In 2011, Primary Care Trusts faced a difficult choice. The Transforming Community Services policy required a complete break of commissioner and provider functions. But what should PCTs do with the community health services they delivered; vertically integrate with an acute trust, horizontally integrate with a mental health trust, or set up a stand-alone community trust or Community Interest Company? Seven years on, this report explores the impact this choice had on the level and growth in emergency hospital use in older people and considers the wider implications for the NHS as it develops new models of care and integrated care systems

Commissioned by NHS England, this report describes the the characteristics and levels of resource required by children and young people (CYP) (0-25 years) with life limiting conditions and/or life threatening conditions (LLC). The scope of this report does not attempt to explain or address the complexity of life threatening conditions and palliative end of life care for children and young people; it does however highlight a new and emerging population of significance for the NHS in England.

Dudley replaced the Quality and Outcomes Framework (QOF) with the Dudley Quality Outcomes for Health framework. This major change was accompanied by an evaluation. Phase 1 of the evaluation looked at uptake and acceptability. Phase 2 (contained in the report below) looked at the service economics of the change – for practices and the local care system more broadly

One of the core features of Dudley’s new care model is a change in relationship between professional and patient. In essence, and especially for patients with long-term conditions, there is a need to move away from a conversation based on the question of ‘what is the matter with you?’ to one based on consideration of ‘what matters to you? How can we achieve that?’. This change is not easy. It requires changes in both professional and patient behaviour. This presentation, given at a public engagement event, outlines some of the starting considerations implied by this.

As a concept, patient ‘activation’ holds promise; evidence suggests an enhanced ability to self-manage long-term conditions (LTCs) and an associated reduction of healthcare use. The Patient Activation Measure (PAM) has been promoted as a tool for measuring activation. It can also be used to structure conversations with patients who have LTCs. Dudley therefore piloted the use of the PAM, backed by health coaching, in one GP practice. This report presents the results of the evaluation.

There is wide consensus that the NHS needs to generate and act upon more patient reported data on outcomes and experience. These measures will also feature in Dudley MCP’s contract. A pilot to use these measures was therefore run in GP practices and evaluated. This report presents the results. It highlights the practical challenges associated with the generation of this data, showing the need for significant further efforts before this type of data becomes ‘mainstream’.

Dudley is one of fourteen vanguard sites nationally developing the Multispecialty Community Provider (MCP) care model. The MCP involves the implementation of new organisational relationships that are intended to result in new system dynamics, incentivising the actions that can improve population health over the long term. The patient is at the centre of the MCP model of care.

Dudley is one of fourteen vanguard sites nationally developing the Multispecialty Community Provider (MCP) care model. The MCP involves the implementation of new organisational relationships that are intended to result in new system dynamics, incentivising the actions that can improve population health over the long term. The patient is at the centre of the MCP model of care.

In order to help Dudley's Partnership Board track progress towards high level goals, this report presents a series of performance measures for Dudley. It presents changes over time and also examines measures of variation 

There is a clear moral case for supporting unpaid carers. They play an essential role in the lives of the people they care for; they often do so at a cost to their own wellbeing. 

But what is the economic case for supporting carers? And to what extent does the evidence base support this case? Where there are gaps in the evidence, how might they be filled?