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Articles by King’s Fund
'Social care buy-in for fair pay plan at risk after Budget tax hike'
By Simon Bottery, King’s Fund On the day before the Budget, I held a round table with social care leaders on the government’s ambition for a ‘fair pay agreement’ to raise care worker pay. This would involve creating a negotiating body, bringing together care providers and unions, to agree higher wages and better terms and conditions for care staff. “Will the plans happen?”, I asked. The sector leaders were largely positive that they would.
ONS refines method to estimate excess deaths
Veena Raleigh, senior fellow King’s Fund, London, UK V.Raleigh{at}kingsfund.org.uk This upgrade should improve our understanding of short term changes in mortality As the UK emerges from the ravages of the pandemic, the Office for National Statistics (ONS) has announced a new method for estimating excess deaths in the UK.1 Measurement of excess deaths became widely used in 2020when timely data on the effect of covid-19 on mortality was vital for monitoring the spread of the virus and...
Cardiovascular disease should be a priority for health systems globally
News & Views Cardiovascular disease...
Will the primary care access plan for England really deliver?
News & Views Will the primary care... Will the primary care access plan for England really deliver?
The health and social care levy won’t be a quick fix
Sally Warren, director of policy King’s Fund, London, UK s.warren{at}kingsfund.org.uk Politicians should level with the public or face even deeper dissatisfaction The health and social care levy has finally arrived, and this month employers and employees will see and feel the increase in national insurance contributions. What might they start to see improving in the NHS and social care as a result, and when might they expect to see it?
Ethnic differences in covid-19 death rates
Intended for healthcare professionals Toggle navigation The BMJ logo Toggle top menu News & Views Ethnic differences in...
Recovery plan for elective care
Richard Murray, chief executive King’s Fund, London, UK R.Murray{at}kingsfund.org.uk Undermined by a deafening silence on the core workforce required to deliver it Covid-19 has been a seismic shock to the health of the population and to health and social care services.
NHS staffing: the longest wait of all
Suzie Bailey, director of leadership and organisational development King’s Fund, London, UK S.Bailey{at}kingsfund.org.uk The 2021 spending review fails to deal with the workforce crisis The government has made many pledges, promises, and manifesto commitments on the NHS and social care and recently took an unexpected step of raising taxes to increase funding.
Parliamentary report on workforce burnout and resilience
Intended for healthcare professionals Toggle navigation The BMJ logo Toggle top menu News & Views Parliamentary report...
The NHS needs a comprehensive plan for recovery
Intended for healthcare professionals Toggle navigation The BMJ logo Toggle top menu News & Views The NHS needs a... The NHS needs a comprehensive plan for recovery Editorials BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n1555 (Published 18 June 2021) Cite this as: BMJ 2021;373:n1555 Richard Murray, chief executive King’s Fund, London, UK R.Murray{at}kingsfund.org.uk This system-wide challenge demands a system-wide response Even before covid-19, the NHS was in need of some emergency treatment.
NHS reforms: politicians will be back in the driving seat
Richard Murray, chief executive King’s Fund, London, UK R.Murray{at}kingsfund.org.uk England’s pandemic experience supports collaboration, not centralisation Given its strapline—“Integration and Innovation”—it is no surprise that the Department of Health and Social Care’s new white paper aims to promote the longstanding integration agenda while downgrading competition as the organising principle for the NHS.1 Many have also noted that the proposals decisively tilt the balance of power back to...
Rises in healthcare spending: where will it end?
John Appleby, chief economist 1 King’s Fund, London, UK j.appleby{at}kingsfund.org.uk John Appleby examines why countries spend more and more of their wealth on healthcare and assesses the long term affordability In the past half century spending on healthcare across virtually all countries—regardless of how they are funded and organised—has increased substantially.
The NHS people plan
S Bailey, director of leadership and organisational development King’s Fund, London, UK s.bailey{at}kingsfund.org.uk A missed opportunity to tackle the workforce crisis NHS England and NHS Improvement published the long overdue people plan for 2020-21 on 30 July 2020.1 The plan had originally been expected last winter, after the interim plan was published in June 2019.2 The NHS is the UK’s largest employer and one of the biggest employers globally.
UK’s record on pandemic deaths
Intended for healthcare professionals Toggle navigation The BMJ logo Toggle top menu News & Views UK’s record on...
The NHS in England in 2013
Chris Ham, chief executive 1King’s Fund, London W1G 0AN, UK c.ham{at}kingsfund.org.uk Funding and service pressures are likely to have an impact on the quality of care The end of 2012 saw the NHS in England facing increasing demands from patients as a result of winter pressures and the norovirus. These demands have been compounded by cuts in social care funding and support, which make it difficult to prevent hospital admissions and ensure timely discharge.
Tackling UK’s mortality problem: covid-19 and other causes
Intended for healthcare professionals Toggle navigation The BMJ logo Toggle top menu News & Views Tackling UK’s...
Money injection for public services
Richard Murray, chief executive King’s Fund, London, UK R.Murray{at}kingsfund.org.uk Where should we direct these precious extra resources? On 11 March, Rishi Sunak, the chancellor of the exchequer, presented his first budget and promised an extra £5bn (€5.7bn; $6.2bn) for public services to help them deal with covid-19.1 What is the £5bn for? £1.6bn is going to local authorities to support social care, social care staff, and the vulnerable.
GPs condemn new specifications for primary care networks
Richard Murray, chief executive King’s Fund, London, UK R.Murray{at}kingsfund.org.uk Lack of capacity means the specifications are set up to fail Back in July when primary care networks (PCNs) got off to a flying start, I warned of two key risks to this good beginning.1 The first was that these emergent PCNs would get overburdened with too many commitments, and the second that some commitments might look sensible in theory but prove too hard to implement in practice.
Kindness: an underrated currency
Intended for healthcare professionals Toggle navigation The BMJ logo Toggle top menu News & Views Kindness: an...
Healthcare for everyone: the trials and tribulations of the NHS model
Nicholas Timmins, senior fellow King’s Fund, London nicholas.timmins{at}gmail.com The NHS has been striving to provide healthcare for all since 1948. This approach has had its ups, downs, and limitations.
Stalling life expectancy in the UK
Veena S Raleigh, senior fellow King’s Fund, London, UK v.raleigh{at}kingsfund.org.uk We must look at austerity and beyond for underlying causes The stalling of improvements in life expectancy in the UK since 2011, highlighted again in the most recent data,1 has prompted much comment and speculation about the causes.
“Doing better, but feeling worse”: doctors’ 70 year relationship with the NHS-an essay by Nicholas Timmins
The 70th anniversary of the NHS also means, of course, 70 years of a relationship between the medical profession, its patients, and the NHS itself. What a long, strange trip it has been. From the original unwritten compact—“give the doctors the money and trust them to do the right thing”—to a time when leading figures in the profession took the view that it had become, quite simply, unsustainable. From general practice experiencing a devastating fall, to a rise, and a fall again.
Cross party approach to NHS and social care
When MPs from different parties come together to argue for more funding for the NHS and social care, it is time to sit up and take notice. Last week’s statement by Nick Boles (Conservative), Liz Kendall (Labour), and Norman Lamb (Liberal Democrat) could not have been clearer.
NHS England throws down challenge to government
The government’s budget delivered more new funding for the NHS than many observers had expected but far less than needed to avoid further restrictions on services.1 At its recent board meeting, NHS England discussed the implications of the budget and considered a paper that started from the premise that “with its 2018-19 budget the NHS will likely not be able to do everything being expected of it.
Simon Stevens speaks out over NHS funding
A minor earthquake shook the NHS last week. The epicentre of the earthquake was a speech by Simon Stevens, boss of NHS England, at the annual conference of leaders of NHS trusts. Stevens used his speech to outline the consequences for patient care of continuing constraints on NHS funding ahead of the government’s budget on 22 November.
State of health and care in England
The annual assessment of health and social care by the Care Quality Commission (CQC) provides a veritable treasure trove of information about the state of services in England.1 Based on inspections of 21?256 adult social care services, 152 NHS acute trusts, 197 independent acute hospitals, 18 NHS community health trusts, 54 NHS mental health trusts, 226 independent mental health locations, 10 NHS ambulance trusts, and 7028 primary care services over three years, the assessment offers grounds...
Yet more performance ratings for the NHS
In July NHS England published its first “progress dashboard” for the NHS’s 44 new sustainability and transformation partnerships (STPs)1—the groups of NHS organisations and local authorities expected to deliver the NHS’s sustainability and transformation plans (also, confusingly, referred to as STPs). The plans cover all areas of NHS spending in England up to 2021.
The general election, the NHS, and social care
The outcome of the general election will mean more of the same for the NHS and social care in the short term and huge uncertainty on two fronts in the medium term. The Conservative government has failed to obtain the mandate it was seeking and now hopes to rely on the support of Democratic Unionist MPs to implement its programme.
Next steps on the NHS five year forward view
The fingerprints of Simon Stevens, chief executive of NHS England, are all over the NHS delivery plan,1 which has been widely trailed as an important update on the state of the NHS. The plan, published at a difficult time for the NHS, summarises progress in improving care since the NHS Five Year Forward View was published in 2014.2 It also outlines ambitions for the future. The plan seeks to strike a balance between realism about the challenges facing the NHS today and promises to improve care.
Sustainability and transformation plans for the NHS in England: what do they say and what happens next?
Planning guidance produced by national NHS bodies in December 2015 asked NHS organisations to work together to make plans for the future of health and care services in their area.1 The plans—called sustainability and transformation plans (STPs)—needed to cover all areas of NHS spending up to 2021 as well as how NHS services work with social care and other local authority services.
Spring budget: cash for social care and a green paper on future funding
The spring budget delivered £2bn of new funding for social care over three years from 2017?18 and a commitment to publish a green paper outlining options for future funding. The government’s decision to find additional resources reflects the huge pressures facing social care in England, which the Care Quality Commission described as near “tipping point,”1 and the effect of these pressures on the NHS.
The hospital bed: on its way out?
John Appleby examines trends in the number of hospital beds and wonders how low we can go In 1967 the King Edward’s Hospital Fund for London, now known as the King’s Fund, published a new specification for the design of a “hospital bedstead.”1 This had followed an evaluation of various bed designs in collaboration with Bruce Archer, an engineering designer at London’s Royal College of Art.2 As Lawrence notes, the evaluation was intensive and “relied on extensive data collection, mathematical...
The trouble with locums
The role of locums—and temporary clinical staff more generally—is in the spotlight.
Political crisis in the NHS
The real NHS crisis is political not humanitarian. Politicians of all parties have failed to provide sufficient funding for health and social care, with predictable and sometimes distressing consequences. Hospitals are struggling to meet rising demands from a growing and ageing population, and most are failing to hit the four hour waiting time target in emergency departments.
UK government’s autumn statement: no relief for NHS and social care in England
If silence speaks volumes then this year’s autumn statement sent a deafening message to the NHS and its partners in social care. The decision of the chancellor of the exchequer, Philip Hammond, not to heed widespread calls for additional funding, especially for social care, reflects an uncertain outlook for the economy after the June referendum vote to leave the EU.
Wellbeing and being well
What does being healthy mean? What it does not mean—according to the well worn World Health Organization definition—is the absence of disease.1 More positively than that, as the WHO definition clarifies, health is a “state of complete physical, mental, and social wellbeing.” This classic definition of what it means to be healthy is great—as far as it goes. But what does wellbeing mean? And—at the risk of getting into a definitional loop—is wellbeing essentially the same as being well?
Challenges facing the health secretary in new Cabinet
The immediate challenge facing Jeremy Hunt, who has been reappointed as health secretary in the new Cabinet, is to confront the parlous state of NHS finances in England. The aggregate deficit of £1.85bn (€2.2bn; $2.5bn) in 2015-16 was the largest in NHS history and resulted from increasing demands on providers at a time of constrained funding.1 Savings from other parts of the Department of Health’s expenditure may help to offset NHS overspending but cannot be relied on to do the same in future.
I’m a healthy patient; get me out of here
News & Views I’m a healthy patient;...
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