Sustainability and Transformation Plans (STPs) have been developed by NHS and local government leaders in 44 parts of England. The plans offer a chance for health and social care leaders to work together to improve care and manage limited resources. But will they succeed where other initiatives have failed? Despite ...
The literature on geographical variations in health care is large and growing. A comprehensive review of this literature would be a major task and is beyond the scope of this paper. Instead, the paper summarises some of the key issues which emerge from the literature and identifies the implications for ...
This book is a sequel to 'Tragic Choices in Health Care: the case of Child B', and continues the examination of ethical questions and conflicts of interest arising from priority setting and treatment decisions. Discussing five cases where funding of a treatment was refused or questioned, it assesses whether lessons ...
This report presents the results of the authors' review of experience of health care technology assessment in the UK and overseas. It was prepared principally to inform the programme of work on technology assessment being developed at the King's Fund Institute, and was a benchmark exercise, seekingto establish the state ...
This book is based on interviews with the four politicians who served as secretary of state for health between 1988 and 1997; Kenneth Clarke, William Waldegrave, Stephen Dorrell and Virginia Bottomley, and offers insights into the events of this period. The author explores the world in which the health secretaries ...
This report summarises the main results of a survey of approaches to commissioning. All health authorities were surveyed and a 100 per cent response was achieved. The survey sought to map different approaches to commissioning and to assess the impact of these approaches from the perspective of health authorities. The ...
This book tells the story of Jaymee Bowen (Child B) whose case has come to epitomise the dilemmas involved in making tragic choices in health care. It shows that the story was complex and not simply an example of health care rationing. While media reports at the time emphasised the ...
This paper examines four major policy developments which are forcing changes in medical staffing arrangements and also in the reconfiguration of clinical services within and between hospitals. These developments are the primary care-led NHS, the New Deal on junior doctors' hours, the Calman report on specialist medical training and the ...
This report is based on a seminar held in Southampton in October 1991 which explored an alternative approach to health rationing from that of the Oregon experiment. A specially designed simulation exercise examined the dilemmas facing purchasers in the new NHS. Organised over 24 hours, the simulation centred on three ...
The successful implementation of the NHS reforms hinges on the development of district health authorities as effective purchasers of health care for their residents. The NHS has always been provider driven and if services are to be delivered more efficiently and responsively then it is essential that health authorities are ...
This report looks at the new role of district health authorities as purchasers of services for their residents. The report shows that non-executive members have the following contributions to make to the work of their authorities: bringing a wider range of experience than is available among the executive members; ensuring ...
The first part of this briefing looks at the implications of the NHS reforms in theory and in practice and presents the six lines of enquiry which might be pursued. The second section discusses the particular impact of the NHS reforms on London which has maintained a very significant number ...
This paper seeks to analyse how the role of district health authority members developed in the period around and after the 1982 reorganisation of the NHS, and it seeks to identify how the role of members can be strengthened within the existing framework of the NHS. Some ideas and principles ...
In encouraging innovation and experimentation in health authorities the idea of a development agency for the N.H.S. has been explored under the aegis of the Royal Institute of Public Administration. This report examines the development agency model, setting out the case for an agency, presenting a range of critical appraisals ...
This briefing paper analyses the management of clinical activity in the NHS. It does so against a background of increasing concern that practices are not always as effective or efficient as is sometimes claimed. The paper considers critically the various policy options that have been put forward for tackling this ...
In the current debate surrounding methods of health finance, there has been no shortage of proposals for reform, but there has been a serious shortage of careful analysis of these proposals. This is the main aim of this briefing paper. Through a systematic examination of policy choices, it seeks to ...
This paper is concerned with policy making in the Swedish health service. The paper begins with a description of the organisation of the Swedish health service and a brief summary of the main issues of debate within the service. This is followed by an examination of the role of the ...
This report reviews the performance of health services in Sweden, Holland, West Germany, Canada and USA. The main aim has been to identify the countries' studies, to draw parallels with the UK, and to establish the lessons, if any, from abroad. Chapter one traces the origins of the Prime Minister's ...