Health Management and Policy Alert

Devolution and the NHS

Two reports have been published by the Nuffield Trust on the effects of devolution upon UK health systems. Devolving policy, diverging values? aims to contribute to the debate about how we define the values of our national health service in the face of both devolution in the UK and the development of the wider European Union. Devolution and health focuses on how the health systems in the UK’s three devolved administrations have developed, and how their approaches have differed from those in England, since 2003. (Nuffield Trust - publications)

Public service productivity - healthcare: summary

The Office of National Statistics (ONS) has published an article that sets out changes in health care inputs, output and productivity from 1995 to 2006, using indices which combine a wide range of types of health care and resources used. Measures of change in the quality of healthcare are included in the output where available, from 2001 to 2005. Three time periods can be distinguished:

• From 1995 to 2001 productivity was stable, with growth in the quantity of health care (with no quality adjustments) matching growth in inputs
• From 2001 to 2005 productivity fell, as high growth in health care was lower than even higher growth in inputs. Even with the available adjustments for quality change in output, productivity fell by 2 per cent a year, on average, between 2001 and 2005. Without quality adjustment for output, productivity over the same period would have fallen by 2.5 per cent a year on average
• From 2005 to 2006 productivity fell less quickly, by 0.2 per cent. Quality adjustments are not yet available

(ONS - news release)

2008 Patient Safety Solutions: consultation

The World Health Organization (WHO) World Alliance for Patient Safety has embarked on the second year of an international programme of safety solutions development through the work of the WHO Collaborating Centre on Patient Safety Solutions. The National Patient Safety Agency (NPSA) is raising awareness of a consultation process which is currently underway. Comments are being sought on one or more of the draft solutions covering the areas of:

• Communicating critical test results
• Central venous catheter infections
• Prevention of falls
• Preventing pressure ulcers
• Deteriorating patients

The solutions have been developed with involvement from a number of countries including England and Wales. WHO plans to distribute them to all its member states on completion for local adaptation and implementation as appropriate. Consultation ends 29 February 2008. (NPSA - news)

Safer management of controlled drugs: changes to record keeping requirements (for England only)

This guidance is intended to inform and support relevant healthcare professionals and organisations in implementing changes to record keeping requirements for controlled drugs. It also informs and supports implementation of the changes required to the format on the Controlled Drugs Register, and the headings/titles of the columns used to capture the mandatory fields of information. It replaces the interim guidance published in October 2007. (DH - publications)

PCT SPDCS contract implementation toolkit

The aim of the toolkit is to support PCT HR Directors and Clinical Directors of salaried primary dental care services in successfully implementing the new contract in an effective, consistent and timely manner. As such, the focus is predominantly on the transactional agenda required over the next three months to transfer all salaried dentists on national terms and conditions to the new contract by 1 April 2008. (Primary Care Contracting - salaried services)

NHS statistics

GP registered populations 2007

Healthcare Commission maternity services review

The Healthcare Commission has ranked one in four NHS maternity services in England as “best performing” in a national review. But the comparative review also found significant variations in the quality of care across the country. The Commission ranked 22% of maternity services as “fair performing” (32 trusts) and 21% as “least well performing” (31 trusts). Some 26% of trusts were “best performing" (38 trusts) and 32% were “better performing” (47 trusts). Further details are available in a briefing note, and the results for each trust are viewable.

(Healthcare Commission - news) [DH - press release] [BBC Health - news]

Releasing resources to the frontline: the Department of Health’s review of its arm’s length bodies

This report by the National Audit Office indicates that DH is on track to meet most of the key targets identified in a review of its arm’s length bodies. By the end of 2007-8, expenditure will have reduced by £555 million, against the target of £500 million. The number of posts in the sector will have decreased by 27 per cent, compared to the target of 25 per cent. Over the same period, the Department will have spent £61 million on implementing the review, including redundancy costs of £47 million. While year-on-year savings are being released from the arm’s length body sector, the Department expects that full savings, net of final implementation costs, will be realised from 2010 onwards. An executive summary of the report is also available.

(National Audit Office - publications)

Options for the future of payment by results: 2008/09 – 2010/11 - response to consultation

This document summarises responses to The ‘Options for the future of payment by results: 2008/09 – 2010/11’ consultation. That consultation put forward proposals for future developments in PbR including tariff setting, coding and classification, expanding the scope of PbR, and supporting health policies through financial reform. The consultation ran from March to June 2007.

(DH - consultations)

Improving services and support for people with dementia

This report examines the prevalence and costs of dementia, diagnosis and early intervention, access to and quality of support services, and experiences of people with dementia in hospital and care homes.  It follows on from a 2007 report by the National Audit Office.

(House of Commons Public Accounts Committee - publications)