In this report, we focus on what needs to be done to strengthen commissioning in the NHS, through an analysis of the problems with current commissioning arrangements. We begin by examining what is meant by ‘commissioning’ in the English NHS.
Since the 1950s, the NHS has been looking at ways of improving care coordination. Lord Darzi’s NHS Next Stage Review introduced a new concept, that of the integrated care organisation (ICO). Since then, the Government has begun piloting schemes that offer different models of integrated care. This report, published jointly ...
This paper has been written as a contribution to the work of the NHS Future Forum and in support of the government’s espoused aim of placing integrated care at the heart of the programme of NHS reform. Integrated care is essential to meet the needs of the ageing population, transform ...
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 ...
This paper argues that the NHS in England cannot meet the health care needs of the population without a sustained and comprehensive commitment to quality improvement as its principal strategy. Despite a succession of well-meaning policy initiatives over the past two decades, the paper argues that the NHS in England ...
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 ...
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 ...