This paper outlines priorities for commissioners in the NHS, with a view to changes to the healthcare system from April 2013.
“The ageing population and increased prevalence of chronic diseases require a strong re-orientation away from the current emphasis on acute and episodic care towards prevention, self-care, more consistent standards of primary care, and care that is well-coordinated and integrated. This paper is designed to support commissioners to meet these challenges by transforming the health care system”. (p.2)
The authors set ten priorities for commissioners to achieve the changes needed. They are:
- Active support for self-management.
- Primary prevention.
- Secondary prevention.
- Managing ambulatory care-sensitive conditions (ACS). Ambulatory care-sensitive conditions are chronic conditions for which it is possible to prevent or reduce the need for hospital admissions by active management.
- Developing a more integrated response to improve the management of patients with mental and physical health needs.
- Care coordination through integrated health and social care teams.
- Improving primary care management of end-of-life care.
- Medicines management: to support better and more cost-effective prescribing in primary care, helping patients to manage medications, and reducing medication errors.
- Managing elective (planned) hospital activity by reviewing and auditing referrals.
- Developing an integrated approach to urgent and emergency care. Reducing emergency admissions to hospital is likely to involve hospital, community, primary and ambulance services, coordinated by means of improved joint service planning and better sharing of clinical information across different agencies.
A table is supplied which maps each of the above priorities to indicate their likely relative impact versus their ease of implementation.
This paper was published in March 2011 initially but has been updated to reflect NHS reforms.
Naylor, C. Imison, C. [and] Addicott, R. [et al] (2013). Transforming our health care system: ten priorities for commissioners London: King’s Fund, April 2013.
[A brief reference to this item features in Dementia and Elderly Care: the Latest Evidence Newsletter (RWNHST), Volume 3 Issue 7, May 2013].