The practice of system leadership: Being comfortable with chaos – King’s Fund – 20 May 2015

Posted on May 21, 2015. Filed under: Health Mgmt Policy Planning | Tags: , |

The practice of system leadership: Being comfortable with chaos – King’s Fund – 20 May 2015

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Acute hospitals and integrated care: From hospitals to health systems – King’s Fund – 19 March 2015

Posted on March 20, 2015. Filed under: Health Mgmt Policy Planning, Health Systems Improvement | Tags: , |

Acute hospitals and integrated care: From hospitals to health systems – King’s Fund – 19 March 2015

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Staff engagement: Six building blocks for harnessing the creativity and enthusiasm of NHS staff – King’s Fund – 19 February 2015

Posted on February 25, 2015. Filed under: Workforce | Tags: , |

Staff engagement: Six building blocks for harnessing the creativity and enthusiasm of NHS staff – King’s Fund – 19 February 2015

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Population health systems: Going beyond integrated care – King’s Fund – 23 February 2015

Posted on February 25, 2015. Filed under: Public Hlth & Hlth Promotion | Tags: , |

Population health systems: Going beyond integrated care – King’s Fund – 23 February 2015

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Managing quality in community health care services – King’s Fund – 4 December 2014

Posted on December 18, 2014. Filed under: Clin Governance / Risk Mgmt / Quality, Community Services | Tags: |

Managing quality in community health care services – King’s Fund – 4 December 2014

“Community health care services provide vital care out of hospital for millions of people. From children’s services to care for older people and end-of-life support, the community sector plays a key part in meeting the challenges facing our health and care system. This report presents findings from a small-scale study into how quality is managed in community services. It explores how community care providers define and measure quality and recommends important next steps to support better measurement and management of quality.”

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Managing quality in community health care services – The King’s Fund – 4 December 2014

Posted on December 5, 2014. Filed under: Community Services | Tags: |

Managing quality in community health care services – The King’s Fund – 4 December 2014

“Community health care services provide vital care out of hospital for millions of people. From children’s services to care for older people and end-of-life support, the community sector plays a key part in meeting the challenges facing our health and care system. This report presents findings from a small-scale study into how quality is managed in community services. It explores how community care providers define and measure quality and recommends important next steps to support better measurement and management of quality.”

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The reconfiguration of clinical services. What is the evidence? – The King’s Fund – 25 November 2014

Posted on November 28, 2014. Filed under: Health Mgmt Policy Planning, Health Systems Improvement | Tags: |

The reconfiguration of clinical services. What is the evidence? – The King’s Fund – 25 November 2014

“The reconfiguration of clinical services continues to generate public and political controversy, locally and nationally. Given significant financial and workforce constraints, now and in the future, pressure to reconfigure services is only likely to increase. But what are the key drivers of reconfiguration and what is the evidence to underpin it?

This paper aims to help those planning and implementing major clinical service reconfigurations ensure that change is as evidence-based as possible. It investigates the five key drivers – quality, workforce, cost, access and technology – across 13 clinical service areas, summarising the research evidence and professional guidance available in each. It builds on a major forthcoming analysis of reviews of service reconfigurations commissioned by the National Institute of Health Research and conducted by the National Clinical Advisory Team (NCAT). “

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What is the evidence on the economic impacts of integrated care? – Integrated Care Summit – The King’s Fund, 14 October 2014

Posted on October 29, 2014. Filed under: Health Systems Improvement | Tags: , |

What is the evidence on the economic impacts of integrated care? – Integrated Care Summit – The King’s Fund, 14 October 2014

Ellen Nolte, Emma Pitchforth

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Specialists in out-of-hospital settings: Findings from six case studies – King’s Fund – 22 October 2014

Posted on October 24, 2014. Filed under: Health Systems Improvement, Medicine | Tags: |

Specialists in out-of-hospital settings: Findings from six case studies – King’s Fund – 22 October 2014

“Demographic changes, technological advances and the changing pattern of disease are pushing up the numbers of patients with complex needs who require treatment in the community. But outside hospital, the resources and expertise are often not available to treat them, and patient care can be disjointed as different parts of the system fail to understand each other. In response, consultants in some areas of England are developing services that link secondary, primary, community and social care professionals.

The King’s Fund visited six services where consultants are delivering or facilitating care outside hospital. This report presents the findings from those visits as case studies. It identifies key characteristics and challenges to this way of working and seeks out evidence of the benefits to patients and the NHS more broadly.”

Case studies and interviews

Portsmouth and South East Hampshire diabetes service
Leeds interface geriatrician service
Imperial child health general practice hubs
Sunderland dermatology and minor surgery service
Haywood rheumatology centre
Whittington respiratory service

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System leadership: Lessons and learning from AQuA’s Integrated Care Discovery Communities – The King’s Fund – 14 October 2014

Posted on October 20, 2014. Filed under: Health Mgmt Policy Planning | Tags: , |

System leadership: Lessons and learning from AQuA’s Integrated Care Discovery Communities – The King’s Fund – 14 October 2014

“A consensus is emerging in England around the concept of ‘integrated care’ as the best hope for a sustainable NHS. For leaders in the health care system, this represents an immense challenge. Leading across complex interdependent systems of care is a new and different role, undertaken alongside the already difficult task of leading successful institutions.
This paper seeks to identify the skills, knowledge and behaviours required of new system leaders and to learn from systems attempting to combine strong organisational leadership with collaborative system-level leadership approaches. The paper draws on three years’ development work with leaders in health care systems in north-west England, undertaken by the Advancing Quality Alliance (AQuA) and The King’s Fund which has adopted a ‘discovery’ approach to developing integrated care and the leadership capabilities supporting it.”

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Financial failure in the NHS: What causes it and how best to manage it – The King’s Fund – 9 October 2014

Posted on October 13, 2014. Filed under: Health Economics | Tags: |

Financial failure in the NHS: What causes it and how best to manage it – The King’s Fund – 9 October 2014

“This report describes the current financial state of the NHS and the reasons for the deterioration in financial performance and ultimately financial failure. These include weak leadership, legacy costs, PbR, and the impact of the wider health economy.
It considers the challenge of the conflict between quality of care and financial balance and sets out the approaches used to avert financial failure and to deal with it once it occurs. The role of ‘bail-outs’, loans, Public Dividend Capital, increased tariffs, whole health economy solutions, mergers and the importance of leadership are all considered. The report then sets out some recommendations for the future.”

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Transforming mental health: A plan of action for London – King’s Fund – 25 September 2014

Posted on September 26, 2014. Filed under: Mental Health Psychi Psychol | Tags: |

Transforming mental health: A plan of action for London – King’s Fund – 25 September 2014

“The government’s mandate for achieving parity of esteem between physical and mental health has put the spotlight on mental health provision. In London, meeting the mental health needs of the large and diverse population poses major challenges, and the London Health Board has identified improving the mental wellbeing of Londoners as a priority. But so far, there has been little consideration of what is required to meet the future mental health needs of London’s population and how this can be achieved.

This report describes a vision for the future of mental health provision in London, generated through a process of engagement with key stakeholders in the capital. The vision is based on a collaborative, integrated approach towards mental health that is relevant in London and elsewhere.”

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Evaluating our hospital inspection model: Report by Manchester Business School and The Kings Fund – 30 July 2014

Posted on August 1, 2014. Filed under: Clin Governance / Risk Mgmt / Quality | Tags: , |

Evaluating our hospital inspection model: Report by Manchester Business School and The Kings Fund – 30 July 2014

Evaluation helps hospital inspection development – Care Quality Commission – 30 July 2014

“A report we have published today evaluates the first two waves of our new style hospital inspections.

The report covers inspections carried out in 18 hospital trusts between September 2013 and April 2014.

The evaluation, by researchers from Manchester Business School and The King’s Fund was commissioned by us as part of our ‘learning by doing’ approach.

The authors found that the new approach commands strong credibility, in particular through the use of specialists to inform assessments, and the granular detail of ratings within services rather than at provider level, with the report stating:

“Overall CQC’s new acute regulatory model receives more or less universal endorsement from stakeholders, not least from the hospitals themselves, and is seen as transformative in comparison with the form of regulation it replaces. It is regarded as much more credible, authoritative, rigorous and in-depth and much less likely to miss any issues of significant concern.”

The new inspection method was evolving even as the evaluation was carried out, and will continue to evolve. The report will inform that evolution.”

… continues on the site

 

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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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Medical engagement: A journey not an event – The King’s Fund – 10 July 2014

Posted on July 11, 2014. Filed under: Medicine | Tags: |

Medical engagement: A journey not an event – The King’s Fund – 10 July 2014

” What is good medical engagement? In those organisations where it exists, how has good medical engagement been created and sustained? These questions are at the heart of this report, which builds on earlier work from The King’s Fund on medical leadership.

This report is based on case studies of four NHS trusts with acknowledged high levels of medical engagement. It aims to help other organisations that are seeking to create cultures in which doctors want to engage more in the management, leadership and improvement of services. Based on interviews with a range of executives, senior and junior doctors, the report presents key features of each of the four trusts. Its final analytical section highlights common themes and includes a checklist to allow organisations and individuals to assess how far medical engagement is being sought and developed.”

… continues on the site

 

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Future organisational models for the NHS: Perspectives for the Dalton review – The King’s Fund – 1 July 2014

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

Future organisational models for the NHS: Perspectives for the Dalton review – The King’s Fund – 1 July 2014

“With a growing number of health care providers in deficit and others placed in special measures because of concerns about the quality of their care, the search is on to find ways in which they could be supported. Sir David Dalton’s forthcoming review provides a timely opportunity to explore the range of organisational models that providers could use to meet their current strategic and financial challenges.

This publication explores some of the organisational options available, including how high-performing NHS organisations might support providers in difficulty. It provides an evidence review and a range of individual perspectives on some of those new organisational arrangements, in health and other sectors, nationally and internationally – in a bid to inform the work of the Dalton review. The individual contributions highlight the benefits and challenges of different organisational models.”

… continues on the site

 

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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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Patient and Family-Centred Care: practical tools to improve patient experience – King’s Fund – 4 June 2014

Posted on June 5, 2014. Filed under: Patient Participation | Tags: , |

Patient and Family-Centred Care: practical tools to improve patient experience – King’s Fund – 4 June 2014

Details

Blog entry

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Developing collective leadership for health care – The King’s Fund – 21 May 2014

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

Developing collective leadership for health care – The King’s Fund – 21 May 2014

“With the NHS facing bigger challenges than ever before, leaders must ensure that cultures within health care organisations sustain high-quality, compassionate and ever-improving care. Key to shaping these cultures is leadership.

This paper argues that collective leadership – as opposed to command-and-control structures – provides the optimum basis for caring cultures. Collective leadership entails distributing and allocating leadership power to wherever expertise, capability and motivation sit within organisations. NHS boards bear ultimate responsibility for developing strategies for coherent, effective and forward-looking collective leadership.

This paper explains the interaction between collective leadership and cultures that value compassionate care, by drawing on wider literature and case studies of good organisational practice. It outlines the main characteristics of a collective leadership strategy and the process for developing this.”

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Supporting people to manage their health: An introduction to patient activation – King’s Fund – 16 May 2014

Posted on May 16, 2014. Filed under: Chronic Disease Mgmt, Preventive Healthcare | Tags: |

Supporting people to manage their health: An introduction to patient activation – King’s Fund – 16 May 2014

” With 60 to 70 per cent of premature deaths caused by detrimental health behaviours, it is vital that people engage more with improving their own health. This paper introduces a way of conceptualising and measuring that engagement known as ‘patient activation’.

Patient activation can be used to reduce health inequalities and deliver improved outcomes, better quality care and lower costs. Drawing on US and UK-based evidence, the paper describes the robust patient-reported measure – the PAM – used to gauge patient activation. PAM measures an individual’s knowledge, skill, and confidence for self-management. Research shows that appropriately designed interventions can increase patients’ levels of activation, with associated health benefits. The paper explores how this is being achieved in practice and offers recommendations for extending early use of the PAM in the United Kingdom.”

How do people become good managers of their own health? – King’s Fund – 16 May 2014

 

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The NHS productivity challenge: Experience from the front line – The King’s Fund – 1 May 2014

Posted on May 1, 2014. Filed under: Health Economics | Tags: , |

The NHS productivity challenge: Experience from the front line – The King’s Fund – 1 May 2014

“The unprecedented slowdown in the growth of NHS funding in England since 2010 required the NHS to pursue the most ambitious programme of productivity improvement since its foundation. It has broadly risen to the challenge, with pay restraint, cuts in central budgets, and the abolition of some tiers of management producing significant savings. But the strongest pressure has been applied and felt at the front line, by hospitals and other local service providers, faced with squeezing more and more value from every health care pound.

This report describes how six trusts have been grappling with the productivity challenge. It also suggests ways to divert the NHS and social care from their current trajectory, which is heading towards a major crisis.”

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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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Accountable care organisations in the United States and England: Testing, evaluating and learning what works – King’s Fund – 27 March 2014

Posted on March 28, 2014. Filed under: Chronic Disease Mgmt | Tags: , |

Accountable care organisations in the United States and England: Testing, evaluating and learning what works – King’s Fund – 27 March 2014

“The health system in England is facing a number of challenges including an ageing population, an increasing number of people with multiple, long-term conditions and a difficult financial climate. To meet these challenges, more integrated approaches to care delivery are needed to improve both the quality of care and patients’ experience.

More people now need care across a number of different settings – hospitals, primary care, clinics, nursing homes and home care agencies – which are not co-ordinated, resulting in duplication of cost and effort and gaps in information and communication. In the United States, accountable care organisations (ACOs) – a group of providers that take responsibility for providing all the care for a given population for a specified period of time – have been developed to provide a more integrated approach to care.

Accountable care organisations in the United States and England describes the different types of ACOs emerging in the United States; presents some early evidence on their performance; assesses the future for ACOs; and discusses the implication of these developments for integrated care initiatives in England.”

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Evaluating the Care Quality Commission’s acute hospital regulatory model: emerging findings – Care Quality Commission – 14 March 2014

Posted on March 26, 2014. Filed under: Acute Care, Clin Governance / Risk Mgmt / Quality | Tags: , |

Evaluating the Care Quality Commission’s acute hospital regulatory model: emerging findings – Care Quality Commission – 14 March 2014

“In September 2013, the Care Quality Commission asked a team from Manchester Business School and the King’s Fund to undertake a formative evaluation of CQC’s new acute hospital regulatory model.

The design of the new acute hospital regulatory model is described in the inspection framework [1] and guidance, and in other CQC documents such as the logic model [2]. It is an almost complete departure from the approach used by CQC in recent years. The key differences– as described in those documents and to us in interviews – are:”

… continues on the site

Review of our new approach to inspecting hospitals – Care Quality Commission – 19 March 2014

“We commissioned the Kings Fund and Manchester Business School to carry out this evaluation and will use this information to improve the way it inspects. The full report will be published in May.

The paper published today explored whether the new approach provides a better analysis of the performance of an acute hospital – whether:

the measures used are valid and reliable.
the data is meaningful.
it adds significantly to what is already known.
it helps to not just assess performance but to understand the causes of performance variation.

It also explored:

whether the new model works in practice.
how the inspections are prepared, carried out and reported.
whether it could be done more effectively.

Author Professor Kieran Walshe presented themes from the paper at our board meeting today. The report says:”

… continues on the site

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Making our health and care systems fit for an ageing population – The King’s Fund – 6 March 2014

Posted on March 7, 2014. Filed under: Aged Care / Geriatrics, Health Systems Improvement | Tags: , , |

Making our health and care systems fit for an ageing population – The King’s Fund – 6 March 2014

“Our fragmented health and care system is not meeting the needs of older people, who are most likely to suffer problems with co-ordination of care and delays in transitions between services. This report sets out a framework and tools to help local service leaders improve the care they provide for older people across nine key components.”

A year is a long time in the politics of integrated care – blog entry on the King’s Fund site – 5 March 2014

John Oldham to lead Labour ‘commission’ on integration – 23 April 2013

“Labour will set up an independent commission to examine how health and social care can be integrated to meet what Ed Miliband claims is the biggest challenge in the history of the NHS.

The Labour leader will highlight the gap between NHS and care demand which is expected in coming years, and current funding.

HSJ revealed in January that shadow health secretary Andy Burnham was developing plans for the vast majority of NHS funding to councils.

Mr Miliband will today claim integration is being damaged by the government’s “free market ideology”.

An Independent Commission on Whole-Person Care will be set up and led by former Department of Health clinical lead for efficiency and productivity Sir John Oldham, who is a GP.

Launching the commission on a visit to Lancashire today, Mr Miliband was expected to say: “The NHS is facing the biggest challenge in its history. The toughest financial pressures for 50 years are colliding with our rising need for care as society gets older and we see more people with chronic illnesses like cancer, diabetes and dementia.”

… continues on the site

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Commissioning and funding general practice: Making the case for family care networks – King’s Fund – 19 February 2014

Posted on February 21, 2014. Filed under: General Practice, Primary Hlth Care | Tags: , , |

Commissioning and funding general practice: Making the case for family care networks – King’s Fund – 19 February 2014

“As England’s population both expands and ages, so the demands on primary care will grow. Within the current commissioning and funding system innovative models of primary care provision are already being used. This report describes examples of these through four case studies in different areas of England. It also highlights how the existing system is imperfectly understood, particularly regarding contracts.

Building on ideas articulated in previous work, the report argues for a new approach that brings together funding for general practice with funding for many other services. It would entail new forms of commissioning, with GPs innovating in how care is delivered. Over time, the report foresees ‘family care networks’ emerging that provide forms of care well beyond what is currently available in general practices.”

 

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Community services: How they can transform care – The King’s Fund – 13 February 2014

Posted on February 14, 2014. Filed under: Community Services | Tags: |

Community services: How they can transform care – The King’s Fund – 13 February 2014

“This paper looks at the changes needed to realise the full potential of community services for transforming care. The Transforming Community Services policy, launched in 2008, was mainly concerned with structural changes. While the emphasis on moving care closer to home has resulted in some reductions in length of hospital stay, it is now time to focus on the bigger issue of how services need to change to fundamentally transform care.

The paper is based on contributions from a working group of community providers convened by The King’s Fund, which was tasked with exploring how community services can help deliver the transformation in care that was promised by the 2008 policy.”

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Service transformation: Lessons from mental health – The King’s Fund – 4 February 2014

Posted on February 5, 2014. Filed under: Health Systems Improvement, Mental Health Psychi Psychol | Tags: , |

Service transformation: Lessons from mental health – The King’s Fund – 4 February 2014

” Mental health services have undergone radical transformation in the past 30 years. A community-based care model has largely replaced the acute and long-term care provided in large institutions.

Similar change – from hospital to community-based alternatives – is a long-standing policy objective for physical health care in the United Kingdom. How far the two can be compared has been remarkably under-explored. This paper seeks to correct this by examining the transformation of mental health services in England and the relevance to current policy. Drawing on workshops with those involved in the changes and a review of published literature, the paper explores the context and factors that enabled change to happen in mental health. It includes 10 lessons for service transformation based on these experiences.”

… continues on the site

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Providing integrated care for older people with complex needs – King’s Fund – 30 January 2014

Posted on January 31, 2014. Filed under: Aged Care / Geriatrics, Chronic Disease Mgmt, Health Mgmt Policy Planning | Tags: , , |

Providing integrated care for older people with complex needs – King’s Fund – 30 January 2014

by Nick Goodwin, Anna Dixon, Geoff Anderson, Walter Wodchis

“Lessons from seven international case studies

Around the world, rapidly ageing populations are resulting in increased demand for health and social care services, which presents significant challenges for national health and care systems. Many have adopted an integrated care approach to meet the needs of older people with chronic or multiple conditions. This approach often involves a single point of entry – designating a care manager to help with assessing needs, sharing information, and co-ordinating care delivery by multiple caregivers (formal and informal).

This report synthesises evidence from seven case studies covering Australia, Canada, the Netherlands, New Zealand, Sweden, the United Kingdom and the United States. It considers similarities and differences of programmes that are successfully delivering integrated care, and identifies lessons for policy-makers and service providers to help them address the challenges ahead.”

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Improving the public’s health: A resource for local authorities – King’s Fund – 12 December 2013

Posted on December 13, 2013. Filed under: Public Hlth & Hlth Promotion | Tags: |

Improving the public’s health: A resource for local authorities – King’s Fund – 12 December 2013

“This resource pulls together evidence from successful interventions across key local authority functions about ‘what works’ for improving health and reducing health inequalities. You can also see our related infographics

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Co-ordinated care for people with complex chronic conditions – King’s Fund – 24 October 2013

Posted on October 25, 2013. Filed under: Chronic Disease Mgmt | Tags: , , |

Co-ordinated care for people with complex chronic conditions – King’s Fund – 24 October 2013

More, including case studies 

“The costs of caring for people with age-related chronic and complex medical conditions are high and will continue to rise with population ageing. Yet people with multiple health and social care needs often receive a very fragmented service, resulting in less than optimal care experiences, outcomes and costs. Many countries have developed strategies to improve care co-ordination, but these have often failed to achieve their objectives. There is also a general lack of knowledge about how best to apply (and combine), in practice, the various strategies and approaches to care co-ordination.

This report presents the findings from a two-year research project funded by Aetna and the Aetna Foundation, which aimed to understand the key components of effective strategies employed by studying five UK-based programmes to deliver co-ordinated care for people with long-term and complex needs. It elicits some key lessons and markers for success to help identify how care co-ordination might be transferred from the UK to the US context.”

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Revalidation: The early experiences and views of responsible officers from London – The King’s Fund – 15 October 2013

Posted on October 16, 2013. Filed under: Allied Health, Medicine, Nursing, Workforce | Tags: , , |

Revalidation: The early experiences and views of responsible officers from London – The King’s Fund – 15 October 2013

“This paper summarises the results of a small research study designed to capture the experiences of and reflections on revalidation of responsible officers (ROs) in London. Fifty-three responsible officers took part in an online survey and twenty of these ROs took part in in-depth interviews.

The results provide a snapshot of what the implementation of revalidation has meant for the new ROs six months in. The paper also draws some conclusions on what is currently aiding successful implementation, which can be drawn on by ROs, doctors, boards and senior leaders across the country to prepare for the second year of revalidation.”

… continues on the site

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Delivering better services for people with long-term conditions: Building the house of care – King’s Fund – October 2013

Posted on October 4, 2013. Filed under: Chronic Disease Mgmt | Tags: |

Delivering better services for people with long-term conditions: Building the house of care – King’s Fund – October 2013

Extract from the key messages:

“The management of care for people with long-term conditions should be proactive, holistic, preventive and patient-centred. This report describes a co-ordinated service delivery model – the ‘house of care’ – that incorporates learning from a number of sites in England that have been working to achieve these goals.

The house of care model differs from others in two important ways: it encompasses all people with long-term conditions, not just those with a single disease or in high-risk groups; and it assumes an active role for patients, with collaborative personalised care planning at its heart. Implementing the model requires health care professionals to abandon traditional ways of thinking and behaving, where they see themselves as the primary decision-makers, and instead shifting to a partnership model in which patients play an active part in determining their own care and support needs.”

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Integrated care in Northern Ireland, Scotland and Wales: Lessons for England – The King’s Fund – 16 July 2013

Posted on July 24, 2013. Filed under: Health Mgmt Policy Planning | Tags: , |

Integrated care in Northern Ireland, Scotland and Wales: Lessons for England – The King’s Fund – 16 July 2013

“At a time when policy-makers in England have made a commitment to bring about closer integration of care both within the NHS and between health and social care, what can the health and social care system in England learn from the experiences of the other countries of the United Kingdom?

Integrated care in Northern Ireland, Scotland and Wales examines the context in which health and social care is provided; identifies policy initiatives that promote integrated care and the impact of these initiatives; and considers the barriers and challenges to achieving integrated care. The King’s Fund commissioned authors in each of the three countries to write a paper considering these issues. The authors reflect on what England can learn, drawing on their own experience of what has and has not been achieved.

The report concludes that structural integration of health and social care will not bring benefits in itself but must be accompanied by other changes.”

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Clinical commissioning groups: Supporting improvement in general practice? – The King’s Fund and the Nuffield Trust – 22 July 2013

Posted on July 24, 2013. Filed under: General Practice | Tags: , |

Clinical commissioning groups: Supporting improvement in general practice? – The King’s Fund and the Nuffield Trust – 22 July 2013

“Introduction

Clinical commissioning groups (CCGs) are one of the main components of the government’s reforms to the health and social care system. In April 2013, these newly established, clinically led organisations replaced primary care trusts as the commissioners of most services funded by the National Health Service (NHS) in England, and now control around two-thirds of the NHS budget. All general practices in England are now legally obliged to be a member of a CCG. The intention is to encourage clinicians to play a greater role in deciding how funds are spent in order to shape services to meet local needs.

CCGs have two important, but distinct, roles: they are responsible for commissioning secondary and community care services for their local populations; and they have a legal duty to support quality improvement in general practice. This second role has received less attention to date, but is vitally important if CCGs are to achieve their wider objectives and deliver more integrated forms of care. It will, however, be a challenging role for them to fulfil, particularly as general practitioner (GP) services are commissioned by NHS England.

About this research

The King’s Fund and the Nuffield Trust are working together over a three-year period to assess the implementation and impact of CCGs. We are examining clinical commissioning in six case study sites between 2012 and 2015, focusing on:
. the nature of relationships being built inside CCGs, particularly the interface with member practices and the extent of GP involvement in CCG activities
. the role of CCGs in supporting quality improvement in general practice
. the structures and processes through which these relationships and improvement activities are conducted.”

… continues

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Securing the future of general practice: new models of primary care – The King’s Fund and the Nuffield Trust – 18 July 2013

Posted on July 24, 2013. Filed under: General Practice, Primary Hlth Care | Tags: , , |

Securing the future of general practice: new models of primary care – The King’s Fund and the Nuffield Trust – 18 July 2013

“This report from the Nuffield Trust and The King’s Fund examines the new GP organisations forming to allow care provision at greater scale.”

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NHS buildings: obstacle or opportunity? – The King’s Fund – 11 July 2013

Posted on July 14, 2013. Filed under: Hosp Design Planning Architecture | Tags: |

NHS buildings: obstacle or opportunity? – The King’s Fund – 11 July 2013

“There has been little real attention given to how the NHS estate could help to improve efficiency, move more care out of hospitals and exploit new technologies. This Perspectives piece demonstates how models of care are still designed around buildings, and asks whether re-thinking the way that the NHS uses its estate could catalyse change.”

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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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Urgent and Emergency Care: A review for NHS South of England – The Kings Fund – March 2013

Posted on April 26, 2013. Filed under: Emergency Medicine | Tags: |

Urgent and Emergency Care: A review for NHS South of England – The Kings Fund – March 2013

Can we keep up with the demand for urgent and emergency care? – King’s Fund – 24 April 2013

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

The methods for running a hospital in the face of high levels of variable demand are now quite well understood. They are, however, based on an assumption that capacity and demand are in balance – which may not always be the case. For example, it may be necessary to make major changes to consultants’ job plans to provide 18-24 hour cover, seven days a week. These methods are also hard to implement and need continuous monitoring and maintenance. The key to success is to ensure that patients flow quickly through the hospital and are discharged rapidly. This may have been made more difficult by attempts to improve efficiency and utilisation, and close beds, which have left hospitals running at high levels of occupancy and with reduced ability to respond to fluctuations in demand or to discharge patients.”

… continues on the site

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How should we pay for health care in future? – The King’s Fund and Ipsos MORI – 15 April 2013

Posted on April 16, 2013. Filed under: Health Economics | Tags: , , |

How should we pay for health care in future? – The King’s Fund and Ipsos MORI – 15 April 2013

“Public remain wedded to NHS funding model says new research by The King’s Fund and Ipsos MORI”

How should we pay for health care in future? – paper

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Making integrated care happen at scale and pace: Lessons from experience – King’s Fund – 21 March 2013

Posted on March 22, 2013. Filed under: Aged Care / Geriatrics, Chronic Disease Mgmt | Tags: , , |

Making integrated care happen at scale and pace: Lessons from experience – King’s Fund – 21 March 2013

“The current fragmented services in health and social care fail to meet the needs of the population. A shift to an approach that develops integrated models of care for patients, especially older people and those with long-term conditions, can improve the patient experience and the outcomes and efficiency of care.

Making integrated care happen at scale and pace: Lessons from experience is intended to support the process of converting policy intentions into meaningful and widespread change on the ground. The authors summarise 16 steps that need to be taken to make integrated care a reality and draw on work by The King’s Fund and others to provide examples of good practice.

There are no universal solutions or approaches to integrated care that will work everywhere and there is also no ‘best way’ of integrating care, and the authors emphasise the importance of discovery rather than design and of sharing examples of good practice when developing policy and practice.

Finally, the paper acknowledges that changes are needed to national policy and to the regulatory and financial frameworks for local leaders to fully realise a vision of integration.”

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Volunteering in health and care: securing a sustainable future – The King’s Fund – 14 March 2013

Posted on March 15, 2013. Filed under: Health Mgmt Policy Planning | Tags: |

Volunteering in health and care: securing a sustainable future – The King’s Fund – 14 March 2013

Chris Naylor, Claire Mundle, Lisa Weaks, David Buck

“This report considers the role and value of volunteers in health and social care. It looks at the important part that volunteers play in improving patient experience, addressing health inequalities, and building a closer relationship between services and communities.

It also outlines the changing nature of volunteering, why this can cause tensions, and why volunteering does not always reach its full potential. Examples of good practice in the NHS and voluntary sector illustrate how these barriers can be overcome.

The authors discuss the future of volunteering in the light of the financial challenges facing public services and the reforms introduced by the Heath and Social Care Act 2012. They conclude by presenting two different scenarios and giving recommendations for achieving the best case scenario.”

… continues

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Spending on health and social care over the next 50 years: Why think long term? – The King’s Fund – 31 January 2013

Posted on January 31, 2013. Filed under: Health Economics | Tags: |

Spending on health and social care over the next 50 years: Why think long term? – The King’s Fund – 31 January 2013

“In the past 50 years, spending on the NHS in the United Kingdom has increased from 3.4 per cent to 8.2 per cent of gross domestic product (GDP). If the next 50 years follow the same trajectory, the United Kingdom could be spending nearly one-fifth of its entire GDP on the public provision of health and social care.

This report considers the drivers of spending on health and long-term care, and asks whether spending must or should consume such large proportions of GDP in the future, and the fiscal feasibility of this.

It examines the evidence that spending will inexorably rise, considers projections and high-level modelling of future health spending both in the United Kingdom and internationally, and debates alternative systems of assessing current and future spending.

Finally, the report suggests a need for engaged and informed public debate about the choices to be made in future spending on health and social care.”

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Developing supportive design for people with dementia – King’s Fund – 9 January 2013

Posted on January 11, 2013. Filed under: Aged Care / Geriatrics | Tags: , , , |

Developing supportive design for people with dementia – King’s Fund – 9 January 2013

The King’s Fund’s Enhancing the Healing Environment Programme 2009-2012

“Developing Supportive Design for People with Dementia is the latest publication from the EHE programme. It marks the completion of 26 schemes in 23 NHS acute, community and mental health hospitals in England to improve the environment of care for people with dementia.

The Environments of Care for People with Dementia programme was funded by the Department of Health as part of work to support the implementation of the National Dementia Strategy in England. There was tight competition for the available places, and projects were chosen for their ability to reflect the care pathway from diagnosis to end-of-life care.

This publication seeks to provide practical, value-for-money examples to encourage and inspire staff and their organisations to provide an environment of care that better supports people with dementia. As well as case studies with before and after photographs from participating sites, Developing Supportive Design for People with Dementia includes information about the development and evaluation of the EHE assessment tool; overarching design principles for creating a more supportive environment for people with dementia; and a project directory detailing the artists and designers involved in each scheme along with costs involved.”

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Hospital Pathways programme: lessons learned – King’s Fund – 19 December 2012

Posted on January 8, 2013. Filed under: Clin Governance / Risk Mgmt / Quality | Tags: |

Hospital Pathways programme: lessons learned – King’s Fund – 19 December 2012

“This article tells the story of the Hospital Pathways programme, a collaborative programme in which five acute trusts worked with The King’s Fund and the Health Foundation to apply techniques, not widely used in the NHS, to improve both processes of care and interactions between staff and patients.

Here we describe the programme; the method used to evaluate it; what we learned about the approach, and how the lessons have influenced the next programme called Patient and Family-centred Care.”

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General practice in London: supporting improvements in quality – King’s Fund – 5 December 2012

Posted on December 10, 2012. Filed under: General Practice, Primary Hlth Care | Tags: , |

General practice in London: supporting improvements in quality – King’s Fund – 5 December 2012

Veena Raleigh, Yang Tian, Nick Goodwin, Anna Dixon, James Thompson, Christopher Millet, Michael Soljak

“General practice in London face a number of demographic and socio-economic challenges in addition to the unprecedented financial pressures facing the NHS as a whole.

NHS London commissioned an independent report to provide a fresh analysis of those challenges and the improvements that will be needed to address them. The report has been prepared by a team of researchers at The King’s Fund and Imperial College London.

It is a companion piece to a framework that NHS London will be co-creating with practices across the capital as a resource for clinical commissioning groups in taking on their new responsibilities for continuously improving primary care services.

The King’s Fund and Imperial College London are also providing clinical commissioning groups with more detailed data on the indicators used in this report, along with guidance on how to interpret and use the data, as a starting point from which to understand priorities at local level.”

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Improving GP services in England – The King’s Fund – 7 November 2012

Posted on November 8, 2012. Filed under: Clin Governance / Risk Mgmt / Quality, General Practice, Patient Participation | Tags: |

Improving GP services in England – The King’s Fund – 7 November 2012

“Exploring the association between quality of care and the experience of patients

Two key elements of the quality of health care provided by GPs are the Quality and Outcomes Framework (QOF), which rewards GP practices for achievement against a range of indicators of clinical quality, and the GP Patient Survey, which asks patients about their experience of using GP services.

Using data for more than 8,000 general practices in England, this paper examines the association between patients’ perceptions about the non-clinical aspects of care and practice performance on measures of clinical quality.”

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Payment by Results: How can payment systems help to deliver better care? – King’s Fund – 2 November 2012

Posted on November 2, 2012. Filed under: Health Economics | Tags: |

Payment by Results: How can payment systems help to deliver better care? – King’s Fund – 2 November 2012

“The way the NHS currently pays hospitals for the work they do – including Payment by Results – should change to incentivise new models of care, concludes a report, Payment by Results: How can payment systems help to deliver better care?, published today by The King’s Fund. While recognising the positive impact that Payment by Results has had on the NHS in England, the report suggests that current payment systems may be obstructing changes in services required to meet current and future health care needs.

The report finds that there is an urgent need to experiment with and evaluate new and innovative payment methods that will move away from a system primarily driven by a desire to boost activity rather than outcomes and facilitate more integrated care. It proposes that the NHS adopt an approach that enables local experimentation in payment systems within a clear national framework, with a requirement for evaluation.”

… continues on the site

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Dealing with financially unsustainable providers: how will the failure regime work? – The King’s Fund – 20 September 2012

Posted on September 21, 2012. Filed under: Health Economics | Tags: , |

Dealing with financially unsustainable providers: how will the failure regime work? – The King’s Fund – 20 September 2012

“The financial pressures within the NHS are being particularly harshly felt by acute hospital trusts, with some trusts and foundation trusts being rated as at financial risk and others declaring themselves financially unsustainable. With the current economic situation more organisations are likely to find themselves financially challenged and unable to survive in their present form.

This paper explains why a failure regime is required in the NHS, outlines how the failure regime for NHS trusts (currently being applied in South London) works and how the failure regime for foundation trusts introduced by the Health and Social Care Act 2012 will work in future. It concludes with a discussion of key issues that need to be resolved if providers of acute services to the NHS are to be put on a financially sustainable footing.”

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Transforming the delivery of health and social care. The case for fundamental change – King’s Fund – 6 September 2012

Posted on September 7, 2012. Filed under: Health Mgmt Policy Planning | Tags: , , |

Transforming the delivery of health and social care. The case for fundamental change – King’s Fund – 6 September 2012

“Summary

The UK has the second highest rate of mortality amenable to health care among 16 high-income countries, and evidence shows that variations in health outcomes between social groups are widening. This paper (the first in a series on the future of health and social care in England) explores how the current health and social care delivery system has failed to keep pace with the population’s needs and expectations. It argues that incremental changes to existing models of care will not be sufficient in addressing these challenges and that a much bolder approach is needed to bring about innovative models that are appropriate to the needs of the population and are high quality, sustainable and offer value for money.”

Blog entry from Chris Ham of The King’s Fund.

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Clustering of unhealthy behaviours over time: Implications for policy and practice – King’s Fund – 23 August 2012

Posted on August 24, 2012. Filed under: Health Status, Preventive Healthcare, Public Hlth & Hlth Promotion | Tags: |

Clustering of unhealthy behaviours over time: Implications for policy and practice – King’s Fund – 23 August 2012

David Buck, Francesca Frosini

“Summary

People’s lifestyles – whether they smoke, how much they drink, what they eat, whether they take regular exercise – affect their health and mortality. It is well known that each of these lifestyle risk factors is unequally distributed in the population.

Less is known about how these behaviours co-occur or cluster in the population and about how these patterns of multiple lifestyle risk have been evolving over time. This paper considers this in the context of the English population and sets out the implications for public health policy and practice that flow from the findings.

It reviews the current evidence on multiple lifestyle risks and analyses data from the Health Survey for England on the distribution of these risks in the adult population and how this is changing over time.”

… continues on the site

Blog entry on this report:  Improving the health of the poorest, fastest: why clusters of lifestyle behaviours matter

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Explaining variation in use of emergency hospital beds by patients over 65 – The King’s Fund – 9 August 2012

Posted on August 10, 2012. Filed under: Aged Care / Geriatrics, Emergency Medicine | Tags: , |

Explaining variation in use of emergency hospital beds by patients over 65 – The King’s Fund – 9 August 2012

Blog discussion on the paper

“Summary

This paper explores factors that might be driving the significant variation in use of hospital beds by patients over 65 admitted as an emergency.  It considers the contribution made by patient-based (demand-side) factors, hospital (supply-side) factors, the availability of community services and resources, and broader system relationships (how care systems and staff work together and relate to each other) in driving the observed variation in length of stay and rate of admission. Its conclusions are based on new analysis by The King’s Fund of Hospital Episode Statistics (HES) and local population -based data.”

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Preparing for the Francis report: How to assure quality in the NHS – The King’s Fund – 26 July 2012

Posted on July 31, 2012. Filed under: Clin Governance / Risk Mgmt / Quality | Tags: |

Preparing for the Francis report: How to assure quality in the NHS – The King’s Fund – 26 July 2012

by       Anna Dixon, Catherine Foot, Tony Harrison

“The national structures and systems designed to assure the quality of care delivered by the NHS are currently under intense scrutiny.

It is widely expected that regulators will come in for further criticism in the autumn when the Public Inquiry into the serious failures of care at Mid Staffordshire NHS Foundation Trust reports. The Francis Inquiry’s Chair, Robert Francis QC, is likely to propose far-reaching changes at all levels of the system, including to the external organisations that regulate quality. But will further changes to national structures and systems make such gross failings in quality less likely in future?

In this paper we set out our views on how the system of quality assurance, including regulation, needs to evolve, the principles on which it should be built and how it should operate.”

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Patients’ preferences matter: Stop the silent misdiagnosis – King’s Fund – 29 May 2012

Posted on May 31, 2012. Filed under: Patient Participation | Tags: |

Patients’ preferences matter: Stop the silent misdiagnosis – King’s Fund – 29 May 2012

Al Mulley, Chris Trimble, Glyn Elwyn

“Summary

Many doctors aspire to excellence in diagnosing disease. Far fewer, unfortunately, aspire to the same standards of excellence in diagnosing patients’ preferences for their care. Because doctors are rarely made aware of an erroneous preference diagnosis, it could be called ‘the silent misdiagnosis’. Misdiagnosing patients’ preferences may be less obvious than misdiagnosing disease, but the consequences for the patient can be just as severe.

Patients’ preferences matter: stop the silent misdiagnosis outlines the scale of the problem, showing that:

when they are well informed, patients make different choices about treatment
what patients want often differs from what doctors think they want
there are significant variations in care across geographic regions.

Written by Al Mulley, The King’s Fund’s first international visiting fellow, and colleagues in The Dartmouth Center for Health Care Delivery Science, this paper challenges the NHS to stop the silent misdiagnosis and argues that by doing so it will improve not only the service offered to patients but also the performance of the health system as a whole. The central recommendation is that the NHS must measure and report the incidence of preference misdiagnoses. Also, both doctors and patients will need better tools and information.

Addressing the problem of the silent misdiagnosis will require a co-ordinated effort at all levels of the NHS, including patients, clinicians, commissioners and policy-makers. This paper offers suggestions for how that might be achieved; its findings are timely and relevant to all who have the best interests of the patient at heart.”

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Leadership and engagement for improvement in the NHS: Together we can – King’s Fund – 22 May 2012

Posted on May 23, 2012. Filed under: Health Mgmt Policy Planning | Tags: , |

Leadership and engagement for improvement in the NHS: Together we can – King’s Fund – 22 May 2012

Summary

“The NHS faces a number of challenges – driving up quality of care, making significant productivity gains, ensuring the government’s reforms work. To meet these challenges, individuals and organisations need to rethink the way in which power and responsibility are shared within teams and organisations and  across the health and care system. Leaders need to cultivate a strong culture of engagement for patients and staff and to deploy a range of leadership styles and behaviours.

Leadership and engagement for improvement in the NHS: together we can makes the case for engaging staff, patients and boards and for building relationships across systems of care. Building on the work of The King’s Fund’s 2011 Leadership Commission, the 2012 review has taken evidence from a number of national and international experts. Their evidence makes a compelling case for leadership and engagement:”

… continues on the site

Press release: New style of NHS leadership could deliver better patient care and financial performance says The King’s Fund review

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The contribution of Schwartz Center Rounds® to hospital culture – King’s Fund – 3 May 2012

Posted on May 14, 2012. Filed under: Clin Governance / Risk Mgmt / Quality | Tags: , , , |

The contribution of Schwartz Center Rounds® to hospital culture – King’s Fund – 3 May 2012

“Written for the 8th International Organisational Behaviour in Healthcare Conference, Dublin April 2012, Joanna Goodrich and Jocelyn Cornwell consider the benefits and contribution of Schwartz Center Rounds® on hospital culture on the UK.”

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Thinking about rationing – King’s Fund – 3 May 2012

Posted on May 4, 2012. Filed under: Health Economics, Health Mgmt Policy Planning | Tags: |

Thinking about rationing – King’s Fund – 3 May 2012

“Summary

Given the unprecedented financial pressures on the NHS, difficult decisions have to be made about how to allocate and use resources. It is important to be clear about the different rationing strategies employed and the various, often conflicting criteria used when judging the acceptability or otherwise of the decisions taken.

Thinking about rationing provides a guide to the practicalities and controversies surrounding the issue and identifies what is known about how it works in practice. It offers examples and illustrations, drawing on the available evidence and conversations with clinicians and managers.

Rationing can take various forms:”

… continues on the site

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Health and wellbeing boards. System leaders or talking shops? – King’s Fund – 12 April 2012

Posted on April 13, 2012. Filed under: Patient Participation | Tags: |

Health and wellbeing boards. System leaders or talking shops? – King’s Fund – 12 April 2012

by Richard Humphries, Amy Galea, Lara Sonola, Claire Mundle

“Summary

The reforms to the health and social care system set out in the recent Health and Social Care Act have emphasised the need for integration. Central to these reforms is the establishment of statutory health and wellbeing boards to encourage local authorities to take a more strategic approach to providing integrated health and local government services. Past efforts to achieve the vision of joined-up, well-co-ordinated and jointly planned services have had only limited success. Faced with complex organisational change, unprecedented financial pressures and rising demand for services, will health and wellbeing  boards be able to fulfil these expectations and achieve greater success than previous bodies?

The King’s Fund is well-placed to try to answer that question. We have supported several local authorities and their health partners to develop shadow boards, held a summit to discuss the issues with a range of professionals, and conducted a survey of 50 areas to find out how the new boards are being implemented. Health and wellbeing boards: System leaders or talking shops?  presents the findings from that survey and includes case studies based on the experience of two early implementers.”

… continues on the site

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Data briefing: Emergency hospital admissions for ambulatory care-sensitive conditions. Identifying the potential for reductions – King’s Fund – 3 April 2012

Posted on April 4, 2012. Filed under: Chronic Disease Mgmt, Emergency Medicine, Primary Hlth Care | Tags: |

Data briefing: Emergency hospital admissions for ambulatory care-sensitive conditions. Identifying the potential for reductions – King’s Fund – 3 April 2012

“Summary

Ambulatory care-sensitive conditions (ACSCs) are conditions for which effective management and treatment should limit emergency admission to hospital. Nevertheless, ACSCs currently account for more than one in six emergency hospital admissions in England. These emergency admissions cost the NHS £1.42 billion each year.

High levels of admissions for ACSCs often indicate poor co-ordination between the different elements of the health care system, in particular between primary and secondary care. An emergency admission for an ACSC is a sign of the poor overall quality of care, even if the ACSC episode itself is managed well.

This data briefing considers patterns of admissions for ACSCs in terms of age, sex, condition, socioeconomic group and local authority area. The authors analyse these patterns and assess the potential for reducing emergency admissions for ACSCs, highlighting the disease areas and patient groups where the greatest reduction can be achieved.

The briefing concludes that the number of emergency hospital admissions for ACSCs could be reduced by:

18 per cent (potentially saving £238 million) if all local authorities performed at the level of the best-performing local authorities
8 per cent (potentially saving £96 million)  if each local authority improved their service to the level of the next best  local authorities
11 per cent (potentially saving £136 million) if the poorer (than the average) performing local authorities performed at the level of the better (than the average) ones.

This briefing highlights for commissioners the opportunities for improving the quality of care and saving costs that reducing emergency hospital admissions for ACSCs presents. To realise the potential savings, changes will be needed in the management and prevention of these conditions.”

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Improving safety in maternity services. A toolkit for teams – King’s Fund – 29 March 2012

Posted on March 30, 2012. Filed under: Multidisciplinary Care, Nursing, Obstetrics, Patient Safety | Tags: |

Improving safety in maternity services. A toolkit for teams – King’s Fund – 29 March 2012

“Summary

The safety of maternity services is of paramount importance. Maternity teams face many challenges in delivering safe care to mothers, babies and families. The King’s Fund launched an independent inquiry into the safety of maternity services in 2006. The report from that inquiry, Safe Births: Everybody’s business, made a series of recommendations about how the safety of maternity care could be improved.

Building on the recommendations from our inquiry and in partnership with the Royal College of Obstetricians and Gynaecologists, the Royal College of Midwives, the NHS Litigation Authority, Centre for Maternal And Child Enquiries and the National Patient Safety Agency, The King’s Fund launched the Safer Births Improvement Programme, providing customised support to 12 multidisciplinary maternity teams in England. This toolkit shares the experiences and lessons from those teams.

Improving Safety in Maternity Services: a toolkit for teams is organised around five key areas for improvement in maternity care on which the teams focused:

teamworking
communication
training
information and guidance
staffing and leadership.”

… continues on the site

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Continuity of care failing frail older people in hospitals – King’s Fund – 27 March 2012

Posted on March 27, 2012. Filed under: Aged Care / Geriatrics | Tags: , |

Continuity of care failing frail older people in hospitals – King’s Fund – 27 March 2012

“Two reports published today by The King’s Fund highlight how frail older people are being exposed to unacceptable standards of care and moved around from pillar to post in hospital because of a lack of continuity of care.

The first report draws attention to breakdowns in continuity of care inside hospitals. Analysis of inpatient surveys cited in the report shows that measures of continuity of care – that is, the effective planning, communication and co-ordination of care – have remained static or slightly worsened between 2005 and 2010:”   … continues

“Alongside this report, the Fund has also published the conclusions of a two-day summit (2) attended by senior figures from the NHS and social care, academics and organisations representing patients and older people. This specifically addresses how to improve care for frail older people with complex needs, making five key recommendations:”  … continues

Continuity of care for older hospital patients: a call for action by Jocelyn Cornwall, Ros Levenson, Lara Sonola and Emmi Poteliakhoff.

The care of frail older people with complex needs: time for a revolution.  The Sir Roger Bannister Health Summit, Leeds Castle

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Sustainable health and social care. Connecting environmental and financial performance – King’s Fund – 21 March 2012

Posted on March 23, 2012. Filed under: Environmental Health, Health Economics | Tags: |

Sustainable health and social care. Connecting environmental and financial performance – King’s Fund – 21 March 2012

Chris Naylor, John Appleby

“Summary

The activities of an organisation as large as the NHS inevitably have consequences for the environment. Carbon dioxide emissions attributable to the NHS in England alone are greater than the total admissions from all passenger aircraft departing from Heathrow Airport. As financial challenges for the health and social care sector increase, so too does the need for services to be delivered in ways that are environmentally sustainable.

Sustainable Health and Social Care: Connecting environmental and financial performance is based on a literature review and stakeholder consultation carried out by The King’s Fund on behalf of the National Institute for Health Research and the Social Care Institute for Excellence. The report provides an overview of current knowledge about the environmental impacts of health and social care and examines the evidence for a connection between sustainability, productivity and other system objectives.

The authors consider how health and social care needs to change to become more environmentally sustainable.”

… continues on the site

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What impact does telehealth have on long-term conditions management? – King’s Fund – 15 March 2012

Posted on March 16, 2012. Filed under: Chronic Disease Mgmt, Telehealth | Tags: |

What impact does telehealth have on long-term conditions management? – King’s Fund – 15 March 2012

“Our online prezi presentation sheds light on the impact telehealth can have (positive or negative) on the management of people with long-term conditions.

To find out more about how we carried out the study and what our results show, read our review of the evidence.”

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Service-line management. Can it improve quality and efficiency? – King’s Fund – 26 January 2012

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

Service-line management. Can it improve quality and efficiency? – King’s Fund – 26 January 2012

“Summary

At a time when hospitals are under pressure to improve quality and make productivity savings, they need to find tools to support them. Service-line management (SLM) and service-line reporting (SLR) offer one approach. Service-line management is a system in which a hospital trust is divided into specialist clinical areas that are then managed, by clinicians, as distinct operational units. SLM enables clinicians and managers to plan service activities, set objectives and targets, monitor financial and operational activity and manage performance. Service-line reporting provides the necessary data on financial performance, activity, quality and staffing.

Service-line management: Can it improve quality and efficiency? presents the findings from a series of interviews with staff at seven NHS trusts that are using SLM or SLR, revealing how they are implementing this approach and identifying what helps and what hinders this way of working.

The paper outlines a number of important issues for trusts to consider when introducing SLM.”

… continues on the site

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Integrated care for patients and populations: Improving outcomes by working together – King’s Fund – 5 January 2012

Posted on January 6, 2012. Filed under: Health Mgmt Policy Planning | Tags: , |

Integrated care for patients and populations: Improving outcomes by working together – King’s Fund – 5 January 2012

A report to the Department of Health and the NHS Future Forum

by Nick Goodwin, Judith Smith, Alisha Davies, Claire Perry, Rebecca Rosen, Anna Dixon, Jennifer Dixon, Chris Ham

“Summary

Integrated care is essential to meet the needs of the ageing population, transform the way that care is provided for people with long-term conditions and enable people with complex needs to live healthy, fulfilling, independent lives. In its June 2011 summary report, the NHS Future Forum stated: ‘we need to move beyond arguing for integration to making it happen’.

The NHS Future Forum’s report built on the ideas that The King’s Fund and the Nuffield Trust presented as part of the government’s listening exercise on the Health and Social Care Bill.

In response, the Department of Health approached The King’s Fund and Nuffield Trust for help in supporting the development of its national strategy on integrated care and to feed ideas directly into the ongoing work of the NHS Future Forum.

Our resulting report examines:

the case for integrated care
what current barriers to integrated care need to be overcome and how
what the Department of Health can do to provide a supporting framework to enable integrated care to flourish
options for practical and technical support to those implementing integrated care, including approaches to evaluating its impact.”

… continues on the site

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Data briefing: Emergency bed use. What the numbers tell us – King’s Fund – December 2011

Posted on January 4, 2012. Filed under: Emergency Medicine | Tags: , , |

Data briefing: Emergency bed use. What the numbers tell us – King’s Fund – December 2011

“Summary

The NHS will need to find £20 billion in productivity improvements by 2015 to avoid reducing quality and making significant cuts to services. The acute sector is already receiving less for treating patients and so is under particular pressure to make those improvements. Could reducing the use of hospital beds for emergency admissions help?

Hospital beds are used for emergency admissions and elective admissions, but bed use for elective admissions has fallen significantly in recent years – although they account for 55 per cent of admissions, they occupy less that 30 per cent of overall bed days. So reducing bed use for emergency admissions offers the most potential for savings. Our new data briefing explores the figures in more detail and identifies the groups of emergency patients with the greatest scope for reductions in bed use.”

… continues

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Improving health and health care in London. Who will take the lead? – King’s Fund – 13 December 2011

Posted on December 13, 2011. Filed under: Health Mgmt Policy Planning | Tags: |

Improving health and health care in London. Who will take the lead? – King’s Fund – 13 December 2011

Summary
“For more than 100 years, reviews of health care in London have highlighted the poor health of the population in some areas, variations in the quality of primary care, and inappropriate configuration of hospital services. The most recent review, led by Ara Darzi, set out some proposals for change, many of which were implemented by NHS London. However, the coalition government has halted these reforms and offered different criteria for change.

Many of the historical problems remain and the crucial question, highlighted by The King’s Fund’s latest report is:  who will take the lead in improving health and health care in London? London is at risk of operating within a strategic vacuum following the abolition of London’s strategic health authorities by April 2013. This report suggests there needs to be much greater clarity of roles and responsibilities within the reformed structure to avoid ambiguity and confusion.

The particular challenges for London are:”

… continues

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Case management. What it is and how it can best be implemented – The King’s Fund – 17 November 2011

Posted on November 21, 2011. Filed under: Chronic Disease Mgmt | Tags: , |

Case management. What it is and how it can best be implemented – The King’s Fund – 17 November 2011

Shilpa Ross, Natasha Curry, Nick Goodwin     32 pages    ISBN: 978 1 85717 630 8

“Summary

Case management is a well-established way of integrating services around the complex needs of people with long-term conditions. It is a targeted, community-based and pro-active approach that identifies individuals at high risk of hospital admission, assesses their needs, produces a personal care plan, and ensures co-ordination of that plan. However, evidence to date suggests that case management is not always implemented in a cost-effective way or to the benefit of patients and carers.

Case Management: What it is and how it can best be implemented examines how this key strategy can improve delivery of integrated care for people with long-term conditions. The authors explore the questions:”

… continues on the site

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Economic regulation in health care. What can we learn from other regulators? – King’s Fund – 3 November 2011

Posted on November 4, 2011. Filed under: Health Economics | Tags: |

Economic regulation in health care. What can we learn from other regulators? – King’s Fund – 3 November 2011

by Anna Dixon, Tony Harrison, Claire Mundle

“Summary

Economic regulation was originally set up to regulate natural monopolies in the interests of consumers and to promote competition where appropriate. The need to ensure the health care market operates in the interests of the public and patients is one of the main objectives behind the introduction of economic regulation in health care. Can we learn anything from the experience of economic regulation in other sectors?

The coalition government has built on the market-orientated policies of the previous government, creating a stronger and more independent system of economic regulation that will apply to the whole health care sector, public and private providers. The Health and Social Care Bill proposes extending Monitor’s responsibilities to include:

price-setting
tackling anti-competitive behaviour
ensuring continuity of essential services in the event of financial failure.

There has been some concern about the impact of competition in health care, with critics claiming that it cannot be treated in the same way as the nationalised utilities. Economic regulation in health care seeks to look at these issues dispassionately. It outlines the development of economic regulation in England and describes the differences between the market in health care and the market in the utility sector. In looking at the experiences of other sector-specific economic regulators, it considers their objectives, how they are held to account and what regulatory instruments they use. It also briefly compares the proposals for the regulation of health care in England with the experience of economic regulation of health care in The Netherlands and the United States.”

… continues on the site

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Perspectives on telehealth and telecare – The King’s Fund – 3 November 2011

Posted on November 4, 2011. Filed under: Telehealth | Tags: |

Perspectives on telehealth and telecare – The King’s Fund – 3 November 2011

Authors: Richard Giordano, Senior Lecturer, School of Health Sciences, University of Southampton and Mike Clark, Co-Project Lead, Whole System Demonstrator Action Network (WSDAN) with Nick Goodwin, Senior Fellow, The King’s Fund and Co-Project Lead, WSDAN

“This paper, the third in a series of Whole System Demonstrator Action Network (WSDAN) briefing papers, examines the experiences of the network’s 12 member sites in implementing telehealth and telecare.

It examines the challenges and barriers they faced, and the progress they made, in developing and adopting new technologies.”

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How is the NHS performing? October 2011 quarterly monitoring report – King’s Fund – 14 October 2011

Posted on October 17, 2011. Filed under: Clin Governance / Risk Mgmt / Quality | Tags: , , |

How is the NHS performing? October 2011 quarterly monitoring report – King’s Fund – 14 October 2011
John Appleby, James Thompson, Amy Galea

“Summary
Many NHS hospitals will struggle to deliver productivity improvements essential to maintaining quality and avoiding significant cuts to services, according to our latest quarterly monitoring report.

This is the third quarterly monitoring report produced by the Fund as we aim to provide a regular update on how the NHS is coping as it grapples with the evolving reform agenda as well as the more significant challenge of making radical improvements in productivity. It complements our NHS health check prezi and is a continuation of work that we have done historically to assess, analyse and report on the performance of the NHS.”

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Integrated care summary: What is it? Does it work? What does it mean for the NHS? – King’s Fund – 22 September 2011

Posted on September 23, 2011. Filed under: Health Mgmt Policy Planning | Tags: , |

Integrated care summary: What is it? Does it work? What does it mean for the NHS? – King’s Fund – 22 September 2011

“Chris Ham summarises the different forms of integrated care and their impact so far on the NHS. Based on our major review of integrated care (Ham and Curry, 2010), it has been prepared in the light of the increased interest in integrated care arising out of the work of the NHS Future Forum and the government’s response.”

 

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Environments of care for people with dementia – King’s Fund project – 13 December 2011

Posted on September 16, 2011. Filed under: Aged Care / Geriatrics, Hosp Design Planning Architecture | Tags: |

Environments of care for people with dementia – King’s Fund project – 13 December 2011

“The Department of Health has commissioned The King’s Fund to develop a number of specific programmes to enhance the environment of care as part of its work to improve the patient experience. The latest of these is a programme to improve the care environment for people with dementia to support the implementation of the national dementia strategy.

What are the current issues for people with dementia?

25 per cent of people accessing acute hospital services are likely to have dementia and the number of people with dementia is expected to double during the next 30 years. Hospital stays are recognised to have detrimental effects on people with dementia.

Generally, there is a low level of knowledge in the health professions – even among those who have been trained to care for people with dementia – and among estates and facilities staff about what makes a positive therapeutic environment for people with dementia. The volume of applications for the EHE programmes has shown that there is a considerable level of interest in creating dementia-friendly environments and there is a desire across the service for practical advice to enhance the quality of the care provided to people with dementia.”

… continues on the site

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Briefing: Reconfiguring hospital services – The King’s Fund – 6 September 2011

Posted on September 6, 2011. Filed under: Health Mgmt Policy Planning | Tags: |

Briefing: Reconfiguring hospital services – The King’s Fund – 6 September 2011
“Our briefing on reconfiguration calls for radical changes to streamline the process for reorganising hospital services and to prevent politicians from blocking essential changes that would improve the quality and safety of NHS care.”

Press release

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The Patient-Centred Care project: Evaluation report – King’s Fund – 11 August 2011

Posted on August 22, 2011. Filed under: Oncology, Patient Participation | Tags: |

The Patient-Centred Care project: Evaluation report – King’s Fund – 11 August 2011

“The Patient-Centred Care Project, an evidence-based co-design (EBCD) project, that aimed to improve the experience and quality of care for patients receiving treatment for breast cancer and lung cancer at Guy’s and St Thomas’ NHS Foundation Trust and King’s College Hospital NHS Foundation Trust. Supported by King’s College London and The King’s Fund, it was funded by Guy’s & St Thomas’ Charity.

This independent evaluation report, commissioned by the Fund, describes the process and impact of the EBCD project within breast cancer services (the first phase of the project). It presents a summary of the findings, including:

the process of evidence-based co-design
the key successes, outcomes and impact of the project
the lessons learned during the project
the solutions implemented in response to the project’s findings.”

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Experience-based co-design. Working with patients to improve health care – The King’s Fund – August 2011

Posted on August 22, 2011. Filed under: Patient Participation | Tags: |

Experience-based co-design. Working with patients to improve health care – The King’s Fund – August 2011

“This toolkit outlines a powerful and effective way of improving patients’ experience of services, and helps you assess how it can help you meet your aims.”

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Environments for care at the end of lifeThe King’s Fund’s Enhancing the Healing Environment Programme 2008-2010 – The King’s Fund – 18 August 2011

Posted on August 22, 2011. Filed under: Hosp Design Planning Architecture, Palliative Care | Tags: |

Environments for care at the end of lifeThe King’s Fund’s Enhancing the Healing Environment Programme 2008-2010 – The King’s Fund – 18 August 2011
96 pages   ISBN: 978 1 85717 625 4

“Summary

There is growing awareness of the importance of the environment within health care. The King’s Fund’s Enhancing the Healing Environment (EHE) programme encourages and enables nurse-led teams to work in partnership with patients to improve the environment in which to deliver care.

This publication describes projects in 19 NHS trusts and one HM prison that took part in schemes to improve the environment of care at the end of life. It describes the broader EHE programme, which has been supported by the Department of Health in a series of publications entitled ‘Improving the patient experience’  and goes on to present case studies of the sites that took part in the programme. Each of the case studies includes photographs of the original space that was chosen for improvement and of the finished project. There are also comments from staff and from users highlighting the importance of the changes to the environment  for both the cared for and the carer. The projects show that, even in the most uninspiring environment, it is possible to create welcoming and comfortable spaces that are fit for purpose, good value for money and can improve the quality of care and the patient experience.

The text includes a  summary of the independent evaluation of the programme by the University of Nottingham and also a comprehensive project directory, offering details of the individual work carried out in each project, names of artists and others from whom work was commissioned and also project costings.”

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Social enterprise in health care. Promoting organisational autonomy and staff engagement – King’s Fund – 4 August 2011

Posted on August 5, 2011. Filed under: Health Mgmt Policy Planning | Tags: |

Social enterprise in health carePromoting organisational autonomy and staff engagement – King’s Fund – 4 August 2011

“Summary

In the White Paper Equity and Excellence, the government announced its ambition to establish the ‘largest and most vibrant social enterprise sector in the world’. Social enterprise in health care explores the organisational and leadership changes that will be needed to support the development of social enterprises and makes recommendations that will be of particular interest to policy-makers and health care providers.

Based on the responses of a small group of directors of social enterprises and chief executives of acute and mental health foundation trusts, this paper explores the motivations for becoming a social enterprise and whether their ambitions have been realised in practice. In particular, the paper looks at the impact of social enterprises on the financial framework and on employees’ attitudes. One of the aims of the health reforms was to give greater autonomy to providers, but there is considerable uncertainty about how such organisations would develop and function. Interviews with the chief executives of foundation trusts showed they were receptive to the social enterprise model in principle but had concerns about the scale of change needed  and about whether it would detract from the underlying intention  – increasing staff engagement in decision-making.

A number of key conclusions are reached.”

… continues

 

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Making shared decision-making a reality. No decision about me, without me – The King’s Fund – 28 July 2011

Posted on August 1, 2011. Filed under: Patient Participation | Tags: , |

Making shared decision-making a reality. No decision about me, without me – The King’s Fund – 28 July 2011
Angela Coulter, Alf Collins

Summary

“The government wants to place patients’ needs, wishes and preferences at the heart of clinical decision-making, a vision articulated by the Secretary of State for Health, Andrew Lansley, in the phrase ‘nothing about me, without me’. But what does this mean in practice?

Making shared decision-making a reality: No decision about me, without me aims to answer that question. It clarifies what is meant by the term shared decision-making and what skills and resources are required to implement it and it also outlines what action is needed to make this vision a reality.

The principle of shared decision-making in the context of a clinical consultation is that it should:”

… continues on the site

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The voluntary and community sector in health – implications of the proposed NHS reforms – The King’s Fund – 2011

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

The voluntary and community sector in health – implications of the proposed NHS reforms – The King’s Fund – 2011
ISBN: 978 1 85717 621 6

Extract from the executive summary:
“The government’s health and social care White Paper and subsequent Health and Social Care Bill (House of Commons Bill 2010–11) set out clear aspirations for the voluntary and community sector as a provider of health services, a source of support for commissioning, and a partner in tackling health inequalities. However, the proposed reforms present a number of challenges and risks.”  … continues

Introduction 1
Context 2
The sector’s current involvement in health 2
The financial and demographic context 4
The Health and Social Care Bill 5
The sector’s future involvement in health 8
Can the aspirations for the sector be realised? 11
How will the sector be able to operate in a competitive market? 12
How will the sector be able to engage with the right partners? 16
Will the sector be able to support the health inequalities agenda? 18
What can the sector do to succeed in the new system? 20
Conclusion 23
The best-case scenario 23
The worst-case scenario 24
What next? 25
Recommendations

 

 

 

 

 

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Accountability in the NHS: Implications of the government’s reform programme – The King’s Fund – 1 June 2011

Posted on June 3, 2011. Filed under: Clin Governance / Risk Mgmt / Quality, Health Mgmt Policy Planning | Tags: , |

Accountability in the NHS: Implications of the government’s reform programme – The King’s Fund – 1 June 2011

64 pages ISBN: 978 1 85717 617 9

“Summary

The government’s health reforms propose radical changes to the structures and processes within the National Health Service (NHS) in England that have provoked unprecedented debate, protest and opposition. One of the core issues is how providers and commissioners of care will be held to account in the future if many of the existing lines of accountability are removed, and there are deep concerns about whether the proposed substitutes are adequate for the task.

The reforms could significantly reduce the day-to-day involvement of politicians, civil servants and managers in health care. Localisation, GP empowerment and patient choices will be the new priorities.

Accountability in the NHS: Implications of the government’s health reform programme seeks to inform the debate around the nature of accountability relationships in the NHS and how these will change under the reforms. The authors identify five types of accountability most relevant to health care – by scrutiny, management, regulation, contract and election.”

… continues on the site

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Where next for the NHS reforms? The case for integrated care – The King’s Fund – 23 May 2011

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

Where next for the NHS reforms? The case for integrated care – The King’s Fund – 23 May 2011

“Written as a contribution to the government’s current listening exercise, this paper sets out the challenges facing the NHS and identifies the reforms we believe are needed to meet these challenges. We offer suggestions for revisions to the current Bill and future policy development but we also lay out a more radical model that we believe holds the prospect of greater progress towards the vision of integrated care and a health system sustainable in the longer term.”

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The future of leadership and management in the NHS: No more heroes – King’s Fund – 18 May 2011

Posted on May 20, 2011. Filed under: Health Mgmt Policy Planning | Tags: , |

The future of leadership and management in the NHS: No more heroes – King’s Fund – 18 May 2011

“Summary
At a time of enormous change in the NHS, leaders and managers have a crucial role to play. But what sort of leaders does the service need?  Does the model, prevalent in public service over recent years, of the ‘hero’ chief executive still hold sway?

The King’s Fund set up a commission on leadership and management in the NHS with a brief to:

take a view on the current state of management and leadership in the NHS
establish the nature of management and leadership that will be required to meet the quality and financial challenges now facing the health care system
recommend what needs to be done to strengthen and develop management and leadership in the NHS.”

… continues on the site

38 pages ISBN: 978 1 85717 620 9

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Variations in health care: The good, the bad and the inexplicable – King’s Fund – 14 April 2011

Posted on April 14, 2011. Filed under: Clin Governance / Risk Mgmt / Quality, Evidence Based Practice, Surgery | Tags: |

Variations in health care: The good, the bad and the inexplicable – King’s Fund – 14 April 2011

press release

“A new report from The King’s Fund has found persistent and widespread variations across England in patients’ chances of undergoing surgery for common medical conditions.” 

“The report Variations in health care: The good, the bad and the inexplicable, outlines differences in admission rates for several routine interventions by analysing the geographical variation in health care provision in the NHS in England. Thirty-six different procedures were selected for analysis because they were either:

generally recognised to be clinically effective, or
there is uncertainty regarding their intervention, and/or
there are cost-effective alternatives available for conducting surgery – for example, treatment as a day case, rather than being admitted as an inpatient.

Evidence suggests that medical opinion and/or doctor preferences and attitudes have a substantial influence over which treatment patients will receive and are a major source of variation. Studies have also found that patients, if fully informed about their options, will often choose differently from their doctors and are less likely to elect for surgery than control groups.”

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Improving the quality of care in general practice: Report of an independent inquiry commissioned by The King’s Fund – 24 March 2011

Posted on March 24, 2011. Filed under: Clin Governance / Risk Mgmt / Quality, General Practice | Tags: |

Improving the quality of care in general practice: Report of an independent inquiry commissioned by The King’s Fund – 24 March 2011

Summary
“General practice is often regarded as the bedrock of the English health care system. Surveys consistently report high levels of trust in GPs and good levels of patient satisfaction with the services they receive in general practice. However, other than data available through the Quality Outcomes Framework and the GP Patient Survey, very little information is published on the quality of care in general practice.

It was for this reason that The King’s Fund set up, in April 2009, an independent inquiry into the quality of general practice in England. The aim of the inquiry, which was conducted by an independent panel of experts and chaired by Sir Ian Kennedy, was to help to support the work of general practice and to provide a guide to ensure that quality is at the heart of the service that it offers to patients.

Improving the quality of care in general practice is the report of the inquiry; it represents the most extensive review of quality across general practice carried out in recent years. Its work was informed by specially commissioned research and analysis of routinely available data across a range of aspects of general practice including: core elements of day-to-day practice – for example, diagnosis, referral and prescribing; non-clinical aspects of quality – for example, access to care and patient engagement; and areas where the role is shared with others – for example, maternity and end-of-life care.”

…continues on the site

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Social care funding and the NHS: An impending crisis? – The King’s Fund – 17 March 2011

Posted on March 21, 2011. Filed under: Health Economics, Social Work | Tags: |

Social care funding and the NHS: An impending crisis? – The King’s Fund – 17 March 2011

ISBN: 978 1 85717 612 4

“Summary

The impact of funding cuts to the NHS has been widely reported and discussed, but less attention has been given to social care – and, most importantly, to the inter-relationships of health and social care.

Social care funding has increased in real terms for the past decade, but there has been considerable variation in how that funding has been spent – in part because spending on social care is handled by local councils, whose circumstances vary. The wide geographical variations in cost and performance across a number of measures – for example, emergency hospital admissions, delayed transfers – reflect different relationships between health and social care. The government has pledged to facilitate closer integration so that people can receive a more joined-up service.”  …continues on the site

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Staffing in maternity units. Getting the right people in the right place at the right time – The King’s Fund – 6 March 2011

Posted on March 8, 2011. Filed under: Obstetrics, Workforce | Tags: |

Staffing in maternity unitsGetting the right people in the right place at the right time – The King’s Fund – 6 March 2011

Jane Sandall, Caroline Homer, Euan Sadler, Caroline Rudisill, Ivy Bourgeault, Susan Bewley, Pauline Nelson, Luke Cowie, Chris Cooper, Natasha Curry

“Summary
Maternity services – in common with the rest of the NHS – need to focus on new ways of working to maintain and increase levels of safety and quality of care within the resources available. There are particular pressures on maternity services because of the rise in birth rates and the increasing complexity of many births.

Following on from its previous inquiry into the safety of maternity services, The King’s Fund commissioned further research to answer a fundamental question: Can the safety of maternity services be improved by more effectively deploying existing staffing resources?”   …continues on the site

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Reconfiguring hospital services: lessons from South East London – King’s Fund – 3 March 2011

Posted on March 3, 2011. Filed under: Health Mgmt Policy Planning | Tags: |

Reconfiguring hospital services: lessons from South East London – King’s Fund – 3 March 2011
Keith Palmer
ISBN: 978 1 85717 610 0

Extract from the press release:

“Market forces alone will not deliver essential changes to hospital services, says The King’s Fund

The King’s Fund has questioned whether the government’s health reforms will deliver much-needed changes to the provision of hospital services, in a new report published today.

The report, Reconfiguring hospital services: lessons from South East London, outlines recommendations for policy-makers to ensure that so-called ‘reconfigurations’ of hospital services improve the quality of care for patients. It is based on a detailed analysis of protracted efforts to reorganise services in South East London, where financial problems and concerns about patient care have plagued four of its six local hospitals.”

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Choosing a high-quality hospital: The role of nudges, scorecard design and information – The King’s Fund – 18 November 2010

Posted on January 19, 2011. Filed under: Clin Governance / Risk Mgmt / Quality, Patient Participation | Tags: |

Choosing a high-quality hospital: The role of nudges, scorecard design and information – The King’s Fund – 18 November 2010
88 pages ISBN: 978 1 85717 603 2

Summary

“Patient choice, particularly the choice of hospital, has been at the heart of health policy for a number of years. The aim of this policy is to create competition, which in turn drives improvements in quality; for this to work effectively, patients have to make their choices on the basis of clinical quality. Significant resources have been devoted to offering patients more information to help them make their choices. But do people use the information that is available?

Choosing a high-quality hospital explores how information can help patients to make informed choices. It is based on a research study, which began with a series of focus group discussions, the results of which informed the design of an online experiment.  People were presented with information using a number of different ‘scorecards’ comparing the performance of hospital, and different ‘nudges’ were used to influence their choices.”  …continues on the site

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How do quality accounts measure up? Findings from the first year – The King’s Fund – 6 January 2011

Posted on January 19, 2011. Filed under: Clin Governance / Risk Mgmt / Quality, Health Systems Improvement | Tags: |

How do quality accounts measure up? Findings from the first year – The King’s Fund – 6 January 2011
36 pages ISBN: 978 1 85717 608 7

Summary

“Quality accounts are a key mechanism through which health care organisations can demonstrate their focus on improving the quality of their service. The government has recently undertaken an evaluation of the 2009/10 quality accounts and set out their expectations for 2010/11.

The King’s Fund undertook an independent analysis of a sample of quality accounts produced by a range of providers – acute trusts, mental health trusts, independent providers.”  …continues on the website

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Clinical and service integration: The route to improved outcomes – The King’s Fund – 22 November 2010

Posted on January 19, 2011. Filed under: Health Systems Improvement | Tags: , |

Clinical and service integration: The route to improved outcomes – The King’s Fund – 22 November 2010
56 pages ISBN: 978 1 85717 605 6

“Over the past decade a number of health policies have sought to put the patient first and to improve health outcomes. Choice and competition have been key elements of these policies, but the importance of integrated care was highlighted by Lord Darzi in the final report of the NHS Next Stage Review.

Does integration of care act as a barrier to choice and competition? This question has long been debated and highlights the complexities and nuances of the issue. The debate should be informed by evidence on the performance of integrated systems – and by greater clarity on the terminology used.”

…continues on the site

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Avoiding hospital admissions: What does the research evidence say? – King’s Fund – 16 December 2010

Posted on January 14, 2011. Filed under: Acute Care, Emergency Medicine | Tags: |

Avoiding hospital admissions: What does the research evidence say? – King’s Fund – 16 December 2010

“Summary:  Emergency admissions to hospital are costly to the NHS and also cause disruption to planned health care. Considerable efforts have been made within the health service to reduce emergency admissions, but few primary care trusts have been successful, with some primary care trusts recording an increase.

In order to successfully reduce avoidable emergency admissions, we need to fully understand which interventions are the most effective. The King’s Fund commissioned this review of research evidence to establish which interventions work in avoiding emergency or unplanned hospital admissions.”  … continues

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Mental health and the productivity challenge: Improving quality and value for money – The King’s Fund – 2 December 2010

Posted on January 14, 2011. Filed under: Health Economics, Mental Health Psychi Psychol | Tags: |

Mental health and the productivity challenge: Improving quality and value for money – The King’s Fund – 2 December 2010
64 pages ISBN: 978 1 85717 606 3

“Summary:  The NHS is facing a significant financial challenge and needs to make substantial improvements in productivity if it is to provide high-quality services without additional  funding. Spending on mental health accounts for around 10 per cent of the overall health budget and so the mental health sector has a key role in responding to this challenge.

The King’s Fund and Centre for Mental Health, with the support of the Royal College of Psychiatrists and the NHS Confederation’s Mental Health Network, have worked together to explore how mental health services could be delivered in a different and more cost-effective way. The consensus from their work, including an expert seminar and a review of evidence, is that there is scope for mental health services not only to improve their own productivity but also to support productivity improvements in other parts of the NHS.”  … continues

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How to deliver high-quality, patient-centred, cost-effective care. Consensus solutions from the voluntary sector – King’s Fund – 16 September 2010

Posted on October 19, 2010. Filed under: Clin Governance / Risk Mgmt / Quality, Health Systems Improvement | Tags: |

How to deliver high-quality, patient-centred, cost-effective care. Consensus solutions from the voluntary sector – King’s Fund – 16 September 2010

“This publication is the collective effort of ten of the leading health and social care organisations in the voluntary sector. Each organisation submitted evidence to The King’s Fund, which independently analysed and assessed each submission and worked with the organisations to establish a common position. Together we have identified the five key themes that the health and social care system must embrace to be sustainable and to ensure quality. The themes are:

  • co-ordinated care
  • patients engaged in decisions about their care
  • supported self-management
  • prevention, early diagnosis and intervention
  • emotional, psychological and practical support.”
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Leadership needs of medical directors and clinical directors – King’s fund – 19 August 2010

Posted on September 7, 2010. Filed under: Health Mgmt Policy Planning, Medicine, Workforce | Tags: , |

Leadership needs of medical directors and clinical directors – King’s fund – 19 August 2010

Download publication (pdf 184kb)
12 pages ISBN: 978 1 85717 599 8

“Summary

The National Health Service (NHS) is facing one of the toughest financial periods of its history during which it will need to maintain the quality of care. Clinical leadership will be critical as the service faces this challenge. The King’s Fund has a wealth of experience in developing the skills of leaders in the NHS, and is constantly adjusting its approach to meet the needs of those leaders. With this in mind, we conducted a survey of clinical and medical directors to find out what skills they believed they need to face these challenging times.

Leadership needs of medical directors and clinical directors includes the following findings.

Both medical and clinical directors embrace the quality agenda articulated by Lord Darzi in High Quality Care for All (Darzi 2008), and are committed to preserving it.
Both medical and clinical directors are eager to work with their managerial colleagues as equal partners to maintain clinical quality, ensure patient safety and improve patients’ experience in the face of reduced resources. They see an urgent need for clinicians and managers to share a single mindset on maintaining quality efficiently.
Clinical directors believe that they are largely cut off from the decision-making and planning processes, and view this as a critical challenge that must be overcome.
Clinical directors and medical directors have high levels of confidence in their influencing, negotiation and communication leadership skills, and in their ability to use resources to maintain the quality of care.”

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Referral management: lessons for success – The King’s Fund – 2010

Posted on August 20, 2010. Filed under: General Practice | Tags: , |

Referral management: lessons for success – The King’s Fund – 2010

76 pages ISBN: 978 1 85717 600 1

This report aims to provide practical advice to those seeking to influence the content and pattern of GP referrals. It draws on the current literature and new qualitative and quantitative research to evaluate the full range of referral management activities from full-scale referral management centres to the ‘passive’ provision of guidelines to GPs.

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The role of GPs in maternity care – what does the future hold? – The King’s Fund’s Inquiry into the Quality of General Practice in England – August 2010

Posted on August 5, 2010. Filed under: General Practice, Obstetrics | Tags: |

The role of GPs in maternity care – what does the future hold? – The King’s Fund’s Inquiry into the Quality of General Practice in England – August 2010  Report in pdf    (pdf 397 kb)

“To inform its work, the Inquiry panel commissioned a discussion paper to examine what good-quality maternity care looks like and the implications for general practice. The [report] assesses the current state of general practice involvement in maternity care, what GPs can do to stimulate and maintain care quality, and how care quality can be measured. The paper’s authors are Alex Smith, former Health Policy Researcher, The King’s Fund, and Judy Shakespeare, GP.”

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Improving NHS productivity More with the same not more of the same – King’s Fund – July 2010

Posted on July 27, 2010. Filed under: Health Economics, Health Mgmt Policy Planning | Tags: , |

Improving NHS productivity More with the same not more of the same – King’s Fund – July 2010
32 pages ISBN: 978 1 85717 598 1

Authors: John Appleby Chris Ham Candace Imison Mark Jennings

(pdf 236kb)

“Summary
Although the coalition government has pledged to protect funding for the NHS, the pressures to meet rising demand will put a strain on spending. Building on a previous analysis produced in association with the Institute for Fiscal Studies, this paper examines the gap between the likely available funding and the level of funding required to achieve the progress projected by Sir Derek Wanless in his 2002 report for the Treasury. It sets out: the scale of the problem; strategies for managing the cost and demand pressures; strategies for improving productivity and suggests that improving productivity offers the best option for reducing the shortfall.

Improving productivity is not a straightforward or well-understood option: it can suggest that the NHS needs to dramatically cut budgets, reduce services for patients and sack staff.  In fact, this paper suggests that the overall approach is one of ‘doing things right and doing the right things’; a number of strategies are outlined that will reduce production costs and improve outcomes; others will free up resources to be used more productively; others may lead to actual cash savings. This information will help health care leaders at national and local level to select the strategies which, together, produce more value from the same or similar resource – rather than the same for less.

The biggest challenge facing the NHS is to act on the knowledge of what needs to be done and to make it happen. This action is required at all levels in the system – from government to frontline teams.”

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Patient choice: how patients choose and how providers respond – The King’s Fund – 3 June 2010

Posted on June 11, 2010. Filed under: Patient Participation | Tags: |

Patient choice: how patients choose and how providers respond – The King’s Fund – 3 June 2010
Anna Dixon, Ruth Robertson, John Appleby, Peter Burge, Nancy Devlin, Helen Magee
215 pages ISBN: 978 1 85717 596 7

“Summary
The policy of offering patients a choice in where they receive hospital treatment was intended to create competition between providers, encouraging efficiency and responsiveness to patients’ preferences and ultimately to drive up the quality of care. So has the policy met those aims?”

…continues

Download publication (pdf 4934kb)

Download summary (pdf 184kb)

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Putting quality first in the boardroom: improving the business of caring – the King’s Fund / Burdett Trust for Nursing 2010

Posted on May 6, 2010. Filed under: Health Mgmt Policy Planning | Tags: , , |

Putting quality first in the boardroom: improving the business of caring – the King’s Fund / Burdett Trust for Nursing 2010   By Sue Machell, Pippa Gough, David Naylor, Vijaya Nath, Katy Steward, Sally Williams

ISBN: 978 1 85717 592 9

“This report is part of a programme of work undertaken by The King’s Fund to better understand how NHS boards assure themselves about the quality of clinical care that patients receive, and how nurse executives can help them with this vital task. In essence, the aim of the programme is to support nurse executives and NHS trust boards to ‘bring the ward to the board’.”

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