While the 'postcode lottery' of accessing drugs such as Herceptin on the NHS attract media headlines, there has been growing awareness of more fundamental variations in spending by primary care trusts (PCTs), the organisations responsible for purchasing the bulk of NHS care for people living in their catchment areas. 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 ...
This publication is a comprehensive review of health care policy issues. It contains a calendar of events from August 2000 to January 2001 and articles on areas of health policy such as: setting targets for health spending; allocating resources to reduce health inequalities; health policy developments in Europe; the politics ...
The NHS Plan was launched a year and a half ago, and this edition of Health Care UK brings together views on the key health care policy issues the Plan addressed. Articles deal with: patient involvement; access to health services; delivering the NHS Plan; capacity and service delivery; public-private partnerships ...
Because the NHS was founded to provide equal access to all on the basis of need rather than the ability to pay, price was eliminated as a method of bringing demand for services into line with supply. This means that the Government has to make decisions about the amount of ...
The King's Fund Long-Term Care Finances project began in October 1999. Its aim is to find ways in which the debate on funding long-term care can move forward. This report gives the results of an interview survey of 100 people undertaken in June and July 2000. They were asked questions ...
This publication is a comprehensive review of health care and policy issues. From 2000, there will be three issues per year. It contains a calendar of events for the months October 1999 to February 2000 as well as discussion of key policy issues. Specific areas dealt with in this issue ...
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 ...
This protocol describes those components of the national evaluation of 53 'second wave' total purchasing pilot sites commissioned by the Department of Health from a Health Research Consortium headed by the King's Fund Policy Institute which form research contract 121/6090 dated 6 December 1995
This protocol describes those components of the national evaluation of 53 second wave total purchasing pilot sites commissioned by the Department of Health from a Health Research Consortium headed by the King's Fund Policy Institute which form research contract 121/6090 dated 6 December 1995
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 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 report contains an abbreviated appraisal of the options for future health policy in Guernsey. It is divided into three main sections. The first section makes clear the main objectives that any policy must meet. The second section identifies the key components of alternative reform packages with an assessment of ...
Fundholding by general practices is the most innovative and potentially far reaching aspect of the NHS reforms. It also raises the most potential difficulties in implementation. The study falls into two parts. The first is a description of the preparatory period from January 1990, soon after practices were asked if ...
Against the background of profound change now affecting the British health and social care system this report examines economic aspects of the support of people (particularly adults) with severe learning difficulties in England, and their implications for future service development. It briefly outlines ideas and data relevant to: the evolution ...
This paper traces the origins of the Oregon plan, explains how it works and passes judgment on its worth. The Oregon plan is a controversial health rationing plan for the poor under America's Medicaid system. Over 700 services have been ranked in priority order and the state legislature has said ...
The report attempts to review the main issues surrounding the funding and management of units providing dialysis services to people suffering from end-stage renal failure in the UK for the benefit of health service managers, renal physicians and other staff. The objective is to review the experience and information currently ...
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 ...
In the current debate surrounding methods of health finance, there has been no shortage of proposals for reform, but there has been a serious shortage of careful analysis of these proposals. This is the main aim of this briefing paper. Through a systematic examination of policy choices, it seeks to ...
The aim of this study is to explore the effect of alternative methods of financing health services on health service performance - particularly performance with respect to efficiency and equity - in the United States, Canada and the United Kingdom. All countries face certain dilemmas in financing health services: health ...
This is a review of recent British initiatives based upon the principles of "An ordinary life", for both children and adults with learning difficulties. Key issues discussed include establishing commitment to basic principles, planning comprehensive services, acquiring appropriate housing, financing and staffing the residential service, operational policies and management, staff ...
This project paper is the product of a working party convened by the King's Fund Centre to examine the provision of day services for people with mental handicaps. The importance of work in society and for people with mental handicaps is discussed and principles of service design described. Problems with ...
This study was commissioned by the Department of Health and Social Security and the King's Fund Centre to provide an independent account of alternatives to hospital care for children with learning difficulties who need long-term residential care. The report draws on examples from health and social services authorities and discusses ...
This report gives an account of the development of the King's Fund London Programme. It was launched in 1979 to develop activities in relation to health care in London. Its broad aim is to identify, encourage and disseminate good practice in inner city areas through a coordinated programme of research ...
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 document is the report of the general situation of the nursing home and looks at: the general financial situation; bed occupancy; levels of staffing; catering provision; and cleaning services.Various recommendations are made by which the running of the Home could be improved.
Bringing together the findings from the Caring Choices events and website, this report looks at possible solutions to the problem of funding long-term care. Caring Choices, a coalition of 15 organisations from across the long-term care system, aimed to raise awareness and encourage debate, as well as generate and test ...
In March 2005, the King's Fund published An Independent Audit of the NHS under Labour (1997-2005), which included an analysis of where extra NHS funding had been spent. This briefing provides an update to the question "where's the money going?" It analyses new data recently released by the Department of ...
Agenda for Change is the most ambitious pay reform introduced into the NHS. In addition to simplifying the system of pay, its objectives were to improve the delivery of patient care as well as staff recruitment, retention and motivation. This paper examines progress in implementation based on interviews with key ...
The Wanless review Securing our Future Health, published by the Treasury in 2002, concluded that the United Kingdom would need to spend substantially more on health care and that fundamental reform would be needed to enable those resources to be used effectively. Five years on, The King's Fund has commissioned ...
Despite the rapid growth of funding, in 2005/6 NHS trusts in aggregate overspent by more than £1.2 billion, and the NHS as a whole overspent by more than £500 million. More than 60 trusts incurred significant deficits, and turnaround teams were sent in to find out why. Although until recently ...
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 ...
An important component of the 1997 King's Fund report on mental health services in London was to analyse the costs of service provision. Over the six years since 1997, there have been some major policy and practice developments in the provision of mental health services in the UK, particularly the ...
In 2002 the Department of Health announced a fundamental change to the way in which NHS hospitals in England are paid for the work they do. Under this new system - Payment by Results (PbR) - hospitals are reimbursed for the activity they carry out using a tariff of fixed ...
In December 2006, the Department of Health issued its second 'operating framework', The NHS in England: The operating framework for 2007/08, which provides a set of rules and guidance for NHS organisations in England for the year ahead. Aimed primarily at managers and clinical staff, the operating framework for 2007/8 ...
The 2006/7 Operating Framework, published at the end of January 2006, sets out the Department of Health's priorities for the NHS in England over the next financial year, a year which the document expects to be 'challenging'. It is aimed primarily at NHS managers and their counterparts in local government. ...
This note responds to the Department of Health's review, led by Professor Mike Richards, into the consequences of additional private drugs for NHS care.
The current system for funding adult social care in England has been criticised as unfair, complex and financially unsustainable. There are significant local variations in who is eligible for what kinds of support and a host of complicated local and national rules that apply to the funding of different elements ...
How are top-ups distinct from other charges in the NHS and why have they become such a contentious issue now? This briefing gives some background on the relevant legislation and guidance in this area. [Introduction]
Recognising the significance of mental health in terms of both expenditure and the overall health of the population, the King's Fund commissioned a review. This report presents current and projected needs for mental health services and their related costs. It gives details on a number of specific disorders, including depression, ...
Primary care trusts (PCTs) spend around 75 per cent of the NHS budget in England. How do they decide on their spending priorities? This paper examines the data collected by the Department of Health on the amounts PCTs spend on the 23 programmes of care based on medical conditions such ... and An update to the briefing "Local variations in NHS spending priorities" published in 2006.
NHS spending in England may have more than doubled in real terms since 1999/2000, but the prospects for future funding now look bleak. Although there is consensus that the NHS faces a tough financial future, there is no agreement about just how cold the financial climate will be. Starting with ...
This background paper looks at the evidence and information informing the demographic, economic, social, health and other relevant trends over the next 20 years that are likely to affect the demand for, and nature of, social care for older people in England. The full report is due in Spring 2006. ...