This report examines the kind of work facilitators do, their achievements and the factors that help or hinder progress in a rapidly changing world. Three different models are described - Oxford, Best Friend and Camberwell.
The future of community services was the title of a conference held in November 1988 at the King's Fund. This report follows the format of the conference, with speakers' presentations followed by reports of the discussions which took place in the afternoon workshops. Also explored are the role of the ...
The DHSS funded three development workers to work in three differing health authorities to explore the possibilities for improving primary health care in the inner city by developing patch or locality management and planning of services work more closely together; and to establish three local experiments with different approaches to ...
In this publication the author states:- A new approach is needed for agenda-setting in primary health care. It should draw on the public health and participatory model espoused by W.H.O.; build on the experiences of local projects and initiatives, and seek to create planning and management structures which achieve change ...
This briefing paper critically reviews the proposals, assesses financial implication and highlights major omissions in the White Paper 'Promoting Better Health' : the Government's review of primary care services. It concludes that, despite welcome attention to issues of accountability and value for money, some basic questions remain unanswered : which ...
This book aims to provide an account of the range of work carried out by the Family Practitioner Committees, the bodies responsible, in England and Wales, for administering the contracts of general practitioners, dentists, opticians and pharmacists. This is the first comprehensive study of FPCs. It analyses the political environment ...
Increasing interest in the quality of health services and the appointment of officers with designated local responsibilities has generated an urgent demand for ideas on implementing quality assurance, especially from district officers. This collection is one individual's view of relevant literature and activity. It reflects the initial emphasis of the ...
In January 1980 the Conservative Government appointed a study group under Sir Donald Acheson to produce ambitious proposals for rapid and effective action on primary care in London. This report examines how and why the study group was established, the issues it confronted, the route by which it reached its ...
This pamphlet describes three aspects of primary health care which were commonly referred to in the evidence to the Royal Commission. The first gives an outline of the current position of deputising services and examines issues of debate. The appendix gives details of the location and ownership of deputising services. ...
In 1986 the King's Fund, with the financial support of the DHSS, established three experimental projects in inner London to explore the possibilities for improving primary health care by developing small scale management and planning of services. One of these projects was located in Riverside HA. This report describes how ...
This response to the Green Paper `Primary health care : an agenda for action' steers a middle course between `alternative' green papers and detailed comments on the few firm proposals. The structure of the response follows that of the six objectives outlined in the Green Paper: 1) raising standards of ...
The publication of "Primary health care: an agenda for discussion" was welcomed by the London Project Executive Committee of the King's Fund as an opportunity to contribute to the debate on the future of primary health care. In order to prepare a response which would contain practical recommendations for improving ...
This report presents an appreciation of the significance of Primary Care Development Fund supported schemes for the future of UK primary care generally, and offers a point of common entry into a vital area of national health debate to a range of audiences amongst NHS service providers, users and purchaser ...
This report from the Primary Health Care Group of the King's Fund Centre explores the context of primary care planning and provides examples of how joint working may be successfully achieved. It outlines why FPCs and DHAs need to work together and argues that primary care planning has been neglected ...
The conference sought to discuss, in the broadest terms, what the definition, function, purpose and relationship of primary health care should be in the future. The conference was held within the context of 'Health for All by the Year 2000' as resolved by the World Health Assembly in 1977. One ...
This workshop arose from a meeting at the DHSS stimulated by Dr. Peter Pritchard in July 1980 between officers of the DHSS who were interested and involved in management and general practice, the King's Fund and Dr. Pritchard. The aim of the workshop was to identify some of those who ...
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 working paper is based on the assumption that change in the direction of primary health care is desirable and inevitable. It explores the interface between acute hospitals and primary care, and describes developments that improve integration and show how a shift towards primary care might be achieved. It goes ...
This report analyses the interlocking set of problems posed by health services, medical education and research in London. It demonstrates that Londoners receive a poor deal from present-day services. It warns that health care in the inner-city may become unsuitable unless there is the political will to back a strategy ...
This report describes how audit can be made effective. Drawing on the experience of people who have been involved in organising audit in primary care, it suggests how medical audit advisory groups (MAAGs) could help all practitioners to take part in relevant and worthwhile audit. With the help of lively ...
The aim of this unpublished paper is to provide all Londoners with primary and community health services which both meet their needs for high quality health care and which - over time - can appropriately substitute for certain services currently provided in acute hospitals. If Sir Bernard Tomlinson's recommendations are ...
This publication is the fifth in a series aimed at helping health service staff to obtain the views of service users, and it is written for anyone who has been given this responsibility, whether nursing, medical, paramedical or managerial. The series presumes no social science background and offers a flexible ...
The impetus for this publication came from a seminar which was set up on behalf of the NHS Management Executive to investigate the lessons learned for the development of integrated purchasing from the Localities Project. Purchasing patient-centred health (and social) care requires deliberate focus on the patient through: patient centred ...
This working paper is based on the assumption that change in the direction of primary health care is desirable and inevitable. It explores the interface between acute hospitals and primary care, and describes developments that improve integration and show how a shift towards primary care might be achieved. It goes ...
The imbalance in London between primary health care and hospital services has long been recognised. Attempts are now being made to address this issue by strengthening community-based services. This paper quantifies the nature of the challenge facing primary health care in the capital relative to the rest of the country. ...
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.
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 briefing paper aims to contribute some background analysis and data to inform a debate in the House of Commons on 28 April 1994 about London's health care system. It begins with comparative considerations; whether high needs and poor community based care lead to greater pressure on hospitals; and key ...
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 ...
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 ...
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 ...
The Innovation in Medical Education project, based in the Department of General Practice and Primary Care, King's College School of Medicine and Dentistry aimed to explore the implications of a substantial move of medical education into the community. The main areas covered were: interviews with a wide range of interest ...
This report summarises the brief which was given to the King's Fund on finding the views of GPs following the Tomlinson report; setting up GP networks; clarifying what the King's Fund might expect from the Investment Fund launch; and improving working with GPs.
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 ...
The six case studies in this book describe how purchasers, one of them a fundholding practice, bought interventions to improve the health of local populations in direct response to information which had revealed particular needs. The case studies have been published as examples of good practice because this effective and ...
Following on from the King's Fund London initiative in 1992 the authors investigated the extent to which acute services in London have moved from hospital into primary or community care. This article considers the extent of movement away from traditional acute care in hospital into the following settings: general practice; ...
This report is the result of a major study examining the links between acute, primary and community services in Bromley, Kent. Results of the study, funded by the King's Fund and South Thames Regional Health Authority, contributed to Bromley Health's future strategy for change and led to the redevelopment of ...
This is the third edition of this publication which was published for the first time in 1994. This edition is structured in three parts. The first is a calendar of events in London's health care during 1995, followed by a commentary by the editor. The second section presents the relevant ...
This manual contains organisational standards for primary health care commissioning. It forms one part of the King's Fund Organisational Audit project for health authorities and primary health care commissioners. The standards apply to all primary care commissioning organisations, whether these are GP fundholding practices, multi funds or non-fundholding practices that ...
This is the review of the full report which analyses the interlocking set of problems posed by health services, medical education and research in London. It warns that health services in the city may become unsustainable unless tehre is the political will to back a strategy of fundamental reform. It ...
This report provides a comprehensive review of the health and health care of the population of London, based on a variety of published and unpublished data sources. The report considers London in three ways: first, by providing comparisons between different parts of the capital; second, by comparing areas of London ...
This publication gives an account of a project co-funded by the NHS Executive and the King's Fund. It was devised as a response to the crisis in GP morale which began to be recognised in 1994. A participative workshop, 'A Day in the Life of a GP 2010' was designed, ...
This Review is based on the financial year 1995 to 1996. The first part examines the main events of the year in five key policy areas: creating the new NHS ; community care ; public health strategy; serving the consumer; and clinical knowledge. The second part of the work contains ...
This guide has been written for members of primary health care teams (PHCTs) where the team has decided to run a community -oriented primary care (COPC) programme on depression or anxiety. It is designed to assist at the two stages of detailed problem assessment and intervention planning. As a result ...
This report is a case study of primary-secondary substitution as an achievable means of reconfiguring health care in London and the UK more generally. It systematically reviews the available local, national and international evidence on the potential for cost-effective primary-secondary substitution of emergency care. The evidence relating to substitution and ...
This report is a review of the evaluation of the London Initiative Zone (L.I.Z.) primary care development projects which were established through the former London Implementation Group (LIG) and which were in progress in 1995/6. It particularly focuses on the evaluation of revenue projects aimed at service development in primary ...
This manual has been produced to meet the demand for the development of standards and a peer review process for commissioning organisations. It provides an organisation with the means to question practice and to stimulate development work. It has been introduced at a time when health authorities and family health ...
This guide explores the benefits of introducing community development health programmes. Using a community-oriented primary care approach (COPC), the guide explains how to use resources more effectively, set health goals and health programmes linked to local needs, identify those who most need health care, and support people's desire to take ...
Community-oriented primary care (COPC) is an approach to health care which combines the principles and skills of public health and family practice. It offers participants an action-oriented framework for working together on health needs at practice level. In 1992, the King's Fund, in association with other organisations, initiated a pilot ...
This report presents some of the main themes that emerged from a series of workshops on various aspects of primary care organised and hosted by the King's Fund in the summer and autumn of 1996. The topics covered in the workshops were change in primary health care, frail elderly people, ...
The National Health Service in London faces profound challenges. Currently, services are under intense strain. Access to appropriate care for Londoners is jeopardised, and public confidence has declined. In inner London, in particular, there are high levels of deprivation and growing health inequalities. While some of the country's leading hospitals ...
The National Health Service in London faces profound challenges. Currently, services are under intense strain. Access to appropriate care for Londoners is jeopardised, and public confidence has declined. In inner London, in particular, there are high levels of deprivation and growing health inequalities. While some of the country's leading hospitals ...
This publication consists of organisational standards and criteria for primary health care service providers which have been revised to reflect changes in general practice since the previous edition of this publication in 1994.
The findings outlined in this book describe a service in inner London that cannot be sustained because it is unable to meet the demands imposed upon it. Services in outer London are comparable with those in other English cities. The mental illness services are in a state of transition, and ...
The London Health Partnership is an alliance of charitable foundations, business interests and government, formed in June 1994. Its purpose is to generate a distinctive programme of work over the next few years to help develop urban health care. This is a report of their progress at the end of ...
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 workshop explored the approaches developed by five NHS general practices who are learning from their patients and communities to develop resources which provide new health creating options. Human considerations are kept to the fore, teamwork and an active partnership with patients are encouraged and a wide range of integrated ...
This paper reconsiders the meaning and impact of projects, the most common device for spending development monies. They argue that projects can distort the priorities of the host organisation. There are four aspects to this problem: the disruption caused to an organisation by the existence of a project; the project ...
This paper examines what is known about linkworkers, using information derived from a review of the literature and from interviews with those working in the field. It discusses how linkworkers might make a contribution to primary care in the future, and considers some of the organisational issues that will need ...
This pamphlet describes the whole systems approach taken by the London Health Partnership to achieve their aim of improving the well-being of older people by addressing long-standing problems of providing care and promoting health in cities. This summary was presented to the 1996 British Urban Regeneration Association Conference.
The White Paper "The new NHS" set out the Government's health policy for the next ten years. All general practices in England are to belong to a Primary Care Group (PCG), whose core functions will be to: improve the health of their community and reduce inequalities; commission a range of ...
In this collection of stories, six managers and practitioners talk about their experiences of working with their counterparts in health and social services in development initiatives that were supported by the King's Fund in the period 1993-98. All of the accounts provide insights into the way people in primary health ...
This paper tells the story of the first two years (1994-96) of the London Health Partnership's primary care development programme. It describes the background to the project and its guiding principles, and then goes on to describe the diagnostic phase of its work and how systems theories influenced the ongoing ...
The King's Fund Primary Care Programme and the Health Quality Service have collaborated on a project to define standards of good practice for primary care groups in England. The purpose of the standards is to define good practice from inception and to guide primary care groups in developing as effective ...
New Health Network exists to encourage the NHS to fulfil its potential by stimulating an environment of innovation and change in the NHS for the benefit of patients. Its aim in publishing this book is to stimulate debate and provide a space for thinking that will be necessary to achieve ...
Policy changes in health and social care present new opportunities for primary care to work in partnership with others to improve provision for people with mental health problems. Policy connections between mental health services, primary and community care were not always made effectively in the past and attention to implementation ...
People with long-term mental health problems suffer considerable disability and are at risk of relapse or deterioration. Primary and secondary care have traditionally been separated, leading to poor communication and lack of role definition. Furthermore, there has been no national programme aiming to improve service delivery for this group of ...
This is the final report on the evaluation of an urban primary health care development programme undertaken by the London and Northern Health Partnerships (L&NHP). These partnerships were established in 1994 to generate a distinctive programme of work aiming to improve primary health care in urban areas, particularly in London. ...
This booklet is a brief guide for general practitioners (GPs) and colleagues in the primary health care team who have patients who are refugees or asylum seekers, and wish to ensure that they have the knowledge and skills to deliver an appropriate service to those patients. It provides information on ...
This item gives the critiques and papers produced for a conference held at the King's Fund Centre in November 1994. The aim of the conference was to use the OXCHECK and British Family Heart studies as a springboard for the future, to critique them for their unique contribution to the ...
This review analyses selective UK literature from 1994 to the present day on the attitudes towards, experiences of and comments by and about the capabilities of primary care.
The aim of this work is to support primary care groups (PCGs) in developing primary care in London. It is directed at all those involved in primary care development , including members of PCGs, trusts and health authorities. Primary care development is taken here to mean the constellation of ideas, ...
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 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.
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 ...
This publication is a comprehensive review of health care and policy issues. It contains a calendar of events for the months June to August 2000 as well as discussion of key policy issues. Specific areas dealt with in this issue include: the NHS Plan; public attitudes towards the NHS between ...
This publication summarises the key points from the publication 'Improving Health at Local Level : the role of primary care' by Ros Levenson and Lucy Johnson. The fundamental questions about the role of primary care in public health are: how can primary care develop its input into public health while ...
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 ...
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 ...
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 ...
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 ...
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 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, ...
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, ...
In 2002, the King's Fund commissioned a major inquiry into the state of the capital's mental health and mental health services and how far they meet the needs of service users. The inquiry set out to: investigate whether mental health care had improved in the capital since the King's Fund ...
At the beginning of 1995 King's Fund Organisational Audit set up a project to develop organisational audit for health service commissioning. Six health authorities and five primary care organisations agreed to become pilots for the newly developed process. This report presents the results of the evaluation process, including the findings ...
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 ...
The aim of this paper is to develop statistical models which explain the utilisation of GP services and which can also subsequently be linked to the 1991 census data to calculate weighted population estimates for areas based on their need for health care
The NHS (Primary Care) Act 1997 made possible local contracts for general practice services and spawned Personal Medical Services (PMS) pilots. These are intended to make primary care services more sensitive to local needs and are therefore particularly useful in London where long-term infrastructural problems have proved intractable. The King's ...
This publication is a comprehensive review of health care and policy issues. It includes a detailed description of health events in the last twelve months, as well as discussion of key policy issues. Specific areas dealt with in this issue include: influencing the diffusion of new medical technologies; the future ...