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Integrated care and why the NHS needs more deviant leaders
Our integrated care summit on 1 May featured innovations in integrated care from across the world. There was also a guest appearance by Andrew Lansley as part of a Dragon’s Den session to assess three examples of integrated care in England. At the end of the session, Torbay’s well-known work on health and social care integration narrowly beat an innovative programme in north west London on integration for people with diabetes and older people in a vote among the 200 participants at the summit.But the highlight for many of those who attended was an inspiring keynote address by Ken Kizer who led the transformation of the Veterans Health Administration (VA) in the United States in the 1990s. Kizer told a gripping story about how he led the shift away from a fragmented hospital-centred system to an organisation based on 22 integrated service networks. During his five years in office, the use of hospital beds was reduced by more than 50 per cent and the quality of care improved markedly... read on »
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The secret of their success
Much has been written about the integrated health care system that the Kaiser Permanente health group makes possible in the eight states and nine regions which it serves in America. But what did the participants who ventured to Kaiser in our recent study tour learn from the experience? And what is the value of taking NHS leaders out of their own system to learn from another?On the tour, UK leaders joined equivalent representatives from 15 other countries and health systems. Participants wanted to hear first-hand about clinical engagement and physician leadership and this expectation was met at every level. The leaders of the system made clear the ingredients of the ‘secret sauce’ – that is Kaiser Permanente’s key to success – without giving away the recipe... read on »
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The colour of money: Dilnot and the social care White Paper
Reading the runes of an imminent government White Paper used to be straightforward. Some months before there would have been a Green Paper, setting out the government’s broad thinking and consulting on key options. The subsequent White Paper would set out firmed-up proposals as a prelude to draft legislation. However the Equity and Excellence: Liberating the NHS White Paper turned that on its head, with consultation papers published afterwards and then the pause and listening exercise.In contrast, many hope that the forthcoming care and support White Paper will not require a colour chart to detect more than a hint of green. Unlike the NHS reforms, there is universal consensus that the social care system is not fit for purpose and requires radical reform – which is not the same as reorganisation. The NHS will never work properly without it... read on »
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Beware the rationing of care
More than four in five GPs expect the rationing of NHS care to increase in response to financial pressures, according to a poll conducted for the BBC in March of this year. And that matters, since they will be the ones having to do it: as the members of newly formed clinical commissioning groups, it is GPs who will be responsible at the local level for ensuring that NHS spending is kept within budget, in a context in which funds remain roughly flat and demand and costs continue to rise.Of course, rationing health care – that is, denying patients potentially beneficial treatments because of limits to resources – is nothing new, and neither is it the sole preserve of the NHS in England. Governments and private health insurers the world over face the challenge of finite resources, and must make tough choices about what not to provide to patients... read on »
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Do local voluntary organisations hold the key to improving health outcomes?
The central pillar of the Health and Social Care Act 2012 is localism – involving clinical commissioning groups, health and wellbeing boards and Healthwatch. This drive for localism is also reflected in the coalition government’s vision for the Big Society which aims to empower communities and boost social action and volunteering.The voluntary and community sector (VCS) is an excellent example of why localism in health care can be so effective. Overall, the NHS spends £3.4 billion annually in the voluntary and community sector, which has a strong track record of working with communities and supporting individuals to manage their health better... read on »
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Welcome to The King’s Fund Blog. Here you will find up-to-date comment and analysis on the key issues surrounding health and social care in England. We actively encourage comments and discussion on the blog, to further the debate and to help inform our thinking. To comment, please take a few moments to register with us. Please read our comments policy.