How *does* the NHS get funded and work? The King’s Fund pulls it together for you.

Confused on how a CCG (clinical commissioning group) is funded? Mystified about the relationship between local authorities and the NHS? Updated last month, The King’s Fund’s handy organograms (US=org chart) explain the formal organization of the NHS, how it is funded by Parliament, and the relationships between entities. The slides are downloadable. There are also two six-minute videos that tackle how NHS and NHS England work. See this page also for links to content on local service design, governance, and regulation, plus NHS finances. How is the NHS structured?

What are the impacts of NHS CCGs forcing disabled and LTC patients into care homes? (UK)

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2014/04/Thomas.jpg” thumb_width=”150″ /]Care for elderly and disabled goes off the tracks again. A report in the Health Service Journal (subscription required), covered in an opinion piece in the Guardian, indicates that thousands of patients who are disabled and also those who require long-term care may be forcibly put into care homes (US=nursing homes) rather than being treated and maintained in home care. According to the HSJ, “Freedom of Information (FOI) requests from campaign group Disability United found that 37 NHS clinical commissioning groups (CCGs) in England were introducing rules about ongoing care that could force up to 13,000 people with health conditions into care homes.” CCGs due to NHS cuts have been setting limits on financing home care, between 10 and 40 percent above the care home option. In other words, where a care home is cheaper, the CCG will withdraw payment for home care, and unless the individual can self-pay or has an advocate who can organize a care plan, that person may be involuntarily moved.

The word ‘institutionalization’ deservedly strikes fear on both sides of the Atlantic as a recipe for patient decline, physical and verbal abuse, theft and generally bad care. It’s a blunderbuss solution to ‘bed-blocking’ which we discussed here [TTA 7 Sep 16]–the care plan becomes ‘move ’em out’. By going this way in policy, NHS England is going counter-trend, against more personalized care delivered in home settings, and setting an unfortunate trend for other countries like the US.

Outside the scope of the article, but in this Editor’s thoughts, is the knock-on effect it will have on the UK’s developers and providers of telehealth and telecare services/TECS designed to support home care. Many of these technologies are in a transition period to the greater capabilities (and freedom from land line) of digital from analogue care, which was discussed in TTA here. Cutting domestic demand may not only be critical not only to companies’ survival, but also to their expansion in the (now far more open to the UK) US market. Readers’ thoughts?

Conflicting telehealth signals – is the VA or E Riding of Yorkshire CCG on the money?

Can there be two greater contrasts than the recent decisions by the Dept of Veteran Affairs in the US (VA) to award a five year $28.8m telehealth contract to AMC Health and that of the E Riding of Yorkshire CCG to “axe” its telehealth service?

The sheer size of the VA deal makes every recent deal in Europe seem very small in comparison. AMC’s CEO said: “AMC Health’s outcomes-based approach to telehealth and ability to actively engage patients to proactively self-manage their chronic conditions perfectly aligns (more…)