Anna Dixon

• Msc Econ, PhD
• Chair Archbishops' Commission at Church of England

Dr Anna Dixon, Chief Executive at the Centre for Ageing Better, examines the issues around an ageing population, how we have reached this stage and offers potential solutions to the problems it presents. Her book, The Age of Ageing Better? turns the misleading and depressing narrative of burden and massive extra cost of people living longer on its...

‘The Age of Ageing Better?’ takes a radically different view of what our ageing society means. Anna turns the misleading and depressing narrative of burden and massive extra cost of people living longer on its head and shows how our society could thrive if we started thinking differently. This book shines a spotlight on how as a society we’re curre...

There are several advantages of Bevan’s design, such as progressive funding through taxation and equity of access regardless of income, that we must not lose sight of as we celebrate the NHS’s (National Health Service) 70th birthday. However, there remain historical fault-lines dividing health and social care. The challenge is how to preserve equit...

Clear policy objectives encourage primary care and general practice to address health inequalities. In this chapter, we explore the potential impact of the Quality and Outcomes Framework (QOF) on health inequalities in more detail and review the available evidence including analysis of the area-based differences in performance between practices in...

Background: To address the challenges of caring for a growing number of older people with a mix of both health problems and functional impairment, programmes in different countries have different approaches to integrating health and social service supports. Objective: The goal of this analysis is to identify important lessons for policy makers and...

Key messages n The management of care for people with long-term conditions should be proactive, holistic, preventive and patient-centred. This report describes a co-ordinated service delivery model – the 'house of care' – that incorporates learning from a number of sites in England that have been working to achieve these goals. n The house of care...

Public policy decisions often appear based on an assumption that providing more options, more information, and greater decision-making autonomy to consumers will produce better outcomes. We examine reasons why this "more-is-better" approach exists based on the psychological literature. Although better outcomes can result from informed consumer choi...

Objectives This study examines whether the information used to inform hospital choice, and the sources of that information, varies with patients’ socio-demographic characteristics. It also examines whether information used by patients to inform choice is associated with attending their local hospital.MethodsA survey of 1033 patients who were offere...

Key messages n Health resource allocation decisions-how much money clinical commissioning groups and local authorities get from the Department of Health, and on what basis-will soon come under increasing scrutiny as NHS funding slows, reforms are implemented, and local services are held more accountable. n While the principles behind and methods of...

Easy-to-use, concise and practical, and reflecting recent advances, this resource presents the most promising developments in practical public health, as well as maintaining essential summaries of core disciplines.

Reform of the National Health Service in England will increase power and responsibility for family doctors. They will have a larger role in planning and buying health care including control of substantial budgets. This article examines the likely implications of the proposed reforms for primary care, and in particularly for family doctors. This art...

Requires moving away from the usual solutions and applying the right remedies The experience of South London Healthcare NHS Trust highlights the inadequacies of existing approaches to dealing with failing healthcare providers.1 The trust, which was created from a merger between hospitals that had well known financial and quality challenges, had a...

To determine how levels of case finding differ between general practices in England by level of population socio-economic deprivation. Observational analysis of data from the Quality and Outcome Framework in England for 2005/06. It covered 8339 primary care practices. Reported prevalence and estimated prevalence for coronary heart disease, chronic...

This paper compares the introduction of policies to promote or strengthen patient choice in four Northern European countries - Denmark, England, the Netherlands and Sweden. The paper examines whether there has been convergence in choice policies across Northern Europe. Following Christopher Pollitt's suggestion, the paper distinguishes between rhet...

The challenges facing European health systems have changed little over 30 years but the responses to them have. Policy ideas that emerged in some countries spread to others; however, the way policies were implemented and the impact they have had has been shaped by specific national contexts. Comparative policy analysis has evolved in response to th...

To examine whether the Health System Reforms delivered the promise of being a coherent and mutually supporting reform programme; to identify the underlying programme theory of the reform programme; to reflect on whether lessons have been learned. Documentary analysis mapping the implicit and explicit programme theories about how the reforms intende...

Emergency hospital admissions for ambulatory care-sensitive conditions: identifying the potential for reductions DATA Briefing Summary • Ambulatory care-sensitive conditions (ACSCs) account for one in every six emergency hospital admissions in England. • The proportion of emergency admissions for ACSCs is larger in under-5s and over-75s. Children a...

To analyse how competition is experienced and characterized by NHS and independent sector acute care providers in the English National Health Service (NHS). Semi-structured interviews with 49 senior staff in 15 NHS trusts and independent sector providers between November 2008 and April 2009, in England. The market was predominantly defined based on...

This report presents the findings of research examining the impact of the QOF on preventable admissions, for example, appears modest. The QOF acts as a barrier to PCTs commissioning primary care that is focused on the health needs of the local population, and does not provide appropriate incentives for practices serving populations with complex nee...

The government set a series of targets to reduce health inequalities in England by 2010. Primary care has an important role in reducing health inequalities. The aim of the study was to assess the impact of general practice on reducing area-based health inequalities. Analysis of differences in achievement on clinical indicators between practices in...

The implementation of choice for patients over where and when they are seen by specialists in hospital outpatient clinics has been supported by electronic referral systems in England and the Netherlands. This paper compares the implementation of 'Choose and Book' in England and 'ZorgDomein' in a region of the Netherlands. For England the analysis d...

To map and describe the formal accountability relationships of foundation trusts in England and to explore the interpretations of these relationships by the key actors. Documentary analysis and interviews with chief executives, chairs, directors and governors in six acute trusts and two Strategic Health Authorities. Although vertical accountability...

To understand how the public understand comparative quality information as presented on NHS Choices, the Department of Health website in England. We explore what quality information people value, how they understand different measures of quality, and their preferences for different types of information. Seven focus groups were conducted. Participan...

There are clear policy objectives in England to encourage primary care and general practice to address health inequalities. In this paper we explore the potential impact of the Quality and Outcomes Framework (QOF) on health inequalities and review the available evidence including analysis of the area based differences in performance between practic...

Patient choice, particularly the choice of hospital, has been at the heart of health policy for a number of years. The aim of this policy is to create competition, which in turn drives improvements in quality; for this to work effectively, patients have to make their choices on the basis of clinical quality. Significant resources have been devoted...

: People with chronic conditions are better able to self-manage if they are more engaged, informed, and confident. Healthcare providers are increasingly offering support for self-management, and there is interest in improving the efficacy of these efforts by tailoring them to a person's knowledge, skill, and confidence to self-manage - so-called 'a...

The concept of medical savings accounts (MSAs), while apparently at odds with the underlying principles of the NHS (i.e. free at the point of need), has some parallels with the ideas behind personal budgets and direct payments. Both of these are used already in social care and are being piloted in the NHS in England (the latter subject to regulatio...

to explore health-care professionals' views about safety in maternity services. This paper identifies aspects of care that are less safe than they should be, possible ways to improve safety, and potential obstacles to achieving these improvements. This study was part of the King's Fund inquiry into the safety of maternity services in England. quali...

The Government has promised patients a choice of hospital when referred by their GP for treatment, and much time and money has been spent on implementation. But are patients being offered a choice of hospital, and if so, how are they choosing? This article presents findings from interviews with NHS patients about whether and how they chose a hospit...

Using panel data from two surveys of employees at one large employer from 2004 and 2005, this paper examines consumer-directed health plans' (CDHPs') influence on the use of health-related information and health services. We compare enrollees in a high-deductible CDHP, a lower-deductible CDHP, and a preferred provider organization (PPO). Enrollees...

To identify factors that explain patient satisfaction with general practice physicians and hence that may drive patients' choice of practice. Logistic regression analysis of English National Health Service national patient survey data is used to identify the aspects of general practice care that are associated with high levels of overall satisfacti...

Public policy discussions on how to regulate acupuncture and herbal medical practitioners have reached a stalemate in the United Kingdom. After considerable activity in the first half of the current decade a wider review of professional regulation has re-opened the discussion as to the most appropriate way to regulate the practice of all health-car...

While consumers are increasingly expected to use complex health care information to make informed decisions, it is unclear how many have the skills to do so. In this investigation we examine health literacy, numeracy, and patient activation, assessing the contribution of each to the comprehension of comparative health care performance reports and t...

Is the British National Health Service (NHS) equitable? This paper considers one part of the answer to this: the utilization of the NHS by different socioeconomic groups (SEGs). It reviews recent evidence from studies on NHS utilization as a whole based on household surveys (macro-studies) and from studies of the utilization of particular services...

Much effort has been put into improving measures of health care quality. Although early research suggested that consumers made little use of quality reports, most reports were based on nonstandardized measures and were not user friendly. Information presentation approaches, however, will have a significant influence on what information is attended...

Taking the cases of five complementary therapies in the United Kingdom, the study seeks to explain why some complementary medical practitioners are statutorily regulated while others remain unregulated. It also asks why regulation has taken the form that it has. The analytical framework used draws on sociology, economics and political science. The...

Consumer Directed Health Plans (CDHPs) are new and increasingly popular insurance products in the United States that aim to increase consumer involvement in health care decision-making. Using quantitative and qualitative methods, we examine characteristics of employees in a large firm that voluntarily enroll in CDHPs. We find salaried and hourly hi...

There are substantial inequities within the current National Health Service (NHS), with people in lower socioeconomic groups (SEGs) using a wide range of services less relative to their needs than people in higher SEGs. These inequities are likely to arise due to factors on both the demand and the supply side of the system. On the demand side, they...

This paper examines some policies to increase or restrict consumer choice in western European health systems as regards four decisions: choice between public and private insurance; choice of public insurance fund; choice of first contact care provider and choice of hospital. Choice between public and private insurance is limited and arose for histo...

Mental disorders account for a significant and growing proportion of the global burden of disease and yet remain a low priority for public financing in health systems globally. In many low-income countries, formal mental health services are paid for directly by patients out-of-pocket and in middle-income countries undergoing transition there has be...

General practice/family medicine has a central role in health care, helping to keep the focus on the needs of the patient. Both policy experts (Starfield, 1998) and official organizations (WONCA/WHO, 2002), support this view, believing that the balance in health care should shift from supply-driven development to needs and community-driven priority...

Human resources for health are key determinants of health system performance. They represent, however, the largest and most expensive input into health care and are particularly challenging to develop. This book examines some of the major problems facing health care professionals in Europe and the best solutions for dealing with these. The book ana...

Health systems in transition: learning from experience The period following the break-up of the Soviet Union has brought enormous political and socioeconomic change to the European Region. The health sector has not been spared the effects of transition, and the countries emerging from the process have each engaged to varying degrees in health syste...

This paper examines the reforms of health sector financing in Georgia using the conceptual framework by proposed by Kutzin 2001 [1]. The authors present the context and historical perspective about how the financing reforms evolved in Georgia and discuss the major reform policies as well as its achievements/failures. The conceptual framework and pr...

To summarize the international experience of medical savings accounts (MSAs), make a preliminary evaluation of the impact of MSAs, and assess their feasibility in other countries, particularly Central and Eastern Europe. A review of published literature in academic journals, books, Internet sources, and other "gray" literature. Most published studi...

Social health insurance systems in Europe are complex and this makes it difficult to establish who is paying for healthcare. France and Germany are seeking to widen their revenue base through taxation. A wholesale move to SHI in the UK would involve significant upheaval and it is not clear what benefits it would bring.

Adopting a cross-national, cross-disciplinary perspective, this title assesses the merits of the main methods of raising resources, including taxation; social, voluntary and supplemental forms of insurance; and self-pay including co-payments. It is for students of health policy and health economics, and for health managers and policy makers.

The increased availability of genetic tests poses new challenges to society. Here, we address the wider implications of genetic testing, with an emphasis on the markets for insurance. It also considers issues such as confidentiality, patient autonomy and fear of discrimination and the doctor-patient relationship.

The Portuguese healthcare system has been in a state of continuous change since the political revolution of 1974, which brought about a constitutional commitment to a universal and comprehensive national health service. Despite much legislative activity, only partial implementation of these laws has taken place and the current system requires furth...

Key points n The Quality and Outcomes Framework (QOF) has incentivised general practices to have a more organised approach to chronic disease management, and provides a strong incentive to engage in secondary prevention. However, it has not given general practices incentives to undertake primary prevention and public health activities. n GPs have n...