Submitted by Mike Birtwistle on 16-05-2012

Whoever becomes Lead for Domain 1 of the NHS Outcomes Framework will find themselves at the heart of political debates about the quality of the NHS as the next election approaches.  In the NHS Outcomes Framework, all domains are equal, but some are clearly more equal than others.  The reason for this is simple: the outcome measures in Domain 1 – preventing people from dying prematurely – are the easie

Submitted by Mike Birtwistle on 10-05-2012

It has been a tempestuous time for the NHS.  Reform, restructuring and delivering unprecedented levels of savings have sapped the energy of the health service and those leading it.  The summer of 2012 represents a turning point, as the reforms shift from legislation to implementation and the efficiency agenda moves from national action to local delivery.  Yet the Health and Social Care Act has now passed.   After one of the hardest fought and most con

Submitted by Mike Birtwistle on 10-05-2012

Following the passage of the Health and Social Care Act, the NHS Commissioning Board has been steadily putting flesh on the bones of how it will actually operate.  As I have written before

Submitted by Mike Birtwistle on 17-04-2012

Parliament spent countless hours debating the relationship between the Secretary of State and the NHS.  The result, enshrined in the Health and Social Care Act, is undoubtedly a radical shift, as we have discussed on this blog.  Yet, often in the NHS it is relationships – not rules – that actually determine how things do or don’t work.  So, despite the endless controversies about the respective duties and powers of the Secretary of State, clinical commissioning groups and the NHS Commissioning Board, how will relationships shape the impact of the Board?  There are four key relationship dynamics which will shape the character and culture of the Board – between the Chief Executive of the Board and the Secretary of State; between the Board and other national bodies; between the centre and localities; and between individual key players on the Board.

Submitted by Mike Birtwistle on 27-03-2012

At times he must have thought that he would never get to this point.   The Health and Social Care Bill will today become the Health and Social Care Act and its architect, Andrew Lansley, is still at the helm of the Department of Health.  At various times written off as a dead man walking, and briefed against by people in Number 10 and his Cabinet colleagues, the Secretary of State is still in post, secure in the knowledge that his ref

Submitted by Mike Birtwistle on 22-03-2012

Submitted by Mike Birtwistle on 20-03-2012

It’s all over, bar some (more) shouting.  The Health and Social Care Bill is nearly law but, after hundreds of hours of debate, thousands of amendments and countless controversies, what will it actually mean?  And how on earth did it ever get passed?

Submitted by Mike Birtwistle on 19-03-2012

Some academic historians – which I am by training, even if that training is increasingly forgotten in the fog of health geekery – will tell you that many apparently distinct wars are in actual fact a series of battles in a much longer campaign.  The underlying causes of conflict remain unresolved and so ongoing hostility is – with the benefit of hindsight – entirely predictable.  This argument has been made for the

Submitted by Mike Birtwistle on 13-03-2012

For politics watchers, Liberal Democrat Spring Conference is like a history show.  Constitutional manoeuvring, votes on what to vote on, amendments which completely change the meaning if not the substance of motions: this is Labour in the early 1980s all over again.

Submitted by Mike Birtwistle on 05-03-2012

One of the defining factors of the early years of the Coalition Government has been the scope and pace of public service reform.  David Cameron was apparently determined to avoid what he considers to be the wasted early years of the Blair administration, where large areas of public services were tinkered with, but little more.  There seems little danger that the same accusation will be levelled at the current Prime Minister.