This document summarizes the history and reforms of the UK's National Health Service (NHS). It discusses how the NHS was established in 1948 to provide free healthcare. It went through various reforms in the 1970s, 1990s, and 2000s focused on increasing efficiency and choice. The current Coalition government has dramatically changed the commissioning system by giving new roles to local governments and GPs. The document reflects on lessons for policymakers around engaging frontline staff, balancing incentives, and focusing on gradual improvement over time.
Since the 1940s, the NHS has employed innovation and the most recent created technology to help combat hearing loss | UK Hearing Care News
http://www.ageukhearingaids.co.uk/hearing-aid-news/nhs-helping-people-hear-1948
Introduction to British Model in International Seminar on Social and Health systems in Europe organized by SITRA. Helsinki 7 - 8 September 2010.
Presentation by Andrew Hine, partner, KPMG LLP (UK)
Since the 1940s, the NHS has employed innovation and the most recent created technology to help combat hearing loss | UK Hearing Care News
http://www.ageukhearingaids.co.uk/hearing-aid-news/nhs-helping-people-hear-1948
Introduction to British Model in International Seminar on Social and Health systems in Europe organized by SITRA. Helsinki 7 - 8 September 2010.
Presentation by Andrew Hine, partner, KPMG LLP (UK)
Health Financing System of United KingdomAditya Sood
Discussing in brief bout the latest statistics of Health Financing in UK, with emphasis on National Health Services (NHS) model and the key challenges being faced by the UK health system financing.
Making the case for public health interventionsThe King's Fund
In partnership with the Local Government Association, we have produced a set of infographics that describe key facts about the public health system and the return on investment for some public health interventions.
We hope they will be a useful resource for you – please feel free to use them in your office, in documents or presentations.
The Health and Social Care Act (2012) paved the way for far-reaching reforms to how patient care in the English NHS is organised, managed and delivered. The changes were formally implemented on 1 April 2013.
This slideshow outlines the main changes to management, accountability and funding structures resulting from the Act.
The first slides show the old and new structure in overview, together with a slide detailing the transitional arrangement. Further slides compare the earlier arrangements that were in place for funding, regulation and monitoring, advice and performance management, and patient and public participation, with the new system at both the national and local level. The final slide outlines the new medical education and training arrangements.
You are welcome to download and use individual slides in your own presentations providing suitable acknowledgement is given.
To find out more about our work on the NHS reforms, visit our dedicated project page. You can also access an interactive timeline showing the complete history of the NHS, putting the current reforms in historical context.
Concept diagrams are one of the best bang-for-buck deliverables available to today’s UX designer. In its most basic form, a concept diagram uses nouns connected by verbs to describe a system, idea, or application. It can be a sophisticated deliverable or a quick-and-dirty sketch. The technique is not unlike diagramming sentences in elementary school — though it tends to be quite a bit more fun.
This is a fast-paced primer on building better concept diagrams and using them to understand relationships between ideas in new ways. In particular, we’ll examine how to use concept diagrams to represent domain expertise and create a mechanism for transferring knowledge between stakeholders, subject matter experts, and designers.
Learn the simple rules for creating concept diagrams, when you will and won’t want to create one, and what to do with it once you have it. Understand how concept diagrams differ from similar techniques such as affinity diagramming and mindmapping, and when best to apply each in your process.
Variations on this talk have been presented at the 2014 Information Architecture Summit in San Diego, MinneWebCon 2014 at the University of Minnesota, Web 2013 at Penn State, and the 2014 University of Illinois Web Conference.
Information Architecture: The Strategic Structure of Great UX - WIAD 2017Jessica DuVerneay
World IA Day Talk 2017, Chicago. This talk begins by illustrating the relationship between strategy, IA, and UX. Then, it outlines the importance of information architecture as a crucial step between strategy and ux - and what to expect if any one of these key steps is overlooked. The presentation concludes with practical, actionable tips on advocating for IA to ensure great UX.
Health Financing System of United KingdomAditya Sood
Discussing in brief bout the latest statistics of Health Financing in UK, with emphasis on National Health Services (NHS) model and the key challenges being faced by the UK health system financing.
Making the case for public health interventionsThe King's Fund
In partnership with the Local Government Association, we have produced a set of infographics that describe key facts about the public health system and the return on investment for some public health interventions.
We hope they will be a useful resource for you – please feel free to use them in your office, in documents or presentations.
The Health and Social Care Act (2012) paved the way for far-reaching reforms to how patient care in the English NHS is organised, managed and delivered. The changes were formally implemented on 1 April 2013.
This slideshow outlines the main changes to management, accountability and funding structures resulting from the Act.
The first slides show the old and new structure in overview, together with a slide detailing the transitional arrangement. Further slides compare the earlier arrangements that were in place for funding, regulation and monitoring, advice and performance management, and patient and public participation, with the new system at both the national and local level. The final slide outlines the new medical education and training arrangements.
You are welcome to download and use individual slides in your own presentations providing suitable acknowledgement is given.
To find out more about our work on the NHS reforms, visit our dedicated project page. You can also access an interactive timeline showing the complete history of the NHS, putting the current reforms in historical context.
Concept diagrams are one of the best bang-for-buck deliverables available to today’s UX designer. In its most basic form, a concept diagram uses nouns connected by verbs to describe a system, idea, or application. It can be a sophisticated deliverable or a quick-and-dirty sketch. The technique is not unlike diagramming sentences in elementary school — though it tends to be quite a bit more fun.
This is a fast-paced primer on building better concept diagrams and using them to understand relationships between ideas in new ways. In particular, we’ll examine how to use concept diagrams to represent domain expertise and create a mechanism for transferring knowledge between stakeholders, subject matter experts, and designers.
Learn the simple rules for creating concept diagrams, when you will and won’t want to create one, and what to do with it once you have it. Understand how concept diagrams differ from similar techniques such as affinity diagramming and mindmapping, and when best to apply each in your process.
Variations on this talk have been presented at the 2014 Information Architecture Summit in San Diego, MinneWebCon 2014 at the University of Minnesota, Web 2013 at Penn State, and the 2014 University of Illinois Web Conference.
Information Architecture: The Strategic Structure of Great UX - WIAD 2017Jessica DuVerneay
World IA Day Talk 2017, Chicago. This talk begins by illustrating the relationship between strategy, IA, and UX. Then, it outlines the importance of information architecture as a crucial step between strategy and ux - and what to expect if any one of these key steps is overlooked. The presentation concludes with practical, actionable tips on advocating for IA to ensure great UX.
Event: NHS: Not for Sale
Date: 20th October 2011
Venue: Newcastle University
Dr Clive Peedell, Prof. John Spencer, Prof. Wendy Savage and Pete Campbell explain the history of politics with the NHS, the repercussions of the Health and Social Care BIll, how it will affect the NHS and what we can do to fight to keep our nhs public.
Where there is no vision the people perishJohn Middleton
A presentation of the work of the Faculty of public Health and the place of rights, values, ethics and law in improving the health of the public. 181102 middletonj scottish conference final
Getting to grips with Population Health - 28th Feb 2018James Carter
A set of slides produced by Thames Valley Strategic Clinical Network to support the familiarisation event on Population Health held in Maidenhead on Wednesday 28th February 2018.
With thanks to all colleagues, attendees, chairs and speakers for their involvement on the day.
James Carter - Senior Network Manager TVSCN
james.carter1@nhs.net
FPH Brexit Campaign:FPHMI Winter Scientific Meeting John Middleton
Presentation to the Faculty of Public Health Medicine of Ireland winter conference. Considering the implications of the the UK leaving the EU for the public's health in the UK and in Europe.
171206 middletonj dublin
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
The Roman Empire A Historical Colossus.pdfkaushalkr1407
The Roman Empire, a vast and enduring power, stands as one of history's most remarkable civilizations, leaving an indelible imprint on the world. It emerged from the Roman Republic, transitioning into an imperial powerhouse under the leadership of Augustus Caesar in 27 BCE. This transformation marked the beginning of an era defined by unprecedented territorial expansion, architectural marvels, and profound cultural influence.
The empire's roots lie in the city of Rome, founded, according to legend, by Romulus in 753 BCE. Over centuries, Rome evolved from a small settlement to a formidable republic, characterized by a complex political system with elected officials and checks on power. However, internal strife, class conflicts, and military ambitions paved the way for the end of the Republic. Julius Caesar’s dictatorship and subsequent assassination in 44 BCE created a power vacuum, leading to a civil war. Octavian, later Augustus, emerged victorious, heralding the Roman Empire’s birth.
Under Augustus, the empire experienced the Pax Romana, a 200-year period of relative peace and stability. Augustus reformed the military, established efficient administrative systems, and initiated grand construction projects. The empire's borders expanded, encompassing territories from Britain to Egypt and from Spain to the Euphrates. Roman legions, renowned for their discipline and engineering prowess, secured and maintained these vast territories, building roads, fortifications, and cities that facilitated control and integration.
The Roman Empire’s society was hierarchical, with a rigid class system. At the top were the patricians, wealthy elites who held significant political power. Below them were the plebeians, free citizens with limited political influence, and the vast numbers of slaves who formed the backbone of the economy. The family unit was central, governed by the paterfamilias, the male head who held absolute authority.
Culturally, the Romans were eclectic, absorbing and adapting elements from the civilizations they encountered, particularly the Greeks. Roman art, literature, and philosophy reflected this synthesis, creating a rich cultural tapestry. Latin, the Roman language, became the lingua franca of the Western world, influencing numerous modern languages.
Roman architecture and engineering achievements were monumental. They perfected the arch, vault, and dome, constructing enduring structures like the Colosseum, Pantheon, and aqueducts. These engineering marvels not only showcased Roman ingenuity but also served practical purposes, from public entertainment to water supply.
Embracing GenAI - A Strategic ImperativePeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Operation “Blue Star” is the only event in the history of Independent India where the state went into war with its own people. Even after about 40 years it is not clear if it was culmination of states anger over people of the region, a political game of power or start of dictatorial chapter in the democratic setup.
The people of Punjab felt alienated from main stream due to denial of their just demands during a long democratic struggle since independence. As it happen all over the word, it led to militant struggle with great loss of lives of military, police and civilian personnel. Killing of Indira Gandhi and massacre of innocent Sikhs in Delhi and other India cities was also associated with this movement.
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
2. www.leicspt.nhs.uk
Agenda
NHS Briefest of history lessons!
Some general comments about health
systems
Mental Health’s journey – the last decade
An outcomes based approach
What does the future hold? (Discussion)
….off to Old Trafford!
3. www.leicspt.nhs.uk
As the debate over how best to look after American patients rages on, Britain's
socialised health care system has increasingly found itself being drawn into
the argument. Critics of the Obama administration's plan to overhaul US health
care say the president is seeking to model the U.S. system on that of Britain or
Canada - places they paint as countries where patients linger for months on
waiting lists and are forbidden from paying for their own medication
A Republican National Committee ad said that in the UK "individuals lose their
right to make their own health care choices." Another ad by the anti-tax group
Club for Growth claimed that government bureaucrats in Britain had calculated
six months of life to be worth $22,750. "Under their socialised system, if your
treatment costs more, you're out of luck," the ad says, as footage of an elderly
man weeping at a woman's bedside alternate with clips of the Union Jack and
Big Ben.
Editorial, printed in the Investor's Business Daily, claimed that renowned
physicist Stephen Hawkins, who is disabled, "wouldn't have a chance in the
UK, where the National Health Service would say the life of this brilliant man,
because of his physical handicaps, is essentially worthless."
Healthcare Reform International perspectives
What the US says about the NHS
4. www.leicspt.nhs.uk
What the NHS Costs
The UK government department responsible for
the NHS is the, headed by the Secretary of State for
Health. Most of the expenditure of The Department of
Health (£98.7 billion in 2008-9) is spent on the NHS.
This year the NHS budget is $180 billion, over
$5,000 per household.
13% on behavioural health care.
5. www.leicspt.nhs.uk
5th
July 1948
The NHS…Providing a
comprehensive range of
services for all in need
Bringing organisation to the
work of physicians, barber,
surgeons and apothecaries!
“A fixed quantity of illness in
the community which the
introduction of a health
service, free at the point of
consumption; would
gradually reduce.” !!!
… Doctors and Nurses in charge … for 30 years …
7. www.leicspt.nhs.uk
At one point … Director General…The Department of
Health…
The Blair years….lots of chances to consider
international comparisons with our own system
8. www.leicspt.nhs.uk
Which country has the best system?
A league table of 191 countries published in 2000
Where did the UK rank?
Where did the US rank?
Name the top country in the WHO’s league table
18th
37th
France
The answers
9. www.leicspt.nhs.uk
The ideal system?
Japanese health outcomes
French style patient choice
German levels of access to doctors and hospitals
US levels of hospital efficiency (in the best
performing organisations)
UK work on quality and safety
Chris Ham – CEO
Kings Fund England
10. www.leicspt.nhs.uk
Big challenges for the NHS
Bringing our outcomes up to the best: life
expectancy, infant mortality, cancer survival etc (this
includes addressing inequalities)
Tackling risk factors like obesity, smoking and
alcohol misuse to reduce the future disease burden
Rising to the challenge of chronic diseases through
support for self management, consistently good
primary care, and greater integration of care
…Likely to feature as key outcome areas
11. www.leicspt.nhs.uk
NHS as a real political priority for
investment circa $100B
“Reforms needed to be bold and
many and varied
Encompassing
- Targets
- Performance Management
- Regulation
- National policy
- National Licensing
- Innovation and change support
NHS – The Blair Years
3 priorities CANCER, HEART DISEASE, MENTAL HEALTH
12. www.leicspt.nhs.uk
Standards – National Service
Framework and accompanying
strategies
New Community Teams –
Assertive Outreach, Crisis
Resolution, Early Intervention
Reducing suicide – National
Strategy
Investment - $1.4 b
The National Institute for Mental
Health in England and the
Results …
1999 / 2000 … 2008 / 9
Contrast with Learning Disability
13. www.leicspt.nhs.uk
0
2
4
6
8
10
12
1993/4/5 1995/6/7 1997/8/9 1999/2000/1 2001/2/3 2003/4/5 2005/6/7 2007/8/9 2009/10/11
Suicide rate in England
Death rates from Intentional Self-harm and Injury of Undetermined Intent in England
1993-2007
Death rate per 100,000 population
Target:
20%
minimum
reduction
from
1995-97
baseline
rate
baseline Progress target
Source: ONS
9.2
7.3
7.8
Rates are calculated using the European Standard Population to take account of differences in age structure.
3 year average
Progress since baseline:
A fall of 15.2%
14. www.leicspt.nhs.uk
Number of new Mental Health Teams in place from 2001 to 2009
compared to target
0
50
100
150
200
250
300
350
400
Crisis resolution Assertive outreach Early intervention
Sept 2001
Sept 2002
Sept 2003
Sept 2004
Mar 2005
Jan 2006
Mar 2007
Mar-08
Mar-09
Target
NHS Plan Teams
Source: Service Mapping exercise
15. www.leicspt.nhs.uk
In the last throws of New Labour…?
New Horizons: the next phase of mental health policy
Key points:
• New Horizons sets out the Government’s vision for
improving mental well-being and improving adult
mental health services in England
• There are no new targets for public services or
commitments on future funding
• Public mental health initiatives include targeting
young people, tackling stigma and improving
employment and housing outcomes
• Mental health services need to improve quality and
efficiency, and focus on recovery
• Improving access for vulnerable and hard-to-reach
groups, such as veterans, is key
• Improving transitions and intervening early are
major themes
Currently being re-cast for Launch soon….
17. www.leicspt.nhs.uk
“Relative” protection for NHS finances
Dramatic changes to the commissioning system including new roles for local Government
working with General Practice/Primary Care…NEW OBLIGATIONS
www.capsticks.com
“Market” strengthening
A very different Department of Health “Arms length
management” of the NHS through an Independent Board
…and clinicians have influenced this
…ministers with years of shadowing the health portfolio
…and they have been talking to…?
Current position…the NHS has been
liberated…no one can find it….if found please
call 0800…
21. www.leicspt.nhs.uk
Reflections on the reform of the NHS- Lessons
for policy makers, managers and clinicians
Policy making in the opposition is often weak. – No master
plans
Politicians are inexperienced in leading large scale change
It takes time to deliver change
Things may get worse before they get better- the ‘J’ Curve
Improvement is rarely liner
Changes in Leadership may impede progress
Regulation and inspection are likely to become more important
– at least in the English system
Front line staff need to be fully engaged
Levers and incentives need to be balanced
22. www.leicspt.nhs.uk
“What the front line requires is a policy Framework
and goals, not hundreds of micro-announcements…
Now I realise that real ‘delivery’ is about the grind,
not just the grand. It’s the combination of often
small things that build over time, through individual
relationships and genuine expertise and hard work.”
Peter Hyman – School Teacher, North London and former head
of Tony Blair’s Strategic Communications Unit
23. www.leicspt.nhs.uk
Key Shift
Quality of services combined with productivity.
Focus on efficiency of £1.20 billion
Voice of Consumer/Personalisation
Input from Private Sector more real
Quality Accounts as well as Financial Accounts
measuring outcomes: Experience/Safety/Clinical
Strengthened Regulation
(public enquiry into Mid Staffs
24. www.leicspt.nhs.uk
• Specialist Commissioning of MH Services
• Risk for MH and Learning Disability
• Market Exit and Entry
• Need to get close to Consortia – GP “Commissioning”
• - The importance of Doctor to Doctor relationships
• Be Business like
• Clinical Leadership
Reflections on Future Commissioning
Challenges…DISCUSS!!
Thank you and let’s hope Manchester United
beat Blackburn this afternoon!
Editor's Notes
George Bush body – great what you can do with a computer.
Leadership significant – represented great hope for collective action on key social challenge.
Commissioners and services will be held to account for the level of their involvement in these programmes