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A Perspective from England

A Perspective from England. Professor Chris Ham Chief Executive The King’s Fund 15 May 2014. Commonwealth Fund International Ranking. Note: * Estimate. Expenditures shown in $US PPP (purchasing power parity).

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A Perspective from England

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  1. A Perspective from England Professor Chris Ham Chief Executive The King’s Fund 15 May 2014

  2. Commonwealth Fund International Ranking Note: * Estimate. Expenditures shown in $US PPP (purchasing power parity). Source: Calculated by The Commonwealth Fund based on 2007 International Health Policy Survey; 2008 International Health Policy Survey of Sicker Adults; 2009 International Health Policy Survey of Primary Care Physicians; Commonwealth Fund Commission on a High Performance Health System National Scorecard; and Organization for Economic Cooperation and Development, OECD Health Data, 2009 (Paris: OECD, Nov. 2009).

  3. Three main approaches to NHS reform • Targets and performance management • Inspection and regulation • Competition and choice • Plus substantial investment from 2000-10

  4. The King’s Fund View • Complementary approaches are needed • Top down and bottom up • Working through hierarchies and networks • Collaborating and competing • Innovating and standardising • The transformation of the VA from 1995-1999 as a case study

  5. Implications? • Complementary approaches are very demanding of system stewards and organisational leaders • System stewards in the UK and Canada are inexperienced in steering large systems • Politics and policy usually work on quite different cycles • Organisational leaders need time and persistence to achieve sustainable performance improvement • Building leadership capabilities and skills in quality improvement are often neglected

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