Primary care capitation payments in the UK. An observational study

<p>Abstract</p> <p>Background</p> <p>In 2004 an allocation formula for primary care services was introduced in England and Wales so practices would receive equitable pay. Modifications were made to this formula to enable local health authorities to pay practices.</p> <p>Similar pay formulae were introduced in Scotland and Northern Ireland, but these are unique to the country and therefore could not be included in this study.</p> <p>Objective</p> <p>To examine the extent to which the Global Sum, and modifications to the original formula, determine practice funding.</p> <p>Methods</p> <p>The allocation formula determines basic practice income, the Global Sum. We compared practice Global Sum entitlements using the original and the modified allocation formula calculations.</p> <p>Practices receive an income supplement if Global Sum payments were below historic income in 2004. We examined current overall funding levels to estimate what the effect will be when the income supplements are removed.</p> <p>Results</p> <p>Virtually every Welsh and English practice (97%) received income supplements in 2004. Without the modifications to the formula only 72% of Welsh practices would have needed supplements. No appreciable change would have occurred in England.</p> <p>The formula modifications increased the Global Sum for 99.5% of English practices, while it reduced entitlement for every Welsh practice.</p> <p>In 2008 Welsh practices received approximately £6.15 (9%) less funding per patient per year than an identical English practice. This deficit will increase to 11.2% when the Minimum Practice Income Guarantee is abolished.</p> <p>Conclusions</p> <p>Identical practices in different UK countries do not receive equitable pay. The pay method disadvantages Wales where the population is older and has higher health needs.</p

Housing supply and brownfield regeneration in a post-Barker review world: A comparison of policy and practice in England and Scotland

The findings of the Barker review, which examined the reasons for the undersupply of UK housing, have important implications for the devolved constituents of the UK, including Scotland. This paper traces the emergence of the brownfield regeneration policy agenda across the UK and examines how the Barker review connects with this brownfield policy focus. The paper compares housing and brownfield policies and practices in England and Scotland, places them in an international context and elicits wider lessons for devolved governance in relation to housing policy, in terms of `centrist—local' tensions. Estimates based on published data suggest that Barker's emphasis on increased housing supply cannot easily be reconciled with the current emphasis on brownfield development and is likely to require a return to greenfield development in both countries

Local Air Quality Management policy and practice in the UK: The case for greater Public Health integration and engagement

© 2016 Elsevier Ltd. The UK's Local Air Quality Management (LAQM) regime is designed to protect people's health from the ill-effects of air pollution, but it is failing to achieve its full potential. The Public Health aspects of, perspectives on, and integration and engagement in, LAQM have been poorly considered to date. This critical literature review assessed LAQM-related strengths and limitations in order to explore how Public Health, through greater integration and engagement, can add value to the regime.'Structure' and 'process' weaknesses were identified, including: A poorly defined Public Health role, a narrowly-scoped prescribed process, risk assessment uncertainties, ineffective communications, shallow evaluations and disconnected policies. Separately and cumulatively, these have hindered Public Health integration in LAQM policy and practice and stunted the regime's evolution. Engaging Public Health in LAQM future design and delivery can help solve these problems, by improving risk assessments and raising awareness of air pollution and other health-influencing relationships, targeting action in high-need areas, coordinating air pollution mitigation and health improvement interventions, and connecting different policy areas.Increasing Public Health integration and engagement in LAQM can enhance the existing regime. Acting now is timely from both LAQM and Public Health perspectives. This review's findings should be used to inform debates and decisions around the future development of Local Air Quality Management arrangements both in the UK and beyond

Examining the Effects of Zero‐Dollar Unemployment Payment Sanctions*

Existing evidence has demonstrated that sanctions affect unemployment payment recipients' behaviour. However, in addition to financial impacts, sanction application includes administrative processes. This study examines a feature of Australian unemployment benefits, whereby jobseekers not meeting requirements may face a zero‐dollar sanction (termed suspension). The results indicate a strong behavioural response, with previously suspended jobseekers 13.1 percentage points more likely to attend their next appointment. Further, ongoing behavioural change was observed, even for jobseekers with a history of previous non‐compliance. This suggests temporary payment suspension and associated administrative processes are effective at securing behavioural change, without the need for lasting financial impact

Job Seeker’s Allowance (JSA) benefit sanctions and labour market outcomes in Britain, 2001–2014

The dominant view among British policy-makers is that benefit sanctions for the unemployed who are claiming the Job Seeker’s Allowance (JSA) are effective at increasing flows from unemployment into sustainable employment. This paper tests this theory using aggregate cross-sectional data for Great Britain for the period May 2001 to December 2014. Descriptive analysis found the relationship between sanctions and labour market outcomes was ambiguous, while trends in labour market outcomes were highly correlated with labour market demand. Multivariate SVAR time-series analysis, controlling for labour market demand, found evidence that changes in the threat and use of sanctions had a positive impact on flows into work in the short run but not in the long term, and had no definitive impact on ILO unemployment at all. Interrupted time-series analyses suggest we cannot reject the null hypothesis that the impact of introduction of a new JSA sanctions regime in October 2012 (with higher financial penalties associated with being sanctioned) had no impact on flows into work from JSA. In Britain, intensifying the use of sanctions and introducing harsher penalties associated with being sanctioned has been largely ineffective at increasing flows from JSA into sustainable employment. Given the negative financial and social impacts of sanctions on those affected, and the lack of evidence of a sustained positive impact on employment, the basis for the new sanctions policy is unclear