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A study of 53 TPPs that went live in April 1996 finds that setting budgets, especially for 1996-97, was among the most serious preparatory problems. 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They function as pilots within the health system.","Answer",{"name":114,"@type":109,"acceptedAnswer":115},"What was one of the most serious problems identified in the 53 TPPs study?",{"text":116,"@type":112},"Setting budgets for the financial year 1996-97 emerged as one of the most serious problems during the preparatory period. Basic data on activity and expenditure were a key issue for authorities.",{"name":118,"@type":109,"acceptedAnswer":119},"How does the report connect TPP budgeting lessons to broader NHS commissioning?",{"text":120,"@type":112},"The paper argues that the budgeting problems and proposed resolutions are relevant to developing locality commissioning in the NHS. It also highlights potential for improving equity and efficiency in resource use within health authorities.","https://schema.org",{"og:url":83,"og:type":123,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":125,"canonical":83},"index,follow",{"doc_id":127,"site_id":62},570404,1791880910,{"code":4,"msg":5,"data":130},{"doc_id":127,"user_id":131,"nickname":92,"user_avatar":132,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":133,"file_id":134,"file_url":135,"file_type":136,"file_size":137,"view_count":4,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":36,"language":138,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":139,"faqs":140,"seo_title":141,"seo_description":67,"update_tm":128,"read_time":142},1099513958607,"https://ap-avatar.wpscdn.com/avatar/100002390cf8733938c?x-image-process=image/resize,m_fixed,w_180,h_180&k=1778829742770036399","Resource  \nAllocation  \nwithin Health  \nAuthorities  \nLessons from  \ntotal purchasing pilots  \nGwyn Bevan  \nReader in Public Policy Analysis  \nDepartment of Operational Research  \nLondon School of Economics and  \nPolitical Science  \nQUARTO  \nG  \n15.2  \nKIN  \n'Total purchasing'is potentially the mostsignificant development in NHS purchasingof health services since the introduction ofgeneral practitioner fundholding in 1991.It offers fundholding practices the opportunityto purchase all of the health care not includedin fundholding for patients on their lists.  \nThe study of 53 TPPs,which went 'live'inApril 1996,found that setting budgets wasone of the most serious problems they facedin their preparatory period.This report reviewsthese problems and suggests how they mightbe resolved through new kinds of analysis.This offers lessons for developing localitypurchasing in the NHS.  \nPublished by  \nKing's Fund Publishing11-13 Cavendish SquareLondon W1M 0AN  \nKing's Fund,1998.All rights reserved  \nISBN 1857171764  \nDistributed by Grantham Book Services LimitedIsaac Newton Way,Alma Park Industrial EstateGRANTHAM,Lincolnshire NG319SDTel:01476541080 Fax:01476541061  \nThe Total Purchasing National Evaluation Team(TP-NET)  \nThe national evaluation of total purchasing pilots in England and Scotland is a collective effort by a largeconsortium of health services researchers.The study is led by the King's Fund Policy Institute,but alsoinvolves the National Primary Care R&D Centre;Universities of Edinburgh,Bristol,Southampton,York andBirmingham;the London School of Hygiene &Tropical Medicine;and the London School of Economics andPolitical Science.More information about the evaluation is available from:Nick Goodwin,King's Fund PolicyInstitute,11-13 Cavendish Square,London W1M 0AN.  \nAcknowledgements  \nThis paper is based on a survey of lead GPs by Sally Wyke and Jacinta Lee at the University of Edinburgh;anda survey of health authorities by Gwyn Bevan.We are very grateful to those GPs and staff in health authoritieswho took time to reply to our questions.  \nAn earlier draft of this was circulated to the 300 from England,Scotland and Wales who came to workshopson budget setting for Total Purchasing Pilots in November/December 1996.These workshops were organisedby Regional Offices of the NHS Executive.I am grateful to Doreen Hounslea(North West),Christina Craig(South and West),Peter Lemmey(North Thames)and Paul Gardner(West Midlands)and their staff fororganising these workshops.  \nI am grateful to Max Bachmann,Jennifer Dixon,Howard Freeman,Karen Hancock,Brian Maynard-Potts,Nick Mays,Colin Sanderson,and Trevor Sheldon,forcomments on an earlier draft.The usual disclaimer applies.  \nThis work draws on collaborative research over twenty years into resource allocation in the NHS.I amindebted to colleagues on the Resource Allocation Working Group of the Welsh Office(1987-90),theMedical Practices Committee of England and Wales(1993-94),and the South and West Sub-HealthAuthority Working Group on Technical Target Setting Issues(1997).I am particularly grateful to the chairs:John Wyn Owen,John Ball and Mark Callingham.Iam grateful to many others in universities and the NHSwho are too numerous to mention individually.I would,however,like to mention my gratitude to John Perrin,Nick Mays,Walter Holland and Trevor Sheldon.It is with great sadness that I record debts I owe to BrianAbel-Smith and Dani Bevan who have died.  \nThe national evaluation was commissioned and funded by the Department of Health.However,the viewsexpressed in this paper do not necessarily represent the policy of the Department  \nThe Author  \nGwyn Bevan is a member of TP-NET,Reader in Public Policy Analysis at the London School of Economics&Political Science,and a member of the NHS Executive's Technical Advisory Group on Resource Allocation.  \nContents  \nList of boxes,tables and figuresSummary  \n1 Introduction  \n2 Objectives  \n3 Methodological problems  \n4A new approach  \nNotes  \nBibliography","cbCaipdEYFDjHpVl","https://ap.wps.com/l/cbCaipdEYFDjHpVl","pdf",4187338,"English","# Summary\n# Introduction\n# Objectives\n# Methodological problems\n# A new approach\n# Notes\n# Bibliography\n# Boxes, Tables and Figures\n## Boxes, Tables and Figures","[{\"question\":\"What are Total Purchasing Pilots (TPPs) in the NHS context?\",\"answer\":\"TPPs are general practices where GPs opt to extend fundholding and can contract for virtually all hospital and community health services, with no statutory basis. They function as pilots within the health system.\"},{\"question\":\"What was one of the most serious problems identified in the 53 TPPs study?\",\"answer\":\"Setting budgets for the financial year 1996-97 emerged as one of the most serious problems during the preparatory period. Basic data on activity and expenditure were a key issue for authorities.\"},{\"question\":\"How does the report connect TPP budgeting lessons to broader NHS commissioning?\",\"answer\":\"The paper argues that the budgeting problems and proposed resolutions are relevant to developing locality commissioning in the NHS. It also highlights potential for improving equity and efficiency in resource use within health authorities.\"}]","Resource Allocation within Health Authorities - Lessons from Total Purchasing Pilots | PDF",101]