This report reviews the evidence of effectiveness of Quality and Outcomes Framework (QOF) in the context of a changing policy landscape
This report is an evidence synthesis on GP recruitment, retention and re-employment.
This report summarises the findings of a literature review of the available evidence concerning the characteristics of these new contractual models and their implementation in other sectors.
This is the fourth annual review of our research and provides a brief overview of our current research activities.
The PHOENIX project aims to examine the impact of structural changes to the health and care system in England on the functioning of the public health system, and on the approaches taken to improving the public’s health.
This is a final report of our project investigating how commissioners in local health systems managed the interplay of competition and cooperation in their local health economies, looking at acute and community health services.
This report presents early findings from the third phase of a longitudinal study following the development of CCGs since their inception in 2011. The over-arching aim of this phase of the project is to explore the significant changes to the work of CCGs as they took varying levels of new responsibility for commissioning primary care services from April 2015.
In this study we explored the potential added value that clinicians, specifically GPs, bring to the commissioning process in interviews, and followed this up with observations of commissioners at work. Our research used ‘Realist Evaluation’ (Pawson & Tilley, 1997) which involves: seeking out participants ‘programme theories’ as to how a particular policy or programme will bring about the desired outcomes; exploring the extent to which these programme theories ‘work’ in the real world; and examining in detail the mechanisms and contexts which underpin them. We applied this approach to GPs roles in CCGs, using interviews to find out what CCG leaders believe are the key aspects of their contribution to commissioning. We then observed a wide range of meetings in order to explore the extent to which the claims they made were borne out in practice, and to try to elucidate the important conditions which supported their roles.
Since 1998, The University of Manchester has undertaken regular surveys of the perceptions of GPs in England about their working lives. These surveys provide important independent evidence for the Department of Health, which contributes to informing policy around GP retention and recruitment.
The results of the 8th National GP Worklife Survey are published today. The survey was undertaken in the spring and summer of 2015 and responses were received from over 2,600 GPs.
The respondents reported the lowest levels of job satisfaction since before the introduction of their new contract in 2004, the highest levels of stress since the start of the survey series, and an increase since three years ago in the proportion of GPs intending to quit direct patient care within the next five years.
The survey was carried out by the Manchester Centre for Health Economics in the Institute of Population Health, on behalf of the Policy Research Unit in Commissioning and the Health Care System (PRUComm), and the report is available here (PDF 784KB).
Over the last year PRUComm’s research activities have continued to expand culminating in a new phase of work examining co-commissioning of primary care by CGGs and NHS England and additional short research projects on primary care to include new projects on the public health system in England and research on competition and collaboration. We have also continued our research on aspects of the functioning of the health care system with work on contracting and competition and also continued to examine the developing public health system. This is our third annual review of research and provides a brief overview of our current research activities.
Blog by Anna Coleman & Julia Segar
A recent publication by the New Local Government Network (NLGN) looked at how local councils are preparing for the future and suggests depressingly that“there is simply no way that local government can reach 2018 let alone 2020 while still delivering the full range and quality of services currently on offer”(p6). Simply put, we have an ageing population, with associated increasing demand for care services and draconian cuts in council budgets. The NLGN suggest we could be facing a future of “private affluence and public squalor”. However, it is not all doom and gloom. Perhaps austerity can be a strong stimulus for innovation? How would this work I hear you ask?
Professor Stephen Peckham (Director of PRUComm) is the lead author of a recently published NIHR HS&DR funded research which explored the role and impact of patient and public engagement and involvement in commissioning for people with LTCs.
Blog by Julia Segar
GPs now lead the process of planning, designing and purchasing health services for their local populations. The rationale for this was the notion that GPs are on the ‘frontline’ of patient care so they know and understand their patients’ needs and in turn are trusted by their patients. We have been tracking and researching these changes and in our Sage Open paper we examine the impact of these reforms on the roles and identities GPs and managers.
Blog by Kath Checkland
Our recent CCG research published in BMJ Open explored the early stages of this transition, using contracting theory to try to understand how CCGs were approaching the decisions they needed to make: should they ‘make’, ‘buy’ or ‘ally’? We found that some CCGs were reluctant to outsource commissioning support, fearing that they would lose local knowledge and trusted local relationships.
Blog by Neil Perkins
Our paper published by the British Journal of General Practice looks at what ‘added value’ GPs think they bring now they are responsible for commissioning healthcare in their local communities.
Seminar hosted by PRUComm, The Nuffield Trust and the King’s Fund on 1st May at The King’s Fund, London.
Blog by Anna Coleman