Mental health funding squeeze has lengthened waiting times, say NHS finance leads

The King’s Fund | December 2018 | Mental health funding squeeze has lengthened waiting times, say NHS finance leads

Eight out of ten NHS trust finance directors say that funding pressures have led to longer waiting times for people who need mental health treatment, according to The King’s Fund’s latest quarterly monitoring report.


New analysis for the report also shows that despite NHS England meeting its commitment to increase its investment in mental health, nearly a quarter of mental health trusts recorded a reduction in income between 2016/17 and 2017/18. An analysis of mental health trusts’ financial accounts carried out for the report found that, while mental health trusts as a whole reported an overall increase in funding, 21 per cent recorded a reduction in income last year, up from 13 per cent the previous year.

The report is published ahead of NHS England’s long-term plan, which was recently delayed amidst political turmoil over Brexit and is now expected early in the new year (Source: The King’s Fund).

Read the full press release from The King’s Fund

A vision for population health: Towards a healthier future

The King’s Fund | November 2018 | A vision for population health:Towards a healthier future

A recent report from The King’s Fund looks at  population health, an approach that aims to improve physical and mental health outcomes, promote wellbeing and reduce health inequalities across an entire population. A vision for population health:Towards a healthier future  outlines The King’s Fund’s vision for population health, their reasoning for why such a vision is needed and the steps required to achieve it.

The report considers:

  • The case for change
  • What affects our health?
  • What is population health?
  • What needs to change?
  • Where next?
a vision
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The King’s Fund calls for action at national, regional and local levels. This should include: ambitious and binding national goals to drive progress; a cross-government strategy for reducing health inequalities; stronger political and system leadership; greater clarity on the roles and accountability of national bodies and local organisations; and increased investment in prevention, public health and spending that supports population health (Source: The King’s Fund).

Download summary (PDF)

Download publication (PDF)

Relentless staff shortage leaves home care sector struggling

The King’s Fund | December 2018 | Relentless staff shortage leaves home care sector struggling

Relentless staff shortage leaves home care sector struggling is a new report from The King’s Fund explores new approaches to care, for instance providing joined-up care closer to home and enabling people to remain independent and in their own homes. This report considers their potential to provide care that is more closely aligned with what people want (Source: The King’s Fund).


Download report (PDF)

See also:

Home care in England: views from commissioners and providers

Home care in England: views from commissioners and providers

The King’s Fund | December 2018 | Home care in England: views from commissioners and providers

In the period between 2016 and 2018, The King’s Fund carried out three pieces of research exploring:

  1. the factors driving commissioning adult social care; the mechanisms of purchasing and delivery of home care;
  2. alternatives to traditional models of delivering care at home.

This research forms the basis of a new report: Home care in England: views from commissioners and providers, unites the findings of those research projects, which record the stated opinions of commissioners, providers and other stakeholders.



Key points:

  • Recruitment and retention of home care staff remains a fundamental challenge for providers, but the extent of the challenge varies greatly depending on geographical location
  • Most councils commissioning home care attempted to drive down the fees they pay. Commissioners and providers disagreed about whether quality of home care had declined  in recent years and, if it had, the role of fees in that process.
  • Home care continues to be commissioned on a ‘time and task’ basis rather than with a view to health  and care outcomes. Nor is there much evidence that health and care providers are joining up commissioning of home care.
  • Alternative approaches to home care provision  have yet to demonstrate they can be scaled up effectively, while approaches using new technology have not yet had time to be properly evaluated. (Source: The King’s Fund)

Download summary (PDF)

Download report (PDF)

See also:

The King’s Fund [press release]  Relentless staff shortage leaves home care sector struggling

The three pieces of research mentioned are:

 Adult social care: local authority commissioning behaviours

Understanding domiciliary care in England

New models of home care

All three are available from The King’s Fund 

Round two for STP plans: a fresh start or a dangerous distraction?

The King’s Fund | November 2018 | Round two for STP plans: a fresh start or a dangerous distraction?

Anna Charles, writing on The King’s Fund blog, discusses a recent letter
to Trust  chief executives and clinical commissioning group (CCG) accountable officers, NHS England and NHS Improvement confirmed that they ‘expect all sustainability and transformation partnerships (STPs) and integrated care systems (ICSs) to develop and agree new strategic plans for improving quality, achieving sustainable [financial] balance and delivering the long-term plan.’  Charles writes that these will be developed during the first six months of 2019 and submitted for sign-off later that year. At the same time, one- year organisational plans will be submitted for 2019/20 (Source: The King’s Fund). 

Read the long read in full from The King’s Fund blog 

Sustainability and transformation partnerships in London

Sustainability and transformation partnerships in London: an independent review | Kings Fund

This report, commissioned by the Mayor of London, reviews the progress made over the past year by the capital’s five sustainability and transformation partnerships (STPs), new bodies established to implement local plans for the future of health and care services. It argues that the capital’s complex and cluttered health and care system is hampering plans to improve Londoners’ health.

kings fund stp
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The review finds evidence of improvements in services for patients in boroughs and neighbourhoods across London which are often supported by the partnerships, but that London’s STPs are less advanced than those in many other parts of England.

The analysis found that the partnerships have spent much of the past year trying to overcome the problems associated with the nationwide introduction of STPs, which was undermined by a lack of engagement with the public and saw them unfairly labelled as vehicles for cuts and privatisation.

As a result, London’s STP leaders have spent much of their time over the past 12 months focusing on the internal workings of the partnerships, building relationships with their partners and addressing gaps in staff and public engagement.

Full document: Sustainability and transformation partnerships in London: an independent review | Kings Fund

See also:

Improving quality and cost

Approaches to better value: improving quality and cost | The Kings Fund

  • The NHS is increasingly focusing on how it can improve the value of its services, to deliver the highest quality health outcomes for patients at the lowest possible cost.
  • This report shares learning and insight from three NHS hospital trusts that have developed organisation-wide strategies for value improvement. It draws on interviews, roundtables and site visits with senior leaders in the NHS who are committed to developing better value services.
  • The report suggests a wide variety of approaches are being taken to improve value in the NHS. These include top-down programmes that focus on a wide range of clinical services from their inception, to value improvement strategies that are more organically grown from a few individual services until they cover a wider breath of hospital-based care.
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  • While there are differences in how organisations are approaching value improvement, there are also several common conditions for success. These include fidelity to a clearly defined strategy that brings the various strands of value improvement work together; recognition that value improvement is a long-term commitment that will require considerable staff time and resources; and a new leadership approach that requires continuous engagement with frontline clinicians and managers.

Full report: Approaches to better value: improving quality and cost

Summary available here