In this report, we focus on what needs to be done to strengthen commissioning in the NHS, through an analysis of the problems with current commissioning arrangements. We begin by examining what is meant by ‘commissioning’ in the English NHS.
Since the 1950s, the NHS has been looking at ways of improving care coordination. Lord Darzi’s NHS Next Stage Review introduced a new concept, that of the integrated care organisation (ICO). Since then, the Government has begun piloting schemes that offer different models of integrated care. This report, published jointly ...
This report examines the nature of emergency admissions in London, pointing out that the main peaks in demand appear to be due to respiratory disease during the Christmas period. Chronic disease in the elderly is a major factor, and residents of the East End of London seem to be affected ...
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 purpose of this paper is to stimulate debate about the appropriate standard of proof to use in GMC hearings. The GMC currently uses a criminal standard of proof (beyond reasonable doubt). However, this is a matter of custom and practice and is not specified. Recently there have been calls ...
This paper looks at definitions of different types of accountability, political and administrative, and at the accountability of health authorities, GP fundholders and the pilot projects for total purchasing. The research has revealed models of financial, managerial and public accountability which are described. The paper concludes with discussion of the ...
This book describes the trend towards more diverse and devolved forms of purchasing and combinations of purchaser organisations within health authorities in the NHS. It presents a multi-dimensional profile of each of the current models of purchaser organisation. Trends and policy developments are discussed in relation to the likelihood that ...