In August 2008, the Department of Health asked The King's Fund to lead a stakeholder engagement review on the proposal for a Centre of Excellence. This report reflects what was heard from stakeholders during the consultation and sets out a series of recommendations that aim to support effective implementation. [Summary]
This report describes the way in which Trafford South Primary Care Group consulted local people about older people's services. It decided to host two day-long events for local people, inviting their comments on the health and social care needs of older people in the area. A key feature was the ...
This technical paper offers an understanding of the different contracting, reimbursement and incentive mechanisms available to deliver value and outcomes-based healthcare in a UK context.
This is the second digital edition of the Quarterly Monitoring Report (QMR). The new QMR still includes a shorter PDF of the headline findings this quarter, but also features digital versions of the survey results, interactive performance data charts and an infographic with the key findings for this quarter. and Our Quarterly Monitoring Report (QMR) reveals the views of NHS trust finance directors and clinical commissioning group finance leads on the productivity challenges they face, and examines some key NHS performance data.
Street drinking has a major negative effect on communities and drinkers alike. But street drinkers often find it hard to get the support they need, especially those who are unable or unwilling to stop drinking. There is widespread interest in how far wet centres can offer a way forward. In ...
This background paper looks at the evidence and information informing the demographic, economic, social, health and other relevant trends over the next 20 years that are likely to affect the demand for, and nature of, social care for older people in England. The full report is due in Spring 2006. ...
Securing good care for more people: options for reform proposes new, fairer funding arrangements for adult social care, a review of the current settlement for older people and a long-term staged approach to reform based on political consensus. While demonstrating that the cost of the social care system is set ...
In 2009, The King’s Fund and the Burdett Trust for Nursing set out to ‘bring the ward to the board’, emphasising the role of the nurse executive in ensuring that boards are as fully engaged with the clinical quality agenda as they are with financial performance. As leaders of the ...
Continuity of care contributes importantly to patient experience, whether it's continuity of a relationship, by seeing the same GP, or management continuity, that coordinates an individual’s care across the wider health care system. However, continuity is not monitored or incentivised in the same way as other aspects of good practice. ... and This paper was commissioned by The King’s Fund to inform the panel of the Inquiry into the Quality of General Practice in England. The views expressed are those of the authors and not of the panel.
The government is committed to improving the quality of care, and as part of this commitment they aim to make more information available to the public about the performance of trusts. Providers of NHS services are now required to publish quality accounts – reports for the public on the quality ...
The contents of this paper come from a review of the literature on compassion, or concepts related to it, and from views and comments arising from the workshop on this topic held in November 2008. The experiences of workshop members were collected on the day and by anonymous written contributions, ...
In 2008 the NHS celebrates its 60th birthday. This briefing looks at key health care issues over the last 60 years and forward to its 120th birthday. [Introduction]
General practice has changed considerably over the past decade. Practice size has increased, the workforce has grown and become more diverse, the range of services offered has expanded, and the contracting and financing arrangements for GPs have changed. Current government policy aims to improve access and choice for patients, to ...
Independent sector treatment centres (ISTCs) provide services to NHS patients but are owned and run by organisations outside the NHS. This briefing paper explains why ISTCs were introduced, and how they are funded, staffed and regulated. It assesses their impact so far, including the quality of their services and whether ...
The King's Fund response to the National Institute for Health and Clinical Excellence consultation on new indicators for the Quality and Outcomes Framework (QOF). The King's Fund broadly supports the introduction of each of the new indicators, particularly the six mental illness indicators as there is strong evidence of the ...
Since internal markets were created in the NHS, commissioners have purchased health care on behalf of patients and the public from a variety of competing providers. Commissioning was intended to drive improvements in the quality, accessibility and cost-effectiveness of services, but has so far largely failed to achieve these objectives. ...
For the past three years patients referred by their GP for a specialist outpatient consultation have had a choice over where to be treated. As part of a larger research project, a survey was sent to patients in four case study areas of England to ask them about their experience ...
Unhealthy behaviours - smoking, alcohol misuse, poor diet, lack of exercise - lead to ill health, with resulting costs to individuals, to the NHS and to society as a whole. PCTs are expected to commission support to help people change their behaviour to adopt healthier lifestyles - but what should ...
The government’s End of Life Care Strategy set out to improve the care that patients receive at the end of their life and to give them meaningful choice about where they are cared for and where they die. Implementation of the strategy has proved challenging, however, for a number of ...
If the health of the population is to improve significantly, patients need to be engaged in managing their own health. The increase in availability of information, developments in new technology, and changes in public attitudes mean that patients want to interact differently with health services. These developments present a challenge ...
This review assesses how far the investment and accompanying reforms since 1997 have transformed the NHS in England into a high-performing health system. The review focuses on England because health policy has now diverged from that in the devolved administrations of Scotland, Wales and Northern Ireland. It has drawn on ...
NHS spending in England may have more than doubled in real terms since 1999/2000, but the prospects for future funding now look bleak. Although there is consensus that the NHS faces a tough financial future, there is no agreement about just how cold the financial climate will be. Starting with ...
In 2006 a pilot programme was launched in partnership with six NHS trusts, supported by their charities, and two Marie Curie Cancer Care hospices to improve Environments for Care at End of Life. The objective was to see whether the King's Fund run Enhancing the Healing Environment (EHE) could be ...
The pace of change and reform in the NHS has been relentless as government and those who work in the NHS seek ways to improve the service. The King's Fund set up an expert working group to examine how effective the current incentives were in achieving this aim. The group ...
Ensuring that you are measuring the things that matter most to patients is an essential component of a successful strategy for improving patients' experience. It is important to choose methods that are fit for purpose. This paper provides a brief guide to these to help trust boards and other interested ...
Primary care trusts (PCTs) spend around 75 per cent of the NHS budget in England. How do they decide on their spending priorities? This paper examines the data collected by the Department of Health on the amounts PCTs spend on the 23 programmes of care based on medical conditions such ... and An update to the briefing "Local variations in NHS spending priorities" published in 2006.
Workforce planning for the NHS is a large undertaking. The NHS in England employs approximately 1.3 million staff, 70 per cent of recurrent NHS costs relate to staffing, and more than £4 billion is spent annually on staff training. Securing a sufficient number of staff with the appropriate skills and ...
The National Institute for Health and Clinical Excellence (NICE) is acknowledged as a world leader in its field, yet the prevailing media image of NICE is as a controversial mechanism for denying patients expensive new drugs. Teresa Poole looks at how NICE appraises new and existing drugs through clinical and ...
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? Since January 2006, patients requiring a referral ...
Recognising the significance of mental health in terms of both expenditure and the overall health of the population, the King's Fund commissioned a review. This report presents current and projected needs for mental health services and their related costs. It gives details on a number of specific disorders, including depression, ...
Practice-based commissioning (PBC) has been a major strand of NHS policy since 2005. There continues to be a high level of commitment to the policy among GPs, but many still remain hesitant about its impact to date and unsure if its potential will be fulfilled. In 2007, The King's Fund ...
This briefing examines the recent history of the quality and safety, financial and economic regulation of health care providers in England. It describes the new regulatory machinery that is being introduced and considers how the relationship between these different regulatory systems may develop in the future. [Introduction]
How can we ensure that patients in hospital are treated with respect and compassion? The Point of Care programme has been set up to transform patients' experience of care in hospital, and to enable health care staff to deliver high-quality care. Based on existing research and qualitative studies with patients ...
Primary care trusts (PCTs) provide a broad and complex range of community-based services. However, the commissioning and management of these services have been a challenge for the NHS and in particular for PCTs. As PCTs provide community health services, there is a potential conflict of interest for their role as ...
Government health policy has been encouraging a shift in the balance of care from hospital to community settings. The Department of Health commissioned The King's Fund, in partnership with Loop2, to undertake a simulation-based project entitled SeeSaw to understand how this shift in care could be achieved. This report outlines ...
How are top-ups distinct from other charges in the NHS and why have they become such a contentious issue now? This briefing gives some background on the relevant legislation and guidance in this area. [Introduction]
Social and technological changes are challenging doctors, causing many to rethink their role, the way they practise and the nature of their professionalism. What does the future hold? The Royal College of Physicians and the King's Fund convened ten events around England and Wales where doctors and other health professionals ...
As part of Lord Darzi's review of the NHS, each strategic health authority (SHA) outside London was commissioned to produce a report outlining their 'vision' for care in their region over the coming decade. This briefing provides a thematic summary of some of the key features of the nine SHA ...
In recent years, NHS boards have often been preoccupied with financial performance, but they also have to engage with the quality of clinical care. A programme of work developed by The King's Fund, in partnership with the Burdett Trust for Nursing, has focused on the role of nurse executives in ...
In July 2007 Professor Lord Ara Darzi, a surgeon and health minister, started a wide-ranging review of the NHS in England and the final report is due to be published before the 60th anniversary of the NHS on 5 July 2008. This briefing provides the background of the review and ...
The current system for funding adult social care in England has been criticised as unfair, complex and financially unsustainable. There are significant local variations in who is eligible for what kinds of support and a host of complicated local and national rules that apply to the funding of different elements ...
The challenges facing the NHS at present are the same core challenges that face all organisations, commercial or otherwise: the delivery of an effective and efficient service with limited resources. While commercial organisations may additionally seek to make profit from this process, the differences in ownership, objectives and structure between ...
It has long been recognised that engagement of employees with their work and organisation is a factor in their job performance, but the research evidence for this has been steadily increasing over recent years. In this article we summarise this evidence along with the theories underlying it,
paying special attention ... and This paper was commissioned by The King’s Fund to inform its review of leadership in the NHS.
This paper was commissioned by The King’s Fund to inform its review of leadership in the NHS. and One of the major consequences of the failures in quality of care and patient safety in the NHS, exposed by the public inquiries such as those relating to Bristol Royal Infirmary and Mid Staffordshire NHS Foundation Trust, has been the Department of Health’s initiatives to improve the governance and leadership ...
In response to the commitment to clinical leadership, The King’s Fund instigated a project to determine the impact leadership programmes have on individuals and the system. Junior doctors who had completed or were currently on leadership programmes were interviewed in order to determine their experiences and aspirations for the future. and This paper was commissioned by The King’s Fund to inform its review of leadership in the NHS.
In early 2009 The King’s Fund conducted a survey of primary care trusts (PCTs) in England, examining the use of external support for commissioning, and eliciting views on the world class commissioning programme. The survey revealed that PCTs are increasingly turning to external organisations, and the private sector in particular, ...
This research paper was commissioned by The King's Fund to inform the panel of the Inquiry into the Quality of General Practice in England. The views expressed are those of the authors and not of the panel. and Recent government guidance, "End of Life Care Strategy: Promoting High Quality Care for All Adults at the End of Life" and "Guidance on Cancer Services: Improving Supportive and Palliative Care for Adults with Cancer", has raised the profile of end-of-life-care (EOLC). However, historically care has been poorly organised, with large ...
This paper was commissioned by The King’s Fund to inform the panel of the Inquiry into the Quality of General Practice in England. The views expressed are those of the authors and not of the panel. and This paper assesses the barriers to providing high quality clinical leadership in general practice, what general practice can do to develop leadership capacity, and ways to measure the extent and quality of clinical leadership.
This is the fourth paper in a series, Kicking Bad Habits, on how people can be encouraged to adopt healthy behaviour. The paper considers the influence of an individual's motivation and confidence in modifying their health behaviours. While there is good evidence, in theory, that they are two key determinants ...
This briefing paper argues that an additional £3.2 billion a year is required to reverse the impact of government cuts to the public health grant and ensure that it is re-allocated according to need. The grant enables local authorities to deliver vital public health services, such as obesity programmes, drug ...
Under the Health and Social Care Act, the NHS Commissioning Board and Clinical Commissioning Groups (CCGs) will be accountable for improving health and treatment outcomes in the NHS.
We've produced two slide sets to help CCGs make the best use of measurement to support them to commission for improved outcomes.
Croydon Primary Care Trust has been piloting the practical use of the Combined Model on behalf of the King's Fund and Health Dialog since May 2006. It has developed a package of care called virtual wards that is offers solely to people at highest predicted risk. Part of the PARR ...
This is a joint project commissioned by Essex Strategic Health Authority on behalf of the 28 strategic health authorities, the Department of Health and the NHS Modernisation Agency and undertaken by the King's Fund, in partnership with Health Dialog and New York University. This review informed the project to develop ...
This paper was commissioned by The King’s Fund to inform the panel of the Inquiry into the Quality of General Practice in England. The views expressed are those of the authors and not of
the panel. and There is evidence that a good-quality therapeutic relationship improves both patient satisfaction and professional fulfilment, saves time, and increases compliance with prescribed medication. Yet the subtle and intangible elements that underpin a strong therapeutic relationship are difficult to define and to measure. To inform its work, the Inquiry into the ...
In response to growing concerns about the safety of maternity services in England, the King's Fund has set up an independent inquiry with the aim of identifying obstacles to the delivery of improvements in the safety of maternity services and robust strategies for overcoming them. There is already a substantial ... and This background paper summarises what is currently known about the safety of maternity services in England. The paper begins with some background information on trends in numbers of births, place of birth and changes in maternity services. Data is then presented on the type, incidence and causes of adverse outcomes ...
There is increasing public concern about the availability, quality and appropriateness of care services for London's diverse older population. In February 2004, the King's Fund launched an inquiry to investigate whether the care market was working for older people in London and if there would be enough care services of ...
Published by The King’s Fund on behalf of the Burdett Trust for Nursing. and This handbook has been written as part of 'From Ward to Board' - a joint project by the Burdett Trust for Nursing and The King's Fund. It aims to help nurses successfully navigate the transition into the role as an executive and contains chapters on the demands of the role, ...
New technology is promising to transform a health and social care sector that is increasingly struggling with the need to do more with less funding. Many providers and commissioners are looking for opportunities to use technology to improve services and cope better with the long-term demographic pressures that the system ...
This working paper makes the basic case for supporting and developing advocacy. It explores the advocacy sector in London and the government's growing interest through a literature review, document analysis, and explorative questionnaire to advocacy providers, in-depth interviews with key stakeholders, and focus groups with a range of community leaders. ...
This document is a summary of the King's Fund Inquiry into care services for older people in London. The Inquiry was established to find out whether the care system operating in 2004 was meeting the needs and preferences of older Londoners who require care and whether there will be sufficient ...
As the government seeks to accelerate change in the NHS and make services more responsive to public demands, the argument for market discipline versus planned provision is being hotly debated: can a highly centralised system sit comfortably alongside a market-led approach?; can market forces provide an effective response to the ...
This paper is a formal response by the King's Fund to the Department of Health consultation on the smokefree elements of the Health Improvement and Protection Bill.
This research summary, based on a review of the literature and a series of focus groups with NHS staff, shows that while it is difficult to measure how people feel about their work, there is much to suggest that morale and motivation of the NHS workforce are low. It identifies ...
Since its beginnings, the NHS has had a close relationship with the pharmaceutical industry. While not an official public-private partnership (PPP) there has been, in effect, an implicit PPP for pharmaceutical research and provision. This partnership has been an undoubted economic success. However, the interests of users of the health ...
This research summary presents the findings of a two year research and development project, supported by a King's Fund grant, examining how London's primary care professionals are working in the community to provide palliative care, and how general practitioners, district and community nurses , and PCT and specialist palliative care ...
The King's Fund has produced this briefing ahead of the second reading of the Health Bill in the House of Commons. The briefing examines the measures outlined in the Bill to introduce a Constitution for the NHS; pilot direct payments for patients; require providers of NHS-funded care to produce annual ...
This report brings together the findings and conclusions from three strands of research that addressed different aspects of the main research topic, which is the identification of successful strategies for sustaining reductions in waiting times. They are: identifying successful strategies for sustaining reductions in waiting times; the impact of waiting ...
The research on which this paper is based was commissioned from The King’s Fund by the Joseph Rowntree Foundation (JRF) to inform its work to develop an anti-poverty strategy for the United Kingdom. The overarching question addressed is, how can the NHS make a better contribution to tackling poverty? We ...
This paper explores the role of medical leadership and engagement as a means to improve productivity. It looks at the evidence about how doctors may best improve productivity, and how doctors practising today feel about this. and This paper was commissioned by The King’s Fund to inform its review of leadership in the NHS.
This paper will concentrate on medical leadership. The paper was commissioned to contribute to The King’s Fund’s 2012 review of leadership and engagement. It will therefore describe models of medical leadership and predominantly refer to the medical literature. Importantly, this paper’s focus on medical leadership is not intended to detract ... and This paper was commissioned by The King’s Fund to inform its review of leadership in the NHS.
This report describes how clinical commissioning groups (CCGs) in England are innovating with two broad models – the prime contract and alliance contract. It draws on experiences from five geographical areas, covering different population and disease groups (cancer, end-of-life care, musculoskeletal services, mental health rehabilitation, and older people’s services). It ...
This paper draws on academic leadership literature and leadership development practice but is not based specifically on the health care literature or on health care leadership development. Its purpose is to outline some of the latest thinking in leadership theory and leadership development, regardless of sector, in order that the ...
Patient and public engagement has been on the NHS agenda for many years, but the impact has been disappointing. There have been a great many public consultations, surveys, and one-off initiatives, but the service is still not sufficiently patient-centred. In particular there has been a lack of focus on engaging ... and This paper was commissioned by The King’s Fund to inform its review of leadership in the NHS.
This paper forms part of The King’s Fund 2012 leadership review, addressing the topic from the perspective of those seeking to provide leadership extending well outside their own immediate organisational boundaries. To establish firm foundations on which to study this whole-system aspect
of leadership, the paper first explores leadership, management ... and This paper was commissioned by The King’s Fund to inform its review of leadership in the NHS.
This paper will review the evidence which supports the view that securing greater engagement of doctors in management, leadership and service improvement is critical to improving performance. It will also draw on examples of good practice nationally and internationally, as well as offering some frameworks for obtaining and securing greater ... and This paper was commissioned by The King’s Fund to inform its review of leadership in the NHS.
This is one of a series of case studies exploring how individuals living in London have used the King's Fund Millennium Awards scheme to make a real difference to the health of others in their communities. According to the mental health charity MIND, one in four people in Britain will ...
This is a summary of a joint project commissioned by Essex Strategic Health Authority on behalf of the 28 strategic health authorities, the Department of Health and the NHS Modernisation Agency and undertaken by the King's Fund, in partnership with Health Dialog and New York University. This review informed the ...
Technology is widely used in many areas of life, and the NHS Next Stage Review highlighted the role that technology can play in improving health outcomes. However, the use of everyday technologies such as email and online booking systems is poor in the health service. This report aims to improve ...
It is clear that the era of unprecedented investment in health care is over, and prospects for future funding now look bleak. But just how the NHS will respond to this is uncertain. To test how those in the system might respond, we used a behavioural simulation - Windmill 2009, ...
The King's Fund commissioned Opinion Leader Research to carry out an investigation of people's attitudes to their own and the nation's health. The four themes examined were: health expectations, individual responsibility and control, the role of the government and the role of the NHS. Findings suggest that support is strongest ...
This paper tells the story of an innovative approach by the King's Fund to develop the role of learning from practice in the voluntary sector through its new grants programme, Partners for Health, which was set up in 2005. The paper presents the findings of an evaluation of the programme, ...
Our Quarterly Monitoring Report (QMR) reveals the views of NHS trust finance directors and clinical commissioning group finance leads on the productivity challenges they face, and examines some key NHS performance data. and This is the first digital edition of the Quarterly Monitoring Report (QMR). The new QMR still includes a shorter PDF of the headline findings this quarter, but also features digital versions of the survey results, interactive performance data charts and an infographic with the key findings for this quarter.
This paper was commissioned by the UK government's Department for Communities and Local Government (CLG) as part of its National Strategy for Housing in an Ageing Society., As the population ages, the prevalence of complex conditions requiring intensive social care will increase to a point where the costs are difficult to sustain. To avoid this crisis, preventive 'upstream' interventions should be targeted at those people at lower, emerging risk. Evidence suggests that these interventions could avoid future ..., and Copyright HMSO