The NHS Explained: how the health system in England really ...

[Pages:13]The NHS Explained: how the health system in England really works

Week two: reading list

Funding and finance

NHS expenditure House of Commons Library What have been the trends in NHS funding since its inception in 1948? This briefing explores the history of NHS funding and how it has been financed.

Health expenditure in England and the UK: social indicators page House of Commons Library This briefing brings together key statistics and figures on health spending in England and the UK.

How is the NHS funded? Full Fact Explore the data and facts on how the NHS in England is funded.

UK health spending Institute of Fiscal Studies This briefing note analyses how UK public spending on health has changed over time, and both the short- and long-run pressures faced by the health service.

The NHS budget and how it has changed

The King's Fund Explore the data on the Department of Health and Social Care's budget and how it has changed over time.

What's happening to NHS spending? Institute of Fiscal Studies This video looks at what is happening to spending in the NHS in England.

Is ?84 billion being spent on the NHS? Full Fact Explore the facts behind the UK government's announcement of an ?84 billion real-terms increase in funding for the NHS.

The reality behind the 2019-24 NHS funding settlement NHS Confederation The infographic outlines the financial challenge facing the NHS over the next five years. It also looks at why the NHS deficit has developed, despite considerable efficiency savings delivered by both service providers and commissioners.

The NHS funding settlement: recovering lost ground NHS Providers Following the announcement of the NHS funding settlement, this report looks at the likely costs of getting the NHS back on track.

The NHS funding settlement: is it enough and how should it be spent? British Medical Association This report gives the view from the doctors' trade union and professional body on the NHS funding settlement and how it should be spent.

How health care is funded The King's Fund The way that health care is funded varies between different countries. This briefing explains the main models used to finance health care: taxation, private health insurance and social health insurance.

Making money work in the health and care system PricewaterhouseCooper This report explores how financial flows could be redesigned to find a better way to make money work in the health and care system. It sets out why change is necessary and

proposes a number of radical financial reforms so that benefits to patients are maximised and resources are put to their most effective use.

How to fix the funding of health and social care Institute for Government This report calls for a parliamentary inquiry into how to raise money for health and social care both now and in the future. It dismisses the idea of a `Brexit dividend' and argues that unless the government identifies a clear way to raise the additional money it will have to come from cuts to other parts of public expenditure.

13 reasons for (and some against) spending more on the NHS Nuffield Trust What are the arguments for and against increasing NHS funding in England?

Hypothecated funding for health and social care: how might it work? The King's Fund Hypothecation is the earmarking of a tax to be spent on a specific area of public expenditure and it is increasingly being discussed as a potential way in which NHS funding might be increased. This paper explores the pros and cons of a hypothecated approach and provides a brief history of hypothecation in the UK.

Does the NHS need more money and how could we pay for it? The King's Fund, Nuffield Trust and the Health Foundation The UK government spends ?150 billion every year on health. Even after taking account of inflation, this spending is twice what we spent less than 20 years ago at the start of the 2000s. But might the NHS still require more funding and, if it does, how could we find more money?

Spending on public health The King's Fund What have been the trends on spending in public health in local councils since 2013/14? Find out more and explore the data in this explainer.

Adult social care spending The King's Fund What has been the direction of travel on adult social care spending in England over the last decade?

Commissioning and decision-making

What is commissioning? NHS England Explore what commissioning is and who does it in the English NHS.

NHS funding allocations: clinical commissioning groups House of Commons Library This briefing and spreadsheet outlines the data on the funding allocated to each CCG in England from 2013/14 to 2020/21. It also gives details of the process used to calculate and decide the funding levels for each CCG.

What is commissioning and how is it changing? The King's Fund Commissioning is the process by which health and care services are planned, purchased and monitored. This explainer looks at the commissioning process in more detail, the organisations involved and how it is changing.

Understanding the new commissioning system in England: contexts, mechanisms and outcomes Policy Research Unit in Commissioning and the Healthcare System (PRUComm) In order to investigate the impact of the 2012 reforms on commissioning, PRUComm undertook a three year study to explore how the new commissioning system was functioning. This research aimed to assess the impact of the reforms on the operation and outcomes of the commissioning system.

Investigating recent developments in the commissioning system Policy Research Unit in Commissioning and the Healthcare System (PRUComm) 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.

A review of the role and costs of clinical commissioning groups (CCGs) National Audit Office This review sets out changes to the commissioning landscape before CCGs were established; the role, running costs and performance of CCGs; and the changing commissioning landscape and the future role of CCGs.

About primary care co-commissioning NHS England Primary care co-commissioning is a move towards a greater number of CCGs being involved in commissioning GP services, sometimes in partnership with NHS England. Find out more about this model of commissioning and the benefits of it.

Co-commissioning: a new relationship between GPs and their CCG The King's Fund blog How will the move towards co-commissioning change the relationship between GPs and CCGs? This blog explores the opportunities presented by co-commissioning and GP attitudes towards this model of commissioning.

Understanding primary care co-commissioning: uptake, development, and impacts Policy Research Unit in Commissioning and the Healthcare System (PRUComm) This report is part of a series from a project exploring the development of CCGs in England. It looks at how CCGs are developing and their experiences in relation to their uptake of primary care co-commissioning responsibilities.

The commissioning of specialised services in the NHS National Audit Office This report assesses whether NHS England is delivering value for money from its commissioning of specialised services.

Rationing in the NHS Nuffield Trust This briefing provides an overview of the current difficulties in making decisions about rationing healthcare in England.

Six ways in which NHS financial pressures can affect patient care The King's Fund How have the NHS funding pressures affected patients' access to care? This article examines the six ways in which access to care can be affected and limited.

NHS internal market

No-one knows the exact cost or benefit of the NHS internal market in England Full Fact Explore the facts and data behind the claim that the NHS internal market costs around ?10 billion a year.

Understanding New Labour's market reforms of the English NHS The King's Fund Over 20 years on from New Labour's NHS reforms, what does the evidence tell us about the successes and lessons we need to take from the market-led changes?

The impact of the NHS market: an overview of the literature Civitas NHS `internal' or `quasi' market policies in England have aimed to promote competition among providers in the hope of replicating the benefits markets have been known to bring about in the private sector: decreases in cost, and increases in efficiency, quality, innovation, and provider responsiveness. This briefing presents the results of a large-scale literature search on the effectiveness of these policies over the past 20 years.

Competition in health care Health Foundation This evidence scan summarises empirical research about improving quality using a competitive market, the system features needed for competition to work most effectively and any unintended or negative consequences.

Competition and quality: evidence from the NHS internal market 1991-1999 Centre for Market and Public Organisation, University of Bristol What has been the effect of the internal market on quality of care? This paper looks at data on heart attacks during the market reforms to investigate the relationship between competition and quality.

Privatisation

Is the NHS being privatised? The King's Fund The involvement of the private sector in the NHS is a hotly contested topic. Private companies have always played a role in the NHS, but critics claim that their increasing involvement is evidence of growing privatisation of care and is undermining the service's core values. Explore the evidence behind privatisation in this briefing.

How much more is the NHS spending on private providers? Full Fact Fact-checking the claims on the rise in NHS spending on private providers in England.

The role of the independent sector in the NHS: busting the myths NHS Confederation Throughout its history, the health service has relied on independent and voluntary organisations to provide care and support the NHS in a host of different ways. This infographic takes a look at the independent sector and dispels four myths on its role in the NHS.

Evolution, revolution or confusion? Competition and privatisation in the NHS Health Foundation The precise role of private sector organisations providing NHS-funded care is a dividing line for the political parties. This briefing considers key questions relating to the role of competition and the role of non-NHS providers within the NHS.

Privatisation and independent sector provision in the NHS British Medical Association This report explores the data on spending on private and independent sector services in the NHS.

Out of contract: time to move on from the `love in' with outsourcing and PFI The Smith Institute How effective has the move towards outsourcing and PFI in public services been? This report explores whether it has delivered savings and improvements and what the costs have been.

Empty promises: the impact of outsourcing on the delivery of NHS services UNISON This independent report, carried out by the University of Greenwich, examines the impact of outsourcing on patient care.

FactCheck: will a Trump trade deal leader to the privatisation of the NHS? Channel 4 News Following recent statements by the US Government on the place of the NHS in a US-UK trade deal, what is the evidence behind concerns around the privatisation of the NHS?

Making sense of PFI Nuffield Trust Why is everybody talking about the private finance initiative (PFI)? Is it really costing the NHS lots of money?

What is the NHS paying for private finance initiatives? Full Fact Fact-checking the claims behind NHS PFI debts.

Workforce

The NHS workforce in numbers Nuffield Trust Find out more facts around the NHS workforce and staff shortages in the NHS in England.

NHS staffing numbers The King's Fund Explore the data on trends in the NHS workforce in England in this explainer.

NHS workforce statistics NHS Digital Data on the NHS workforce in England is collected centrally and made publicly available by NHS Digital. Explore the data on their website.

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