My mission statement

The times we are working in now need a great deal of accelerated change and there must be no negotiating that down. So my mission statement for this part of my consultancy career is to be clear that there needs to be and will be a lot of change from the work that I do with individuals and organisations and if organisations don’t want that, then it is probably best to go somewhere else.

Read my statement in full »

To realise patient based value will require some investment – So where, in times of austerity, does that come from?

Filed Under (Creating public value, Health Improvement, Patient involvement, Public Health) by Paul on 11-05-2012

Having set out the general case for moving away from the old fashioned idea that value in health care can only be found by buying more medical staff, kit or drugs, I have suggested that investment in patient health literacy would increase the value they contribute to their own care. This would, as a consequence,  add value to the NHS as a whole and help change its resource base at this time of austerity. Read the rest of this entry »

What do commissioners have to buy to increase the health care value that could be created by patient co-production?

Filed Under (Creating public value, Health Improvement, Patient involvement, Self Management) by Paul on 10-05-2012

Why doesn’t it just happen anyway?

To rehearse the argument so far. Given that the percentage of GDP spent on the NHS will not rise very fast and the demand for health care will, those of us that want to save the NHS will have to help it find new sources of value to develop significantly more health care outcomes from the same resource. Read the rest of this entry »

Why self-management is only a part of the co-production of health care value.

Filed Under (Creating public value, Health Improvement, Patient involvement, Self Management) by Paul on 09-05-2012

The moral arguments in favour of greater self-care within the NHS have been around for some time. I have myself been involved in them for over 30 years. Therefore some of the counter arguments against co-produced health care have been trailed and discussed for some time. Read the rest of this entry »

‘Saving the NHS’ – by developing new value within it.Trying to bring many arguments together.

Filed Under (Creating public value, Patient involvement, Reform of the NHS, Self Management) by Paul on 08-05-2012

Last week I posted twice about the importance of working towards health ‘outcomes’ in the NHS. The first discussed the difference between inputs, outputs and outcomes; the second drew on the excellent work of the Richmond group of patient organisations in using outcome measurement in creating much more patient-centred healthcare. Read the rest of this entry »

Markets, business and the creation of innovative value for money health care for NHS patients.

Filed Under (Creating public value, Health Improvement, Innovation, Private Health Care) by Paul on 10-11-2011

A small story last Friday exemplified a much bigger issue. The story concerned the results of research from the University of Birmingham on how the effectiveness of different weight loss schemes. Read the rest of this entry »

Centralisation, grip and improving NHS efficiency

Filed Under (Creating public value, Expenditure, Health Policy, Reform of the NHS) by Paul on 06-07-2011

One of the outcomes of the Government’s June 2011 reform of its July 2010 NHS reforms has been the increased centralisation of Government control. As I will explore later in the week, the first set of reforms that was intended – in the heady days of July 2010 – to liberate the NHS and localise decision making is now set to provide much more national centralisation of commissioning than has ever previously existed. Read the rest of this entry »

Disruptive innovation and the NHS – better outcomes with less resource.

Filed Under (Creating public value, Culture of the NHS, Innovation) by Paul on 09-06-2011

Yesterday I spoke at a conference organised by Reform – the think tank that argues for better and faster reform of the NHS and other public services. It highlighted the ways in which different aspects of the NHS and other health services can make disruptive innovations to improve their outcomes for fewer resources. Of course much of the conference spoke about specific innovations that could both save money and improve outcomes. One of the most inspiring for me was an example from India which I quote at length below. Read the rest of this entry »

So what is the nasty party going to do to NICE?

Filed Under (Conservative party, Creating public value, GP Commissioning, NICE) by Paul on 04-11-2010

Monday’s post raised the issue of the future of NICE’s powers to say whether drugs were value for money for the NHS. Then I was unsure whether the issue had been floated by the Government to see what would happen – or if this was the announcement of a new policy.

On Tuesday in the House of Commons at Health Question Time the current Secretary of State clarified what he plans for NICE. Read the rest of this entry »

The NICE debate – some clarifications

Filed Under (Creating public value, GP Commissioning, NICE) by Paul on 03-11-2010

I have been asked to clarify my thinking on how I see the new system for deciding on value for money working once NICE has been removed from the system.

At the moment NICE decides on the cost effectiveness of drugs for the NHS based on  formulae about their cost in relation to the quality of life years that they provide. If a drug is expensive and provides a small amount of quality of life years then it is unlikely to be cost effective. Conversely if it is cheap and provides a lot then it will be.  This means that the NHS has a great interest in using drugs that are available at a price that provides good outcomes. Read the rest of this entry »

More thoughts on the nasty party abolishing NICE.

Filed Under (Creating public value, NICE) by Paul on 02-11-2010

Yesterday’s post laid out three different ways in which the story on NICE could go. There still hasn’t been a definitive statement from the Government, but the statement from the DH yesterday does lead us all to believe that they are going to abolish NICE’s duty to decide on drugs’ value for money. Read the rest of this entry »