Reports

August 2021: National Evaluation of the Vanguard New Care Models Programme: Report of qualitative case studies

12 August 2021
This report forms part of a wider evaluation of the National Vanguard programme, funded by the NIHR Policy Research Programme and taking place between 2017 and 2021. The aim of this national evaluation is to explore the implementation and impact of the Vanguard New Care Models programme.

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June 2021: 10th National GP Worklife Survey

14 June 2021
The National GP Worklife Survey was run for the 10th time in 2019, and the results are now available. We found that the mean level of overall satisfaction, measured between 1 (extremely dissatisfied) and 7 (extremely satisfied), increased by 0.24 (95% CI: 0.08, 0.40) points from 4.25 in 2017 to 4.49 in 2019. Mean levels of satisfaction increased between 2017 and 2019 to varying degrees in all nine domains of job satisfaction, although this remains lower than the peak of satisfaction found in 2005. Overall hours of work showed a slight decline, but responses to questions about stressful aspects of the job suggest that GPs feel they need to work increasingly intensively. Intentions to quit practice remain high, with 63% of respondents over the age of 50 reporting a considerable or high likelihood that they will leave patient care roles in the next five years. More worryingly, perhaps, 11% of GPs under 50 suggested they might also leave, although this is a slight decline since 2017.

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June 2021: Exploration of the National Health Services Community Services Data Set Report

9 June 2021
This report describes and explores the newly publicly available aggregated national Community Services Data Set (CSDS). The data are available monthly from October 2017 aggregated to provider level for public use. A brief review is provided about data held by CSDS: 1) a range of Care Activities provided; 2) Care Contacts stratified by gender, age group, attendance status and medium, through which the care contact was conducted; 3) Patient Care Contacts, i.e. the number of patients who used care contacts, by gender and age group; 4) Immunisations by age group; 5) Patients with Referrals by gender and age group; and 6) Referrals to community services by gender and age group, source, reason and age group. This report includes an assessment of the data quality for researchers’ and policy makers’ information. We used the data between October 2017 and September 2019, with some initial insights made from the dataset between October 2017 and December 2018.

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March 2021: NHS Reorganisation

12 March 2021
The current NHSE legislative proposals to restructure the NHS, set out in a government white paper in February 2021, represent a profound change to the way that services have previously been overseen and planned. PRUComm colleagues are concerned about the lack of detail and the failure to explain how current functions will be carried out in the new system, as well as the effects on accountability of the proposals. This note summarises the main issues we think the proposals raise.

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Feb 2021: Integrated Care Systems interim report published

23 February 2021
This report sets out the interim findings of our study of the development of Integrated Care Systems. We are engaged with three case studies of ICSs in different stages of maturity, examining the development of leadership and co-operative arrangements, the way system partners are reconciling individual and system roles and the way local priorities are being reconciled with system priorities.

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Dec 2020: Primary Care Networks: exploring primary care commissioning, contracting, and provision

11 December 2020
Today we can publish the interim report from our Primary Care Networks evaluation. The initial stages of the project included: interviews with policy makers to explore their objectives for PCNs; quantitative analysis of the size and shape of PCNs on the ground, including their make up and disease burden; and telephone interviews with CCG leads responsible for supporting PCNs as they develop.

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Nov 2020: Publication of ‘On Primary Care’

10 November 2020
Professor Kath Checkland and PRUComm colleagues from the University of Manchester have contributed to the publication of a collection of essays on the current challenges facing primary care in the UK, titled 'On Primary Care'.

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Nov 2019: New models of contracting in the NHS

18 August 2020
This research project investigated why NHS commissioners are choosing new models of contracting, the characteristics of these models, how they are used in practice and the impact they are having. The report draws on findings from three case studies, which each focused on a new model of contracting which was being introduced or was in place in a local area in the English NHS.

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Nov 2019: Integrated Care Systems: What can current reforms learn from past research on regional co-ordination of health and care in England? A literature review

11 November 2019
This report presents the findings of a literature review examining research into previous intermediate tiers in the NHS.

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Jan 2019: National evaluation of the Vanguard new care models programme. Interim report: understanding the national support programme

22 January 2019
This short report sets out the results of one part of the research, a survey of Strategic Transformation Partnership (STP) Leads, to examine how the Vanguard programme has been understood and managed at the meso level.

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Nov 2018: Investigating recent developments in the commissioning system

23 November 2018
This study aimed to investigate how recent policy developments, including the emphasis on place-based planning, have affected the process of commissioning and planning at local level.

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Jul 2018: Impact of removing indicators from the Quality and Outcomes Framework

4 July 2018
The project aimed to analyse the effect of indicator removal in a large, nationally-representative cohort of patients whose care quality has been consistently recorded over time. The research provides intelligence on the likely patient impacts of changing existing incentives. This is key to understanding the risks of change, but also what the change in practice activity has been as a consequence of removing incentives.

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May 2018: Ninth National GP Worklife Survey

31 May 2018
The number of GPs who say they are likely to quit direct patient care within five years rose to an all-time high of 39% in 2017, up from 35% in 2015, according to a new survey carried out by University of Manchester researchers.

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Mar 2018: Understanding primary care co-commissioning: Uptake, development, and impacts. Final report

21 March 2018
This report presents the findings from a study following the development of Clinical Commissioning Groups (CCGs) in England. This is the third phase of the project, which aims to understand the ways in which CCGs are responding to their new primary care co-commissioning responsibilities from April 2015. The study provides detailed evidence about the experiences of CCGs as they took on delegated responsibility for primary care commissioning.

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Mar 2018: Next steps in commissioning through competition and cooperation (2016-2017)

4 March 2018
The aims of this stage of the field work remained the same as those of the initial study. The project aimed to investigate 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 (CHS).

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Nov 2017: How are CCGs managing conflicts of interest under primary care co-commissioning in England? A qualitative analysis

13 November 2017
From April 2015, NHS England (NHSE) started to devolve responsibility for commissioning primary care services to clinical commissioning groups (CCGs). The aim of this paper is to explore how CCGs are managing potential conflicts of interest associated with groups of GPs commissioning themselves or their practices to provide services.

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Aug 2017: PRUComm Research Review 2017

15 August 2017
This is our fifth annual review of research and provides a brief overview of our research activities.

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Feb 2017: Review of the Quality and Outcomes Framework in England

8 February 2017
This report reviews the evidence of effectiveness of Quality and Outcomes Framework (QOF) in the context of a changing policy landscape.

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Nov 2016: Improving GP recruitment and retention needs a long-term strategy

4 November 2016
This report is an evidence synthesis on GP recruitment, retention and re-employment.

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Oct 2016: Alliance contracting, prime contracting and outcome based contracting: What can the NHS learn from elsewhere?

25 October 2016
This report is part of the research of the Policy Research Unit in Commissioning and the Health Care System (PRUComm) on new models of contracting in the NHS, commissioned by the Department of Health.

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Aug 2016: PRUComm Research Review

11 September 2016
This is the fourth annual review of our research and provides a brief overview of our current research activities.

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Jul 2015: PHOENIX: Public Health and Obesity in England – The new infrastructure examined

15 July 2016
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.

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Jun 2016: Commissioning through competition and cooperation

17 June 2016
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.

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Apr 2016: Understanding primary care co-commissioning: Uptake, scope of activity and process of change - An Interim Report

20 April 2016
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.

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Oct 2015: Exploring the GP ‘added value’ in commissioning

13 October 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.

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