Author: Great Britain: National Audit Office
Publisher: The Stationery Office
ISBN: 9780102953015
Category : Medical
Languages : en
Pages : 60
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Book Description
Each year general medical practices provide some 290 million consultations. The new contract (implemented in April 2004 but increased spending began in April 2003) changed the basis for commissioning primary care services. Instead of contracting with individual General Practitioners (GPs), Primary Care Trusts (PCTs) commission services from some 8,325 GP practices with around 33,000 GPs. This study examines the negotiation and implementation of the new contract and how well it is working in practice. In the first three years the PCTs spent £1.76 billion (9.4 per cent) more than the minimum committed by the Department of Health. Mostly this was due to an underestimation of the amount that GPs would earn from the pay for performance scheme, the Quality and Outcomes Framework (QOF), and the additional cost of providing out-of-hours care (most GPs have opted out of providing this service). GPs' salaries have increased by an average of 58 per cent. Practice nurses have not benefited to the same extent. While the number of consultations with patients has increased, these are not in proportion with the increase in costs, and productivity has fallen by 2.5 per cent per year. GPs are working less hours. Some progress has been made in extending the range of patient services, reduced administration, high quality care and linking pay and performance, and staff satisfaction and morale. Progress has not yet been demonstrated in productivity, and re-designing the services around patients. The contract has contributed to improved recruitment and retention of GPs. The NAO recommends that the Department develop a strategy for yearly negotiations on the QOF, which should be based more on health outcomes. PCTs should provide more services based on local need and review the number and skills of staff employed to commission and performance manage GP services with the aim of improving local commissioning.
Author: Great Britain. National Audit Office
Publisher: The Stationery Office
ISBN: 9780102954562
Category : Medical
Languages : en
Pages : 44
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Book Description
The NHS has successfully transferred 1.1 million NHS employees on to a new simplified pay system. This was a substantial task which the NHS, in partnership with the trade unions, achieved in a short timescale. There are some examples of NHS trusts using Agenda for Change to help introduce new roles. But the Department of Health did not put enough emphasis on getting trusts to develop these new ways of working to secure the full benefits from the new pay system, so the programme is not yet achieving the intended value for money. Agenda for Change has reduced pay administration in the NHS, simplified pay negotiations and made it easier to estimate staff costs and monitor budgets. The NAO estimates that for 2007-08 the £28 billion NHS paybill is broadly similar to what it might have been if the programme had not been implemented. The Department predicted that Agenda for Change would save at least £1.3 billion by 2008-09 and productivity would increase, but it did not put in place any central monitoring arrangements to show what impact the new contract has had on productivity. The only productivity measure available for the NHS as a whole shows that productivity continued to fall when Agenda for Change was introduced, though the rate has since slowed. A key element of Agenda for Change, the Knowledge and Skills Framework, which defines the skills needed for a certain role and provides a tool for reviewing their use in the workplace, has not yet been fully implemented by many trusts. Effective use of the Framework is fundamental to achieving the full benefits of Agenda for Change.
Author: Great Britain: Parliament: House of Commons: Committee of Public Accounts
Publisher: The Stationery Office
ISBN: 9780215532268
Category : Medical
Languages : en
Pages : 44
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Book Description
Agenda for Change, the pay modernisation programme for 1.1 million NHS staff in England, representing a pay bill of £28 billion in 2007-08, was implemented between December 2004 and December 2006. It covered all NHS staff, except doctors, dentists and senior managers. Agenda for Change introduced a job evaluation scheme and harmonised employment terms and conditions for the multitude of jobs within the NHS. A key part of the programme is a process for encouraging staff development and improving staff performance known as the Knowledge and Skills Framework. Agenda for Change was expected to bring about new ways of working which would contribute to improved patient care and to more efficient delivery of services. Total savings of £1.3 billion over the first five years were predicted. These were to come from improvements in productivity of 1.1 to 1.5 per cent a year, reductions in equal pay claims, reduced use of agency staff and more controllable pay costs. The Department and NHS Trusts did not establish ways of measuring the effects of Agenda for Change and there is no active benefits realisation plan. The NHS pay bill for the staff covered by Agenda for Change has risen by 5.2 per cent a year on average since 2004-05 while productivity fell by 2.5 per cent a year on average between 2001 and 2005. By autumn 2008 (nearly two years after Trusts had completed transferring staff to Agenda for Change terms and conditions and pay rates) only 54 per cent of staff had had a knowledge and skills review.
Author: Stephen Bach
Publisher: Bloomsbury Publishing
ISBN: 1350304727
Category : Business & Economics
Languages : en
Pages : 200
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Book Description
The Modernisation of the Public Services and Employee Relations provides an integrated and up-to-date account of changes in work and employment in the public services. The book examines a range of different sectors focusing on core public services, especially local government, the NHS and the civil service.
Author: Great Britain: National Audit Office
Publisher: The Stationery Office
ISBN: 9780102951653
Category : Medical
Languages : en
Pages : 50
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Book Description
In the last financial year the Department of Health made financial recovery priority and managed to turn the deficits of 2005-06 to a surplus of £505 million in 2006-07. The Comptroller and Auditor General is the statutory auditor of the financial accounts of the NHS and has the duty to certify and report to Parliament on them. This report is published alongside in the NHS Summarised Accounts to provide more detail on the financial performance of the NHS, how it moved into balance and the challenges that face it in the future.
Author: Stephen Gillam
Publisher: CRC Press
ISBN: 1315357607
Category : Medical
Languages : en
Pages : 216
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Book Description
The Quality and Outcomes Framework has deeply divided UK general practitioners. I commend this book and applaud its determination to scrutinise every aspect of the Quality and Outcomes Framework - good and bad and in-between. - From the Foreword by Iona Heath General practice in the UK faces transformation following the introduction of the Quality & Outcomes Framework (QOF), a pay-for-performance scheme unprecedented in the NHS, and the most comprehensive scheme of its kind in the world. Champions claim the QOF advances the quality of primary care; detractors fear the end of general practice as we know it. The introduction of the QOF provides a unique opportunity for research, analysis and reflection. This book is the first comprehensive analysis of the impact of the QOF, examining the claims and counter-claims in depth through the experience of those delivering QOF, comparisons with other countries, and analysis of the wealth of research evidence emerging. Assessments of the true impact of QOF will influence the development of health services in the UK and beyond. This book is essential reading for anyone with an interest in the future of general practice and primary care, including health professionals, trainers, students, MRCGP candidates and researchers, managers, and policy-makers and shapers.
Author: Nigel Crisp
Publisher: OUP Oxford
ISBN: 0191628611
Category : Medical
Languages : en
Pages : 248
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Book Description
24 hours to save the NHS. It was a political slogan but it hid a deeper question. Could the NHS survive? Could it continue to offer free health care for every citizen regardless of their ability to pay? Could the extraordinary, liberating ambition and dream of its founders 50 years before be maintained in the 21st Century - that everyone, no matter how poor or ill, should be freed from worrying about how to pay for their health care. By 2000 the NHS was in decline with falling standards and failing public support. Its supporters were beginning to question its viability, whilst its enemies were eager to catalogue its faults. Five years later we had an answer. Radical change and investment meant that the NHS had survived. Standards were improving and the NHS was expanding. Proof came from outside. Public satisfaction doubled and fewer people opted for private healthcare. Most tellingly, all the major political parties went into the 2010 general election committed to the NHS and to helping it develop and prosper. Today the question has changed. The NHS has survived but can it become sustainable at a time of austerity and as demand for its services grows? 24 hours to save the NHS shows what we can learn from the past, and describes what more we need to do to innovate for the future. It is the inside story of the last reforms written by the man charged with implementing them, and who was given unprecedented authority as both Chief Executive of the NHS and Permanent Secretary of the Department of Health. A very practical book - it describes the successes and failures as well as the pressures and the difficulties of making improvements in the fourth biggest organization in the world which employs 1.3 million people and spends £100 billion a year. It will be of interest to the general reader, health workers, policy makers, academics and students alike.
Author: NHS Pay Review Body
Publisher: The Stationery Office
ISBN: 9780101850124
Category : Medical
Languages : en
Pages : 182
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Book Description
This report considers how to make pay more market-facing in local areas for NHS Agenda for Change (AfC) staff and recommends market-facing pay to support recruitment and staff retention. The AfC system is perceived as fair and objective by all parties, supports stable industrial relations, and is viewed as compliant with equal pay principles. Analysis does not provide firm evidence for further investment in additional market -facing pay in the NHS at this time and further development of AfC is needed to meet the challenges and cost pressures in the NHS. AfC is considered the appropriate vehicle through which to develop market-facing pay as it already has positive features for it. The Review Body therefore specifically recommends a fundamental review of high cost area supplements, appropriate use of local recruitment and retention premia, and regular review of AfC, including its flexibilities, with any necessary negotiations brought to a conclusion at a reasonable pace
Author: Great Britain: National Audit Office
Publisher: The Stationery Office
ISBN: 9780102970029
Category : Medical
Languages : en
Pages : 44
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Book Description
Productivity in hospitals has been falling by around 1.4 per cent a year since 2000 whilst NHS expenditure has increased by over two thirds in ten years. The Department of Health has achieved significant improvements in such areas as waiting times, healthcare associated infection rates, patient outcomes, reduced cancer mortality and the patient experience. However, the NHS pay contracts introduced since 2003 have increased costs but are not always used effectively by hospitals to drive productivity improvements. The NHS needs to deliver between £15 billion and £20 billion of efficiency savings per year by 2013-14. Around 40 per cent of these savings are expected to come from increasing efficiency in hospitals, requiring productivity gains of approximately six per cent per annum. The 'Payment by Results' system of setting national tariffs has promoted some efficient practice, but there is still substantial variation between hospitals. If all hospitals performed at the level of the top 25 per cent in respect of staff costs, use of estate, control of emergency admissions and bed management, the NAO estimates that the NHS could save around £1.6 billion a year. The Department has launched a national initiative (QIPP) to help the NHS deliver annual savings of up to £20 billion. There are risks to the delivery of the initiative, which is the responsibility of Strategic Health Authorities and Primary Care Trusts, whose focus may be distracted by the proposals for their closure by 2013.
Author: K. Wetzel
Publisher: Springer
ISBN: 0230514626
Category : Business & Economics
Languages : en
Pages : 241
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Book Description
Over the past 25 years, governments that operate publicly-funded health care systems have endeavoured to modernize service delivery and to control health spending. This has occasioned high profile efforts to reform and restructure previously stable health systems. Health organizations are typically complex, labour intensive and unionized. Health reform can have enormous consequences for workers and their unions. Governments' ideologies determine the nature of reform initiatives. This book examines the experiences of five jurisdictions - Great Britain, New Zealand, New South Wales, Saskatchewan and Alberta.
