Tag Archives: Public Health

PRUComm Annual Research Seminar

Since the establishment of PRUComm in 2011 our research has focused on examining how the changes to the English NHS and public health system have developed. We continue to examine the development of CCGs and the new commissioning structures. We have also been exploring the mechanisms by which commissioning is undertaken, such as contracting and the use of competition and cooperation within the new system.

While most media attention has focused on changes to the commissioning and delivery of healthcare, the shift of public health to local authorities was a major part of the reforms introduced in April 2013. We have examined the progress and developments in the public health system with a particular emphasis on how governance and organisational structures develop and whether being embedded within local councils changes the way that public health services are provided. We have also been focusing on primary and community health care with recent projects examining general practice – including methods of funding primary care; research on recruitment and retention; QOF, scaling up primary care and running and analysing two rounds of the GP WorkLife survey (eight and nine).

Our research on CCGs has most recently focused on primary care co-commissioning and new forms of contracting, such as outcomes-based and alliancing. Given the increasing policy emphasis on this area of healthcare we anticipate that we will be increasingly involved in further research on primary and community healthcare. All these topics will be explored in today’s seminar with presentations by researchers from PRUComm.

Programme and speakers biographies [pdf]>>

Agenda

9.30 Registration and refreshments

10.00 – Welcome and introduction: Professor Stephen Peckham (Director PRUComm).

10.00 – 10.25 Jonathan Walden: (Commissioning Policy Lead): Policy update – Department of Health and Social Care priorities.  Slides [pdf]>>

10.25– 11.00 Dr Lindsay Forbes: Incentivising GPs: Review of the Quality and Outcomes Framework in England. Slides [pdf]>>

11.00 – 11.20 Coffee

11.20 – 12.00 Dr Jon Gibson and Prof Kath Checkland: Satisfaction, sources of stress and intentions to quit amongst GPs in England: the results of the 9th GP Worklife survey

12.00 – 12.40 Dr Marie Sanderson: Examining the implementation of new models of contracting in the NHS: what are the lessons for the formation of Accountable Care Systems? Slides [pdf]>>

12.40 – 13.20 Lunch

13.20 – 14.00 Dr Valerie Moran: How are CCGs managing conflicts of interest when they commission primary care? Lessons for Accountable Care. Slides [pdf]>>

14.00 – 15.50 Panel Discussion – STPs, and ACS’s the re-emergence of planning?

15.50 – 16.00 Professor Stephen Peckham: Current PRUComm research programme

16.00 Close

PRUComm Research Review 2017

This is our fifth annual review of research and provides a brief overview of our research activities. Following confirmation last year of our extension until the end of 2018 we have now agreed a programme of work with the Department. This sees a stronger shift towards exploring the impact of system changes on commissioning. The introduction of Sustainability and Transformation Plans and new metapractice organisations creates a rapidly shifting landscape for the commissioning and delivery of healthcare in England.

Download report [pdf]>> 

Commissioning for health improvement following the 2012 health and social care reforms in England: what has changed?

Abstract

Background

The wide-ranging program of reforms brought about by the Health and Social Care Act (2012) in England fundamentally changed the operation of the public health system, moving responsibility for the commissioning and delivery of services from the National Health Service to locally elected councils and a new national public health agency. This paper explores the ways in which the reforms have altered public health commissioning.

Methods

We conducted multi-methods research over 33 months, incorporating national surveys of Directors of Public Health and local council elected members at two time-points, and in-depth case studies in five purposively selected geographical areas.

Results

Public health commissioning responsibilities have changed and become more fragmented, being split amongst a range of different organisations, most of which were newly created in 2013. There is much change in the way public health commissioning is done, in who is doing it, and in what is commissioned, since the reforms. There is wider consultation on decisions in the local council setting than in the NHS, and elected members now have a strong influence on public health prioritisation. There is more (and different) scrutiny being applied to public health contracts, and most councils have embarked on wide-ranging changes to the health improvement services they commission. Public health money is being used in different ways as councils are adapting to increasing financial constraint.

Conclusions

Our findings suggest that, while some of the intended opportunities to improve population health and create a more joined-up system with clearer leadership have been achieved, fragmentation, dispersed decision-making and uncertainties regarding funding remain significant challenges. There have been profound changes in commissioning processes, with consequences for what health improvement services are ultimately commissioned. Time (and further research) will tell if any of these changes lead to improved population health outcomes and reduced health inequalities, but many of the opportunities brought about by the reforms are threatened by the continued flux in the system.

Link to the article [BMC open access] >>