The NHS – a social network?

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By Deborah Rozansky, OPM principal

Deborah RozanskyI realise it’s unusual to get excited about an academic article in a somewhat obscure scientific journal, but a recent piece of research about the evolution of cooperative behaviour caught my eye and got me thinking. (Please stick with me here!)

‘Cooperative behaviour cascades in human social networks,’ written by Fowler and Christakis in the Proceedings of the National Academy of Science, describes a set of laboratory experiments testing how people cooperate and behave towards each other while playing a series of public goods games. In these games individuals were asked to make contributions to a group; some of the experiments also included punishments. Continue reading →

Vital service for public sector mutuals re-launched

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By Phil Copestake, OPM’s head of communications.

Phil CopestakeFor some time now we’ve been writing on this blog and elsewhere about the importance for new public sector mutuals of knowledge sharing, peer support and joining up access to relevant expertise. Yesterday there was really good news on this front, with the Government’s re-launch of the Mutuals Information Service (MIS).

The MIS brings together information, advice and guidance, including a new website to support individuals and teams who are looking to begin the journey, a new national hotline, and – perhaps most significantly – potential access to funding for bespoke professional support (the long-promised £10m Mutuals Support Programme). Continue reading →

Putting social value at the heart of new public sector mutuals

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By Linda Jackson, OPM associate fellow.

Linda JacksonI recently attended a great event held by the Transition Institute to launch their publication on public service spin outs called, Towards a Social Value Ethos. The lively and challenging debate focused on the different things that need to happen in order to spin out public services into a different form of ownership. Whilst the paths, processes and duration of each transition are likely to vary from organisation to organisation, there are some commonalities that need to be in place for the journey to effectively take place. Continue reading →

Patient and public involvement is becoming clearer … except for the big bit

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By Robin Clarke, OPM fellow

Robin ClarkeAs the Health and Social Care Bill takes its final steps through Parliament its impact on patient and public involvement (PPI) is becoming clearer in some areas, but remains murky in one crucial area. Continue reading →

Challenges for clinical health leaders in changing times

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By Helen Brown, OPM principal

Helen BrownAs the NHS Alliance conference begins in Manchester, participants working in primary care and partner organisations will no doubt be keen to hear from leading practitioners, politicians and commentators. We can expect discussion to be wide-ranging, informative and occasionally impassioned as people debate the future health service and their roles within it. Continue reading →

Quality improvement and evaluation: we need a more collaborative approach

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By Shelley Dorrans, OPM fellow

Shelley DorransImproving care quality is a driving force for our healthcare system. Detailed evaluation of this activity is needed to fully understand what works, in what contexts, and why. Continue reading →

Integrating health and social care: from principle to practice

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By Ayesha Janjua, OPM fellow.

Ayesha JanjuaIntegration is a key part of the current health reforms; greater integration of health and social care features strongly in the Health and Social Care Bill. Last year’s health white paper argues that greater integration between these two spheres (and thus between the NHS and local authorities) will facilitate improved outcomes for service users and communities, contribute to efficient and sustainable services, enhance clinical leadership and support choice, control and self directed planning for individual service users, their carers and families.

That’s the theory, but how to make integration work in practice? OPM has recently been supporting local partners to think about integrated commissioning. This is linked to but different from integrated provision or service delivery – but in practice integrated commissioning is likely to naturally lead to integrated service delivery. Our work has thrown up some interesting lessons about how to get started and make integration sustainable. Continue reading →

From compliance to judgement: trusting more, controlling less

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By Sue Goss, OPM principal.

Sue GossLocal authorities – like many other public services – often struggle to move beyond the rhetoric when it comes to taking a common sense approach to managing risk. OPM’s recent work with the London Borough of Ealing provides an example of how turning the traditional ‘top down’ view of management upside down can help to identify practical steps to empower frontline staff.

Last week I was working with the Council’s Senior Leaders Forum – their top 80 or so managers – to think about the transition ‘From Compliance to Judgement’, or how a council like Ealing can shake off the sheer weight of bureaucracy and procedure that slows us down. The Munro Report has brought the issue back on the agenda – arguing that we have created compliance cultures that get in the way of good professional practice (Munro focused on children’s services, but the lessons hold across the piece). Ealing had a particularly good story to tell – about their ‘riot recovery’ work.

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New research suggests NHS does well by international comparison

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By Deborah Rozansky, OPM principal.

Deborah RozanskyThe findings from the Commonwealth Fund’s 2011 International Health Survey demonstrate yet again the falsity of the notion that the NHS provides poor quality care and costs too much. While our system obviously isn’t perfect, the overall picture does beg a handful of questions, not least of which: what are we really trying to fix with the current set of NHS reforms?

Released last week, the Fund’s survey results compared the care received by patients with complex needs (‘sicker adults’) in eleven countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the U.S.

Patients were questioned about their experiences accessing health services and specialist care; out-of-pocket costs; coordination of care across different settings; and communication and engagement by their doctors.

There is clearly a mis-match between how we view the NHS and the picture emerging from the Commonwealth Fund’s findings. When compared to other countries, the UK’s health system has distinct advantages. Continue reading →

Changes to the legal aid system must not endanger women

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By Diane Beddoes, OPM’s head of engagement.

Diane BeddoesAs the bill containing controversial changes to the legal aid system moves to the House of Lords for further scrutiny, one set of provisions in particular urgently requires a second look.

Earlier this month there was a debate in Parliament on amendments to access to legal aid for victims of domestic abuse, as part of the Legal Aid, Sentencing and Punishment of Offenders Bill. Under the bill only domestic violence victims who can prove ‘a high risk of violence’ will qualify for assistance. The BBC’s comment on the debate says that ‘[i]n practice, that is likely to require them to have reported the abuse to police’. Continue reading →