Friday 15 August 2014

Can CCGs become accountable care organisations?

Can CCGs become accountable care organisations? 'We need clinical commissioning groups to become accountable care organisations' – that’s what Jeremy Hunt said recently in parliament and during a speech at the Commissioning Show.

Jeremy Hunt is not the only one saying this kind of thing. I’ve heard representatives from acute hospitals, GP federations and CCGs all make the same claim: they want to become an accountable care organisation (ACO).

But what does this really mean? The basic concept of an ACO is that a group of providers agrees to take responsibility for all care for a given population for a defined period of time under a contractual arrangement with a commissioner.

Essentially accountable care organisations, which have emerged from the United States over the past few years, are the next generation of managed care, but with a fundamental difference. While managed care initiatives in the 1980s and 1990s handed over a capitated contract to a network of providers to manage a defined population, they were not accountable for improving care, or even delivering care (networks quickly realised they could save money by restricting access). Learning from the scars of this legacy, these more recent managed care initiatives have included a stipulation to improve quality.

Research and analysis: Review of radiation dose issues from the use of CT in the UK

Research and analysis: Review of radiation dose issues from the use of CT in the UK In this report, COMARE presents a comprehensive review of the radiation dose issues associated with CT scans in the UK. The implications of the increase in the numbers of CT scans in the UK are considered in the report, with focus on the number of younger patients undergoing CT scans, who have greater sensitivity to x-rays. The report provides an update on the radiation protection aspects of justification (balancing risk and benefit) and optimisation (balancing the risk from the radiation dose with the quality of the image). Department of Health

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Prostate drug ruling 'a fiasco'

The front line of the UK's Ebola prevention efforts

The front line of the UK's Ebola prevention efforts Hugh Pym on how Porton Down is helping the UK get ready. BBC News

Failing GPs: A Pandora's Box?

Is UK obesity fuelling an increase in 10 cancers?

Is UK obesity fuelling an increase in 10 cancers? “Being overweight and obese puts people at greater risk of developing 10 of the most common cancers,” reports BBC News.

The news is based on research using information in UK GP records for more than 5 million people, to see whether body mass index (BMI) was associated with 22 types of common cancers.

The researchers found that increasing BMI was associated with increased risk of several types of cancer. Some of these associations weren’t linear, meaning that there wasn’t always a steady increase in cancer risk with increased BMI. Additionally, some of the links seemed to be dependent on individual patient characteristics, such as gender and menopausal status.

The researchers estimated that 41% of uterine and 10% or more of gallbladder, kidney, liver and colon cancers could be attributable to excess weight.

However, increasing BMI was also found to decrease the risk of some types of cancer (such as prostate and premenopausal breast cancer).

The researchers suggest that BMI affects cancer risk through a number of different processes. However, the study was not able to demonstrate that being overweight or obese directly increase or decrease risk of these cancers, nor is it able to show the biological reasons for any of the associations found.

It is also not able to account for all possible factors that contribute to cancer risk, such as genetics and lifestyle factors.

Cancer patients: best and worst places to live for survival revealed

Cancer patients: best and worst places to live for survival revealed Up to 6,000 patients could be dying of cancer early because of variations in care around the country, charity warns. The Daily Telegraph

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900,000 elderly needing care left to fend for themselves

900,000 elderly needing care left to fend for themselves Age UK estimates that one in three older people in England and Wales who struggle with tasks as basic as washing and dressing get no care. The Daily Telegraph

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NHS faces huge bill over private provider’s botched eye operations

NHS faces huge bill over private provider’s botched eye operations Dozens of NHS patients have been left with damage to their eyes, including partial loss of sight, after undergoing routine cataract operations which had been outsourced to a private provider. The Independent

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