CARE/CARERS

Regional factsheets on carers (4th March 2010)
The Department of Health has commissioned the Centre for International Research on Care, Labour and Equalities (CIRCLE) at Leeds University to produce a set of 9 regional factsheets on carers. These factsheets include data on the number and characteristics of carers in each region as well as information about carer health and well-being.
Factsheets

Funding care: how can each generation pay its fair share? (12th March 2010)
A two-track approach could see each generation paying its own costs of care in later life.

Our present system of paying for care needs replacing. The big sticking point is finding extra funding which both covers the growing needs of an ageing population and shares the cost fairly between generations. This viewpoint:

• proposes a phased two-track approach, with an initial charge on inheritance being gradually replaced by funds built up through extra National Insurance paid by younger age cohorts.
• suggests such a broad sharing of costs among different generations, linked to ability to pay, could be presented as a fair and equitable settlement.

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Funding Social Care: what service users say (9th March 2010)
Service users often aren't involved in discussions about social care funding, yet they will be most affected by any changes to the current failing system.

In 2009, 18 adult social care service users were brought together to explore proposals for funding social care in the future. This Viewpoint reports their views, including:

• Service users feel that a false divide between social care and health care is perpetuated by conflicting funding arrangements.
• Almost all service users consulted think general taxation is the best way to fund social care.
• Service users reject any withdrawal of existing universal disability benefits, such as the Disability Living Allowance and Attendance Allowance, to fund means and needs tested social care.

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CONFERENCE - Putting everyone first: making personalisation work for older people and mental health service users (17th March 2010)
This London conference from the National Development Team for Inclusion (NDTi) on 10 June focuses on how to make personalisation work for older people and people that have mental health problems.

The key themes running through this event are:

• Recent and new guidance on personalisation in both Older people and Mental health fields that has been developed by the NDTi for the Department of Health
• How will commissioning deliver the personalisation agenda, at strategic and operational levels.
• What co-production really means and how to make it happen
• How support planning and person-centred approaches are key to making personal budgets real

Information

Securing good care for more people. Options for reform (16th March 2010)
Social care has never been higher on the political and policy agenda, and the need for fundamental reform has been universally recognised.

In 2006, The King’s Fund commissioned Sir Derek Wanless to review the funding of social care for older people. That review proposed a ‘partnership model’ in which costs were shared between the state and the individual. Since then, the momentum for change has gathered pace. Securing Good Care for More People updates the original review and concludes that a revised version of the ‘partnership model’ is the fairest way of funding social care in the future. This would see the state guaranteeing to pay 50 per cent of everyone’s care costs and matching every £2 contributed by individuals with a further £1.
Report

NHS

General Election - Guidance (11th March 2010)
Two letters have been produced to provide chief executives with information on handling the General Election period, once it starts. It includes links to previous guidance and advice.
Letter for Arms Length Bodies
Letter for NHS Trust AND PCT

The handbook to the NHS Constitution for England (8th March 2010)
This Handbook is designed to give NHS staff and patients all the information they need about the NHS Constitution for England. It outlines the roles we all have to play in protecting and developing the NHS and will help you understand our rights, pledges, values and responsibilities.
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Getting the most out of PROMs. Putting health outcomes at the heart of NHS decision-making (11th March 2010)
More than 100 years ago Florence Nightingale suggested a health-related outcome measure for her patients: relieved, unrelieved and dead. Despite the developments in medical technology since then, attempts to measure the positive outcomes of health care have been slow in coming. An important step forward was made in 2009 when the English NHS began collecting patient-reported outcome measures (PROMs) for four elective procedures.

The aim of this report, from the Kings Fund, is to provoke and encourage thinking about the wide range of ways in which PROMs data can be used to inform decisions. It draws on Bupa’s example to discuss how providers can use PROMs data to improve clinical performance. It also offers practical advice for commissioners in using PROMs data to assess value for money and decide how to purchase health care systems.
Report

Rising to the challenge: health priorities for government and the NHS (11th March 2010)
The document sets out what the NHS Confederation see as the major priorities facing the NHS, what they think NHS leaders can do now to help develop the system and enhance patient care, and what a new government will need to do post-election to facilitate this and create the necessary conditions for progress.
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The NHS Constitution for England (8th March 2010)
This Constitution establishes the principles and values of the NHS in England. It sets out rights to which patients, public and staff are entitled, and pledges which the NHS is committed to achieve, together with responsibilities which the public, patients and staff owe to one another to ensure that the NHS operates fairly and effectively. All NHS bodies and private and third sector providers supplying NHS services are required by law to take account of this Constitution in their decisions and actions.
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Guidance on the attribution of NHS non-commercial Research costs, Support costs and treatment costs (ReSeT Guidance) (15th March 2010)
This document clarifies the distinction between the three categories of costs associated with non-commercial research studies: Research Costs, NHS Support Costs and Treatment Costs. It is supported by two annexes – Annex A provides an exemplar set of common activities that have been attributed to the three specific cost categories and Annex B provides a list of Frequently Asked Questions (FAQs). The first section of the FAQs relates to FAQs that are generic across the United Kingdom and the second section to country specific questions. These Annexes will be updated on a regular basis and users need to ensure that they have the latest version (please refer to individual Health Department websites for their country specific FAQs).
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END OF LIFE CARE

Delivering better care at end of life. The next steps (27th January 2010)
The document includes papers given at the Sir Roger Bannister Summit at Leeds Castle in November 2009 and an account of the debate generated. The summit, organised by The King's Fund covered issues including commissioning, hospice and hospital care, quality markers and challenges for providers. It identified 10 critical actions to help the successful implementation of the government's End of Life Care Strategy. This document should be invaluable for those seeking to improve the quality of the care offered to patients at the end of life.
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QUALITY

Getting the measure of quality. Opportunities and challenges (21st January 2010)
Quality has been at the centre of recent NHS policy, and the NHS Next Stage Review highlighted the role of information and measurement in supporting quality improvement, particularly in relation to patient safety, clinical effectiveness and patient experience. It is therefore important to be clear how quality can be measured and by whom – and how the information can be used to improve services.

Getting the Measure of Quality offers information about how quality is defined and how quality measures can be used – and misused. It sets out the main debates and choices faced by those involved in measuring and using data on quality and outlines some practical issues to be considered in choosing and using quality measures.
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WORKFORCE/WORKPLACE

Pandemic influenza: indemnity cover and associated issues in England (3rd December 2009)
This document describes the provisions in place regarding indemnity cover for staff working during times of pandemic in England. The arrangements by which staff are, or may be, indemnified for their actions largely depends on who they are employed by and this document expands upon this principle, detailing some specific points of note.
Guidance

GMC affiliates pilots: final report of the KPMG evaluation (30th November 2009)
In July 2008 the Department commissioned KPMG to undertake an independent evaluation of two pilots introducing a system of GMC Affiliates aimed at closing the regulatory gap between local workplace management of doctors and national professional regulation. The purpose of this evaluation is to produce feedback and provide an assessment of the feasibility, potential benefits, costs and wider impacts of the introduction of GMC Affiliates at a national level.
Report

NHS Workforce Planning. Limitations and possibilities (26th November 2009)
Workforce planning for the NHS is a large undertaking. The NHS in England employs approximately 1.3 million staff, 70 per cent of recurrent NHS costs relate to staffing, and more than £4 billion is spent annually on staff training.

This report considers the degree to which NHS workforce planning in England is likely to support the delivery of a workforce that is fit for the future. To inform this assessment, the authors examine current developments at national and regional level, highlight relevant international experience, and propose ways in which planning could be made more effective.
Report

PATIENT CHOICE

Choice at the point of referral. Early results of a patient survey (4th November 2009)
England to ask them about their experience of referral and choosing a hospital for treatment.

This report summarises survey findings on:

• whether patients were offered a choice
• patients’ opinions on choice and awareness
• which patients travel away from their local hospital for treatment
• the information and support used by patients to help them choose
• factors that influenced patients choices.

Report

INDEPENDENT SECTOR TREATMENT CENTRES

Independent Sector Treatment Centres (1st October 2009)
Independent sector treatment centres (ISTCs) provide services to NHS patients but are owned and run by organisations outside the NHS. This briefing paper explains why ISTCs were introduced, and how they are funded, staffed and regulated. It assesses their impact so far, including the quality of their services and whether they provide good value for money. Finally, it examines what their future may be now that the contracts ISTC providers hold with the Department of Health are beginning to expire.
Briefing

GENERAL PRACTICE

General Practice in England - An Overview (25th September 2009)
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 enable greater self-management by people with long-term conditions, to expand the role of GPs in areas such as health promotion, to reduce variations in the quality of care provided and to improve quality overall. In the next few years, accreditation will be introduced for GP practices, and new models for commissioning and delivering care will be expanded.

This briefing, from The King's Fund, sets out how general practice is organised, contracted and financed; analyses the impact of recent government policy; and looks at future trends.
Briefing

MATERNITY

Safer Births. Supporting maternity services to improve safety (24th August 2009)
The Safer Births programme, a partnership between The King's Fund, National Patient Safety Agency, Royal College of Obstetricians and Gynaecologists, Royal College of Midwives, Centre for Maternal and child Enquiries and NHS Litigation Authority, ran regional interactive events in early 2009 for an invited audience of heads of midwifery, lead obstetricians and risk managers. The events were designed to help maternity units reflect on current practice, challenges to improving safety and their local priorities. They offered the opportunity for professionals to develop local solutions as a team, share experiences and learn about a range of methods used in improvement work and patient safety.

The short report sets out the views of the maternity professionals who attended the events. Ensuring safe services was the highest priority for staff across the four regions involved – Yorkshire and the Humber, North East, North West and London. The report reveals many examples of innovative local practice with maternity professionals developing better ways of working, improved handovers, joint training and user-friendly summaries of clinical guidelines.
Report
Information

ALTERNATIVE/COMPLEMENTARY MEDICINE

Assessing complementary practice. Building Consensus on appropriate research methods (10th August 2009)
Despite the increasing popularity and use of complementary practice, it is difficult to assess its effectiveness. Lack of research – and lack of agreement on research methods – has led to criticism from branches of conventional medicine.

The King’s Fund set up an advisory group, chaired by Professor Dame Carol Black, to consider how to develop and apply a robust evidence base for complementary practice. The group drew on the experience of a wide range of academics, researchers, practitioners and funders, much of it shared in a two-day participative conference.

This report of the group’s deliberations points out that complementary practice presents researchers with a unique set of challenges.
Report

HOSPITAL CARE

The Point of Care. Measures of patients' experience in hospital: purpose, methods and uses (3rd August 2009)
Ensuring that you are measuring the things that matter most to patients is an essential component of a successful strategy for improving patients’ experience. It is important to choose methods that are fit for purpose. This paper provides a brief guide to these to help trust boards and other interested parties decide which measurement and feedback tools are appropriate for their requirements.
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NHS

Extending professional and occupational regulation: the report of the Working Group on Extending Professional Regulation (16th July 2009)
This is the final report of the Extending Professional Regulation Working Group. The Working Group arose from a recommendation in the White Paper Trust, Assurance, Safety. The Report makes recommendation to Government as to how decision making on extending regulation could be taken forward. Any recommendations which are progressed and which involve a change of policy would require public consultation, equality and economic impact assessment, and be subject to the costs being affordable within available resources.
Report

How cold will it be? Prospects for NHS funding: 2011-2017 (20th July 2009)
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 a look at historical funding for the NHS, The King’s Fund and the Institute for Fiscal Studies set out three plausible future funding scenarios and their consequences. The paper concludes with an assessment of each scenario and the options for funding up to 2017.
Paper

From Feast to Famine. Reforming the NHS for an age of austerity (July 2009)
Over the past two years the Social Market Foundation (SMF) Health project has examined the future of the NHS in the coming decade, in the face of demographic, technological and now economic change. in the context of a crisis in public finances the final report looks again at the sustainability of tax funding, and asks how an equitable health system can be safeguarded in the years ahead. The report examines whether new measures should be taken to manage demand for health services to relieve pressure on the NHS.
Report

COMMISSIONING

Recognising complexity: commissioning guidance for personality disorder services (2nd July 2009)
Guidance for commissioners in the NHS, criminal justice system, local authorities and others, which provides information and suggestions on best practice when considering services and systems for people with personality disorders.
Guidance

PBC two years on. Moving forward and making a difference? (1st July 2009)
In 2007, a straw poll of GPs and practice managers by The King’s Fund and NHS Alliance found that primary care trusts (PCTs) were struggling to put in place the basic building blocks of practice-based commissioning (PBC). Two years on, has PBC moved forward and is it making a difference to patient care? A new poll has found continuing commitment to PBC and optimism about its potential but progress is still hampered by a lack of local vision, a lack of clarity over roles and responsibilities and bureaucratic governance processes. Moving into an era of restricted financial resources, it will become increasingly important for PCTs and practices to work together. Real clinician engagement – underpinned by locally developed visions, structures, agreements and lines of accountability – is key to the development of effective partnership working.
Document

Primary Care and Community Services: improving GP access and responsiveness (7th July 2009)
Part of the world class commissioning suite of practical guides, this document builds on existing good practice within the NHS to support PCTs in improving the accessibility and responsiveness of local GP services.
Guidance

Guide to world-class commissioning competency 5 (June 2009)
A guide to improving performance on world-class commissioning competency 5 is now available. Sponsored by the NHS Information Centre and supported by the Department of Health, the guide includes facts about PCT performance on competency 5 in last year's assessment round and best practice profiles of the PCTs who performed best on the competency.

With its focus on knowledge management and needs assessment, competency 5 underpins all 11 competencies within world-class commissioning and is the one primary care trusts need to master to deliver high quality services for local people.
Guide

PRIMARY CARE TRUSTS

Shaping PCT Provider Services. The future for community health (23rd April 2009)
Primary care trusts (PCTs) provide a broad and complex range of community-based services. However, the commissioning and management of these services have been a challenge for the NHS and in particular for PCTs. As PCTs provide community health services, there is a potential conflict of interest for their role as commissioners. The government is clear that PCTs need to separate their provider and commissioning functions. This report examines the issues surrounding the placement of community health services, the options proposed for their reorganisation, and the steps that must be taken to deliver the desired transformation in community health services.
Report

SOCIAL CARE

CSCI 2004-2009: Making social care better for people (11th March 2009)
This report highlights the Commission for Social Care Inspection (CSCI) key achievements and describes some of the methods they have developed, such as:

• involving people who use services in all aspects of their work
• making regulatory information publicly available.

Report

Funding adult social care in England (20th March 2009)
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 of social care services.

In autumn 2007, the government announced its intention to reform the current system, and a Green Paper containing options for a new system for funding adult social care and support will be published in 2009. Teresa Poole sets out how adult social care is currently funded, outlines some of the main criticisms of the current arrangements and describes the types of changes the government might consider for its reform.
Briefing

NHS

From ward to board. Identifying good practice in the business of caring (February 2009)

What role do nurse executives play in helping boards to engage with clinical quality issues? A programme of work in partnership with the Burdett Trust for Nursing explores this role and offers insight for nurse executives and board members.
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