Health Management and Policy Alert

NHS pressures: winter 2018/19 - a hidden crisis

British Medical Association -
This report uses NHS England figures to examine the performance of the NHS during recent winters and over the long term. The report finds that winter 2018/19 saw the NHS once again under pressure, with A&E attendances and emergency admissions up, high bed occupancy, cancer waiting times growing and 4.3 million people now waiting for treatment. Many doctors worked extra hours and morale suffered.

• Report
• British Medical Association - press release

2019/20 General Medical Services (GMS) contract Quality and Outcomes Framework (QOF): guidance for GMS contract 2019/20 in England

NHS England -

This document provides additional guidance on the interpretation and verification of the QOF indicators for 2019/20 in England, which are listed in Annex D of the Statement of Financial Entitlements Directions (SFE). It is effective from 1 April 2019 and replaces versions issued in previous years.

• Guidance
• More detail

Fracture Liaison Service Database: commissioner's report 2019

Royal College of Physicians -
This report provides CCGs with a summary of the audit’s national key findings, recommendations and results for fracture liaison services (FLSs) within their locality. The report also explains what an FLS is and how FLSs could help CCGs not only to reduce the number and cost of unplanned admissions but make a significant reduction in morbidity and mortality for older people. It finds that there are significantly fewer FLSs available for older patients in some parts of England and Wales than others, with 54,000 preventable life-altering fractures estimated to occur over the course of the next five years as a result.

• Report
• Royal College of Physicians - news

NHS waiting times for elective and cancer treatment

National Audit Office -
This review presents data on the NHS’s performance against current waiting times standards for elective and cancer care in England, and some of the factors associated with that performance. It draws together existing evidence and analysis by the Department, NHS England, NHS Improvement and other stakeholders. The report discusses: changes in waiting times performance, and variations in that performance; the impact of waiting times performance on patients; the factors that influence waiting times performance; and NHS England’s and NHS Improvement’s approach to managing and improving waiting times performance.

• Report
• National Audit Office - press release

Exploring variations in the opportunity cost cost-effectiveness threshold by clinical area: results from a feasibility study in England

Office of Health Economics -
This research paper provides empirical evidence on the relationship between health outcomes and health expenditures in England. Results suggest that setting a cost-effectiveness criterion for NICE may not be capable of being synthesised using scientific methods alone, but involve political judgements.

• Research paper
• Office of Health Economics - news

Clinically-led review of NHS access standards: interim report from the NHS National Medical Director

NHS England - 

In 2018 Professor Stephen Powis, NHS National Medical Director, was asked to carry out a clinical review of standards across the NHS, with the aim of determining whether patients would be well served by updating and supplementing some of the older targets currently in use. In this interim report, Professor Powis sets out his recommendations for doing so.

• Report
• More detail

Age UK’s Personalised Integrated Care Programme: evaluation of impact on hospital activity

Nuffield Trust -
Age UK’s Personalised Integrated Care Programme (PICP) aims to improve the lives of older people through practical support, underpinned by a change in the way that the health and care system works together for these people locally. This report analyses the hospital use of 1,996 older people who had received a service from PICP in eight areas in England, compares their activity to that of a carefully selected control group. The research concludes that it has almost certainly not been able to reduce costs or emergency admissions. However, the results suggest that the scheme may be identifying unmet need in the population, which manifests in greater use of hospital care.

• Report
• Nuffield Trust - publications

Investigation into the management of health screening

National Audit Office -
This report finds that the proportion of eligible adults receiving health screening is inconsistent across different areas in England and that services are not operating to the ‘agreed standards’. The investigation focusesd on: delivery of health screening programmes; performance of health screening programmes; oversight of health screening programmes; and progress in implementing change in screening programmes.

• Report
• Related documents
• National Audit Office - press release

Patient and community engagement indicator guidance

NHS England - 
This guidance aims to support clinical commissioning groups to identify and compile evidence on patient and community involvement for the CCG Improvement and Assessment Framework. 

• Guidance

The NHS long-term plan explained

The King's Fund -
On 7 January, the NHS long-term plan (formerly known as the ten-year plan) was published setting out key ambitions for the service over the next ten years. This explainer sets out the main commitments in the plan and provides a view of what they might mean, highlighting the opportunities and challenges for the health and care system as it moves to put the plan into practice.

• Read it now