This background paper marks the 40th anniversary of the NHS not so much by celebrating past achievements but by addressing some of the issues which are critical to the establishment of an effective agenda for health in the 1990s and beyond. Areas covered are the health debate including financial reform; ...
This report is intended to share the learning which a group of NHS managers derived from an exploration of total quality management (TQM) in the NHS. It sets out to examine the relevance of TQM to the NHS, points out some of the challenges posed by it, and suggests a ...
This background paper forms a contribution to the seminar. The author is the Vice-Chancellor of Academic Affairs, University of California. This paper accompanies KFC 79/179
This book is described as being a 'reflective tour of where the NHS is coming from, the world it is likely to face in the 1990s, and some ways in which we could strengthen it'. It covers demography, social and environmental stress, medical developments, public expenditure constraints, and likely themes ...
This pamphlet examines the history and future of consultation in the hospital service. It shows that, from its beginning, joint consultation faced particular hazards and difficulties to which a large number of committees have succumbed. The fact that some have survived is a sign of latent vitality and it is ...
The topics discussed in this document are all broadly concerned with management in medicine. They include the need to plan and to evaluate the aims and achievements of the health service, consideration of problems involved, and discussion of some techniques and recent developments.
This book questions how much the public really knows and cares about the standard of care and about the priorities for expenditure on and within the health and social services; how well informed are people (including health services staff) about the facts and figures of these services and about the ...
These notes have been prepared with the cooperation of Community Service Volunteers (CSVs) in order to provide some guidance to both hospital staff and individual CSVs who are considering projects of this nature.
The purpose of the Centre Lunch Talks has been to invite some distinguished person to speak for half and hour on a topic related to health and welfare services with the aim of stimulating new thought or action.
The purpose of the seminars was to inform staff in Great Britain about health services in Europe. This document contains the transcripts of talks given by English-speaking representatives from European Community countries who spoke about the planning and organisation of health services in their respective countries.
This report makes observations which it hopes will be of use to the Royal Commission. There are five observations on the `Royal Commission on the National Health Service': morale in the National Health Service; the role of the district; management training; the role of the volunteer; community health councils. The ...
The decision making process in area health authorities is often slow. This is because of the absence of formal management arrangements, the complexity of the consultative machinery and consensus decision making. The case for speedy decision making in the NHS is discussed, expectations and reality are compared and possible remedies ...
This report discusses the special problems of managing health services. It compares the development of management training in the NHS with that of other public services, with an analysis of the role of universities, the DHSS and the NHS authorities; and outlines a future strategy.
This workshop was held to discover and discuss the extent and range of service planning work currently being undertaken by various disciplines in the NHS. Group discussion examined ideas for future development of the role of each discipline in relation to planning in the service, and considered the educational implications ...
This seminar on rehabilitation and resettlement of NHS employees focussed on the needs of those suffering from long-term sickness or disability. The employers' responsibility for individual employees was investigated and present practices and future trends commented on. Possibilities for good practices included a look at the role of the National ...
This book aims to stimulate discussion and action about the serious difficulties facing the NHS in industrial relations. It aims to help the development of more effective industrial relations which the NHS badly needs and looks at how improvements might be made realistically within the current framework of management. Chapters ...
In July 1978, the King's Fund held a conference to discuss the report Education and Training of Senior Managers in the National Health Service, commonly referred to the Thwaites report after the chairman of the working party. This publication is not just an account of the conference, but a personal ...
This seminar had been arranged with a view to discussing the importance of taking capital costs into account in a specialty budgeting system, and if their inclusion was thought necessary, to consider how such costs should be represented. This topic appeared to have been given little consideration previously and therefore ...
The purpose of the conference was to discuss the report of the King's Fund Working Party on The Organisation of Hospital Clinical Work (KF Project paper no. 22). Discussion centred on the main recommendation that medical work should be performed by fully-trained doctors. The implications were: a reduction in the ...
In June 1979, the King's Fund arranged a two-day seminar for nurse managers to consider the Thwaites Report "The Education and Training of Senior Managers in the National Health Service." Following the seminar, a group of senior nurse managers and educators with a responsibility for management training met regularly at ...
In evidence to the Royal Commission, a frequent complaint was that the reorganised structure with its principle of consensus management had led to massive delays in decision-making. Previous studies have examined the process of decision-making through interviews with a sample of NHS staff. The paper reproduced here explores the feasibility ...
This study complements a wide variety of material made available to the Royal Commission on manpower planning in the NHS. The first paper, by Alan Williams, is a consideration of some of the manpower problems facing the Commission within a general theoretical context. The second, by the secretariat, describes existing ...
The first section of this paper examines the need and demand for dental health. It discusses how treatment is provided in the United Kingdom and how the National Health Service is meeting the need. Objectives of dental health services are defined and positive steps towards their attainment suggested. The latter ...
Section one of this report deals with consumer involvement in the NHS. It covers the areas of complaints procedures, the role of community health councils, the voluntary contribution to the NHS, the Wolfenden Report and patient participation in general practice. The second section concentrates on community health councils (CHCs), presenting ...
These papers complement a wide variety of material made available to the Commission on health service finance. The first paper discusses the alternative models of financing health services. The second paper describes one of those models as used in the NHS: health service charges. The third paper discusses efficient management ...
This paper presents an analysis of the factors underlying the conflict over the pay beds issue which erupted in 1974-76; a conflict which some consider to have been one of the precipitating reasons for the appointment of the Royal Commission. The first section of the paper sets out the basic ...
This short book has been prepared to mark the first five years of Community Health Councils' (CHCs) existence. They came into being in 1974 when the NHS underwent a major administrative reorganisation. Nothing quite like them had ever existed before in the form of a special statutory body with the ...
The paper begins with a background study on hospitals in the National Health Service by the Secretariat of the Royal Commission on the NHS. Hospital types and numbers are investigated including district general hospitals, community hospitals, teaching and specialist hospitals, followed by a discussion of specific aspects of the hospital ...
Increasing expectations of social service departments and the need for social work to establish itself as a new and independent profession has led to friction within the NHS. Although the NHS is not the largest customer for social service departments, many patients and clients are the same people. Services have ...
This study arose from an invitation from the King's Fund to study the job of the district administrator in the NHS and to find out what it is really like. 41 senior administrators were interviewed and eight of them observed at work for three days. The findings show wide variation ...
The Royal Commission on the NHS made an early decision to consider the objectives of the NHS, what they should be and how far the NHS does and may succeed in reaching them. The first paper is a personal statement by one of the members of the Commission. The second ...
This conference was organised by the King's Fund Centre in conjunction with the Management Support and Computers Division of the DHSS. The purpose was to present and discuss progress made in developing and applying `performance criteria' in relation to assessing effectiveness and efficiency in the NHS. The performance criteria technique ...
The author has written an invaluable record of the events surrounding the introduction of the National Health Service by researching among contemporary documents. The scope of the account is limited to England and Wales, and there has been no attempt made to assess and judge the emergent NHS from the ...
The aim of the seminar was to identify the importance of clarifying the role and relationships of functional managers and unit administrators if the strengthening of administration at operational level was to be achieved. Functions represented were confined to general administration, catering, domestic management and works. Organisational principles, the development ...
This project paper has been compiled as a result of workshops and conferences on unit management held at the King's Fund College and King's Fund Centre, February 1980 - February 1982. The challenge for management at unit level is to improve efficiency, monitor standards, simplify decision-making processes and carry out ...
This report contains the findings of a survey of chief officers on management teams in the NHS in England and Wales. The survey, carried out in 1981, was part of an initiative by the King's Fund to develop a management education programme for the most senior officers in health services ...
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 publication contains proposals formulated by members of a workshop held in June 1983 about the development of a district policy for the introduction of information technology with particular emphasis on the implementation of computerised departmental information systems.
This paper contains the results of part of a study relating to the information flow in and out of and within the district office. No attempt has been made to prescribe in detail a total system but it is hoped that the general principles and approach described will assist district ...
This project paper summarises the results of a survey of youth training in the NHS. The survey looked at the extent of involvement by the NHS in the Work Experience on Employers' Premises (WEEP) Scheme sponsored by the Manpower Services Commission and at the youth training being undertaken more generally. ...
The NHS employs 900,000 people in hospitals throughout the United Kingdom. Ethnic minority workers are found throughout the service in considerable numbers, but only limited information is available about their distribution in terms of discipline and grade. In talks with health authority administrators and personnel officers it has been asserted ...
This project paper has been produced from a working seminar for senior management in the NHS. This seminar was to discuss with experts in the field of pay determination and the problems of pay in the NHS. The first section of the report outlines aims and assumptions. Further sections deal ...
The basis of the project paper reports a study of area management teams carried out in England by Rockwell Schulz between January and March 1981. Perceptions of consensus management are discussed with a study of the roles of individual team members and the influence of others such as local authorities, ...
Race and Employment in the NHS is based on a conference organised by the King's Fund and the Polytechnic of the South Bank which examined the practical steps that health authorities and managers should take to ensure equal opportunities for people from ethnic minority groups. This booklet describes ways in ...
Among the initiatives launched by the Steering Group was a study involving five district health authorities to review the operational information required about doctor-patient relationships and contacts, and to develop effective ways of collecting the data required. Participants undertook a comprehensive review of the organisational structures and management arrangements which ...
During 1984, the King's Fund and the National Association of Health Authorities agreed to set up a joint working party, under the chairmanship of Lady McCarthy, to review the present system of pay determination in the NHS and to make recommendations for reform. This report covers the present Whitley Council ...
This book explains - in simple and clear language - the value and use of statistical information as an important management tool. The author shows how the content, organisation and presentation of data can illuminate the goals which an authority sets itself and the way it intends to achieve them. ...
Reuse of single use equipment raises many issues, including legal and ethical ones. This report is the proceedings of a King's Fund conference. The following topics are covered: 1. General perspectives of the various groups involved; 2. Clinical issues; 3. Legal and ethical implications; 4. Technical issues; 5. Economic issues; ...
This report contains the findings of a survey of ex-national trainees who are not currently working in the NHS. A surprisingly large number of trainees left the Service before reaching senior positions. Not only did this represent a waste of the money and manpower which had gone into their training ...
The Task Force was established in 1986 to help health authorities to implement equal opportunities policies for all racial groups in the health service. This 'model' policy has been created from a number of policies sent to the Task Force by health authorities, using those sections which seem most suitable ...
The introduction of general management into the NHS has transformed the service. The author asks if the NHS can continue to evolve into a more dynamic, responsive and actively managed service, representing even better value for money or will the transition to general management be arrested?
This book provides a detailed discussion of the organisation of postgraduate medical education in the NHS, and the administrative and financial implications if changes are to be made. The material is organised within a 'demand and supply' framework: demand from employers, notably the NHS, and supply provided by various institutions ...
This is the fourth paper published by the King's Fund and NAHA on the need to change the way in which pay is determined in the NHS. This paper outlines a proposed structure for determining pay, based on principles described in the earlier documents. The system has three elements: a ...
This report examines the present state of the 1987 expenditure plans in the light of the most up to date information available. It discusses the different ways in which public expenditure can be measured, followed by an examination of expenditure on Hospital and Community Health Services during the 1980's. The ...
Public, political and professional pressures have led to a greater interest in quality assurance in the NHS, but there has been no national policy or framework prescribed. The development of, and approach to, quality assurance has therefore varied widely between districts and between regions. This report aims to reflect managerial ...
The development of a network of services and support for people with A.I.D.S. is a challenge for voluntary agencies, for the NHS and for local authorities. There is a consensus that services should, as far as possible, be provided to enable people to be cared for in their own homes. ...
Despite forty years of the NHS, there are continuing geographical variations in the provision, use and outcome of health services. These variations are manifested in the greater availability of doctors and hospital beds in some areas than others; differences in the use made of these doctor and beds; and variations ...
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 ...
The NHS is a vast and complex organisation, never out of the public eye and now the focus of major political argument. The author examines the way the NHS works and the incentives that motivate everyone concerned - the general public, the health professionals and managers, and the government. There ...
This paper explains initially why health authority management should introduce ethnic monitoring systems and deals in later sections with how members and managers should use the data to measure and improve their authority's equal opportunity performance. The bulk of the paper is, however, addressed to personnel and other officers who ...
This edition of the annual publication contains articles on hospice care, job-sharing in the NHS, research ethics committees, day surgery, resource allocation, optical services, cost effectiveness in the NHS, long-term care insurance and hospital care at home.
This study was commissioned by the Manpower Planning Advisory Group to examine the present structure of occupational therapy services and to make recommendations about the most appropriate models for the future. The research team was also charged with studying the various levels of skill needed by occupational therapists to perform ...
This paper explores the issue of user representation in health care in the light of the important changes to the organisation and funding of health and social services outlined in the government's reform programme for the NHS and community care. Its first section summarises the health and community care reforms ...
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 ...
The report examines the likely impact of the indicative drug budgets for family doctors and the government's general practice fund holding initiative in Britain. The authors believe that the new arrangements will sharpen price competition in the UK medicines market, and welcome this. The study also reports on recent European ...
The Single European Market has nearly arrived when people will experience freedom of movement of goods, services and people between the Member States of the European Community. For the health service, this has two main concerns. First, the possible increase in the migration of unskilled labour will effect the health ...
This report examines the history of the series of policy initiatives concerning the use of land and buildings in the NHS. It considers the political and managerial intentions which lay behind the 1983 Ceri Davies report, and charts the extent to which the series of proposals which it produced have ...
This book explores the changing relationship between payers and providers, and how these changing relationships affect patients; how the tensions between payers and providers are managed in the 1990s will be an increasingly important determinant of who gets what care, how good it is and how much it costs. A ...
This is a collection of short papers based on a seminar to mark the eighty fifth birthday of Sir George Godber. They examine issues of substantial relevance to the present and future of the National Health Service.
There is no shortage of people from black or ethnic minority communities who could make a positive contribution to NHS boards, yet few board members are from these communities. This situation must change otherwise a disservice is being done to both the NHS and the community at large. This book ...
This report describes the outcome of a six month study of the management development requirements of the NHS in Scotland, undertaken by the King's Fund College. The report describes: the scope and content of the original brief for the work; the methodology adopted by the King's Fund team; and the ...
The changes in the NHS mean that clinicians will have to accept the need for explicit rationing rather than shirking the issue with reference to clinical decision making. The current system of implicit rationing will be replaced by one which bases resource allocation on explicit criteria. However there are problems ...
This paper proposes an alliance of charitable foundations, together with Government, to make a distinctive contribution to the way in which health services for Londoners are being shaped. It explains how an investment fund could form the basis of a high profile three year development programme; how it could be ...
This publication provides guidance for managers in regional and purchasing authorities and in provider units on how to improve NHS services provided to people from black populations. It should also be a basis on which community organisations and users' groups can evaluate race equality initiatives in local service provision. Managers ...
This is a review of the King's Fund College in 1994. It lists the staff who have joined and those who have left; work in progress from January to August 1994; College activity and finance report; subjects for action; and the Development Fund.
From July 1992 a group of representatives from prison staff and NHS staff across London has worked together using the model of a learning network to develop a better understanding of the health needs of prisoners and to explore new ways of meeting those needs. This report: reviews the health ...
This is the first issue charting the progress of developments in London's health services. Included are: a calendar of events from October 1992 to December 1993; a commentary on the development of the planning process in London including the series of reports from the Government and other professional bodies. There ...
This paper is based on a speech delivered at the 1993 annual meeting of the National Association of Health Authorities and Trusts. The author considers how a policy initiative should call for a shift in the balance of services from the hospital to the community by: a shift in the ...
Reorientating the NHS to be both needs led and responsive to users has to be a joint endeavour for both commissioners and providers. A new synthesis is required to combine the best of personal patient care with a focus on population health. The King's Fund has recognised community oriented primary ...
The author looks at the NHS in London two years after the report of the King's Fund Commission on London and the Tomlinson report and three years before the next general election. Policies shaping the NHS in London have become increasingly controversial. He argues that despite the growing resistance to ...
The first two briefings looked at major issues involved in joint commissioning services for older people and examined progress at each of the five development sites. This third briefing concentrates upon the achievement of change, particularly making a positive impact on older people's lives through collaborative commissioning. A major theme ...
This is a summary of a workshop in a continuing series of short events designed to explore the development of collaborative commissioning in the light of evolving local experience. Participation was drawn from the five sites involved in the King's Fund Centre's Joint Commissioning project, eight other health and local ...
This is a summary of a workshop in a continuing series of short events designed to explore the development of collaborative commissioning in the light of evolving local experience. Participation was drawn from the five sites involved in the King's Fund Centre's Joint Commissioning project, eight other health and local ...
This is a summary of the first workshop in the King's Fund Purchasing Innovations series. The workshop heard from three main contributors on experience to date in their authorities: Durham; Wiltshire and Bath; and Birmingham.
This document builds on work carried out by a group of blind and partially sighted people who were invited to identify the issues which they considered to be most important in shaping their experiences of community care. These issues include access to information, assessment for entitlement to services, inflexibility and ...
This is the second edition of this publication which was published for the first time in 1994. This edition is structured in four parts. The first is a calendar of events in London's health care during 1994, followed by a commentary by the editor. The third section presents the relevant ...
This publication aims to provide a quick guide to improving disability services for senior managers in health and social services who may have overall responsibility for services for adults with physical or sensory impairments yet not have a detailed involvement at an operational level. The guide is written primarily for ...
The purpose of this workshop was to provide the NHS Executive Patients Charter Unit with material and ideas for a leaflet on children's services. Services for children in hospital and in the community were discussed. It was recommended that the format of the charter should be accessible to parents and ...
Early in 1995 the Patient Empowerment Focus Group of the NHS Executive commissioned the King's Fund Centre to run a workshop on patient empowerment. The seminar was designed to meet three objectives: to develop a working definition of what is meant by patient empowerment; to identify probable component parts of ...
This debate is the second of a series organised by the King's Fund. It took place at a time when the NHS stood accused of withdrawing from long-term care, and public concern was running high about the growth of means-tested services previously provided free under the NHS. People from different ...
This report attempts to identify key themes within the seminar and highlight questions pertinent to the use of complementary therapies in mental health treatment. It draws selectively from addresses and workshops presented, comments and discussions during the seminar as well as feedback from the evaluation forms. The report addresses three ...