English National Health Service's Savings Plan May Have Helped Reduce The Use Of Three 'Low-Value' Procedures [Paying For Value]
The pressure to contain health expenditures is unprecedented. In England a flattening of the health budget but increasing demand led the National Health Service (NHS) to seek reductions in health expenditures of 17 percent over four years. The spending cuts were to be achieved through improvements in service quality and efficiency, including reducing the use of ineffective, overused, or inappropriate procedures. However, the NHS left it to the local commissioning (or funding) organizations, known as primary care trusts, to determine what steps to take to reduce spending. To assess whether the initiative had an impact,...
Source: Health Affairs - March 2, 2015 Category: Global & Universal Authors: Coronini-Cronberg, S., Bixby, H., Laverty, A. A., Wachter, R. M., Millett, C. Tags: Access To Care, Insurance Coverage, International Issues, Quality Of Care, Health Spending Paying For Value Source Type: research
Learning from contract change in primary care dentistry: A qualitative study of stakeholders in the north of England
In April 2006, primary care National Health Service (NHS) dental services in England and Wales began operating under a ‘new’ general dental services (nGDS) contract. Fundamentally, three major changes impacted upon NHS dental services at this time. Firstly, financial resources for NHS dentistry became overtly ‘cash limited’ [1] when resources were devolved to Primary Care Trusts (PCTs) in England and Local Health Boards (LHBs) in Wales from the national budget. The devolution of resources and decision-making responsibilities to PCTs and LHBs marked the beginning of local dental commissioning which in turn opened po...
Source: Health Policy - February 25, 2015 Category: Health Management Authors: R.D. Holmes, J.G. Steele, C. Donaldson, C. Exley Source Type: research
Creative subversion
During my time in the British National Health Service, I have lived through so many reorganisations that I have literally lost count. When I first started out as a general practitioner (GP) around thirty years ago, my work was supervised by a Family Practitioner Committee. In time, this was replaced by a Family Health Services Authority. That was superseded by a Primary Care Group and then a Primary Care Trust. These were abolished quite recently, so that the profession is now supervised by Clinical Commissioning Groups. I also held a part-time job in secondary care and worked in a place that was initially called a Clinic,...
Source: Postgraduate Medical Journal - January 12, 2015 Category: Journals (General) Authors: Launer, J. Tags: On reflection Source Type: research
Development of an outcome prediction tool for patients considering a total knee replacement - the knee outcome prediction study (KOPS)
DiscussionA clinically appropriate outcome prediction tool will allow patients to make a more informed decision regarding surgery. Aligning patient expectations with a realistic prediction of outcome should improve satisfaction. Ultimately, this project is likely to inform national policy making and regional service provision. (Source: BMC Musculoskeletal Disorders)
Source: BMC Musculoskeletal Disorders - December 23, 2014 Category: Orthopaedics Authors: Tim BarlowMark DunbarAndrew SprowsonNick ParsonsDamian Griffin Source Type: research
Are muti-disciplinary teams helpful in managing respiratory referrals?
ConclusionOver a 3 year period there has been a consistent ability to ensure referrals are placed in the community setting with few patients who would have previously attended hospital now doing so (14%) This represents a considerable cost that may be saved by directing patients from hospital to a community clinic where there is on-going support of nurses, parking is easier and fulfils the desire for care closer to home. (Source: European Respiratory Journal)
Source: European Respiratory Journal - December 23, 2014 Category: Respiratory Medicine Authors: Weaver, S., Campbell, V., Riley, J., Jordan, T., Allen, M. Tags: 9.3 Nurses Source Type: research
Development of an outcome prediction tool for patients considering a total knee replacement ¿ the Knee Outcome Prediction Study (KOPS)
DiscussionA clinically appropriate outcome prediction tool will allow patients to make a more informed decision regarding surgery. Aligning patient expectations with a realistic prediction of outcome should improve satisfaction. Ultimately, this project is likely to inform national policy making and regional service provision. (Source: BMC Musculoskeletal Disorders)
Source: BMC Musculoskeletal Disorders - December 23, 2014 Category: Orthopaedics Authors: Tim BarlowMark DunbarAndrew SprowsonNick ParsonsDamian Griffin Source Type: research
Re: Primary care trust commissioning of varicose vein intervention - New guidance needed?
PMID: 25480872 [PubMed - as supplied by publisher] (Source: Phlebology)
Source: Phlebology - December 5, 2014 Category: Internal Medicine Authors: Hurst K, Handa A Tags: Phlebology Source Type: research
Primary Care Research Team Assessment (PCRTA): development and evaluation.
Authors: Carter YH, Shaw S, Macfarlane F
Abstract
BACKGROUND: Since the early 1990s the United Kingdom (UK) Department of Health has explicitly promoted a research and development (R&D) strategy for the National Health Service (NHS). General practitioners (GPs) and other members of the primary care team are in a unique position to undertake research activity that will complement and inform the research undertaken by basic scientists and hospital-based colleagues and lead directly to a better evidence base for decision making by primary care professionals. Opportunities to engage in R&D in primary c...
Source: Occasional Paper (Royal College of General Practitioners) - December 2, 2014 Category: Primary Care Tags: Occas Pap R Coll Gen Pract Source Type: research
STAR--People-Powered Prioritization: A 21st-Century Solution to Allocation Headaches
The aim of cost effectiveness analysis (CEA) is to inform the allocation of scarce resources. CEA is routinely used in assessing the cost-effectiveness of specific health technologies by agencies such as the National Institute for Health and Clinical Excellence (NICE) in England and Wales. But there is extensive evidence that because of barriers of accessibility and acceptability, CEA has not been used by local health planners in their annual task of allocating fixed budgets to a wide range of types of health care. This paper argues that these planners can use Socio Technical Allocation of Resources (STAR) for that task. S...
Source: Medical Decision Making - October 17, 2014 Category: Health Management Authors: Airoldi, M., Morton, A., Smith, J. A. E., Bevan, G. Tags: Original Articles Source Type: research
Outbreak of acute respiratory infection in a care home for the vulnerable elderly: investigation, management and challenges
On the afternoon of Friday 2nd April 2012, the West Midlands East Health Protection Team (HPT), based in Birmingham UK, was contacted by a NHS Primary Care Trust (PCT) infection control nurse. Seven deaths due to respiratory illness had occurred since the 13th of March in a 70 bed care home for elderly and end of life patients. The home was contacted and they reported that 18 residents and two members of staff had suffered chest infections since 27th February. (Source: Public Health)
Source: Public Health - October 6, 2014 Category: Global & Universal Authors: A. Mavrodaris, B. Sibal, C. McKerr, J.I. Hawker Tags: Short Communication Source Type: research
The INCENTIVE protocol: an evaluation of the organisation and delivery of NHS dental healthcare to patients--innovation in the commissioning of primary dental care service delivery and organisation in the UK
Introduction
In England, in 2006, new dental contracts devolved commissioning of dental services locally to Primary Care Trusts to meet the needs of their local population. The new national General Dental Services contracts (nGDS) were based on payment for Units of Dental Activity (UDAs) awarded in three treatment bands based on complexity of care. Recently, contract currency in UK dentistry is evolving from UDAs based on volume and case complexity towards ‘blended contracts’ that include incentives linked with key performance indicators such as quality and improved health outcome. Overall, evidence of the effe...
Source: BMJ Open - September 17, 2014 Category: Journals (General) Authors: Pavitt, S. H., Baxter, P. D., Brunton, P. A., Douglas, G., Edlin, R., Gibson, B. J., Godson, J., Hall, M., Porritt, J., Robinson, P. G., Vinall, K., Hulme, C. Tags: Open access, Dentistry and oral medicine, Health economics, Health policy, Health services research, Public health Protocol Source Type: research
Electronic patient information systems and care pathways: The organisational challenges of implementation and integration
We report on the development and implementation of four such pathways within two National Health Service primary care trusts in England: (a) frail elderly care, (b) stroke care, (c) diabetic retinopathy screening and (d) intermediate care. The pathways were selected because each represents a different type of information and data ‘couplings’, in terms of task interdependency with some pathways/systems reflecting more complex coordinating patterns than others. Our aim here is identify and explain how health professionals and information specialists in two organisational National Health Service primary care trust...
Source: Health Informatics Journal - September 2, 2014 Category: Information Technology Authors: Dent, M., Tutt, D. Tags: Special Issue Articles Source Type: research
Authors' response to: primary healthcare factors and hospital admission rates for COPD: no association
We thank White and Jamieson for their comments1 on our 2011 Thorax paper on associations with admission rates for COPD.2 White and Jamieson appear to be confused about the practice population measures we used. If that is because we referred to the variable concerned too loosely in our correspondence with them we apologise. However as table 4 of our paper demonstrates, the only general practitioner (GP) supply variable used in the analysis, at either primary care trust or practice levels, was GPs/100 000 practice population. We do not agree with their statement that COPD admissions/100 000 GP-registered popul...
Source: Thorax - May 14, 2014 Category: Respiratory Medicine Authors: Soljak, M., Calderon-Larranaga, A., Bell, D., Majeed, A. Tags: PostScript Source Type: research
Primary healthcare factors and hospital admission rates for COPD: no association
As the ‘observant researchers’ who questioned the R2 value reported by Calderón-Larrañaga et al we were disappointed by the correction in Thorax, 10 July 2013.1 2 Our concerns were raised by the high adjusted R2 value of 0.75 in the multivariate linear regression of the association of primary care trust (PCT) factors with PCT hospital admission rates and the high bivariate R2 value attributed to general practitioner (GP) supply. The authors pointed out to us their misreading of the bivariate ‘GP supply’ R2 of 0.14% which led to the error. We were surprised to read in their correction t...
Source: Thorax - May 14, 2014 Category: Respiratory Medicine Authors: White, P., Jamieson, A. L. Tags: PostScript Source Type: research
New National Diabetes Footcare Audit of England and Wales
This article is protected by copyright. All rights reserved. (Source: Diabetic Medicine)
Source: Diabetic Medicine - May 13, 2014 Category: Endocrinology Authors: W. Jeffcoate, N. Holman, G. Rayman, J. Valabhji, B. Young Tags: Commentary Source Type: research
