The Department of Health has reported that the NHS achieved £5.8 billion of savings in 2011-12, virtually all of the forecast total of £5.9 billion. Most of the savings were generated through the pay freeze for public sector staff, and reductions in the prices primary care trusts pay for healthcare. NHS bodies also made savings by cutting back-office costs. However, there is limited assurance that all the reported savings were achieved. The NAO substantiated a total of £3.4 billion of NHS efficiency savings. Although the savings made by NHS providers as a percentage of operating costs are increasing, it is not clear what level of savings is sustainable over time. Changes to transform services take time to implement and the Department has always expected that these savings will predominantly come in the latter half of the four-year period. The NHS is seeking to maintain the quality of, and access to, healthcare at the same time as making efficiency savings. In 2011-12, the NHS performed well against headline indicators of quality, including waiting times and healthcare associated infection rates. The indicators focus mainly on hospital care and the Department faces a significant challenge in monitoring quality across the NHS as a whole. The Department does not know whether the demand for healthcare is being managed in ways that inappropriately restrict patients' access to care. Reducing demand and redesigning care pathways to treat patients in the most appropriate setting are key ways of generating savings

The New Politics of the NHS has become established over 30 years as the key overview of the NHS, its processes and paths of influence. The seventh edition remains a clear, easy-to-read guide to often complex debates. It encompasses both the background of the evolution of the NHS since its foundation, and a completely up-to-date picture of its prese

The fact that there is another bill going through Parliament changing the management structure of the NHS means that there is a tendency for every comment about the NHS to be framed by the debate about the bill. But the NHS is well used to management change. In reality the key pressures which are building in the system arise from the fact that demand is continuing to grow at a time when health and social care budgets have stopped growing. This development has been well signposted. The implications were first highlighted by Sir David Nicholson in May 2009, and endorsed by both the previous government and the Coalition. This report is a review of progress within the health and care system towards meeting the 'Nicholson challenge'. The NHS funding challenge can only be met by rethinking and redesigning the way health services are delivered now, in order to deliver lasting long term benefits. The Committee's December 2010 report (HC 512, session 2010-11, ISBN 9780215555601) on health expenditure already expressed concerns then about the ability of the health service and local authorities to make the demanding efficiency gains required of them by the 2010 Spending Review, while maintaining quality of care. Both the NHS and local authorities are struggling to meet current targets in a sustainable, long-term manner that will maintain high quality, efficient care in the future. The need to provide high-quality and efficient services that meet local needs within the funding available must be addressed as a matter of urgency

On cover and title page: House, committees of the whole House, general committees and select committees. On title page: Returns to orders of the House of Commons dated 14 May 2013 (the Chairman of Ways and Means)

The new edition of this landmark international work builds on the previous two volumes, offering a window onto occupational therapy practice, theory and ideas in different cultures and geographies. It emphasizes the importance of critically deconstructing and engaging with the broader context of occupation, particularly around how occupational injustices are shaped through political, economic and historical factors. Centering on the wider social and political aspects of occupation and occupation-based practices, this textbook aims to inspire occupational therapy students and practitioners to include transformational elements into their practice. It also illustrates how occupational therapists from all over the world can affect positive changes by engaging with political and historical contexts. Divided into six sections, the new edition begins by analyzing the key concepts outlined throughout, along with an overview on the importance and practicalities of monitoring and evaluation in community projects. Section Two explores occupation and justice emphasizing that issues of occupational injustice are present everywhere, in different forms: from clinical settings to community-based rehabilitation. Section Three covers the enactment of different Occupational Therapies with a focus on the multiplicity of occupational therapy from the intimately personal to the broadly political. Section Four engages with the broader context of occupational therapy from the political to the financial. The chapters in this section highlight the recent financial crisis and the impact it has had on people's everyday life. Section Five collects a range of different approaches to working to enable a notion of occupational justice. Featuring chapters from across the globe, Section Six concludes by highlighting the importance and diversity of educational practices. - Comprehensively covers occupational therapy theory, methodology and practice examples related to working with underserved and neglected populations - Gives a truly global overview with contributions from over 100 international leading experts in the field and across a range of geographical, political and linguistic contexts - Demonstrates how occupational injustices are shaped through political, economic and historical factors - Advocates participatory approaches which work for those who experience inequalities - Includes a complete set of new chapters - Explores neoliberalism and financial contexts, and their impact on occupation - Examines the concept of disability - Discusses theoretical and practical approaches to occupational justice

Equity and Excellence : Liberating the NHS: Presented to Parliament by the Secretary of State for Health by Command of Her Majesty

This report states that the values of the NHS will only be reflected in practice if NHS and social care services are 're-imagined'. The care provided by the health and social care system will break down if quicker progress is not made to develop more integrated health and social care services which focus on meeting the needs of individual patients. It is unlikely that public expenditure on health and social care services will increase significantly in the foreseeable future. This means that the only way to sustain or improve present service levels in the NHS will be to focus on a transformation of care through genuine and sustained service integration. There must be a much more joined up approach to commissioning health and care services. On other issues the Health Committee also concludes: measures currently being used to respond to the Nicholson Challenge too often represent short-term fixes rather than the sustainable long-term service transformations; changes in tariff payments within the NHS do not constitute ’efficiency savings' - they are simply internal transfers; under-spending against budget of money allocated to the NHS has attracted adverse comment and the MPs call for a general review of the operation of Treasury rules; the NHS will not be able to rely on the present rate of paybill savings once the present restraints on public sector pay are relaxed in April 2013