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Articles by Anna Charles
NHS reluctance to work with pharma must be addressed
Critical stories remain free for registered users Certain articles and Insight pieces remain paying-subscriber only content As a registered user you will get access to: Daily News: an essential email round-up of all the latest news, comment and best practice Breaking news headlines delivered directly to your inbox Limited access to hsj.co.uk Already registered to HSJ?
Driving better health outcomes through integrated care systems
The value of district councils District councils have a number of assets that make them indispensable parts of ICSs. Through these assets they make vital contributions to the health of communities. : district councils have powers in numerous areas relating to housing conditions and local economies, and over both the built and natural environments.
Developing primary care leadership for population health and equity: how to begin
The need for population health approach This quote captures the overwhelming response among the primary care clinicians in Lancashire and South Cumbria we spoke to about why they wanted to spend time thinking about how to improve population health and tackle health inequalities, despite the widely publicised challenges facing primary care. It’s obvious, they said, population health and tackling health inequalities is key to a healthier, more sustainable, and fairer future.
Actions to support partnership
This report provides an overview of the key actions required to tackle barriers and challenges to better partnership working between integrated care systems (ICS) and the voluntary, community and social enterprise (VCSE) sector. It identifies ways of working that can help mitigate barriers and facilitate solutions, and systemic actions that can help embed and spread good practice. This independent report was commissioned by the NHS England Voluntary Partnerships Team.
Standing back from The Hewitt Review: six key take-aways
The central premise is to shift away from a culture of top-down performance management to one of learning and improvement. The ambition is for national and regional bodies to support ICSs to become ‘self-improving’ systems. One of the most eye-catching proposals is to vastly reduce the number of national targets and priorities, with Hewitt suggesting these should be limited to no more than ten. That isn’t to say that systems would be left unchecked.
Regions in the NHS: what are they good for?
Traditional regional functions have focused on joining up NHS organisations. Their number ranging from four to twenty-eight, it is a role that has always been retained (Edwards and Buckingham). The 2022 Health and Care Act’s landscape places an onus on co-operation, creates integrated care board (ICB) structures, and asks the Care Quality Commission (CQC) to regulate partnering behaviours.
The first days of statutory integrated care systems
Context It is only fair to open by noting that ICSs have been born into the mother of all storms. There has been huge political instability, with three prime ministers and three secretaries of state for health and social care, over the period these interviews took place.1 There has been massive economic instability. Record numbers are waiting for treatment and many, though not all, waiting times are getting worse.
Digital health and care congress 2023
Exhibitors If you’d like a conversation about your business goals, and how being involved in this event can help you, please email Rebecca Gorringe at r.gorringe@kingsfund.org.uk. Confirmed speakers Wednesday 11 October 2023 A digital workforce: ensuring the health and care system has the skills, leadership and culture needed for digital change Day one will focus on the health and care workforce and the reality of working towards digital transformation amid current pressures.
Do ICSs face an impossible task?
Corona Virus breaking news and critical stories remain free for registered users Certain articles and Insight pieces remain paying-subscriber only content As a registered user you will get access to: Daily News: an essential email round-up of all the latest news, comment and best practice Breaking news headlines delivered directly to your inbox Limited access to hsj.co.uk Already registered to HSJ? Sign in now
Partnership working through digital transformation
Breaking down the barriers between organisations is key to the successful development of integrated care systems (ICSs), and the underpinning digital transformation that their introduction demands. Digital transformation can become the foundation of partnership working across health, social care, local government, and wider partners – including those in the voluntary, community and social enterprise, and private sectors – as place-based approaches to delivering care develop.
Towards a new partnership between disabled people and health and care services
During the first year of the Covid-19 pandemic in England, from Covid-19 were disabled. People with learning disabilities were eight times more likely to die of Covid-19 than the general population. These numbers are truly shocking. But what is also shocking is that, for many disabled people, this is not a surprise. These statistics reflect multiple inequalities that disabled people have faced and continue to face in British society.
Integrated care systems and social care:
Key issues - The King's Fund analysis The work outlined above has some key messages for adult social care and its partners in ICSs. ICSs offer real potential for partnership with the NHS and other sectors. ICSs are an opportunity to develop genuinely joined-up, personalised care. There is a need for clarity about structures and systems… …but leadership and culture are critical. Resources are a key challenge so making best use of them is essential.
Integrated care systems: how will they work under the Health and Care Bill?
Integrated care systems (ICSs): key planning and partnership bodies from April 2022 Interpreting the diagram The diagram uses the framework of system, place and neighbourhood to explain how organisations will contribute to system working at these different levels. Many organisations will work across more than one level, while there will be variation in ways of working between ICSs given their different sizes and how they have developed.
The Health and Care Bill
What will the new system look like? Integrated care systems (ICSs) are partnerships that bring providers and commissioners of NHS services across a geographical area together with local authorities and other local partners to collectively plan health and care services to meet the needs of their local population.
Understanding integration: how to listen to and learn from people and communities
The move towards integrated care has been the defining policy in health and care over the past decade and will continue to gather pace with the development of integrated care systems (ICSs). The aim of integrated care is to improve people’s outcomes and experiences of care by bringing services together around people and communities. This means addressing the fragmentation of services and lack of co-ordination that people often experience by providing person-centred, joined-up care.
Place-based systems of care: principles for success
The debate about the statutory form for integrated care systems and ensuing legislation must not undermine existing efforts to strengthen place-based working, writes Anna Charles, senior policy advisor at the King's Fund. The importance of ‘place’ is front and centre of the latest proposals for NHS reform.
Developing place-based partnerships
Why did we do this work? Major changes are taking place in the way health and care is organised in England as the emphasis of national policy continues to shift towards promoting collaboration within local health and care systems. Integrated care systems (ICSs) are being established in all areas of the country to drive changes that are intended to lead to better, more joined-up care for patients and improvements in population health.
The biggest hospital in England
The proposed merger of Guy’s and St Thomas’ NHS Foundation Trust and the Royal Brompton and Harefield NHS Foundation Trust will create a genuine super-trust. The new organisation will employ more than 21,000 staff with an annual turnover slightly more than £2 billion – higher than any other trust in England (Figure 1). But this new super-trust will not be alone.
Shielded voices
Too often efforts to understand what goes on for people and to respond to their needs and aspirations can feel like a nice to have rather than a key part of how to deliver health and care services effectively. It is tempting for services to extend this view into crisis periods by saying ‘We don’t have time to do it’, but now, more than ever, health and care services need to base their decisions on the reality people experience.
It’s the Year of the Nurse, but will 2020 see nursing student numbers recover?
According to the latest UCAS figures on 2019 nursing applications for undergraduate courses, the number of applicants increased by 6 per cent from 2018, with almost 3,500 more people applying, the first rise since 2017. There has also been a record number of people accepted on to nursing courses in 2019 – 30,390 applicants were accepted, an increase of 6.1 per cent on 2018 (see Figure 1).
Health and wellbeing boards and integrated care systems
Seven years on, there have been fundamental and far-reaching changes in how the NHS works across different services and with external partners such as local government. There is a new emphasis on collaboration, population health and integration, including new models of care and sustainability and transformation partnerships (STPs), which are evolving into integrated care systems (ICSs).
Community health services
What we think Despite the vital role they play in helping people to maintain their independence, manage long-term conditions and treat acute illnesses, longstanding ambitions to strengthen community services and shift care from hospitals into community settings have not been realised. These services have not been given the priority, funding or support they need, and they remain poorly understood compared to other parts of the NHS.
Why you’re better off being a cleaner than a care worker
It is true that there has been a 27p an hour increase in pay for care workers, driven by the rise in the national living wage, but this rise is pushing up pay in other sectors even faster, making social care less competitive. The result is that in 2012/13 shopworkers and cleaners were paid less than care workers but in 2018/19 they were paid more.
Primary care networks and community health services
We’ve set out elsewhere how central primary care networks are to general practice, primary care and the NHS long-term plan. The first key test for these new primary care networks was whether – in a matter of months – GPs would sign up to join and whether they would do so to the design principles NHS England agreed with the British Medical Association and Royal College of General Practitioners. The answer is: yes, by a positively North Korean general election margin.
Primary care networks and the NHS long-term plan
To date, where GPs have been working at scale, they have mostly been largely informal arrangements, with local variation in both how big they are, what they do and how they relate to the rest of the NHS. The GP contract turns primary care networks into a more formal programme covering all of England, with a clear and very ambitious set of functions.
Primary care networks explained
What are primary care networks? Primary care networks form a key building block of the NHS long-term plan. Bringing general practices together to work at scale has been a policy priority for some years for a range of reasons, including improving the ability of practices to recruit and retain staff; to manage financial and estates pressures; to provide a wider range of services to patients and to more easily integrate with the wider health and care system.
What do cuts in sexual health services mean for patients?
Our report Understanding NHS financial pressures looks at how the slowdown in funding growth since 2010/11 has affected four very different parts of the health system. We chose one local authority-funded public health service to look at in depth: genito-urinary medicine (GUM) services that provide sexually transmitted infection (STI) testing and treatment in hospitals and local clinics.
A year of integrated care systems
Emerging features Our research identified activity at three main levels; neighbourhoods, places and systems. There was broad agreement that all are important in making progress on integration. Current ICSs vary widely in their size and complexity, and therefore in the level at which they are operating (see Figure 1). In future, they are likely to evolve to take on system-level functions, such as strategic planning, aligning commissioning and providing overall system leadership.
Thinking big: lessons for the NHS on large scale change
Thinking big: lessons for the NHS on large scale change By Anna Charles, Joe McCannon2018-06-28T12:20:00 The time is ripe for NHS to spread and scale innovation, creating a lasting movement for change. By Anna Charles and Joe McCannon
Integrated care has the potential to improve health outcomes
Integrated care has the potential to improve health outcomes By Chris Ham, Anna Charles2018-06-11T09:42:00 Chris Ham and Anna Charles outline the findings and recommendations of the health and social care committee’s review of integrated care development in the NHS
Caring for people with learning disabilities
This free live online event will explore various models of care that are set up to support people with learning disabilities in the right setting. Helping people live in the community with the right levels of support and close to home is central to NHS England’s Transforming Care programme. You’ll hear about a service set up in Hull, commissioned by the local authority, to support people with learning disabilities to live independently and as part of mainstream society.
What does the future hold for integrated care systems? | The King's Fund
Integrated care systems, as they were re-branded in updated planning guidance published recently by NHS England, bring together NHS commissioners, providers and local authorities to plan how to improve health and care for the populations they serve. For the organisations involved in these systems, lines of accountability remain unchanged. NHS organisations continue to look upwards to NHS England and NHS Improvement and local authorities look outwards to their communities.
Reimagining community services
The elements of what community services should look like are well understood, and we summarise these elements in 10 design principles. How they are applied will vary from place to place depending on the population’s needs and how services are currently organised and funded. Many examples of these principles being put into practice are described in our report.
A call to action on community services
A call to action on community services By Anna Charles, Chris Ham2018-01-23T00:01:00 The NHS must take concerted action towards widespread adoption and adaptation of community focused approaches to care. By Chris Ham and Anna Charles
Making sense of accountable care | The King's Fund
Accountable care is not a panacea and unless implemented with skill it will not deliver the improvements in health and care envisaged in the Forward View. The King's Fund believes that accountable care should be supported because it offers the best hope for the NHS and its partners to provide the integrated health and care services required to meet the needs of the growing and ageing population.
NHS England should work with local leaders and clinicians to explain accountable care
I know because I’ve had the opportunity to see for myself what is happening in areas of England putting in place accountable care organisations and systems. From Cornwall to Cumbria and from Blackpool to Bury St Edmunds, NHS leaders and their local government counterparts are working in partnership to improve health for the populations they serve.
Devo-London: free at last? | The King's Fund
London’s devolution announcement marks the culmination of several years of effort and some complex negotiations. There is now agreement – in some cases ‘in-principle’ agreement – that some control over health and care will be delegated to the capital. The intention is to give the Mayor, local authorities and London health leaders more control over key decisions. But will devolution deliver on this?
New care models point to a better future for patients and staff
We also learnt of plans to develop accountable care systems (ACSs) to take forward the work of the new care models and develop integrated care at scale. One of the lasting impressions for me was the time we spent in The Frimley Health and Care System where Andrew Morris is chief executive of Frimley Health NHS Foundation Trust and lead chief executive of the sustainability and transformation partnership (STP) and ACS.
Sustainable primary care provides a platform for system change | The King's Fund
In the final blog in our series about the transformation of the Canterbury health system in New Zealand, Vince Barry, Chief Executive of Pegasus Health, looks at how building sustainable primary care creates a platform for change. My week working in the UK with The King’s Fund and NHS colleagues convinced me that the case for change in the NHS is unquestionable.
‘You need a whole system to work for the whole system to work’
Recently, the Fund hosted a visit by leaders of the health system in Canterbury, New Zealand. In this guest blog – the second of three drawing on experiences shared during the visit – David Meates, Chief Executive of the Canterbury District Health Board, explains how organisations within the Canterbury health system have moved from playing the ‘blame game’ to working together to provide the best possible care for the local population.
Whole-system transformation needs whole-system engagement
David Meates, Chief Executive of Canterbury District Health Board, talks of creating a ‘social movement’ when he recalls how the health system undertook transformation. The social movement focused initially on the 19,000 staff working in the system either as direct employees or employed by organisations delivering care under contract to the board. Staff were closely involved in creating a vision for the future and leading work to translate it into practice.
Accountable care: policy fad or step forward on the journey towards integrated care?
Frequently, accountable care systems (ACSs) and partnerships are either all organisations within a single sustainability and transformation partnership (STP) footprint or groups of organisations within an STP that have chosen to take on collective responsibility for the health of a population within a set budget in exchange for greater autonomy. The size and structure of these ACSs and accountable care partnerships (ACPs) varies.
How does the NHS in England work and how is it changing?
Big changes are taking place across the health and care system. What does this mean for the organisations that make up the NHS? How will they collaborate with other parts of the system? And what’ll these changes mean for you and me? When the NHS was set up, it focused on treating single conditions or illnesses. Since then, our health and care needs have changed; more of us are living longer and many have multiple conditions that require regular, ongoing care.
Sustainability and transformation plans in London
Sustainability and transformation plans (STPs) are key to the future of health and care services. This report, commissioned by the Mayor of London and based on work completed in March 2017, looks at the five STPs in London, their contents and common themes. The authors, from The King’s Fund and the Nuffield Trust, assess the main issues and risks to be addressed across the five plans.
How Often Do Saanenland Farmers Move During the Year?
It’s nearly that time of year again. Farmers will begin descending from the alp, where they have spent the summer. They will lead their Simmental cows, adorned with flowers and with cowbells ringing, along the streets of Gstaad. One might even catch a glimpse of a horse and cart accompanying them.
Up and Coming Conductors Electrify at Menuhin Concert
Since its founding in 1957, one of the Menuhin Festival’s main tenets has been to foster and promote the talent of exceptional young artists. A concert conducted by the Gstaad Conducting Academy left the audience electrified and excited about the future of classical music.
Saanenland Sweeps Bilanz Hotel Rankings
The Swiss economic magazine Bilanz has released its annual hotel ratings, with Saanenland hotels earning top marks. The Alpina Gstaad has swept the awards, with kudos in several categories including Best Holiday Hotel – Switzerland 2017.
Gstaad Palace Prepares for Gildo's Goodbye
Gildo Bocchini, the gourmet voice of the Gstaad Palace for 49 years, is finally hanging up his apron. Bocchini was a tour de force in the Saanenland, beloved by guests and hotel staff alike. The Cesena, Italy, native will retire at the end of this summer season. Stepping in to fill his shoes is successor Andrea Buschini.
Innovation and Sustainability
We certainly couldn’t offer the answer to any of these questions. What we hope we achieved, was to trigger your own thoughts and provide input for discussion – and discussion is dearly needed. Questions must be asked and answers must be found if a region is not to stagnate. Our interviewees gave their own interpretation of innovation and sustainability, their opinion of what the region needs, and what can be done to keep moving forwards.
Expat Adventures
“It’s not too deep, but I think it might need a stitch,” he said. “What do you think?” I craned my neck closer to the screen and squinted. Our 18-month-old son had been playing overly-enthusiastically with his brothers and had fallen sideways into the corner of the coffee table. A scarlet gash glared above his left eyebrow. Was the injury bad enough to rush him to hospital (wherever that was)?
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