Is bigger better? Lessons for large-scale general practice

"Traditional general practice is changing. Three-quarters of practices are now working collaboratively in larger-scale organisations – albeit with varying degrees of ambition. Policy-makers and practitioners have high hopes for these organisations and their potential to transform services both within primary care and beyond. But can we be confident that they can live up to these expectations? This research summary presents the key findings from a 15-month study of large-scale general practice organisations in England. It was informed by an extensive literature review, and combined national surveys with in-depth case studies of contrasting, largescale general practice organisations and analysis of 15 quality indicators."

Is bigger better? Lessons for large-scale general practice
R Rosen, S Kumpunen, N Curry, A Davies, L Pettigrew, L Kossarova
Nuffield Trust
July 2016

Read more here.

Sustainability of knowledge translation interventions in healthcare decision-making

"We found few studies focusing on the sustainability of KT interventions. Most of the included studies focused on patient-level outcomes and patient-level KT interventions. A future systematic review can be conducted of the RCTs to examine the impact of sustainable KT interventions on health outcomes."

Sustainability of knowledge translation interventions in healthcare decision-making: a scoping review
AC Tricco, et al.
Implementation Science, 2016, 11:55

Read  more here.

Financially, environmentally, and socially sustainable mental health services

This guide has been written by a group of experts in mental health and sustainability, in consultation with service users and patients, and strengthened by input from a local government and public health perspective. The content is primarily evidence-based but ideas deemed to be best practice by expert consensus have also been included. By the end of this guide, readers should:

• understand the concept of sustainability in mental health care, and how using
• this commissioning framework can create sustainable services
• be aware of the legislation relating to sustainability that the NHS is required
• to meet
• understand what sustainable commissioning looks like in practice
• understand how and why improving the sustainability of mental health interventions will contribute to achieving the aims of both the mental health, public health, NHS, and social care strategies, as well as improving quality and productivity
• be able to commission sustainable mental health services and interventions.

Guidance for commissioners of financially, environmentally, and socially sustainable mental health services
Joint Commissioning Panel for Mental Health, Centre for Sustainable Healthcare
October 2015

Read more here.

Tax and fiscal options for a sustainable UK health and social care system

"Our analysis suggests that there are challenging times ahead for health care across the UK. The NHS needs to embed and sustain rates of productivity improvement for the foreseeable future in a way that has hitherto proved difficult. Our analysis of the extra funding required would be sufficient to maintain the current service. It would not address known weaknesses in our health care system such as the lack of parity for mental health care."

Filling the gap: Tax and fiscal options for a sustainable UK health and social care system
A Roberts, S Thompson, A Charlesworth, B Gershlick, A Stirling
The Health Foundation
November 2015

Read more here.

Sustainable care pathways guidance

In 2015 the Coalition for Sustainable Pharmaceuticals and Medical Devices created an innovative set of guidance to allow users to consistently appraise environmental impacts of health care pathways.

The guidance has been developed to enable sustainability to be considered when designing new models of care, redesigning existing models or investigating the benefits of prevention.

Read more here.

Sustainable health system route map

"The Route Map is a framework for action to help organisations develop a sustainable health system. 
It will help you to coordinate and take action so your organisation can save money, resources, improve health and make changes future proof. The Route Map is the result of a ground-breaking collaboration between the health system and around 70 partners. The Route Map framework isn't set in stone and will evolve over time as we discuss what needs to be done at an individual or an organisational level to make the health system more sustainable."

Access the route map here.

Putting the consumer at the heart of UK healthcare

"The responsibility to allocate healthcare funding should be shifted from politicians and health sector bureaucrats to individual patients. Funding should closely follow patients, so that patients would allocate funding through the choices they made."

A patient approach: Putting the consumer at the heart of UK healthcare
K Niemietz
IEA Discussion Paper No. 64
Institute of Economic Affairs
August 2015

Read more here.

Rethinking the public health workforce

"The report highlights the ‘early adopters’ in the wider workforce. These are the occupations who are already engaged with the public’s health, are enthusiastic to do more and should be acknowledged for their part in prevention. Examples include Fire & Rescue Services, Health Trainers, Allied Health Professions (12 distinct professions who make up 6% of the NHS workforce), Community Pharmacy, and Housing Associations. These occupations equate to over three quarters of a million people."

Rethinking the public health workforce
Royal Society for Public Health
July 2015

Read more here.

Integrated population needs-based planning

"Planning techniques such as the one described here consider the impact of health care policies on service, workforce and expenditure requirements, bringing these together to avoid the roadblocks arising from health-free planning methods."

Improving the fiscal and political sustainability of health systems through integrated population needs-based planning: Seminar briefing 17
S Birch
Office of Health Economics
June 2015

Read more here (free registration is required).

Primary health care interventions for Indigenous people with chronic diseases

"Future interventions should consider the findings of this review as it provides an evidence base that contributes to the successful design, implementation and sustainability of chronic disease interventions in primary health care settings intended for Indigenous people."

Enablers and barriers to the implementation of primary health care interventions for Indigenous people with chronic diseases: a systematic review
O Gibson, et al.
Implementation Science, 2015, 10:71

Read more here.

Paths to sustainability for innovative delivery system programs

"We found widespread interest and activity in testing new care delivery models to improve health care quality and reduce costs in Massachusetts. However, the environment presents great uncertainty for the sustainability of these programs."

Paths to sustainability for innovative delivery system programs
PS Hussey, C Armstrong, EC Schneider
RAND Corporation
May 2015

Read more here.

Enabling local implementation of sustainable urgent and emergency care models

“Efforts should focus on building an effective community offer. This will require adequate investment to transform primary, community and social care – while ensuring that acute and emergency care remains sustainable.”

Rip off the sticking plaster now: Enabling the local implementation of sustainable urgent and emergency care models in 2015/16
NHS Confederation
April 2015

Read more here.

Building the foundations for improvement

"The report draws out some key lessons from the trusts’ improvement journeys which will be useful for organisations that are considering building improvement capability at scale. It also provides a useful checklist of points for organisations to consider before planning, designing and delivering an improvement capability building programme."

Building the foundations for improvement: How five UK trusts built quality improvement capability at scale within their organisations
B Jones, T Woodhead
February 2015

Read more here.

Examining new options and opportunities for providers of NHS care

"Organisational forms should develop to deliver the models of care which best suit local circumstances."

Examining new options and opportunities for providers of NHS care: The Dalton review
D Dalton
December 2014

Read more here.

Click here to read a summary from The Commissioning Elf.

Part of the National Elf Service

Addressing social, economic and environmental determinants of health

"Capacity building is an integral part of the projects analysed."

Addressing social, economic and environmental determinants of health and the health divide in the context of sustainable human development
UCL Institute of Health Equity
July 2014

Read more here.

Applying the NHS institute for innovation and improvement sustainability model to healthcare improvement

"This study indicates the sustainability model provides a potentially useful approach to measuring teams' views on the likelihood of sustainability and prompting action."

Making change last: applying the NHS institute for innovation and improvement sustainability model to healthcare improvement
C Doyle, C Howe, T Woodcock, R Myron, K Phekoo, C McNicholas, J Saffer, D Bell
Implementation Science, 2013, 8:127

Read more here.

A framework for assessing health system resilience in an economic crisis

"The purpose of this paper is to develop a framework for assessing the resilience of health systems in terms of how they have adjusted to economic crisis."

A framework for assessing health system resilience in an economic crisis: Ireland as a test case
S Thomas, C Keegan, S Barry, R Layte, M Jowett, C Normand
BMC Health Services Research, 2013, 13:450

Read more here.

Sustaining and spreading self-management support

"Changing the way healthcare is delivered so that patients are supported to more effectively manage their longterm condition is also hard – it involves redefining the role of professionals and patients and putting in place processes and infrastructure that support new ways of working."

Sustaining and spreading self-management support: lessons from Co-creating Health phase 2
Health Foundation
September 2013

Read more here.

2012-13 update on indicators of financial sustainability in the NHS

"This update focuses on the financial sustainability of the NHS trusts and foundation trusts that provide community, secondary and tertiary health services, and on the primary care trusts that commissioned those services up to the end of 2012-13."

2012-13 update on indicators of financial sustainability in the NHS
National Audit Office, Department of Health
July 2013

Read more here.

Putting innovation to work

"Better Care Faster believes that more effectively identifying and disseminating high-value breakthroughs in chronic disease management (CDM) offers one of the best hopes for our province to improve the quality and efficiency of our public health care system."

Putting innovation to work: improving chronic disease management and health system sustainability in Ontario
Better Care Faster Coalition
June 2013

Read more here.