Kings fund report
This independent report was commissioned by NHS England as part of a package of support provided to primary and acute care system (PACS) vanguard sites by The King’s Fund. The views in the report are those of the authors and contributors, and all conclusions are the authors’ own.
The King’s Fund is an independent charity working to improve health and care in England. We help to shape policy and practice through research and analysis; develop individuals, teams and organisations; promote understanding of the health and social care system; and bring people together to learn, share knowledge and debate. Our vision is that the best possible health and care is available to all.
The traditional divide between primary care, community services, and hospitals – largely unaltered since the birth of the NHS–- is increasingly a barrier to the personalised and coordinated health services patients need.
The report concludes:
At the heart of the new care models programme is a good news story – that despite the pressures the health and care system is under, innovation is still possible when the enthusiasm of local leaders is fully harnessed. In the PACS vanguard sites, as in many other areas, there has been a determination to improve care and redesign the ‘traditional boundaries’ referred to in the Forward View (NHS England et al 2014). This sense of ambition is clear to see in many of the essays in section 2 of this report.
The findings of the formal evaluation, when available, will tell us more about the impact these innovations have had on patient outcomes and resource use. Contributions to this report suggest that for many of those involved, the most significant steps forward have not been about specific service changes (important though these have been), so much as ‘reshaping the overall organisational relationships and incentives in the local system’ (to quote Daljit Lally’s essay). Much of this reshaping remains incomplete and involves moving away from a system predicated on competition between autonomous
organisations paid on the basis of activity levels, to one in which place-based collaboration and pooled funding play a much greater role. An important question that remains is how far this movement can go in the absence of legislative change to ensure the statutory framework keeps pace with developments in the system.
Downloads
The full report can be downloaded and read below
