BMJ  2004;328:763-765 (27 March), doi:10.1136/bmj.328.7442.763

Education and debate

Making the NHS more like Kaiser Permanente

¹ Division of Social and Behavioural Medicine, University of Medicine and Dentistry of New Jersey, USA, ² NHS Alliance, Retford, Nottinghamshire, DN22 6JD

The NHS needs to break down the barriers between primary, secondary, and tertiary care

The first 150 words of the full text of this article appear below.

The US health maintenance organisation Kaiser Permanente has been highlighted as a successful model of integrated, cost effective care. A key policy of the NHS and other health systems is to learn from this model. However, the changes being made by the English government overlook the key features that have enabled Kaiser to develop and implement its clinical and operational programmes. We examine the importance of integrating clinical governance as well as collaborative contracting in achieving integrated, patient centred services.

Comparing the NHS and Kaiser

In a highly influential article, Feachem and colleagues compared the costs and performance of the NHS with those of Kaiser Permanente in California. They concluded that Kaiser provided much better value, largely by using only a third of the acute bed days used in the NHS.¹ Several serious criticisms were levelled at the methods used, but even if they are taken into account, the Kaiser system has much lower hospital . . . [Full text of this article]

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Organisational history and culture

Fiscal and clinical governance by doctors

Internal schisms still plague the NHS

Collaborative contracting

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Rapid Responses:

Read all Rapid Responses

It's the quality of management that differs

James A Dunbar
bmj.com, 26 Mar 2004 [Full text]

shome mishtake, shurely ?

L S Lewis
bmj.com, 9 Aug 2004 [Full text]