If the health of the population is to improve significantly, patients need to be engaged in managing their own health. The increase in availability of information, developments in new technology, and changes in public attitudes mean that patients want to interact differently with health services. These developments present a challenge ...
Published in February 2007. and In order to help inform the debate about funding health over the next five to ten years, the King's Fund organised a meeting of senior managers, health economists and policy advisers at Leeds Castle. They discussed not only what level of public funding is feasible and desirable, but also the ...
Investment in the NHS has increased significantly under the Blair government. Spending will soon reach the EU average, but when we catch up with our European neighbours, what then? Assuming that pressures to spend more will continue, but that marginal health returns on extra investment are likely to diminish, this ...
This report summarises the main findings of a project designed by the King's Fund to engage Londoners in a public debate around controversial issues arising from current public health strategies in the capital. The aims of the project were to: identify the means of eliciting values in a public debate; ...
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 ...
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 report is based on a seminar held in Southampton in October 1991 which explored an alternative approach to health rationing from that of the Oregon experiment. A specially designed simulation exercise examined the dilemmas facing purchasers in the new NHS. Organised over 24 hours, the simulation centred on three ...
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 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 book tells the story of Jaymee Bowen (Child B) whose case has come to epitomise the dilemmas involved in making tragic choices in health care. It shows that the story was complex and not simply an example of health care rationing. While media reports at the time emphasised the ...
Six citizens' juries pilot schemes, sponsored by the Institute for Public Policy Research and the King's Fund, took place in the NHS between June 1996 and March 1997. This book evaluates all aspects of this experiment, from an explanation of the background to the pilots to descriptions of the jury ...
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 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 ...