Local leadership, new approaches: improving the health of local communities

In February 2015, Public Health England and the Local Government Association published a report on how local authorities and the health sector have worked together to improve the health of communities through prevention and early intervention.

An example of this coordination is highlighted in a case study on the new Integrated Wellbeing Service in Blackburn with Darwen. The service has been developed in a joint effort by the borough council and the local GP-led Clinical Commissioning Group (CCG). It combines CCG-funded projects concerning specific long-term conditions (e.g. COPD or stroke), together with public health-funded services (e.g. tobacco cessation, health trainers, community physical activity), as well as core council services to address employment, housing and financial issues. 

As Councillor Mohammed Khan, Chair of Blackburn with Darwen Health and Wellbeing Board, explains: “[L]ocally we have a lot of services that can improve health and wellbeing. But when you put ...

Addressing the continuum of maternal and newborn care in Ghana: implications for policy and practice

In Ghana, nearly 50% of under-five mortality in 2014 could be attributed to deaths during the first 28 days after birth. This article analyses the data across a mixed-methods study of the factors impacting maternal and neonatal care in northern Ghana. Resulting recommendations include the need to improving clinicians’ understanding of and sensitization to local traditional practices, the need for policies to better address quality of care and coordination of training efforts, and the need for comprehensive, integrated programmes that ensure continuity of care from pre-pregnancy through the post-partum period.

What do we mean when we talk about the Triple Aim? A systematic review of evolving definitions and adaptations of the framework at the health system level

Notwithstanding important contributions of the Triple Aim, uncristal enthusiasm regarding the implications of the framework may be leading to  inconsistent use, particularly when apploed at the health system level, which goes beyond he original positioning of the framework as a strategic organizing principle to guide improvement initiatives at the organizational or local community level. This article identified uses of the Triple Aim that extended beyond its original intention to focus on uses at the whole health system level, to assess convergence and divergence with the original definition. They also attempted to identify consistencies in the way the Triple Aim was adapted for different contexts and settings. 

A proposal to reform general practice and enable digital healthcare at scale

General practice has always been the foundation and gateway to the NHS. However the problems are mounting up: a stretched and increasingly burnt-out workforce, no systematic reporting or analysis of activity and demand, fragmentation with secondary care, and confusing and dated contracting and reimbursement mechanisms. The status quo is increasingly unacceptable to both patients and GPs. There is now a consensus that changes are needed, including to the small-scale independent contractor model, to ensure that primary care can thrive in the future.

Policy Exchange has set out a pragmatic proposal for reform. Addressing issues around integration, workforce, digital transformation and scaled provision, we argue that a new model of general practice is required to better meet the needs of patients and the taxpayer – so it feels increasingly at their service.