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 ...
Social enterprises are businesses that deliver goods and services but in pursuit of primarily social objectives. The government is committed to supporting social enterprise in the economy at large and in its recent white paper has suggested that social enterprise models of service delivery can be part of the provider ...
This paper aims to shape discussion about practice-led commissioning. It asks what this kind of commissioning is intended to achieve and what it really means in the new health care context. It explores the lessons of GP fundholding, total purchasing, and locality/GP commissioning pilots, and suggests some constraints and risks ...
Although practice-based commissioning (PBC) receives widespread support among the main political parties and NHS stakeholder groups, implementation of this policy has been slow. The NHS now boasts 'universal coverage' of PBC but in practice this means it has created an environment in which PBC could flourish rather than one in ...
In 1998, the Secretary of State approved nine PMS pilots to offer 'nurse-led' primary care. They were designed to maximise the use of nursing skills and to allow nurses to exercise leadership within the primary health care team. This report describes the experiences of the nine nurse leads as they ...
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 ...
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 ...
The National Health Service (NHS) in England is in a state of transition as the government pushes forward a programme of significant reform. If the government achieves its stated objectives, the NHS will be transformed from a state-owned commissioning and provision system to one in which care is delivered by ...
Foundation trusts, which were first set up in 2004, represent a radical departure from the way in which health services are held to account. The traditional accountability of NHS hospitals to the Department of Health has been replaced by a new accountability of foundation trusts to their members and their ...