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 NHS (Primary Care) Act 1997 made possible local contracts for general practice services and spawned Personal Medical Services (PMS) pilots. These are intended to make primary care services more sensitive to local needs and are therefore particularly useful in London where long-term infrastructural problems have proved intractable. The King's ...
This report describes the evaluation of total purchasing and extended purchasing sites with an interest in mental health services. A consistent objective of these sites was the improvement of communication and information flows between primary and secondary care. The priority was the development of services for people with common mental ...
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 ...
This publication is a comprehensive review of health care and policy issues. It includes a detailed description of health events in the last twelve months, as well as discussion of key policy issues. Specific areas dealt with in this issue include: influencing the diffusion of new medical technologies; the future ...
Many of the potential pitfalls of increasing purchaser plurality in the NHS are relevant in planning and developing general practitioner led locality commissioning. However, this involvement in commissioning or purchasing maternity care may actually provide the 'bite' necessary to move reluctant provider trusts more quickly towards services which meet the ...
Considerable management challenges must be faced in order to ensure the successful operation of primary care groups (PCGs). The insights to be gained from those involved in total purchasing pilots (TPPs) are likely to prove valuable in informing the development of PCGs, and workshops were held to capture some of ...
While most GP practices participating in total purchasing have some experience of contracting with health care providers, the extension of their responsibilities has, in many cases, taken them into entirely new areas and posed a set of challenges for primary care-based purchasing. This paper concentrates on a central element of ...
In a previous working paper the results of a survey of the contracting arrangements of the 53 first wave total purchasing pilot (TPP) projects during 1996-97 were given. This working paper reports the results of a follow-up survey carried out for the 1997-98 contracting round. The survey was designed to ...