Vascular diseases include heart disease, strokes, diabetes and kidney disease. A universal risk assessment and management programme could significantly increase uptake of the preventative interventions, and offers a real opportunity to reduce health inequalities.
Published December 2008, 70 pages
The point of minimum financial risk is reached by placing between 20 per cent and 40 per cent of the inpatient budget into the risk pool. Allocating only five per cent of the budget to a risk pool requires a population base equivalent to the whole of England to achieve a one per cent tolerance on the risk pool. Moving 35 per cent of the practice based commissioning [PBC] inpatient budget into a primary care trust [PCT] held budget leads to between three per cent and eight per cent risk associated with the PCT retained budget for the largest and smallest PCTs in England respectively, i.e. only risk pools consisting of groups of PCTs are sufficiently large to mitigate financial risk.
British Journal of Health Care Management 2008; 14 (6): 240-245
Ask your local health librarian to get hold of this article
The financial risk associated with healthcare budgets is high. To operate within a financial tolerance of less than three per cent a PBC [practice based commissioning] group will need a population of greater than 50,000 (budget £15 million). The point of minimum financial risk is reached by placing all admissions costing more than £3,000 into a larger risk pool. A core of 47 HRGs [health resource groups] accounting for 30 per cent of the budget, are the only HRGs with sufficient volume for a PBC group to discern whether a statistically significant reduction in costs has been made.
British Journal of Health Care Management 2008; 14 (5): 199-204
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North West Specialised Commissioning Team (NHS Net Link)
Dying patients given greater choice to die at home at no extra cost to the NHS, King’s Fund report concludes
Integrated Drug Treatment System for Prisons (IDTS): allocations for 2008/09
Putting prevention first - vascular checks: risk assessment and management
This paper looks at the implications of GP practices commissioning mental health services, and the risks and benefits to the patients who use the services.
(Published November 2004, 8 pages)
Parsonage argues that payment by results represents both an opportunity and a threat for mental health commissioners. On the positive side, it offers PCTs the chance to exert more leverage in the system, for example in the planning and design of services and, where supply conditions permit, in promoting choice and contestability. On the downside, it requires them to manage more risks, particularly financial risks.
Primary Care Mental Health, 2005, vol. 3, no. 4, p. 271-273 (available via your local NHS Library)
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