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.
The Labour Government's commitment to making more use of the private sector in health care is proving controversial. Opponents are concerned that it signals the end of the NHS as we know it. Yet public-private relationships are as old as the NHS. This book analyses existing relationships and the regulatory ...
The overall aim of the third year of the national evaluation of TPPs, spanning October 1997 to September 1998, was to identify the ingredients of successful devolved purchasing based in primary care by in-depth study of twelve first wave TPPs. The analysis presented here considers eleven of the case studies ...
Total purchasing was the first major 'internal market' policy initiative to be extensively evaluated by the Department of Health and Scottish Office. This report draws together the main evidence from the evaluation in order to inform the development of the new primary care organisations in the NHS, which came into ...
This working paper from the second year of TPPs makes the following key findings: larger TPPs are becoming high achievers; a group of TPPs (43 per cent) improved their performance over two years, about a quarter remained at the same level and about a third dropped out; a greater proportion ...
The evaluation of the Total Purchasing Pilots (TPPs) provides important lessons for the development of the new primary care organisations envisaged in the English, Welsh and Scottish NHS white papers. Despite originating in a very different context, total purchasing was essentially about groups of practices working together to develop services ...
This report aims to describe the ways in which the structure, role and impact of TPPs may be instructive to PCGs. Practical illustrations are used to demonstrate how particular changes in services were achieved in the context of local conditions, providing useful examples for PCGs. English PCGs are the main ...
The purpose of this paper is to report initial results from studies of the management costs, associated with TPP and to explore the relevance of current experience for the costs of establishing the new Primary Care Groups (PCGs) outlined in the Labour government's white paper on the NHS. The methodology ...
This working paper is the first report from the national evaluation of total purchasing pilot projects to provide evidence on the achievements of all 53 'first wave' pilots in England and Scotland. It also looks at the range of factors associated with more and less successful total purchasing in 1996-97 ...
This report draws together the interim findings from the first two years of a three year evaluation of all first and second wave TPPs in England and Scotland which began in October 1995, led by the King's Fund. The report discusses whether first wave TPPs have developed the organisational requirements ...