Healthcare-associated infections are a major concern to patients and the public as a result of both high rates of infection across the National Health Service (NHS), and media coverage of outbreaks at individual hospitals. The government has put in place a range of policies designed to reduce healthcare-associated infections in ...
This is the third paper in a series, Kicking Bad Habits, on how people can be encouraged to adopt healthier behaviour. Information-based health campaigns are a major part of the government's health promotion strategy. A £75 million marketing programme has been recently announced to encourage healthy behaviour in children. This ...
Lord Darzi's report, NHS Next Stage Review, attempts to open a new chapter in the story of 'quality' in the English NHS: how to move on from a centrally driven performance management regime - with its focus on driving activity and meeting targets - to a more sophisticated strategy that ...
This is the report of a seminar commissioned by the working party set up by the Department of Health at the end of February 2007 to review the implementation of new arrangements for the regulation of pharmacy in the United Kingdom. The seminar was held at the King's Fund on ...
Under the Race Relations Amendment Act (2000), all public bodies, including NHS organisations, are legally obliged to produce a 'race equality scheme' explaining how they plan to eliminate racial discrimination and promote equal opportunities. This paper examines PCTs' race equality schemes to find out what PCTs are doing to address ...
The War on Waiting for Hospital Treatment (Harrison and Appleby 2005) examined the government's record on reducing the number of people on waiting lists for elective care in England, and the time they had to wait. This briefing provides an update on that analysis. The waiting times targets currently in ...
In recent years, several countries have introduced powers to compel certain people with mental disorders living in the community to engage with services and undergo treatment. This paper explores what happened in the first six months after community-based compulsory treatment orders were introduced in Scotland in October 2005. It looks ...
The reconfiguration of acute and community hospital services in England has recently come to dominate discussions about NHS reform - both locally and nationally - and is provoking a great deal of controversy. This briefing examines the background to the current debate, identifies the main factors driving the changes, explores ...
Although some of the key planks of the NHS reform programme, such as Payment by Results (PbR) and patient choice, began to take shape from 2003, it is only recently that the Department of Health has begun to publish guidance, aimed at people working within the NHS, that attempts to ...
Practice-based commissioning is a policy that aims to give more influence and control to GP practices in England over how money is spent on health care services. At the moment, the bulk of NHS money is allocated to primary care trusts (PCTs) who then commission and reimburse hospitals (and other ...
While the 'postcode lottery' of accessing drugs such as Herceptin on the NHS attract media headlines, there has been growing awareness of more fundamental variations in spending by primary care trusts (PCTs), the organisations responsible for purchasing the bulk of NHS care for people living in their catchment areas. This ...
The King's Fund Inquiry into Care Services for Older People in London 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 care services of the right design and quality ...
A report commissioned by the King's Fund in December 2004 to provide support to the Enquiry into Care Services in London. The data helps to provide an understanding of housing issues that impact on people's ability to make choices about their care and their way of life.
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. One in four people will experience a mental health problem at some point in ...
This guide sets out to show how teams of NHS staff can plan and deliver their own medium-sized design projects in hospitals by making better use of existing resources. It is aimed at a wide audience, including the frontline employees, such as nursing and estates or facilities staff, who may ...
Since 1997, there has been a growing interest in the UK in reducing health inequalities, regenerating disadvantaged neighbourhoods and ending cycles of social exclusion. Large sums of money have been invested in large social programmes, mostly designed to be implemented in partnership with local communities. This policy paper asks to ...
Failure to address avoidable ill health will put huge pressures on the future NHS while deepening health inequalities. This discussion paper asks why, until recently, helping people to stay healthy has had so little emphasis, and what mechanisms and incentives are needed to put wider population health at the heart ...
Improving health and social care is a political priority in the United Kingdom. Boosting the number of health care workers and making better use of their skills are central objectives of the Government's plans for reform. However, recruitment and retention are major problems for the NHS, particularly in inner cities ...
As the government seeks to encourage individuals, organisations and communities to take more responsibility for improving health, the role of the media is considered to be crucial. To find out more about why and how the media deals with public health issues, the King's Fund was asked by the Department ...
Derek Wanless' 2002 report on the future course of NHS spending was immensely important. Not only did it directly inform the Chancellor's spending plans for the NHS for the next five years - which gave the NHS an unprecedented real increase of over 40 per cent by 2007/8 - but ...
The King's Fund, NHS Confederation and Royal College of Nursing produced this briefing that provides key facts and figures on London's health needs, and highlights what they believe are the five most pressing health issues for the Mayor to tackle. The five key messages are: make London a healthy place ...
This publication presents a study of how the news media cover health issues. It tests the premise that television news programmes and newspaper stories distort perceptions of risk to health by under reporting serious public health issues that kill many people, such as obesity and smoking, focusing instead on 'scare' ...
This guide is the new, fully revised second edition of 'Practicalities of Producing Patient Information' (PoPPi), which was published by the King's Fund in 2000. Fully updated in line with the latest developments in new media such as CD ROMs and the internet, the guide also shows how to use ...
This new policy paper, which follows up an interim report published in 2002, aims to take a fresh look at the issues facing planners, policy makers and managers responsible for maintaining and developing the health care workforces in London, and to tease out some of the opportunities, as well as ...
This research summary examines a key aspect of NHS staffing: that of the loss of experience from health services as older staff, who are valuable and much needed, leave early in ever-increasing numbers. With a workforce where about 150,000 of the one million employed are aged 50 or over, and ...
This report was commissioned to review the use of the King's Fund buildings and its universal services in terms of benefit to a variety of stakeholders, including staff, in relation to the achievement of the King's Fund corporate strategy and against cost. Universal services were defined as the King's Fund ...
This publication aims to revive the research debate among policy makers and the research community. It evaluates progress towards meeting the needs of the NHS and examines the role of publicly financed health research alongside that played by the educational, commercial and voluntary sectors. Finally, it assesses the significance of ...
'Working Together in London', a three-year, £2 million programme, was set up by the King's Fund, the Sainsbury Centre for Mental Health and the Department of Health to support people with severe and long-term mental health problems. New assertive outreach services were established in three of London's most deprived communities ...
In the past few years, rapid and significant changes have taken place in the social, political and policy environment in which health professionals and patients interact. This paper reports on the Patient Involvement Project, a King's Fund study that assessed changing relationships between health professionals and patients/clients in a changing ...
This publication summarises the King's Fund Community Pharmacy Programme. It has three components: extending local contracting to community pharmacy; the developmental needs of community pharmacists in North East London; and the role of pharmacists in demand management. The programme outputs will include a conference, publications, a stakeholder event in North ...
The Story of Charin was an interactive session on the King's Fund Millenium Awards Leadership Development Program, it is the story of the Autism Awareness Year campaign. The session focussed on how to work with others and motivate people. The session was led by Ivan Corea, Fellow in Leadership Development ...
As part of its National Strategy for Carers, the government has developed and approved a set of five quality standards for local services to support carers (family and friends looking after those who are sick, disabled, vulnerable or frail). This book is designed to help individuals, local groups and service ...
The ultimate goal of the new Older People's Service Development Programme in London is to promote the independence of older people in London through the development of person-centred coordinated services. The aim will be to establish systems to identify vulnerable older people in the community who may be at risk ...
This book is based on a series of King's Fund seminars which looked at what values mean for a modern, publicly owned health organisation. It highlights specific value conflicts and argues that for values to 'live' as an organisational reality, trade-offs must be visible, managed and explicit. Topics include: the ...
This publication reviews the Labour Party's inheritance when it came to power in 1997, its early promises and its actions to date. It analyses performance against pledges in the areas of funding, waiting, rationing, primary care, workforce, quality assurance, the private sector, long-term care, patient and public involvement and health ...
Organisations such as the National Institute of Clinical Excellence seek to assess the value for money of new health care technologies. Assessment commonly requires the use of thresholds or benchmark levels of cost effectiveness. Key issues that consequently need to be resolved include: the basis on which thresholds should be ...
This publication is based on a briefing paper prepared by the authors for a workshop on the roles of intermediate care coordinators, which sets out the range of functions of intermediate care coordination and their context within the overall implementation framework of the National Service Framework for Older People. It ...
Under One Roof was an interagency project aiming to provide better integrated services to homeless single people in two London boroughs. Over its three year course the project has been able to give us a clear sense of the way forward for rough sleepers' services, from GP surgeries and benefits ...
This summary draws on 'Working for Health : the NHS as an employer and its role in regeneration' published in February 2001, and a public seminar, 'New routes to health through employment' held on 7 February 2001, organised by the King's Fund and the London Regeneration Network.
The Labour Government's commitment to making more use of the private sector in health care is proving controversial. Opponents are concerned that it signals the end of the NHS as we know it. Yet public-private relationships are as old as the NHS. This book analyses existing relationships and the regulatory ...
The King's Fund has been working with the SWLPCO for three years as part of an evaluation of four PMS pilots in London. Using a variety of research methods, including in-depth interviews and a focus group with key stakeholders, a patient satisfaction questionnaire, an audit of chronic disease management and ...
The King's Fund has been working with the North Hillingdon PMS pilot for three years as part of an evaluation of four PMS pilots in London. Using a variety of research methods, including in-depth interviews, a patient satisfaction questionnaire, an audit of chronic disease management and a practice profile questionnaire, ...
The King's Fund has been working with the Isleworth Centre Practice for three years as part of an evaluation of four PMS pilots in London. Using a variety of research methods, including in-depth interviews and a focus group with key stakeholders, a patient satisfaction questionnaire, a registration questionnaire, an audit ...
The King's Fund has been working with the Edith Cavell Practice for three years as part of an evaluation of four PMS pilots in London. Using a variety of research methods, including in-depth interviews and a focus group with key stakeholders, a patient satisfaction questionnaire and a practice profile questionnaire, ...
This inquiry concludes that care and support for older and disabled people could collapse unless the Government allocates at least £700 million extra to social services each year. It shows that Britain's estimated one million care and support workers exist on low pay, with poor training, inadequate support from their ...
In recent years, new health care delivery initiatives have emerged that promise to overcome some of the long-standing difficulties that hinder the various parts of the NHS from working efficiently and effectively together. These include national service frameworks, care pathways and NHS Direct. However, their full implications have yet to ...
The purpose of this publication is to examine the implications of contemporary policy and organisational change for the future of general practice. The opening chapter sets modernisation in context. The next two chapters examine the historical roots of the current situation and the profession's response to current crises. The fourth ...
This book presents the reality of racism in today's NHS. It attempts to tackle the discrimination and injustice some people from minority ethnic groups working in the health service and particularly medicine currently endure. Using a range of anecdotal accounts, historical perspectives and research by contributors from culturally diverse backgrounds, ...
Recently there have been changes in the regeneration policy environment with the establishment of agencies such as the Greater London Authority and Assembly, the London Development Agency and the London Health Commission. The roles of these agencies are detailed in Section One of this publication. Section Two gives a summary ...
This review of the research literature on the relationship between regeneration initiatives and population health was commissioned by the King's Fund in London with support from the Nuffield Institute for Health. It describes the research-based literature reviewed, reviews the evaluative approaches adopted in this field, describes the work identified, considers ...
This report 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 Christmas period. Chronic disease in the elderly is a major factor, and residents of the East End of London seem to be affected ...
This paper presents a resume of two evaluative projects carried out on the Central Stepney SRB (single regeneration budget): the Health Gain Project 1996-2000 and the Household Costs Project 2000-2001. On the basis of the findings, and following reflection on the Hackney and Brighton work, it calls for a rethink ...
This report presents the findings from a two-year research project comprising six case studies of how primary care groups and trusts (primary care organisations, PCOs) are carrying out their health improvement role. It analyses: the approach taken by the six sites to health improvement, and the development of relevant strategies ...
Since 1997, the Labour government has made some momentous changes to the way primary care is managed and delivered. The creation of Primary Care Groups, the development of NHS Direct and the implementation of clinical governance will all have an effect on GP services for decades to come. In "What ...
The Government is planning controversial changes to the funding of long term care for older people. This important book explores the past and future of policy in this area and reflects the changing balance between the state's and the individual's responsibilities to cover risks associated with ill health and disabilities. ...
The first wave of personal medical services (PMS) pilots have now been 'live' for more than three years. Having started life in the shadow of better publicised reforms, they are now at the centre of government strategy for primary care. This publication aims to share the lessons emerging from this ...
Primary care is the life-blood of the NHS. At the core of health care in this country are the relationships between GPs, practice nurses, therapists and their patients. What matters most for these users of health services is that they have access to professionals they can trust. Yet for many ...
Based on six King's College London debates, this book explores the moral dilemmas raised by modern medicine. The public debates tackled issues such as health and poverty, bioengineering, euthanasia and mental health. In each of the six topics, two speakers exchanged views and their talks are published in this volume, ...
This publication is a comprehensive review of health care policy issues. It contains a calendar of events from August 2000 to January 2001 and articles on areas of health policy such as: setting targets for health spending; allocating resources to reduce health inequalities; health policy developments in Europe; the politics ...
This publication is a comprehensive review of health care policy issues. This edition takes London as its theme. It contains a calendar of events from February to May 2001 and articles on areas of health policy such as: public health; mental health services; refugees and asylum seekers' health experience; public ...
The NHS Plan was launched a year and a half ago, and this edition of Health Care UK brings together views on the key health care policy issues the Plan addressed. Articles deal with: patient involvement; access to health services; delivering the NHS Plan; capacity and service delivery; public-private partnerships ...
This review looks at the problems faced by the 3,000 - 5,000 young people leaving care in London each year. Physical health is poor, with high levels of substance abuse, mental health problems are widespread, and the rate of teenage pregnancy is much higher than in the general population. Unhealthy ...
This report summarises a review of the clinical governance baseline assessments prepared by 36 London primary care groups. As every primary care group (PCG) was required to undertake and publish a baseline assessment , they provide insights into the range of approaches being taken to implementing clinical governance.
This book is intended as a guide to effective ways of helping older homeless people. The authors hope to raise awareness of the problems and needs of a generally neglected group of seriously disadvantaged people, to demonstrate that, contrary to widespread assumption, many of them will accept and respond to ...
Close regulation of the pharmaceutical industry has been seen as essential for the protection of the public for most of the last century. Yet the interest of government and the public in the low-cost provision of medicines can often conflict with the existence of a strong, profitable and innovative pharmaceutical ...
Under One Roof is a partnership of over 30 statutory and voluntary organisations addressing the needs of single homeless people in Lambeth and Southwark. It was awarded a King's Fund grant in 1997 with the intention of offering a new one-stop service for single homeless people and improving relationships between ...
This report has been prepared to share information about rapid response services for older people, to encourage the identification and adoption of good practice and to give people the opportunity to learn from the experiences of others. It draws on information shared at a workshop held by the Rehabilitation Programme ...
Barriers to mainstream health and social care services for London's minority ethnic communities include a complex array of poorly organised and delivered services, inadequate communication services for non-English speaking groups, direct staff insensitivity to users' cultural and religious needs, and institutionalised barriers that perpetuate discriminatory behaviour and poor practices. This ...
In the UK, the issue of medical regulation and public trust is now highly politicised. Yet the UK is not alone in finding that citizens and doctors are having to redefine their traditional relationship. In all countries, citizens are demanding more and better health care and governments are having to ...
This paper aims to support primary care groups (PCGs) planning to develop local services for older people and carers. It provides a comprehensive overview of current policy developments and draws on the wider literature to discuss the likely issues and challenges that PCGs will face in reshaping services for their ...
NHS Direct is a nurse-led telephone helpline which was launched in three pilot sites in 1998. An evaluation of the first three sites is still underway and, although preliminary results show high satisfaction among service users, it is too early to draw conclusions about the impact of NHS Direct on ...
This report focuses on the 16 TPPs in England which pursued the objective of reducing acute hospital emergency admissions and/or length of stay to at least the end of the second 'live' year, March 1998. The analysis of hospital episode statistics was undertaken in order to establish whether the action ...
The fundamental questions about the role of primary care in public health are: how can primary care develop its input into public health while also remaining focused on meeting the health care needs of individual patients and their families, and, how can GPs and others in the primary health care ...
This report describes a conference held towards the end of a programme of study set up to identify the learning needs of clinician and the organisational changes required if patients' information needs are to be fulfilled. Prior to this conference, clinicians had been surveyed to identify learning needs and organisational ...
The overall aim of this project was to explore the process of obtaining informed consent in dentistry in order to develop a model for good practice. The specific aims were to find out the range of clinical practice, and discover any difficulties that dentists and patients encounter, including categories of ...
This paper analyses the experiences of other city-wide authorities in the UK and internationally in improving health. It sets out which cities were studied and why, outlines the different ways in which Mayors work to affect change, identifies the available evidence of action to improve health in selected cities, and ...
Since the Labour government came to power in 1997, waiting lists have attracted unprecedented attention. For a time, the number of patients recorded as waiting for hospital treatment fell, but at the same time, numbers waiting more than 13 weeks for an outpatient appointment rose. This outcome had been anticipated ...
Because the NHS was founded to provide equal access to all on the basis of need rather than the ability to pay, price was eliminated as a method of bringing demand for services into line with supply. This means that the Government has to make decisions about the amount of ...
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 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 discussion paper sets out the key points which have emerged from the King's Fund's participation in the public health evidence debate. It addresses four central issues: the need for change (how adequate is the existing public health evidence base?; what issues need to be addressed?; what are the consequences ...
The overall aim of the third year of the national evaluation of TPPs, spanning October 1997 to September 1998, was to identify the ingredients of successful devolved purchasing based in primary care by in-depth study of twelve first wave TPPs. The analysis presented here considers eleven of the case studies ...
This paper aims to assist those who are interested in developing partnership working. It summarises the relevant parts of the Health Act 1999, suggests how these might be used in practice and raises important issues for local consideration. It summarises what is known about care trusts and suggests some key ...
This pack is designed to help all those people with an interest in, or responsibility for, the development of evidence based practice in line with the clinical governance agenda. It has been drawn together following three years of working with small multi-professional groups and the content was piloted with the ...
The provision of high-quality, nationally standardised health information is currently high on the NHS agenda: National Service Frameworks are setting standards for the quality of the information given as part of patient care; every trust must develop an information strategy and policy, to agreed standards; the Patient's Charter lists certain ...
The purpose of this paper is to stimulate debate about the appropriate standard of proof to use in GMC hearings. The GMC currently uses a criminal standard of proof (beyond reasonable doubt). However, this is a matter of custom and practice and is not specified. Recently there have been calls ...
The King's Fund Long-Term Care Finances project began in October 1999. Its aim is to find ways in which the debate on funding long-term care can move forward. This report gives the results of an interview survey of 100 people undertaken in June and July 2000. They were asked questions ...
The Greater London Authority, which provides London with its first directly elected Mayor, has important strategic powers and responsibilities that include a duty to improve the health of Londoners. This report considers how the GLA can best contribute to health improvement and to reducing health inequalities across the capital. It ...