Policy Developments In England Research Articles

PMU44 Can Price-Prevalence Trends be Used to Guide the Pricing and Reimbursement Strategy for New Orphan Drugs? a Two-Country Case Study

Determinants of orphan drugs (ODs) pricing have been extensively investigated in several publications, with various studies identifying different relationships between the price of ODs and the prevalence of the indication. To summarise recent OD policy developments in England and Italy and analyse the correlation between annual treatment cost (ATC) and disease prevalence with a new dataset. HTA agency websites were reviewed to identify relevant OD policies. A five-step process was adopted to analyse the relationship between ATC and prevalence: (1) details of the regulatory approval (2006-2020) and reimbursement status of ODs in Italy and England were collected (2) ex-factory list prices for selected ODs were extracted from the IHS-Markit POLI database; (3) calculation of ATC; (4) extraction of disease prevalence from Orphanet, for multiple indications the most prevalent was reported; and (5) regression analysis of disease prevalence on ATC. The role of unmet need in oncology indications was investigated using 5-year overall survival (OS) data. AIFA introduced new mechanisms to balance between ensuring rapid access to OD for patients and improving the long-term sustainability of the system, whilst in England different routes to access reflect the historical differences in OD assessment and prioritisation. One hundred and sixteen ODs (89 indications) were identified. Regression analysis identified negative association between ATC and prevalence which was statistically significant consistently for Italy and England. Exploratory analyses identified weaker association between ATC and prevalence in oncology relative to non-oncology assets and non-significant association between OS and ATC for oncology assets. The weaker association for oncology ODs may be due to the limited duration of treatment and disease severity. A statistically significant negative association was established between ATC and prevalence for Italy and England. Further research is required into other factors such as disease severity, public pressure and available treatment alternatives.

Learning in and learning from FE and skills policy in Wales: a relational approach

ABSTRACTIn the context of devolution, this paper argues that there is a distinctively Welsh flavour to FE and Skills policy, but that its nature and formation needs to be understood both intrinsically and relationally, especially in terms of its relationship to parallel policy developments in England. Consideration is given to structural aspects and significant changes in the ‘economic narrative’, and also to the reflection of certain values in policy and policy mechanisms. It is argued that policy learning of a sort visible in the realm of economic innovation is not yet apparent in the FE and Skills arena in Wales, where an avoidance of key features of English policy remains a touchstone. Finally, the paper sets out how a ‘relational’ approach is particularly helpful in appreciating these issues and in understanding the challenges in a major FE and Skills reform process in Wales.

Managing water through change and uncertainty: comparing lessons from the adaptive co-management literature to recent policy developments in England

Water management is set to become increasingly variable and unpredictable, in particular because of climate change. This paper investigates the extent to which water policy in England provides an enabling environment for ‘adaptive co-management’, which its proponents claim can achieve the dual objective of ecosystem protection and livelihood sustainability under conditions of change and uncertainty. Five policy categories are derived from a literature review, and are used to conduct a directed content analysis of seven key water policy documents. The findings reveal that although, in part, English water policy serves as an enabling environment for adaptive co-management, there is a level of discrepancy between substantive aspects of the five policy categories and water policy in England. Addressing these discrepancies will be important if English water policy is to allow for the emergence of processes, like adaptive co-management, that are capable of coping with the challenges that lie ahead.

Lessons from Albion: Can Australia learn from England's approach to primary healthcare funding?

As Australia struggles to meet increased demand for healthcare and contain expenditure there has been a focus on primary care and its role in demand management and keeping people out of expensive secondary care. However, with domestic policy struggling to find a suitable approach consideration of English policy could well be fruitful in the quest to strengthen and develop primary care in Australia. The purpose of this paper is to consider policy developments in England and explores these in relation to the Australian healthcare system. The authors highlight the key changes to policy that have occurred in the English healthcare system in recent years, and discuss whether they have proven successful. The authors discuss the barriers to implementing similar approaches in Australia, particularly the difference in system structure that would necessitate policy adaptation. Whilst there are differences in the structure and organisation of funding and service provision between countries, there are developments in England that are worthy of consideration from an Australian perspective. These include a focus on funding and commissioning that rewards quality not just activity and volume. As Australia sees the development of new primary care organisations that are tasked with commissioning then developments and lessons around the technical and relational aspects will be important to consider. The work highlights that Australia might consider learning from the English experience in this area and the types of incentives that may increase efficiency and quality of health service provision. This is important as it potentially gives greater certainty about those approaches most likely to yield beneficial outcomes for patients and the broader system.

The Voluntary Sector and the Mandatory Statutory Supervision Requirement: Expanding the Carceral Net

Recent penal policy developments in England and Wales emphasize the role for voluntary organizations. Voluntary organizations play an important and increasing role in punishment, including imprisonment and supervision, but the effects of their work are ill understood. Existing literature is ambivalent: some argue such work empowers and builds social capital; for others, it extends control. This tension is addressed by analysing two payment-by-results pilot schemes. This analysis adds to the limited empirical knowledge about voluntary organizations. It demonstrates how their involvement in these pilots enabled and justified the new 12-month mandatory statutory supervision requirement, significantly extending the spatial and temporal reach of carceral power. The conclusion considers the theoretical implications of this analysis.

Book Review: Linda Milbourne Voluntary Sector in Transition: Hard Times or New Opportunities?

Linda Milbourne Voluntary Sector in Transition: Hard Times or New Opportunities?, Bristol: Policy Press, 2013. 224 pp. £70 (hbk). ISBN 9781847427236 This book by Linda Milbourne is a theoretically informed and empirically rich study of how recent political and policy developments in England have affected the voluntary sector and how voluntary sector organisations (VSOs) are responding, adapting and in some instances, resisting these developments. Whilst it is primarily based on research conducted during the time of New Labour, Milbourne also examines continuities and changes in the policy landscape that have occurred under the Coalition government since 2010. The author illustrates, in great detail, how the policy landscape is changing and examines the challenges faced by VSOs on a number of fronts including the substantial reduction in funding; growing privatisation of public services and contracting; and the continuing dominance and growth of a culture of managerialism with its emphasis on ‘performance management’. Milbourne draws on extensive field research conducted in England to demonstrate how VSOs are coming under increased pressure to show impact by providing measurable evidence of outcomes and to demonstrate efficiency.

What can social and environmental factors tell us about the risk of offending by people with intellectual disabilities?

A minority of men and women with intellectual disabilities at times engage in, and are suspected, or convicted, of illegal activity. Recent policy developments in England and Wales emphasise the need to respond appropriately to putative offending risk through the provision of safe and effective community management, treatment, and support services. In line with these concerns, research has focused increasingly on testing the utility of an evolving variety of risk assessment procedures. Here, the authors set out to challenge the repertoire of a number of prominent and/or recently developed risk assessment procedures and the scope of an associated research literature, on the basis that contextual risk factors are receiving insufficient attention in relation to offending among people with intellectual disabilities. Drawing on the wider criminological literature, a novel study is reported that compares key contemporary proximal social and environmental circumstances in the lives of offenders and non-offenders with intellectual disabilities. A contextual risk score is derived, providing statistical support for increased consideration of the impact of relevant social and environmental circumstances. Increased emphasis on key contextual risk factors is recommended to strengthen community service responses to offenders with intellectual disabilities.

England and Northern Ireland policy and law update relating to mental health and intellectual disability

PurposeThis article aims to bring readers up to date with policy developments in England and Northern Ireland in the last two years since the journal first reported on these issues.Design/methodology/approachAs well as looking at changes to policy and legislation, the paper highlights not only the differences but also the shared concerns for people with intellectual disability living in the two countries, e.g. equal access to healthcare as experienced by the general population.FindingsIn spite of shared visions of inclusion and equality in mental health care, there are major differences in how both countries approach these issues. Recently this has been highlighted by significant shifts in policy. In Northern Ireland strategies designed to inform the delivery of evidence based services for the future have been witnessed. Whilst in England there has also been a move towards public protection within mental health legislation and the reaffirmation of the need to move towards more individual services. Whilst policy initiatives in both countries have been encouraging; they need to be implemented so issues such as access to healthcare and geographical disparity are addressed by local providers.Social implicationsAlthough there is a desire for change, the reality is that the policies and legislation introduced to address issues such as accessing mental health care and service standards have still to make a significant impact to people's daily lives.Originality/valueThis paper offers an update of current practice and policy relating to mental health for people with intellectual disabilities in England and Northern Ireland.

Listening and responding? Children's participation in health care within England

This article examines recent health policy developments in England in relation to children's rights under Article 12 and 13 of the United Nations Convention on the Rights of the Child (UNCRC). It draws on practice and research literature to explore evidence regarding: children's participation both within decisions about their own care and concerning the development of health services, their access to mechanisms that allow them a voice, the provision of and need for accessible information, and factors which prevent or facilitate children's participation. The paper does not explore in detail issues concerning children's consent or competence to participate.

Re-engaging 14-16-year-olds with their schooling through work-related learning

This article presents the findings from research conducted on a work-related learning programme for disengaged and disaffected 14-16-yearolds. The article begins by examining work-related learning within the context of national policy developments in England. The findings from the research are analysed in relation to the capacity of workplace learning to impact upon the schooling of the participating young people. The analysis focuses upon a range of issues including the problems of securing transfer between workplace- and school-based settings, and the importance of social and cultural capital in shaping the nature of the participants' workplace-based experiences.

Social policy and mental illness in England in the 1990s: violence, moral panic and critical discourse.

Violence perpetrated by people experiencing mental illness poses a continuing challenge to practitioners and policy makers in the mental health field. It has been suggested, however, that policy developments in England during the period 1990--2000 became unduly dominated by the perceived need to prevent such violence and in particular that a 'moral panic' occurred following a series of high profile homicides perpetrated by people experiencing mental illness. This paper critically examines the ability of the moral panic theory to offer a cogent explanation of the relationship between media representations, public perceptions and developments in both social policy and legislation during the last decade. Its conclusions, however, suggest that the evidence does not support assertions of a moral panic and that of moral panic theory itself has serious flaws. Ultimately the paper suggests that we must look elsewhere, particularly to Foucault's conceptualization of discourse and to the work of Birkland, an American political theorist, in our search for an understanding of the relationship between events, ideas and social policy.

Proposals for Performance Related Pay for Teachers in English Schools

This review concentrates initially on contextualising and then describing the many policy developments during 1999 and the early part of 2000 concerning the payment of teachers. This is followed by a consideration of the implications for teacher motivation, particularly as interpreted by Richardson working with the NUT (National Union of Teachers) to explore the implications of the new reward strategy. A broader contextualisation includes the implications of evidence from business and the public sector on performance pay. Finally, research into recent developments in teacher pay in the USA is considered as of the greatest relevance for policy developments in England and Wales. The newly formed National Assembly in Wales has distinctive responsibilities for education so this article will only refer to England. This article ranges widely to present performance related pay and performance management in England in early 2000.

Education, markets and professionalism: Some reflections on recent policy developments in England and Wales

(1992). Education, markets and professionalism: Some reflections on recent policy developments in England and Wales. Melbourne Studies in Education: Vol. 33, No. 1, pp. 56-62.