Health Service Journal
John Appleby
John Appleby is chief economist at The King's Fund.
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John Appleby on risking failure
23-Feb-2012
In his book Adapt: Why success always starts with failure, Tim Harford retells a moving and excellent story about Archie Cochrane’s efforts to conduct a clinical trial in a German internment camp. -
Taking up the Dorrell challenge? It's the money, stupid
23-Feb-2012
There remains a worry that the government’s efficiency drive is still focused on short term savings that may not ultimately deliver the benefits to patients it claims, writes King’s Fund chief economist John Appleby. -
An NHS ice age may have only just begun
1-Jun-2011
Despite positive financial projections for the NHS after the current spending review period ends, the harsh reality is that the funding cold spell could continue beyond 2015 if the economy does not recover as hoped, suggests King’s Fund chief economist John Appleby. -
Waiting times tracker: analysis of seasonal effects
20-Dec-2010
An important issue in understanding trends in waiting times - and what may be influencing changes since June - is seasonal variations. -
'What will a real increase in the NHS budget actually mean?'
20-Oct-2010
The 2010 spending review has announced a real rise each year for NHS funding to 2014-15. However, other spending departments now face a horror show of real cuts in their budgets. -
Why NICE values some patients' lives more
5-Feb-2009
Mike Richards’ review of what to do about top-ups seems to reaffirm the line that the NHS should not subsidise private consumption of healthcare. -
NHS parallels with the finance markets
9-Oct-2008
As JM Keynes observed, if you owe the bank £100 you have a problem. But if you owe £1m, the bank has a problem. -
Scottish approach to healthcare is not paying off
24-Jul-2008
At the British Medical Association’s annual conference this month, chair Hamish Meldrum put in a plea for England to emulate Scotland’s anti-market approach -
A glance towards the next 60 years of the NHS
3-Jul-2008
Looking back over the past 60 years reminds us of some familiar debates in the NHS: concerns about financial sustainability, wastefulness, and rationing of resources are all familiar issues today. -
Maternity services at 60: the birth of a new era
5-Jun-2008
For pregnant women, the birth of the NHS meant the family doctor’s advice could be sought freely without incurring expense, according to the 1949 Ministry of Health report. -
Costs and benefits of new policies
29-May-2008
The systematic evaluation of costs and benefits of health technologies by the National Institute for Health and Clinical Excellence is one of the success stories of the NHS over the past 10 years. -
First of the PROMs
1-May-2008
If you are a primary care or acute trust (or an independent provider of NHS-purchased care), are you planning for one of the most significant breakthroughs in NHS quality measurement? -
Waiting times are just so... 1950s
10-Apr-2008
As waiting times hit an all-time low in the NHS, anecdotal evidence suggests a need to revise the view that waiting continues to be a substitute for prices as a rationing mechanism. -
1948: creation of a new workforce
13-Mar-2008
In 1948 the NHS opened its collective doors to be faced not only with an inherited waiting list of around half a million patients and a clamour for spectacles and false teeth, but also an almost immediate staff shortage. -
How to spend less while doing more
28-Feb-2008
New national reference costs data shows that in 2006-07 the NHS in England spent less cash on inpatient, day case and emergency care than in 2005-06. Scroll down to view the charts at the end of the story. -
Why NHS budgets have always been a bugbear
14-Feb-2008
Setting the first NHS budget in 1948 was no easy task. The Beveridge report, the 1942 blueprint for the welfare state, suggested £130m. -
60 years of eating and smoking
11-Jan-2008
It was in the 'ninth year of austerity' - with the end of full rationing still six years away - that the NHS came into existence on 5 July 1948. The chief medical officer, reporting on the state of the public's health, declared the NHS had begun 'its colossal task' amid 'economic adversity' - though he said the British people were coping with 'their usual good-tempered grumbling'. -
First wave ISTCs: what do we know?
6-Dec-2007
Four years after the first wave of independent sector treatment centres, the Department of Health has provided data on their performance. Unfortunately, this is almost useless in answering questions about their impact on waiting times. -
Is Darzi wrong about GP access?
1-Nov-2007
Everyone has a personal anecdote about their experience of the NHS, from the wonderful nurse to the obstructive receptionist or insensitive consultant delivering bad news. The problem is such stories are just one-off experiences - so how satisfied are patients overall across the millions of patient contacts in the NHS each year and what are they really dissatisfied with? -
Is Darling's spending review a good deal for the NHS?
18-Oct-2007
At first glance, the NHS appears to have done well from chancellor Alistair Darling's comprehensive spending review, but a closer look suggests it falls short of Sir Derek Wanless's recommendations and on the future costs of adult social care, argues John Appleby -
Recalling the offer of choice
20-Sep-2007
The government revealed the results of its£11million GP access survey last month and promised ‘immediate action’ to rectify the areas of underperformance, particularly the poorer access reported by patients in poorer areas; ‘improvement teams’ are being dispatched. -
The NICE threshold
20-Sep-2007
How costly or cheap, relative to its benefits, does a healthcare technology have to be to justify its rejection or acceptance by the National Institute for Health and Clinical Excellence? -
Data Briefing: Did the extra money go on new staff?
1-Jan-2007
A new analysis of the reason for and distribution of NHS deficits published by the Department of Health, Explaining NHS Deficits, contains an interesting analysis of what the extra funding from 2000-04 was spent on. The answer, apparently, is that nearly 80 per cent was consumed by the costs of employing extra staff. -
Data briefing: Scottish tariffs
1-Jan-2007
Following publication last year of Professor David Kerr?s Building a Health Service Fit for the Future, a Wanless-style review of Scottish health services, the NHS in Scotland is now implementing Delivering for Health reforms, which includes a new system of paying hospitals. -
Patient charges
1-Dec-2005
DATA BRIEFING -
Public health
20-Oct-2005
Published: 20/10/2005 Volume 115 No. 5978 Page 21 -
Resource allocation
22-Sep-2005
DATA BRIEFING -
Mental health funding
4-Aug-2005
DATA BRIEFING -
Using statistics to detect poor practice
2-Jun-2005
DATA BRIEFING -
Where should all the money go?
24-Mar-2005
DATA BRIEFING -
Impact of choice on hospital viability
3-Mar-2005
DATA BRIEFING -
Get the measure of delivery
3-Feb-2005
DATA BRIEFING -
Economic growth and NHS spending
6-Jan-2005
If the chancellor sticks to Derek Wanless's 'fully engaged' scenario for future NHS spending, the next few spending rounds are likely to see smaller rises for the NHS than the last two as total healthcare spending flattens out at around 10.5 per cent of GDP across the UK. -
Economic growth and NHS spending
6-Jan-2005
DATA BRIEFING -
Change in attitudes impacts on debate
2-Dec-2004
DATA BRIEFING SMOKING BANS -
Public opinion
4-Nov-2004
DATA BRIEFING -
Cardiac surgery
7-Oct-2004
DATA BRIEFING -
Productivity
29-Jul-2004
DATA BRIEFING -
Market forces factor
25-Mar-2004
Published: 25/03/2004, Volume II4, No. 5898 Page 31 -
Healthcare funding
26-Feb-2004
DATA BRIEFING -
Patient charges
31-Jul-2003
data briefing -
EU health spend
3-Jul-2003
Published: 03/07/2003, Volume II3, No. 5862 Page 25 -
Catch up, keep up
3-Apr-2003
waiting times -
Census results
27-Mar-2003
data briefing -
Target setting
27-Feb-2003
data briefing -
Dentistry
31-Oct-2002
data briefing -
Responsiveness
26-Sep-2002
World Health Organisation figures support critics who said the Health System 2000 report was flawed: the relative responsiveness of healthcare systems around the world has now been updated, says John Appleby -
Japan 's social insurance
4-Jun-2002
data briefing Japan's healthcare system has come in for hard-hitting criticism. It has some of the UK's problems - but for very different reasons. John Appleby reports -
US vs. UK
21-Feb-2002
data briefing: A comparison between the NHS and a US managed care organisation saw the US model out-performing the NHS. But John Appleby examines the methodology and questions the conclusions -
SPENDING UNDER LABOUR
20-Sep-2001
DATA BREIFING: When New Labour took office it was committed to keeping to the previous Conservative government's public spending plans. But surely this would have compromised its pledges on the future of the NHS? John Appleby reports -
SOCIAL INSURANCE
23-Aug-2001
DATA BRIEFING: What would happen if the UK moved from a tax-based health system to one that is insurance based? John Appleby points out some of the misinformation being peddled by the campaigners -
Cut and run
5-Jul-2001
MANAGEMENT COSTS: The way management costs are calculated is confusing.And why is there no consensus on what the NHS needs to operate efficiently? John Appleby investigates -
Caesarean Births
24-May-2001
DATA BRIEFING: Caesarean rates in one part of the UK have now reached the US average - and every 1 per cent rise costs the NHS £5m, says John Appleby -
Health inquality targets
22-Mar-2001
The Department of Health has bitten the bullet and set national targets for reducing health inequalities. Achieving them is likely to prove difficult and beyond the scope of the NHS alone, says John Appleby -
Coronary heart disease
22-Feb-2001
A survey on NHS patients' experiences of coronary heart disease suggests that even 'green light' hospitals have no justification for complacency, says John Appleby -
Outpatient waiting
25-Jan-2001
Understanding how the outpatient system interacts with the rest of the NHS is important - but assessing waiting-list performance is far from straightforward, writes John Appleby -
hospital infections
2-Nov-2000
Nearly one in 10 patients acquires a new infection in hospital, at a cost to the NHS of around £931m. And some of it could be avoided, reports John Appleby -
data briefing
7-Sep-2000
Increased health spending does not necessarily mean a healthier population. John Appleby looks at how the use of different measures can lead to contradictory outcomes -
Medical Insurance
3-Aug-2000
A comparison of five countries' health payment systems reveals that where private insurance dominates, fewer people get the healthcare they need, says John Appleby -
Eletrocovulsive therapy
6-Jul-2000
Electroconvulsive therapy has been around for more than 50 years, yet information on how it works is scant and treatment data is under-recorded. John Appleby reports -
NICE data briefing
8-Jun-2000
Does NICE's remit lack scope? John Appleby assesses the evidence emerging from the assessments so far -
Waiting-list initiative
4-May-2000
Even health ministers would say that targeting the length of waiting lists rather than admission waiting times has been a mistake. But it isn't that simple, argues John Appleby -
Income distribution
6-Apr-2000
With Labour's Budgets showing evidence of old-style redistribution, perhaps the NHS could set a trend by looking at its own income inequalities, says John Appleby -
NHS funding
3-Feb-2000
Throwing more money at the NHS in a bid to match health spending in other countries will only create a self-defeating cycle of higher and higher expectations, writes John Appleby -
modernisation fund
4-Nov-1999
The much-touted modernisation fund owes more to smoke and mirrors than a desire to dish out significant extra cash, says John Appleby -
charges
7-Oct-1999
Charging for drugs and services affects their consumption - it decreases. But, John Appleby reports, it does little to contain costs and is relatively ineffective -
Accidents
12-Aug-1999
data briefing: -
Patients' views
1-Jul-1999
data briefing: -
Global inequalities
3-Jun-1999
data briefing -
Health risks
6-May-1999
data briefing -
Managers
11-Feb-1999
A manager's lot would be greatly improved by a clear way of measuring outcome which shows how their actions impact on health, writes John Appleby -
Performance indicators
8-Oct-1998
On the eve of new performance indicator frameworks, John Appleby says much useful information remains to be extracted from existing statistics -
Social science
1-Oct-1998
The economics of social spending 2nd edition Edited by Howard Glennerster and John Hills Oxford University Press 363 pages 40 -
POPULATION PROJECTIONS
7-May-1998
Predicting demographic change is a tricky business. The one thing certain, says John Appleby, is that people will live longer and this will have a considerable impact on healthcare costs -
The wait goes on
9-Apr-1998
Latest figures suggest the continuous fall in long waits for hospital admission cannot be sustained. John Appleby reports -
Bending and shaping
2-Apr-1998
THE POLITICS OF CHANGE IN THE HEALTH SERVICE By Brian Salter Macmillan 257pages £14.99
