Centre for Health and the Public Interest | March 2019 | Who decides the price and availability of NHS medicines?
Who decides the price and availability of NHS medicines? is a briefing from the Centre for Health and the Public Interest. The release summarises the key forces determining the price and availability of new medicines in the NHS. It explains the tension between pharmaceutical companies, purchasers (e.g. the NHS), and patients’ representative groups.
Since 1983, NatCen Social Research’s British Social Attitudes survey has asked members of the public in England, Scotland and Wales about their views on the NHS and health and care issues more generally. Alongside the Nuffield Trust, in this publication the King’s Fund explores the findings from the 2018 survey.
The BSA is a ‘gold standard’ survey and is conducted the same way every year, with the data provideing a rich time trend going back to 1983. This adds a depth and context to the findings that no other measure of NHS satisfaction provides. As a result, when satisfaction changes in the BSA, we are as confident as we can be that it reflects a genuine change in public attitudes.
Satisfaction with the NHS overall in 2018
Public satisfaction with the NHS overall continued to fall in 2018. Overall satisfaction was 53 per cent – a 3 percentage point drop from the previous year and the lowest level since 2007.
Older people were more satisfied than younger people: 61 per cent of those aged 65 and over were satisfied with the NHS compared to 51 per cent of those aged 18–64.
Satisfaction levels also differed between supporters of different political parties: 58 per cent of supporters of the Conservative party were satisfied compared to 51 per cent of supporters of the Labour party.
The four main reasons people gave for being satisfied with the NHS overall were: the quality of care; the fact that the NHS is free at the point of use; the range of services and treatments available; and the attitudes and behaviour of NHS staff.
The four main reasons people gave for being dissatisfied with the NHS overall were: long waiting times; staff shortages; a lack of funding; and money being wasted.
NHS England |February 2019 | Beyond the high fence from the unheard voices of people with a learning disability, autism or both
Beyond the high fence from the unheard voices of people with a learning disability, autism or both is a joint publication by NHS England and Pathways Associates. It was co-produced with people with a learning disability and autistic people who are, or have been, in hospital and offers their views on what more needs to happen to improve quality of care and support people to make a successful return to their communities (Source: NHS England).
The NHS’ 10 year plan outlines how a third or outpatients appointments may be reduced as the current model is “outdated and unsustainable”.
Outpatients traditionally serve at least three purposes, and in each case there are opportunities for redesign. An outpatient appointment can provide: advice and diagnosis for a patient and their GP; follow-up review after a hospital procedure; and ongoing specialist input into a long-term condition. Technology means an outpatient appointment is often no longer the fastest or most accurate way of providing specialist advice on diagnosis or ongoing patient care.
The plan describes the traditional model of outpatient care as being “outdated and unsustainable”. It outlines its intention to redesign services so that over the next five years patients will be able to avoid up to a third of face-to-face outpatient visits, removing the need for up to 30 million outpatient visits a year.
The document also includes a case study of Tower Hamlets Chronic Kidney Disease e-Clinics where a single pathway from primary to secondary care with rapid
access to specialist advice provided by consultant led e-clinics have transformed the way the way this care is delivered.
Four reasons are cited as enabling these technology-driven shifts:
They are already happening
in parts of the NHS, so this is clearly ‘the art of the possible’.
There is strong patient ‘pull’ for these new ways of accessing services, freeing-up staff time for those people who can’t or
prefer not to.
The hardware to support ‘mobile health’ is already in most people’s pockets –
in the form of their smart phone – and the connection software is increasingly available for the NHS to credential from third party providers.
The Long Term Plan provides dedicated funding to capitalise on these opportunities
Read the NHS Long Term Plan at the NHS Long Term Plan website (Source: NHS Long Term Plan)
Office of Health Economics | January 2019 | Can a Strong Economic Case Be Made for Investing in the NHS? 25th Annual Lecture Publication
The Office of Health Economics has just published Can a Strong Economic Case Be Made for Investing in the NHS? 25th Annual Lecture Publication, which is a transcript of a lecture given last autumn by Professor Peter Smith.
In his lecture Professor Smith argued that an economic case can be made for investment in the NHS. But it is not straightforward and will involve changes in the way the NHS thinks about itself. The NHS must show how it can promote the government’s macroeconomic objectives, including sustainable public finances; a stable economy and financial system; and structural reforms to increase employment, productivity, growth, and international competitiveness; and supporting societal wellbeing.
NHS Confederation | November 2018 | Letting Local Systems Lead
In Letting Local Systems Lead, NHS Confederation are calling for action to remove the barriers to effective local system working.
The publication of Letting Local Systems Lead follows a survey of NHS Confederation members which found that:
Six in ten leaders (61%) agree that sustainability and transformation partnerships (STPs) and integrated care systems (ICSs) represent the right approach for partnership working between the NHS and local government.
But the vast majority of respondents considered that only moderate progress (44%) or a little progress (42%) had been made in implementing the system working approach set out in the NHS Five Year Forward View
When asked what would make a difference, local leaders identified better local partnership working, improved engagement with staff, patients and communities, more effective local governance and a more supportive oversight regime (Source: NHS Confederation)
Interface between health and social care | Public Accounts Committee
This report highlights the widespread consensus that integration and joint working is the right way forward for the health and social care system to deliver the best and most effective outcomes for people and their families.
Financial pressures and an ageing population have both increased the need for joined-up working, with local authorities reducing real-terms spending on adult social care by 5.3% between 2010-11 and 2016-17, while the number of people in England aged 85 and over rose by 28% between 2006 and 2016.
However, the report finds that the government lacks an effective overall strategy or plan to achieve its aim of integrating the health and social care sectors. It recommends the government should set out a costed 10-year plan for social care to go with its 10-year plan for the NHS.