Establishment of partnerships with the municipal sector;
•Assessment of community action programs to influence the built environment.

These interviews were conducted as part of a project by the Healthy Canada by Design Coalition. This coalition is financed by the Canadian Partnership Against Cancer through the Coalitions Linking Action and Science for Prevention (CLASP) program. The efforts of the Healthy Canada by Design coalition are focused on promoting certain public policies that can lead to the creation of healthier built environments – such as transportation and urban planning policies.”

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International Profiles of Health Care Systems – Commonwealth Fund – 19 November 2012

Posted on November 20, 2012. Filed under: Health Mgmt Policy Planning, Health Policy | Tags: |

International Profiles of Health Care Systems – Commonwealth Fund – 19 November 2012

“Overview
This publication presents overviews of the health care systems of Australia, Canada, Denmark, England, France, Germany, Japan, Iceland, Italy, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and the United States. Each overview covers health insurance, public and private financing, health system organization, quality of care, health disparities, efficiency and integration, care coordination, use of health information technology, use of evidence-based practice, cost containment, and recent reforms and innovations. In addition, summary tables provide data on a number of key health system characteristics and performance indicators, including overall health care spending, hospital spending and utilization, health care access, patient safety, care coordination, chronic care management, disease prevention, capacity for quality improvement, and public views.”

S. Thomson, R. Osborn, D. Squires, and M. Jun, International Profiles of Health Care Systems, 2012, The Commonwealth Fund, November 2012.

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We can have it all: Why health care will still be affordable – The Wonk, Institute for Research on Public Policy [Canada] – November 2012

Posted on November 20, 2012. Filed under: Health Economics, Health Policy |

We can have it all: Why health care will still be affordable – The Wonk, Institute for Research on Public Policy [Canada] – November 2012

by William Baumol

“The rising cost of health care is perhaps the most disturbing policy challenge facing Western countries, as expenditures gobble up an ever-increasing share of national wealth. Renowned American economist William Baumol was among the first to identify the condition in which industries dependent on personal services — education, the performing arts and health care — prove resistant to productivity gains. But in an article based on his new book, The Cost Disease: Why Computers Get Cheaper and Health Care Doesn’t, Baumol portrays a consoling future in which innovations in other parts of the economy make alarmingly high health care costs affordable overall.”

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Shifting the Dial: From wellbeing measures to policy practice – Carnegie UK Trust – 2012

Posted on November 15, 2012. Filed under: Health Policy, Public Hlth & Hlth Promotion | Tags: |

Shifting the Dial: From wellbeing measures to policy practice – Carnegie UK Trust – 2012

by Jennifer Wallace and Katie Schmuecker

“This report shares the findings of a project undertaken by Carnegie UK Trust and IPPR North to ask what needs to happen to ensure that measuring wellbeing is made to matter in policy-making practice.”

 

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NHS Mandate published – 13 November 2012

Posted on November 15, 2012. Filed under: Health Policy | Tags: |

NHS Mandate published – 13 November 2012

“The first Mandate between the Government and the NHS Commissioning Board, setting out the ambitions for the health service for the next two years, is published today.

The Mandate reaffirms the Government’s commitment to an NHS that remains comprehensive and universal – available to all, based on clinical need and not ability to pay – and that is able to meet patients’ needs and expectations now and in the future.”

… continues

 

 

 

 

 

 

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Health 2020: a European policy framework supporting action across government and society for health and well-being – WHO – September 2012

Posted on October 5, 2012. Filed under: Health Policy, Public Hlth & Hlth Promotion | Tags: |

Health 2020: a European policy framework supporting action across government and society for health and well-being – WHO – September 2012

“The 53 Member States in the WHO European Region have agreed on a new common policy framework – Health 2020. Their shared goals are to “significantly improve the health and wellbeing of populations, reduce health inequalities, strengthen public health and ensure people-centred health systems that are universal, equitable, sustainable and of high quality.” “

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A Framework for Analyzing Public Policies Practical Guide – National Collaborating Centre for Healthy Public Policy [Canada] – September 2012

Posted on October 5, 2012. Filed under: Health Policy, Public Hlth & Hlth Promotion | Tags: |

A Framework for Analyzing Public Policies Practical Guide – National Collaborating Centre for Healthy Public Policy [Canada] – September 2012

“Public health actors in public, community and academic networks may be called upon to work on public policies and, within the context of this work, to interact with policy makers at different levels (municipal, provincial, etc.). However, they often find that the content of their discourse does not meet all the information needs of these decision makers.

This document presents a structured process based on an analytical framework that reflects a public health perspective, while at the same time integrating other concerns of policy makers. The document addresses four questions:

• What public policies does this analytical framework apply to?
• In what types of situations is it useful?
• Which policy facets does it focus on?
• How is the analysis carried out?”

… continues on the site

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Intersectoral Governance for Health in All Policies: Structures, actions and experiences – European Observatory on Health Systems and Policies – 2012

Posted on September 12, 2012. Filed under: Health Mgmt Policy Planning, Health Policy, Public Hlth & Hlth Promotion | Tags: , , |

Intersectoral Governance for Health in All Policies: Structures, actions and experiences – European Observatory on Health Systems and Policies – 2012

Edited by David V. McQueen, Matthias Wismar, Vivian Lin, Catherine M. Jones, Maggie Davies
ISBN 978 92 890 0281 3

Extract from the foreword

“Since the arrival of the new millennium, the field of health promotion has added many emerging areas related to health to its field of interest and action.

Many of these areas were, of course, anticipated in the Ottawa Charter on Health Promotion; nonetheless there has been an explosion of interest in three critical areas in recent years, namely on the social determinants of health, governance, and Health in All Policies, and more specifically “the translation of Health in All Policies from a policy principle into a policy practice”. Now we have a new and significant book that addresses these three areas in a most exciting way.

The International Union for Health Promotion and Education (IUHPE) acknowledges that many of the solutions to the most pressing health issues reside outside the health sector. It is therefore imperative to facilitate governance practices that enable improved work across sectors in government, the nongovernment sector, academic institutions and the private sector, at all territorial levels.”

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A CEO Checklist for High-Value Health Care – prepared by Participants in the IOM Roundtable on Value & Science-Driven Health Care – June 2012

Posted on June 19, 2012. Filed under: Health Mgmt Policy Planning, Health Policy | Tags: , |

A CEO Checklist for High-Value Health Care – prepared by Participants in the IOM Roundtable on Value & Science-Driven Health Care – June 2012

Institute of Medicine
Delos Cosgrove, Michael Fisher, Patricia Gabow, Gary Gottlieb, George Halvorson, Brent James, Gary Kaplan, Jonathan Perlin, Robert Petzel, Glenn Steele, and John Toussaint

“As leaders of health care organizations, we are acutely aware of the pressures that rising health care costs place on individuals, employers, and the government, as we are of unacceptable shortfalls in the quality and effi ciency of care. But we have also learned, through experiences in our own institutions and through communication and collaboration with colleagues in others, that better outcomes at lower costs can be achieved through care transformation initiatives that yield improved results, more satisfi ed patients, and cultures of continuous learning. These transformation efforts have generated certain foundational lessons relevant to every CEO and Board member, and the health care delivery organizations they lead. We have assembled these lessons here as a A CEO Checklist for High-Value Health Care to describe touchstone principles, illustrated with case examples, central not only to our work to date, but to sustaining and reinforcing the system-wide transformation necessary for continuous improvement in the face of rapidly increasing pressures, demands, and market changes.

“This Checklist is intended to be a living and dynamic document, and we invite both suggestions to improve its utility and reach, and co-signing by our CEO colleagues who wish to support these strategies for effective, efficient, and continuously improving health care for all Americans.”

“Foundational elements
• Governance priority—visible and determined leadership by CEO and Board
• Culture of continuous improvement—commitment to ongoing, real-time learning

Infrastructure fundamentals
• IT best practices—automated, reliable information to and from the point of care
• Evidence protocols—effective, efficient, and consistent care
• Resource utilization—optimized use of personnel, physical space, and other resources

Care delivery priorities
• Integrated care—right care, right setting, right providers, right teamwork
• Shared decision making—patient–clinician collaboration on care plans
• Targeted services—tailored community and clinic interventions for resource-intensive patients

Reliability and feedback
• Embedded safeguards—supports and prompts to reduce injury and infection
• Internal transparency—visible progress in performance, outcomes, and costs”

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Producing Knowledge Syntheses that are Both Rigorous and Relevant to Policy-Makers – National Collaborating Centre for Healthy Public Policy [Canada] May 2012

Posted on May 25, 2012. Filed under: Health Mgmt Policy Planning, Health Policy, Public Hlth & Hlth Promotion |

Producing Knowledge Syntheses that are Both Rigorous and Relevant to Policy-Makers – National Collaborating Centre for Healthy Public Policy [Canada] May 2012

“The Centre was involved in presenting 3 different workshops on Tuesday April 3rd 2012 at The Ontario Public Health Conference (TOPHC). The Conference took place in Toronto from April 2nd to 4th, 2012.

In one workshop, Florence Morestin introduced the NCCHPP’s method for synthesizing knowledge about public policies. Producing Knowledge Syntheses that are Both Rigorous and Relevant to Policy-Makers is a workshop for public health practitioners who deal with public policies in the context of their work.”

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Embedding of research into decision-making processes – WHO Alliance for Health Policy and Systems Research – April 2012

Posted on May 23, 2012. Filed under: Evidence Based Practice, Health Mgmt Policy Planning, Health Policy, Knowledge Translation, Research | Tags: |

Embedding of research into decision-making processes – WHO Alliance for Health Policy and Systems Research – April 2012

Adam D Koon, Devaki Nambiar, Krishna D Rao

Background paper commissioned by the Alliance for Health Policy and Systems Research to develop the WHO Health Systems  Research Strategy

“Objectives
This study is concerned with the uptake of research evidence in policy decisions for health and the factors which are conducive for this. Specifically, this study seeks to:

(a) Present a conceptual understanding of institutional embeddedness and apply it to the context of research in policy making in health. Further, through a review of the literature, document the institutional arrangements that facilitate the embedding of research use in the policy-making domain.

(b) Present country case studies to illustrate the embeddedness of research use in policy-making and the contextual and institutional factors that create enabling conditions for it.

We examine these questions from the perspective of the six WHO building blocks – service delivery, health workforce, information, medical products, financing and governance. Information is sourced from the existing literature and from country case studies.

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Health system performance comparison: an agenda for policy, information and research – WHO on behalf of the European Observatory on Health Systems and Policies – 2012

Posted on May 3, 2012. Filed under: Health Policy | Tags: , , , |

Health system performance comparison: an agenda for policy, information and research – WHO on behalf of the European Observatory on Health Systems and Policies – 2012

by Peter C. Smith, Irene Papanicolas

“Policy issue
• International health system performance comparisons have the potential to provide a rich source of evidence as well as policy influence.
• Country comparisons that are not conducted with properly validated measures and unbiased policy interpretations may prompt adverse policy impacts and so caution is required in the selection of indicators, the methodologies used, and the interpretations made.”

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Living Longer. Living Better – Department of Health and Ageing – 20 April 2012

Posted on April 20, 2012. Filed under: Aged Care / Geriatrics, Health Policy | Tags: |

Living Longer. Living Better – Department of Health and Ageing – 20 April 2012

“On 20 April 2012, the Prime Minister and Minister Butler unveiled a comprehensive package of reforms to build a better, fairer, more sustainable and more nationally consistent aged care system.

The “Living Longer. Living Better.” aged care reform package provides $3.7 billion over five years. It represents the commencement of a 10 year reform program to create a flexible and seamless system that provides older Australians with more choice, control and easier access to a full range of services, where they want it and when they need it. It also positions us to meet the social and economic challenges of the nation’s ageing population.

The reforms give priority to providing more support and care in the home, better access to residential care, more support for those with dementia and strengthening the aged care workforce. They will be progressively implemented from 1 July 2012 to give early benefits to consumers and providers but also to ensure there is a smooth transition for consumers and providers and sufficient time to adapt and plan ahead of further reform.”

More Choice, Easier Access and Better Care for Older Australians [media release]  – 20 April 2012

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Planning for an Aging Nation. New Estimates to Inform Policy Analysis for Senior Health – RAND – 2012

Posted on April 16, 2012. Filed under: Aged Care / Geriatrics, Health Policy | Tags: |

Planning for an Aging Nation. New Estimates to Inform Policy Analysis for Senior Health – RAND – 2012

“This dissertation contains three papers on the health and welfare of the elderly population. Overall, these papers provide insights into the costs and challenges of providing health care to the elderly population. These papers help us understand the effects of obesity on longevity and health care, as well as better understand the benefits of social insurance.

The first paper uses a micro-simulation model to estimate the longevity effects of poor health trends among younger Americans, and finds that difference in these trends can explain 92% of the difference between US and European longevity.

The second paper estimates the welfare effects of Medicare Part-D from gains in market efficiency and dynamic incentives for pharmaceutical companies. It finds that these gains alone nearly cover the welfare cost of funding Medicare Part-D.

The last paper presents and estimates a structural model of health, exercise, and restaurant consumption. It provides estimates for future welfare analyses of programs targeting obesity through restaurants and exercise in the elderly population. It also estimates the long run effects of making policies which make restaurant food healthier. It finds only minor effects of restaurant policies on health for the elderly.

Overall, these papers further our understanding of the challenging objective of improving senior health while containing costs.”

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Country-Level Decision Making for Control of Chronic Diseases – Workshop Summary – Institute of Medicine – 2 April 2012

Posted on April 3, 2012. Filed under: Chronic Disease Mgmt, Health Policy, Preventive Healthcare | Tags: |

Country-Level Decision Making for Control of Chronic Diseases – Workshop Summary – Institute of Medicine – 2 April 2012

Full text

“A 2010 IOM report, Promoting Cardiovascular Health in the Developing World, found that not only is it possible to reduce the burden of cardiovascular disease and related chronic diseases in developing countries, but also that such a reduction will be critical to achieving global health and development goals. One key step to achieving this outcome is to identify practical ways to assist low- and middle-income countries in improving control of chronic diseases through the approaches that are led by a country’s decision makers and stakeholders and that will be most appropriate, effective, and feasible based on a country’s circumstances.

As part a series of follow-up activities to the 2010 report, the IOM planned a workshop to explore ideas and opportunities for supporting country-specific assessment of resource needs and planning of resource allocation for chronic diseases as part of the broader process of priority setting, decision making, and planning. The workshop, held in July 2011, aimed to identify what is needed to create tools for country-led planning of effective, efficient, and equitable provision of programs to prevent and reduce the burden of chronic diseases. This document summarizes the workshop.”

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Saskatchewan Ministry of Health – Plan for 2012 – 2013 – March 2012

Posted on March 30, 2012. Filed under: Health Mgmt Policy Planning, Health Policy |

Saskatchewan Ministry of Health – Plan for 2012 – 2013

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Identifying Trustworthy Experts: How Do Policymakers Find and Assess Public Health Researchers Worth Consulting or Collaborating With? – PLoS One – 5 March 2012

Posted on March 27, 2012. Filed under: Health Policy, Knowledge Translation, Public Hlth & Hlth Promotion |

Identifying Trustworthy Experts: How Do Policymakers Find and Assess Public Health Researchers Worth Consulting or Collaborating With? – PLoS One – 5 March 2012

“Abstract

This paper reports data from semi-structured interviews on how 26 Australian civil servants, ministers and ministerial advisors find and evaluate researchers with whom they wish to consult or collaborate. Policymakers valued researchers who had credibility across the three attributes seen as contributing to trustworthiness: competence (an exemplary academic reputation complemented by pragmatism, understanding of government processes, and effective collaboration and communication skills); integrity (independence, “authenticity”, and faithful reporting of research); and benevolence (commitment to the policy reform agenda). The emphases given to these assessment criteria appeared to be shaped in part by policymakers’ roles and the type and phase of policy development in which they were engaged. Policymakers are encouraged to reassess their methods for engaging researchers and to maximise information flow and support in these relationships. Researchers who wish to influence policy are advised to develop relationships across the policy community, but also to engage in other complementary strategies for promoting research-informed policy, including the strategic use of mass media.”

Croakey commentary on the research

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Guidance for Evidence-Informed Policies about Health Systems – PLoS Medicine – series of articles – 2012

Posted on March 20, 2012. Filed under: Evidence Based Practice, Health Mgmt Policy Planning, Health Policy, Health Systems Improvement | Tags: |

Bosch-Capblanch X, Lavis JN, Lewin S, Atun R, Røttingen J-A, et al. (2012) Guidance for Evidence-Informed Policies about Health Systems: Rationale for and Challenges of Guidance Development. PLoS Med 9(3): e1001185. doi:10.1371/journal.pmed.1001185

Summary Points
Weak health systems hinder the implementation of effective interventions; policies to strengthen such systems need to draw on the best available evidence.
Health systems evidence is best delivered in the form of guidance embedded in policy formulation processes, but health systems guidance is poorly developed at present.
The translation of research on problems, interventions, and implementation into decisions and policies that affect how systems are organised is one challenge facing the development of health systems guidance.
The development of guidance that is timely and usable by the broad range of health systems stakeholders, and of methods to appraise the quality of health systems guidance, are additional challenges.
Further research is needed to adapt existing approaches (e.g., those used in clinical guidelines) to produce meaningful advice that accounts for the complexity of health systems, political systems, and contexts.
This is the first paper in a three-part series in PLoS Medicine on health systems guidance.

Lavis JN, Røttingen J-A, Bosch-Capblanch X, Atun R, El-Jardali F, et al. (2012) Guidance for Evidence-Informed Policies about Health Systems: Linking Guidance Development to Policy Development. PLoS Med 9(3): e1001186. doi:10.1371/journal.pmed.1001186

Summary Points
Contextual factors are extremely important in shaping decisions about health systems, and policy makers need to work through all the pros and cons of different options before adopting specific health systems guidance.
A division of labour between global guidance developers, global policy developers, national guidance developers, and national policy developers is needed to support evidence-informed policy-making about health systems.
A panel charged with developing health systems guidance at the global level could best add value by ensuring that its output can be used for policy development at the global and national level, and for guidance development at the national level.
Rigorous health systems analyses and political systems analyses are needed at the global and national level to support guideline and policy development.
Further research is needed into the division of labour in guideline development and policy development and on frameworks for supporting system and political analyses.
This is the second paper in a three-part series in PLoS Medicine on health systems guidance.

Guidance for Evidence-Informed Policies about Health Systems: Assessing How Much Confidence to Place in the Research Evidence – PLoS Medicine – 20 March 2012

Simon Lewin
Summary Points
“Assessing how much confidence to place in different types of research evidence is key to informing judgements regarding policy options to address health systems problems.
Systematic and transparent approaches to such assessments are particularly important given the complexity of many health systems interventions.
Useful tools are available to assess how much confidence to place in the different types of research evidence needed to support different steps in the policy-making process; those for assessing evidence of effectiveness are most developed.
Tools need to be developed to assist judgements regarding evidence from systematic reviews on other key factors such as the acceptability of policy options to stakeholders, implementation feasibility, and equity.
Research is also needed on ways to develop, structure, and present policy options within global health systems guidance.
This is the third paper in a three-part series in PLoS Medicine on health systems guidance.”

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Health policy and systems research: a methodology reader – WHO – 2012

Posted on February 27, 2012. Filed under: Health Mgmt Policy Planning, Health Policy | Tags: |

Health policy and systems research: a methodology reader – WHO – 2012

edited by Lucy Gibson   ISBN 978 92 4 150313 6

“What does this Reader offer?

Health Policy and Systems Research (HPSR) is often criticized for lacking rigour, providing a weak basis for generalization of its findings and, therefore, offering limited value for policy-makers. This Reader aims to address these concerns through supporting action to strengthen the quality of HPSR.

The Reader is primarily for researchers and research users, teachers and students, particularly those working in low- and middle-income countries (LMICs). It provides guidance on the defining features of HPSR and the critical steps in conducting research in this field. It showcases the diverse range of research strategies and methods encompassed by HPSR, and it provides examples of good quality and innovative HPSR papers.

The production of the Reader was commissioned by the Alliance for Health Policy and Systems Research (the Alliance) and it will complement its other investments in methodology development and postgraduate training.”

… continues

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Were massive reforms necessary to save the NHS? Inquiry into the NHS Health Reforms – All Party Parliamentary Group, Primary Care & Public Health – January 2012

Posted on February 3, 2012. Filed under: Health Mgmt Policy Planning, Health Policy | Tags: |

Were massive reforms necessary to save the NHS? Inquiry into the NHS Health Reforms – All Party Parliamentary Group, Primary Care & Public Health – January 2012

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Protecting Independence: the Voluntary Sector in 2012 – Panel on the Independence of the Voluntary Sector, the Baring Foundation – 9 January 2012

Posted on January 17, 2012. Filed under: Health Policy, Public Sector | Tags: |

Protecting Independence: the Voluntary Sector in 2012 – Panel on the Independence of the Voluntary Sector, the Baring Foundation – 9 January 2012

Media release 

Extract:

“There are “real and present” risks to the independence of the voluntary sector, with support for disadvantaged groups under particular threat, warns the Panel on the Independence of the Voluntary Sector in the first of five annual assessments published today, pointing to the Work Programme as an important example.

Threats to the three aspects of voluntary sector independence – of purpose, voice and action – have existed for some time, says the Panel, but have been considerably heightened by cuts in public spending and other income, and the way in which contracts are awarded. This means that some organisations have to choose between closure and agreeing to sub-optimal delivery. 2012 will be a crucial year, the Panel’s assessment says.

The Panel, which has created a Barometer to measure voluntary sector independence, points to six major challenges:

The effects of a contract model which favours large, often private sector, organisations and can be unnecessarily restrictive
The inability of the voluntary sector to influence service design and delivery or funding models
The blurring of boundaries between public, for profit and voluntary sectors, which may mask important differences and dilute independence
Pressure for self-censorship, with some organisations fearful of using their voice
Pressure on independent governance, as trustees seek to balance survival and independence
Regulation and safeguards for independence that may not be sufficiently robust.”

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Government response to the NHS Future Forum report – June 2011

Posted on June 29, 2011. Filed under: Health Mgmt Policy Planning, Health Policy | Tags: |

Government response to the NHS Future Forum report – June 2011

CM 8113
ISBN: 9780101811323

Foreword 2
Summary of key changes 4
Chapter 1 : Modernising the NHS 7
Chapter 2 : Overall accountability for the NHS 11
Chapter 3 : Clinical advice and leadership 14
Chapter 4 : Public accountability and patient involvement 30
Chapter 5 : Choice and competition 41
Chapter 6 : Developing the healthcare workforce 50
Chapter 7 : The timetable for change

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Four Pillars: Recommendations for Achieving a High Performing Health System – June 2011

Posted on June 24, 2011. Filed under: Health Mgmt Policy Planning, Health Policy |

Four Pillars: Recommendations for Achieving a High Performing Health System – June 2011

A paper produced jointly by the Ontario Hospital Association and the Ontario Association of Community Care Access Centres

“We propose dramatic health system reform based on four pillars. The four
pillars are:
1.  Setting Ambitious Goals
2.  Planning Properly
3.  Letting Evidence Drive Care Decisions
4.  Connecting Care”

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Taking responsibility for complexity: how implementation can achieve results in the face of complex problems – Overseas Development Institute – June 2011

Posted on June 14, 2011. Filed under: Health Mgmt Policy Planning, Health Policy |

Taking responsibility for complexity: how implementation can achieve results in the face of complex problems – Overseas Development Institute – June 2011
ODI Working Papers 330, June 2011

“This paper sets out the central reasons why complex problems are challenging for traditional approaches to policy and programme implementation, and gives readers the tools to decide in what way the challenges they face are complex. ”
70 pages
ISBN: 978 1 907288 39 5

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Debate: does the private health insurance rebate relieve pressure on public hospitals? – Parliamentary Library Flagpost – 1 June 2011

Posted on June 14, 2011. Filed under: Health Mgmt Policy Planning, Health Policy | Tags: , |

Debate: does the private health insurance rebate relieve pressure on public hospitals? – Parliamentary Library Flagpost – 1 June 2011

“As the Government once again prepares legislation to means test the 30 per cent private health insurance rebate—see this recent Flagpost for background—arguments over whether the rebate eases pressure on public hospitals, or exacerbates it, are likely to re-emerge. Because the rebate subsidises the purchase of private health insurance, which can be used to meet the cost of private hospital services, the private health insurance industry and others argue that it keeps pressure off public hospital services. They warn that means testing the rebate will encourage people to drop their private cover and then turn to the over-stretched public hospital system when they require medical treatment. The Australian Council of Social Services counters that the rebate redirects much-needed funding away from the public system—which those on low incomes rely upon—to the less efficient private sector.”

… continues

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Intersectoral Governance for Health in All Policies: An Integrated Framework – National [Canadian] Collaborating Centre for Healthy Public Policy – April 2011

Posted on May 31, 2011. Filed under: Clin Governance / Risk Mgmt / Quality, Health Mgmt Policy Planning, Health Policy | Tags: |

Intersectoral Governance for Health in All Policies: An Integrated Framework – National [Canadian] Collaborating Centre for Healthy Public Policy – April 2011

“The article proposes an analytical framework for a whole of government approach for public health problems calling for multisectoral participation. It was written as part of an international series of reflections on “Health in all policies” (HiAP) strategies.

The authors, the Centre’s Louise St-Pierre and François-Pierre Gauvin, examine the principal conditions for assuring intersectoral governance for health. These include, notably, questions of leadership, coordination and collaboration, accountability, and cultural elements such as capacity building, value adjustment, and collective learning.

This article may be of interest to anyone studying whole-of-government approaches to health.”

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Method for Synthesizing Knowledge About Public Policies – National Collaborating Centre for Healthy Public Policy – September 2010

Posted on May 31, 2011. Filed under: Clin Governance / Risk Mgmt / Quality, Health Mgmt Policy Planning, Health Policy, Knowledge Translation, Public Hlth & Hlth Promotion | Tags: |

Method for Synthesizing Knowledge About Public Policies – National Collaborating Centre for Healthy Public Policy – September 2010

“The Centre proposes this method as a way to overcome the difficulties underlying the study of public policies.

Public policy can act as a lever for action that affects population health. Therefore, public health actors are called upon to produce knowledge syntheses in order to inform decision makers during the promotion, adoption and implementation of public policies. But studying these policies raises specific challenges.

Drawing inspiration from political science, literature on evidence-informed decision making in public health, literature on evaluation and on deliberative processes, the NCCHPP has developed a knowledge synthesis method that is applicable to public policies.

Using this method, one can document the effects and equity of the policies under study, as well as implementation issues of concern to decision makers (costs, feasibility, acceptability), based on the construction of logic models, on the scientific and grey literatures, and on deliberative processes organized to gather contextual information.”

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Towards better use of evidence in policy formation: a discussion paper – NZ – April 2011

Posted on May 4, 2011. Filed under: Evidence Based Practice, Health Mgmt Policy Planning, Health Policy |

Towards better use of evidence in policy formation: a discussion paper – NZ – April 2011

Sir Peter Gluckman KNZM FRSNZ FRS
Chief Science Advisor to the Prime Minister
April 2011

Extract from the foreword:
“It is important to separate as far as possible the role of expert knowledge generation and evaluation from the role of those charged with policy formation. Equally, it is important to distinguish clearly between the application of scientific advice for policy formation (‘science for policy’) and the formation of policy for the operation of the Crown’s science and innovation system, including funding allocation (‘policy for science’). This paper is concerned with the former. A purely technocratic model of policy formation is not appropriate in that knowledge is not, and cannot be, the sole determinant of how policy is developed. We live in a democracy, and governments have the responsibility to integrate dimensions beyond that covered in this paper into policy formation, including societal values, public opinion, affordability and diplomatic considerations while accommodating political processes.”

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Institute for Government [UK] recommendations for better policy making – 15th April 2011

Posted on April 21, 2011. Filed under: Health Policy | Tags: |

Institute [UK] publishes recommendations for better policy making – 15th April 2011

“The Institute for Government has published the results of its year-long research into better policy making. It has found that despite attempts to improve policy making under the last government, reforms fell short and left civil servants and ministers feeling frustrated.”

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Developing Strategies for Improving Health Care Delivery: Guide to Concepts, Determinants, Measurement, and Intervention Design – World Bank – 2010

Posted on March 31, 2011. Filed under: Health Mgmt Policy Planning, Health Policy, Health Systems Improvement, National Health Strategies | Tags: |

Bradley, E.H., Pallas, S., Bashyal,C., Curry, L., & Berman, P. (June 2010). Developing Strategies for Improving Health Care Delivery: Guide to Concepts, Determinants, Measurement, and Intervention Design. The World Bank: Health Nutrition and Population

“Abstract: This report is a user‟s guide for defining, measuring, and improving the performance of health service delivery organizations. We define six core performance domains: quality, efficiency, utilization, access, learning, and sustainability and provide a compendium of metrics that have been used to measure organizational performance in each of these six domains. The compendium, which includes 116 distinct categories of metrics, is based on a detailed literature review of peer-reviewed empirical studies of health care organizational performance in World Bank client countries. We include a bibliography of studies that have used these measures.

Based on our reading of the literature, we define seven major strategy areas potentially useful for improving performance among health care organizations: 1) standards and guidelines, 2) organizational design, 3) education and training, 4) process improvement and technology and tool development, 5) incentives, 6) organizational culture, and 7) leadership and management. We provide illustrations of facility-level interventions within each of the strategy areas and highlight the conditions under which certain strategies may be more effective than others. We propose that the choice of strategy targeted at organizational level to improve performance should be informed by the identified root causes of the problem, the implementation capabilities of the organization, and the environmental conditions faced by the organization.”   …continues on the site

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Health Systems in Transition – United Kingdom (England): Health System Review – European Observatory on Health Systems and Policies – 2011

Posted on March 29, 2011. Filed under: Health Policy | Tags: |

Health Systems in Transition – United Kingdom (England): Health System Review – European Observatory on Health Systems and Policies – 2011
by Seán Boyle, LSE Health and Social Care, London School of Economics and Political Science

Seán Boyle: United Kingdom (England): Health system review. Health Systems in Transition, 2011; 13(1):1–486.
ISSN 1817–6127

“The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of policy initiatives in progress or under development. HiTs examine different approaches to the organization, financing and delivery of health services and the role of the main actors in health systems; describe the institutional framework, process, content and implementation of health and health care policies; and highlight challenges and areas that require more in-depth analysis.”

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The complexities of decentralization – Euro Observer – Spring 2011

Posted on March 29, 2011. Filed under: Health Policy | Tags: |

The complexities of decentralization – Euro Observer – Spring 2011

Euro Observer is The Health Policy Bulletin of the European Observatory on Health Systems and Policies

Contents
The complexities of decentralization
Centralizing England and decentralizing the United Kingdom: The paradox of power in British health services
Health system decentralization in Spain: a complex balance
Recentralization 10 years later – success or failure in Norway?

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Assessing System Performance for Health Governance – WHO – 28 February 2011

Posted on March 29, 2011. Filed under: Clin Governance / Risk Mgmt / Quality, Health Policy | Tags: , , |

Assessing System Performance for Health Governance – WHO – 28 February 2011

“The Tallinn Charter (2008) stresses the importance of fostering transparency and accountability on the basis of progress against measurable results. It commits each Member State to strive to enhance the performance of its health system to achieve the goal of improved health on an equitable basis. The analysis of performance for informed decision-making on policy is a central theme of the Charter, linked closely to the message of moving “from values to action”. Countries honouring this commitment will have acted to measure, analyse and publicly report on the performance of their health systems and/or the effects of specific reform measures (Interim report on implementation of the Tallinn Charter, WHO 2011).”

One of the working papers from the first meeting of the European Health Policy Forum

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Tallinn Charter: Health Systems for Health and Wealth. Interim report on implementation of the Tallinn Charter – WHO – 1 March 2011

Posted on March 29, 2011. Filed under: Health Policy | Tags: , , |

Tallinn Charter: Health Systems for Health and Wealth.  Interim report on implementation of the Tallinn Charter – WHO – 1 March 2011
WHO European Ministerial Conference on Health Systems, held in Tallinn from 25 to 27 June 2008.

“5. The report has six chapters including this introduction.  …
6. Following Chapter II, the rest of the report will focus in greater depth on three key dimensions on the Charter:
 assessing health system performance as a way of improving governance and accountability (Chapter III);
 ensuring solidarity and health gain in times of financial crisis (Chapter IV);
 strengthening health systems impact through leadership of intersectoral action to improve health (Chapter V).
7. Although health system performance is the focus of Chapter III in particular, it is worth emphasizing that the fundamental pillar of the Tallinn Charter is the emphasis on accountability for performance. This theme accordingly runs through the whole report.”

“This draft interim report on implementation of the Tallinn Charter is submitted to the European Health Policy Forum for High-Level Government Officials for comments and suggestions. This paper and the comments received during the European Health  Policy Forum meeting will then be submitted to the Eighteenth Standing Committee of the Regional Committee (SCRC) at its third session (Copenhagen, 30–31 March 2011). The final interim report will then be submitted to the WHO Regional Committee for Europe at its sixty-first session (Baku, Azerbaijan, 12–15 September 2011).”

One of the working papers from the first meeting of the European Health Policy Forum

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Strengthening Public Health Capacities and Services in Europe: A Framework for Action – WHO – 25 February 2011

Posted on March 29, 2011. Filed under: Health Policy, Public Hlth & Hlth Promotion | Tags: , |

Strengthening Public Health Capacities and Services in Europe: A Framework for Action – WHO – 25 February 2011

Working paper from the first meeting of the European Health Policy Forum

“The document outlines some of the major challenges to health policies and systems in the WHO European Region, including consideration of public health services and infrastructures. In view of the differences in the way European health systems and public health services are organized, operated and governed, the paper makes a clear statement on public health and health systems, including definitions, boundaries and concepts.

The paper proposes a set of ten horizontal essential public health operations (EPHOs), and sets out the core public health services within each of them. These will become the unifying and guiding principles for any European health authorities monitoring, evaluating or setting policies, strategies and actions for reforms and improvement in public health. The paper highlights the major avenues that the WHO Regional Office for Europe intends to take in order to tackle public health and health system challenges. It concludes by proposing specific actions and measures to move towards the attainment of the objectives set.”

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NHS reforms in England: managing the transition – Nuffield Trust – 9 March 2011

Posted on March 18, 2011. Filed under: Health Mgmt Policy Planning, Health Policy | Tags: , |

NHS reforms in England: managing the transition – Nuffield Trust – 9 March 2011

Author: Judith Smith & Anita Charlesworth

“The period from 2011 to 2014 is likely to be the most challenging ever faced by the NHS. Primary Care Trusts (PCTs) are required to hold 2 per cent of their allocations with Strategic Health Authorities (SHAs). Allowing for this, the recurrent resources available to PCTs to spend in 2011/12 fall by 2.3 per cent on average in real terms, with a minimum cut of 0.3 per cent and some PCTs facing a reduction of 2.5 per cent. Providers face the challenge of making a 4 per cent overall efficiency saving at the same time as they experience a 1.5 per cent cut to the tariff by which they are paid.

This Nuffield Trust policy response assesses the 2011/12 Operating Framework for the NHS together with guidance on the operation of Payment by Results (PbR) in 2011/12. It sets out the key challenges associated with managing the transition to a reformed NHS, as envisaged in the White Paper: Equity and Excellence: Liberating the NHS, and proposes ways in which the risks associated with transition might be mitigated.”  … continues on the site

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Coalition policy towards the NHS: past contexts and current trajectories – January 2011

Posted on March 18, 2011. Filed under: Health Mgmt Policy Planning, Health Policy | Tags: |

Coalition policy towards the NHS: past contexts and current trajectories – January 2011
by Martin Gorsky

“Executive summary
The Coalition programme for the NHS broadly continues the trajectory of policy development pursued by both parties since 1989. Once adopted it will provide the clearest test yet of the internal market model begun under Prime Ministers Margaret Thatcher and John Major and developed by New Labour.
The current funding settlement will see the rate of real increase severely constrained over four years. This is historically unprecedented.
History suggests several risks attach to rapid adoption of the planned structural reform. These relate to doctors’ ability and willingness to lead consortia, the reduction of managerial capacity, and unresolved weaknesses of commissioning.
The state’s retreat from centralised control may also prove contentious. ‘Top-down’ targets and tough bureaucratic rationing have been effective tools in certain respects.
Proposals for an autonomous NHS Commissioning Board must confront the ‘Enoch Powell problem’ of how to square non-ministerial management with political accountability in a single-payer system.”  …continues on the site

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Neat, Plausible and Wrong: The Myth of Health Care Sustainability – Canadian Doctors for Medicare (CDM) – February 2011

Posted on March 4, 2011. Filed under: Health Mgmt Policy Planning, Health Policy | Tags: |

Neat, Plausible and Wrong: The Myth of Health Care Sustainability – Canadian Doctors for Medicare (CDM) – February 2011

Extract:

“The “Sustainability” Myth
The assertion that Medicare is “unsustainable” has been repeated so many times that in some circles it has become accepted as indisputable fact. Critics of Medicare assert that the cost of our public health care system is growing at an alarming pace.  … 
The Facts:
Medicare and public health care expenditures are not growing rapidly. Any crisis in health care funding has nothing to do with Medicare. The costs of Medicare – medically necessary hospital and physician services – are not growing significantly and can easily be sustained.”

…continues

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A Citizen’s Guide to Health Indicators – Health Council of Canada – January 2011

Posted on February 8, 2011. Filed under: Health Mgmt Policy Planning, Health Policy, Patient Participation | Tags: , |

A Citizen’s Guide to Health Indicators – Health Council of Canada – January 2011

“For individuals with an interest in health care and how to use health information, this resource provides an introduction to health indicators, what they are, where they come from, and how they can influence health care decisions and policies. Health indicators have become a major part of the health information that many Canadians see daily. The guide defines indicators as high-quality statistics or measures that help individuals understand and compare Canadians’ health and health care. “

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Draft National Road Safety Strategy 2011 – 2020 – Australian Government Department of Infrastructure and Transport

Posted on February 7, 2011. Filed under: Health Policy | Tags: , , |

Draft National Road Safety Strategy 2011 – 2020 – Australian Government Department of Infrastructure and Transport

“On average, four people are killed and 80 are seriously injured every day on Australia’s roads. Almost everyone has, at some stage, been affected by a road crash.

Australian Transport Ministers have asked the heads of transport and roads agencies around the country to work together to prepare a new 10-year National Road Safety Strategy for the period from 2011 to 2020. The new strategy is intended to set an ambitious long-term vision for road safety improvement in Australia and to guide national action over the coming decade.

Transport agencies have been working hard to develop a draft National Road Safety Strategy and would like to hear from the community on its proposals.”     … continues on the site

Comment on the draft strategy from the ABC:
Call for total ban on phones while driving

 “There is a push for the use of mobile phones to be totally banned in cars, after a report found drivers using phones are at a much greater risk of crashing – even when using them hands-free.

A draft national road safety report recommended the consideration of the total ban on mobile phone use in vehicles as one of a range of strategies to cut the road toll.

Researcher Mark Stevenson from Monash University’s accident research centre says the report shows the risks to drivers.

“It’s around a fourfold increased risk if you’re holding the phone, in terms of crashing resulting in an injury,” he said.

“Hands-free, it’s around 3.7 times the risk.” ” …continues on the site

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Economic impacts of alcohol pricing policy options in the UK – RAND – 2011

Posted on February 4, 2011. Filed under: Alcohol & Drug Dep., Health Policy | Tags: |

Economic impacts of alcohol pricing policy options in the UK – RAND – 2011

by Priscillia Hunt, Lila Rabinovich, Ben Baumberg

“In an effort to understand the economic implications associated with various possible measures to tackle alcohol harms, the Home Office commissioned RAND Europe to undertake research into three particular policies — minimum pricing, ban on below-cost sales, and taxation. This study presents evidence on the links between alcohol prices and consumption and the economic impacts of each policy option, the statistical data describing the market for alcohol and findings from interviews with key stakeholders.”

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Paternalism in social policy—when is it justifiable? – Parliamentary Research Paper – 15 December 2010

Posted on January 21, 2011. Filed under: Health Mgmt Policy Planning, Health Policy | Tags: , |

Paternalism in social policy—when is it justifiable? – Parliamentary Research Paper – 15 December 2010

ISSN 1834-9854

Parliament of Australia Department of Parliamentary Services
Matthew Thomas and Luke Buckmaster  Social Policy Section

“Executive summary

Governments are increasingly called upon to introduce paternalist policies—that is, policies that  restrict the choices of individual citizens in their own interests and without their consent.

Paternalist policies are often controversial, not least because they infringe a key principle of  liberal societies; namely, that citizens are best placed to know their own interests.

While paternalist policies are often contentious, they are nevertheless ubiquitous. This suggests  that the main issue is not whether or not paternalism itself is justifiable, but rather the  conditions under which particular paternalist policies may be said to be justifiable.

This paper argues that paternalist policies may be considered justifiable under circumstances  where high stakes decisions are involved, the decisions being made by individuals are  irreversible and it is possible to identify failures in people’s reasoning. It is further argued that if  paternalist interventions are able to be justified in terms of people’s own values and  preferences, then this adds weight to their acceptability given that they do not undermine  people’s autonomy.

Relatively little scholarly attention has been devoted to the questions of what particular forms of  paternalism may be deemed to be appropriate. This paper suggests that the principles of  discrimination, proportionality, accountability and efficacy provide a framework with which to  consider the appropriateness or otherwise of various forms of paternalist intervention.”

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Involving the public in healthcare policy: An update of the research evidence and proposed evaluation framework – RAND Corporation – 2010

Posted on January 14, 2011. Filed under: Health Policy, Patient Participation | Tags: |

Involving the public in healthcare policy: An update of the research evidence and proposed evaluation framework – RAND Corporation – 2010
Pages: 81
Document Number: TR-850-BF
Year: 2010
Series: Technical Reports

“Public involvement has been advocated as a means to enhance the responsiveness of healthcare systems. Yet despite its obvious appeal, the concept has remained poorly defined and its rationale and objectives are rarely specified when applied to the healthcare sector. This report aims to update existing work on both the conceptual and the empirical evidence for public involvement in healthcare policy. We draw on a comprehensive review of the published literature, supplemented by exploratory observations from selected public involvement initiatives in different health system contexts.

Despite a growing literature base, the concept of “public involvement” remains poorly defined although as a complex and multidimensional phenomenon a call for simple clarification of the concept may not be desirable. Public involvement practice varies by underlying rationale, public motivation to become involved, and specific mechanisms and their relationship to wider social processes. We propose to interpret the term “involvement” as a descriptive umbrella term for the spectrum of processes and activities that bring the public into the decision-making process as it has the benefit of providing a fuller picture of potential involvement, which is independent of normative assumptions.

Sound empirical evidence of the outcomes of public involvement activities in healthcare remains underdeveloped. We find evidence for the developmental role of public involvement while the evidence for instrumental benefits of public involvement initiatives is less well documented. Yet overly focusing on outcomes of public involvement risks missing the normative argument that involving the public in the process may be seen to be of intrinsic value in itself.”

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MyHospitals – Australian Government site

Posted on January 10, 2011. Filed under: Health Mgmt Policy Planning, Health Policy |

MyHospitals – Australian Government site

“MyHospitals is an Australian Government initiative to inform the community about hospitals by making it easier for people to access information about how individual hospitals are performing.

On this website you’ll find information about bed numbers, patient admissions and hospital accreditation, as well as the types of specialised services each hospital provides. The website also provides comparisons to national public hospital performance statistics on waiting times for elective surgery and emergency department care, where data are available.

This website draws on data collected by the Australian Institute of Health and Welfare, provided by state and territory health departments and private hospitals. For more information about the collection and reporting of hospital statistics in Australia, go to www.aihw.gov.au (external link, opens in a new window).”

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Decisions, Decisions: Family Doctors as Gatekeepers to Prescription Drugs and Diagnostic Imaging in Canada – September 2010

Posted on September 28, 2010. Filed under: General Practice, Health Economics, Health Policy | Tags: |

Decisions, Decisions: Family Doctors as Gatekeepers to Prescription Drugs and Diagnostic Imaging in Canada – September 2010

Health Council of Canada

Extract from the foreword:

“As Canada’s population ages and more and more Canadians live with chronic conditions, the use of Canada’s universal,  publicly-funded health care system increases. In our 2009 discussion paper, Value for Money: Making Canadian Health Care Stronger, we found that this increased use – among other factors – had caused health care spending to double over the last decade, reaching an all-time high of $183 billion in 2009.

As a result, we set out to better understand three major drivers of this use – physician services, prescription drugs, and diagnostic imaging – and the relationships among these drivers. We consulted researchers, experts, and government officials in the fields of physician services, pharmaceuticals, and diagnostic imaging. We also turned to other national organizations – noted in the acknowledgements section – for their data and expertise.

In this report, we discuss the role of family physicians as gatekeepers in the use of prescription drugs and diagnostic imaging, since they are often the first point of contact for Canadians, and their decisions directly impact which specific health care services are used. In particular, we set out to identify the main factors – including the available tools and resources – that influence these physician decisions and ensure that health services are safe and appropriate, an objective shared by all Canadians who are interested in better medicine and ensuring a sustainable health care system.”

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Posted on September 28, 2010. Filed under: Health Policy, Knowledge Translation | Tags: |

Policy-Making as a Struggle for Meaning: Disentangling Knowledge Translation across International Health Contexts – June 2010

Aris Komporozos-Athanasiou, Eivor Oborn, Michael Barrett and Yolande Chan (authors)
School of Management, Royal Holloway University of London Working Paper Series  SoMWP–1005
ISBN: 978-1-905846-46-7

Abstract: Over the last decade, research in medical science has focused on knowledge translation and diffusion of best practices to enable improved health outcomes. However, there has been less attention given to the role of policy development in influencing the translation of best practice across different national contexts. This paper argues that the underlying set of public discourses and ideological presuppositions of healthcare policy significantly influence its development with implications for the dissemination of best practices. Our research examines the policy discourses surrounding the treatment of stroke across Canada and UK, and how they are constituted by different underlying meanings of innovative best practice, user participation, and service restructuring. These findings provide an important yet overlooked starting point for understanding the role of policy development in knowledge transfer and the translation of science into health practice.

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A National Health and Hospitals Network for Australia’s Future Delivering the Reforms – 7 July 2010

Posted on July 8, 2010. Filed under: Health Mgmt Policy Planning, Health Policy, Health Systems Improvement, Nat Hlth & Hosps Reform Comm |

A National Health and Hospitals Network for Australia’s Future Delivering the Reforms – 7 July 2010

ISBN: 978-1-74241-272-6 Online ISBN: 978-1-74241-273-3 Publications Number: 6803
A National Health and Hospitals Network for Australia’s Future – Delivering the Reforms (PDF 3.7 MB) 

This document outlines Government activities over coming months and years, including timelines and major milestones to implement the major health reform agreed by COAG in April 2010.

The Government will closely monitor progress against the milestones for these reforms and will provide regular updates on progress through [the Your Health website].

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Future Foundations: towards a new culture in the NHS – Policy Exchange – 18 March 2010

Posted on April 6, 2010. Filed under: Health Mgmt Policy Planning, Health Policy, Health Systems Improvement | Tags: |

Future Foundations: towards a new culture in the NHS – Policy Exchange – 18 March 2010

ISBN: 978-1-906037-71-4
 
“Writing for think tank Policy Exchange, the architects of the Government’s Foundation Trust programme call for a wholesale change in the culture of the NHS. Currently hampered by tight central control, which stifles innovation and effective delivery of services, their report argues that Ministers and Parliament still assume that the only approach is to exert managerial authority and issue top down instructions.

The report, Future Foundations, is co-authored by Paul Corrigan, former health advisor to Tony Blair and Health Secretaries Alan Milburn and John Reid, and Bill Moyes, who was until recently the Chairman and Chief Executive of the foundation trust regulator Monitor. The report argues that the continuing obsession at the top of Government with ‘being seen to do something’ means that ministers think and act if they were responsible for almost all significant operational decisions, in effect undermining the independence that was at the heart of creating Foundation Trusts.”

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Health Systems Evidence – McMaster University (Canada) – Website

Posted on March 3, 2010. Filed under: Clin Governance / Risk Mgmt / Quality, Evidence Based Practice, Health Economics, Health Mgmt Policy Planning, Health Policy, Health Systems Improvement | Tags: |

Health Systems Evidence – McMaster University (Canada)

“Health Systems Evidence is a continuously updated repository of syntheses of research evidence about governance, financial and delivery arrangements within health systems, and about implementation strategies that can support change in health systems.”

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How Can We Support the Use of Systematic Reviews in Policymaking? PLoS Medicine – 17 November 2009

Posted on December 15, 2009. Filed under: Health Mgmt Policy Planning, Health Policy |

Lavis JN (2009) How Can We Support the Use of Systematic Reviews in Policymaking? PLoS Med 6(11): e1000141. doi:10.1371/journal.pmed.1000141   Published November 17, 2009

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NHS 2010 – 2015: from good to great. Preventative, people-centred, productive – 10 December 2009

Posted on December 15, 2009. Filed under: Health Mgmt Policy Planning, Health Policy, Health Systems Improvement, Preventive Healthcare | Tags: |

NHS 2010 – 2015: from good to great. Preventative, people-centred, productive.

Download NHS 2010 – 2015: from good to great (PDF, 919K)

 Document type: Command paper
 Author: Department of Health
 Published date: 10 December 2009
 Product number: CM 7775
 Gateway reference: 13179
 Pages: 64

“Secretary of State Andy Burnham introduces a five-year plan to reshape the NHS to meet the challenge of delivering high quality health care in a tough financial environment. The report describes practical measures to meet the demands of an aging population and the increased prevalence of lifestyle diseases. The vision is for an NHS that is organised around patients whether at home, in a community setting or in hospital. There will be a renewed focus on prevention with the ambition of delivering cost-effective high quality care across the service.”

King’s Fund analysis of the document.

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Steering without navigation equipment: the lamentable state of Australian health policy reform – article – ANZ Helath Policy – 2009

Posted on December 4, 2009. Filed under: Health Economics, Health Policy, Health Systems Improvement |

Steering without navigation equipment: the lamentable state of Australian health policy reform
Jeff RJ Richardson
Australia and New Zealand Health Policy 2009, 6:27doi:10.1186/1743-8462-6-27
Published: 30 November 2009

“Abstract (provisional)

Background
Commentary on health policy reform in Australia often commences with an unstated logical error: Australians’ health is good, therefore the Australian Health System is good. This possibly explains the disconnect between the options discussed, the areas needing reform and the generally self-congratulatory tone of the discussion: a good system needs (relatively) minor improvement.

Results
This paper comments on some issues of particular concern to Australian health policy makers and some areas needing urgent reform. The two sets of issues do not overlap. It is suggested that there are two fundamental reasons for this. The first is the failure to develop governance structures which promote the identification and resolution of problems according to their importance. The second and related failure is the failure to equip the health services industry with satisfactory navigation equipment – independent research capacity, independent reporting and evaluation – on a scale commensurate with the needs of the country’s largest industry. These two failures together deprive the health system – as a system – of the chief driver of progress in every successful industry in the 20th Century.

Conclusion
Concluding comment is made on the National Health and Hospitals Reform Commission (NHHRC) . This continued the tradition of largely evidence free argument and decision making. It failed to identify and properly analyse major system failures, the reasons for them and the form of governance which would maximise the likelihood of future error leaning. The NHHRC itself failed to error learn from past policy failures, a key lesson from which is that a major – and possibly the major – obstacle to reform, is government itself. The Commission virtually ignored the issue of governance. The endorsement of a monopolised system, driven by benevolent managers will miss the major lesson of history which is illustrated by Australia’s own failures.”

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Ireland: Health system review – November 2009

Posted on November 17, 2009. Filed under: Health Mgmt Policy Planning, Health Policy, Health Systems Improvement | Tags: |

McDaid D, Wiley M, Maresso A and Mossialos E. Ireland: Health system review. Health Systems in Transition, 2009; 11(4): 1 – 268
ISSN 1817-6127   European Observatory on Health Systems and Policies

“The Health Systems in Transition (HiT) profiles are country-based reports that provide a detailed description of a health system and of reform and policy initiatives in progress or under development in a specific country. Each profile is produced by country experts in collaboration with the Observatory’s research directors and staff. In order to facilitate comparisons between countries, the profiles are based on a template, which is revised periodically.”

The European Observatory on Health Systems and Policies is a partnership between the World Health Organization Regional Office for Europe, the Governments of Belgium, Finland, Norway, Slovenia, Spain and Sweden, the Veneto Region of Italy, the European Investment Bank, the World Bank, the London School of Economics and Political Science, and the London School of Hygiene & Tropical Medicine.

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Deliberative Processes: Inventory of Resources – National Collaborating Centre for Healthy Public Policy (Canada) – October 2009

Posted on October 27, 2009. Filed under: Health Policy, Public Hlth & Hlth Promotion | Tags: |

Deliberative Processes: Inventory of Resources – National Collaborating Centre for Healthy Public Policy (Canada) – October 2009

“This inventory of resources was developed in response to interest in deliberative processes expressed by public health actors, many of whom are interested in the role deliberative processes can play in support of efforts to promote healthy public policy.
This inventory is intended to launch inquiry into the subject of deliberative processes as applied to public policy and thus does not claim to be exhaustive. The inventory will be updated periodically to reflect developments in this field.”

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Why Public Hospitals Are Overcrowded: Ten Points for Policymakers – Centre for Independent Studies, Australia – 23 July 2009

Posted on July 28, 2009. Filed under: Emergency Medicine, Health Mgmt Policy Planning, Health Policy, Health Systems Improvement | Tags: |

Why Public Hospitals Are Overcrowded: Ten Points for Policymakers /  Jeremy Sammut
Papers in Health and Ageing (8)  CIS Policy Monograph 99   23 July 2009   The Centre for Independent Studies (CIS)

“Executive Summary

Beside the perennial and serious problem of ever-lengthening waiting lists for elective surgery, major public hospitals are unable to provide timely emergency treatment and unplanned admission to a hospital bed for significant numbers of acutely ill patients.

The technical cause of the hospital crisis and the nationwide shortage of acute inpatient beds is 25 years of cuts to public hospital beds, while the systemic cause is the misallocation of resources away from frontline, bed-based hospital care and the corresponding growth in the size, cost and complexity of the state government bureaucracies that mismanage the public hospital system.

Health bureaucrats and select public sector interest groups routinely claim that greater public spending on prevention and on alternative models of care will solve the crisis. These politically convenient myths and misconceptions have convinced bed-phobic state and federal governments that opening more beds is unnecessary.

This paper states the case for structural reform to ensure the Australian hospital system is equipped to cope with the pressures created by an ageing population. Policymakers should keep the following 10 points in mind:”

…continues on the website

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NHS Mutual: engaging staff and aligning incentives to achieve higher levels of performance – 1 July 2009

Posted on July 2, 2009. Filed under: Health Policy, Health Systems Improvement, Workforce | Tags: , , |

NHS Mutual: engaging staff and aligning incentives to achieve higher levels of performance
Author: Chris Ham & Jo Ellins
Publisher: Nuffield Trust    1 July 2009     ISBN-13: 978-1-905030-39-2
Full text of the report

“Increasing staff involvement and motivation is critical to NHS reform. Since 1998, the NHS has launched many policy initiatives aimed at improving staff engagement. Despite some success, there is evidence that exhortation and guidance alone will not bring widespread changes to practice, and that ways for staff to participate formally in the running of their organisations should be explored.

NHS Mutual: Engaging staff and aligning incentives to achieve higher levels of performance looks at the factors that drive staff engagement in the health service, and examines various models of employee ownership in use both within and outside the NHS. The authors conclude that there are at least five ways in which employee ownership can be fostered within the health service, and that the time is now right for the Government to support those willing to test different approaches.

NHS Mutual is important reading for health care leaders and policy-makers. It will also be of interest to researchers and academic institutions with an interest in this area, as well as all those concerned with improving staff motivation and reviewing the options for social ownership in the public sector.”

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The preferred doctor scheme: A political reading of a French experiment of Gate-keeping – March 2009

Posted on April 17, 2009. Filed under: Health Mgmt Policy Planning, Health Policy, Health Systems Improvement |

The preferred doctor scheme: A political reading of a French experiment of gate-keeping
Michel Naiditch (Denis Diderot University, IRDES)  Paul Dourgnon (IRDES)
March 2009

Study objective:   Since January 2005 France is exploring a new scheme termed “preferred doctor” (médecin traitant) which can be considered as an innovative version of Gate Keeping in order to reduce the excess of postulated excess in health consumption, more especially access to specialist care. This paper describes the political process which lead to its implementation, tries to relate some of the scheme specific features with its results after one year implementation and tries to catch a glimpse for the next steps of the reform.

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Measuring disparaties in health status and in access and use of health care in OECD countries – report 9 March 2009

Posted on April 17, 2009. Filed under: Health Mgmt Policy Planning, Health Policy | Tags: |

Measuring disparaties in health status and in access and use of health care in OECD countries – report 9 March 2009

OECD Health Working Papers Number 32

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