General practice has changed considerably over the past decade. Practice size has increased, the workforce has grown and become more diverse, the range of services offered has expanded, and the contracting and financing arrangements for GPs have changed. Current government policy aims to improve access and choice for patients, to ...
Government health policy has been encouraging a shift in the balance of care from hospital to community settings. The Department of Health commissioned The King's Fund, in partnership with Loop2, to undertake a simulation-based project entitled SeeSaw to understand how this shift in care could be achieved. This report outlines ...
As part of Lord Darzi's review of the NHS, each strategic health authority (SHA) outside London was commissioned to produce a report outlining their 'vision' for care in their region over the coming decade. This briefing provides a thematic summary of some of the key features of the nine SHA ...
This research summary presents the findings of a two year research and development project, supported by a King's Fund grant, examining how London's primary care professionals are working in the community to provide palliative care, and how general practitioners, district and community nurses , and PCT and specialist palliative care ...
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. ...
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 ...
In January 2006 the Department of Health published Our health, our care, our say: a new direction for community services. It is the government's seventh White Paper on health since coming to office in 1997 and, after several years of reform aimed at the acute hospital sector, it represents what ...
Practice-based commissioning (PBC) is a policy intended to give more decision-making power over NHS resources to general practitioners (GPs), and allow them to design and deliver completely new services or commission others to do so. It has a number of underlying policy objectives including delivering more cost effective and convenient ...
The reconfiguration of hospital services in England has been a contentious issue. There have been local public protests against hospital closures and more recently a concerted effort by the government to communicate the clinical case for change. The final report of the NHS Next Stage Review is due for publication ...
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 ...
Nine NHS walk-in centre pilot sites opened in London during 2000. Six of the nine centres are located in hospital sites. The other three centres are in Soho in central London, the High Street in Croydon, and Parsons Green in Fulham. NHS walk-in centres are nurse-led and offer primary care ...
In 1998, the Secretary of State approved nine PMS pilots to offer 'nurse-led' primary care. They were designed to maximise the use of nursing skills and to allow nurses to exercise leadership within the primary health care team. This report describes the experiences of the nine nurse leads as they ...
Although practice-based commissioning (PBC) receives widespread support among the main political parties and NHS stakeholder groups, implementation of this policy has been slow. The NHS now boasts 'universal coverage' of PBC but in practice this means it has created an environment in which PBC could flourish rather than one in ...
This paper aims to shape discussion about practice-led commissioning. It asks what this kind of commissioning is intended to achieve and what it really means in the new health care context. It explores the lessons of GP fundholding, total purchasing, and locality/GP commissioning pilots, and suggests some constraints and risks ...
Social enterprises are businesses that deliver goods and services but in pursuit of primarily social objectives. The government is committed to supporting social enterprise in the economy at large and in its recent white paper has suggested that social enterprise models of service delivery can be part of the provider ...
This working paper aims to revisit findings from the 1997 King's Fund Inquiry on Mental Health and to examine the extent to which primary care mental health services have developed in line with recommendations made at that time. It takes a narrow view of 'primary care' as relating to general ...
This report reveals that two-thirds of the PCTs responding to the survey had not yet carried out any assessment to identify patients who might need support in making choices about which hospital to go to. A similar proportion had not commissioned any new services to support the introduction of patient ...
Government policy is driving a fundamental shift of care from hospitals to more community-based settings. There is a growing expectation that this shift will be supported by the development of a network of new facilities in which primary, community and secondary care services are co-located, often referred to as polyclinics. ...
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. ...
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 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 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 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 ...
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 ...
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 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 ...
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 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 ...
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 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 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 ...
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.
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 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 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 ...
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 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 ...
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 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.
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 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 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 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 ...