Local accountability has been a significant policy issue within the NHS generally. However, primary care trusts are in the main accountable to the centre and there have been calls to review this. This paper discusses a range of options for reforming the relationships between PCTs and their public. It explores ...
Chronic medical conditions such as asthma, diabetes, heart failure and hypertension affect large numbers of people, including patients, carers, families and friends. As the population in England ages, growing numbers of patients will need help with managing complex, multiple conditions over sustained periods. Apart from the burden of ill-health, treating ...
Reforms of the NHS are changing the role of the state in the provision of health care. Competition within the NHS (and with private providers) and the introduction of foundation trusts change the way in which providers should be regulated. This paper explores the impact of market incentives in the ...
Despite initially rejecting the notion of an internal NHS market when it came to power in 1997, the Labour government has reintroduced competition to health services over the last three years. But, as it is the product of a series of separate policy developments, including extending choice of provider, expanding ...
This is a summary of a report on emergency hospital admissions in London, funded by the former London Regional Office of the NHS Executive. It examines the nature of emergency admissions in London, pointing out that the main peaks in demand appear to be due to respiratory disease during the ...
Chronic medical conditions such as asthma, diabetes, heart failure and hypertension affect large numbers of people, including patients, carers, families and friends. As the population in England ages, growing numbers of patients will need help with managing complex, multiple conditions over sustained periods. Apart from the burden of ill-health, treating ...
Primary care has been the subject of a quiet revolution in recent years, with the ending of the monopoly of provision by independently contracted GPs and the introduction of a range of new targets and new forms of first contact care. Now it is poised for further radical change with ...
Primary care trusts (PCTs) are struggling to deliver the demanding modernisation agenda set for them by ministers. In consequence, two new policy themes - stronger market incentives and the decentralisation of budgetary power - have been introduced to strengthen the commissioning role of PCTs. This discussion paper looks at how ...
Improving management of high cost patients, especially those with long term conditions, it is increasingly viewed as an important strategy for improving health outcomes and controlling health care expenditures. An essential component of any strategy to improve care and services for these patients is the development of a case finding ...
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 ...