Dr Stephen Gillam (left), Director of Primary Care, and Andrew Bell, Head of Public Affairs, King's Fund

The King's Fund was established in 1897 by the Prince of Wales, later King Edward VII. It was a central place for all of London's voluntary hospitals to raise funds from the public – essentially providing the best available means of delivering healthcare to London's most disadvantaged families before the establishment of the National Health Service.

Since that time, the King's Fund has evolved along with the health system around it. But the organisation continues to pursue its core objective, namely to find the most effective ways of improving the health of Londoners and of reducing avoidable inequalities between them.

The King's Fund no longer provides funding directly to hospitals. Instead, it uses the monies generated from investing the reserves accumulated from the original appeal for funds to carry out a wide range of functions that help the NHS and others to improve the health of Londoners.

  • It provides grants worth £2 million a year to organisations and individuals working 'on the ground' to tackle the causes of ill health and to improve access to healthcare.
  • It runs a number of education and leadership development programmes for the NHS, equipping managers, doctors and senior nurses with the skills and knowledge to lead the service into the future.
  • It carries out: research into health and health services; analysis of policy options; and development work to help service providers find new ways of tackling longstanding problems.

In all of its diversity, the purpose of the King's Fund is to make the vital connections across health, social care and other aspects of public policy that affect people's health.

Grant-making activities, for example, both inform and are informed by policy research and development work.

In working to improve support for people with mental illness, the King's Fund has made connections with employers, training bodies, the police and churches, as well as primary care groups (PCGs) and social services.

The King's Fund recognises that primary care services are central to improving Londoners' health. For many years, the King's Fund has worked with doctors, nurses and managers in primary care to develop new ways of delivering support to disadvantaged communities.

The organisation now has a dedicated work programme that focuses on primary care (see Figure 1, below). This provides a clear focus for the full range of research, development and education work carried out in this area. The central concern of the primary care programme is how primary care organisations (PCOs) can address inequalities in health.

Figure 1: Main page from the 'Primary Care' section of the King's fund website
web page

'Tracker survey'

With the National Primary Care Research and Development Centre in Manchester, the King's Fund carries out an annual 'tracker survey' which measures the progress made by PCGs and PCTs.

The survey highlights both the successes and the weaknesses of PCGs and PCTs, assessing the degree to which they are meeting the many demands on them and raising awareness of the difficulties they face.

The King's Fund works with a number of PCGs and PCTs in London to assist with the development of some of their functions.

At present, there are pilot projects that help PCOs plan and implement better services for older people and boost the amount of meaningful public involvement in PCG/T activity.

In each case, the aim is to build the capacity of the organisations involved to respond more effectively to the needs of local people.

Personal medical services

The development of personal medical services (PMS) pilot projects is another key area of research for the King's Fund.

Since their inception in 1998, the King's Fund has kept track of the progress made by London's PMS pilots and contributed to the growing body of understanding about the possible benefits (and pitfalls) of salaried general practice and nurse-led primary care.

NHS Direct

London's first NHS Direct and walk-in centres have also come under scrutiny from the King's Fund, to increase understanding of how the many new access points to primary care are affecting the capital's population.

Clinical governance

Building in the work of the PACE (Promoting Action in Clinical Effectiveness) project, clinical governance remains a focus for the programme.

In addition to charting progress in implementation, a development programme is being established for clinical governance leads in the capital.

Ensuring equal access

The King's Fund is concerned always to ensure that the most excluded and disadvantaged in society get equal access to healthcare. In so doing, it has produced guidelines for PCGs to ensure that they are providing culturally competent and fully accessible services for minority ethnic groups in their localities.

A number of recent grant-funded projects, meanwhile, have focused on the support of health advocacy projects among refugee communities. The King's Fund works with the NHS to help individuals negotiate the system effectively and to inform primary care providers about the needs of their particular group.

The success of these projects, and the isolation of health advocates, have led the King's Fund to make the promotion of wider support for health advocacy a major priority over the next 2 years.

Communicating with primary care workers is always a major King's Fund priority. By working with a small number of pilot sites and research projects, the organisation ensures that lessons are learnt and knowledge is disseminated widely as a result of its findings.

A number of seminars for primary care workers and board members are held each year, in addition to the many conferences and breakfast discussions convened by the King's Fund.

Publications on paper and on the King's Fund website (www.kingsfund.org.uk), outline major research findings and provide guidance for people working in primary care on how to bring good practice from other areas into their own work, while reflecting their own local circumstances.

Finally, the King's Fund has a major health and social care library and information service, which is open to the public every weekday.

the king's fund

Set up 1897
Objectives To support, promote and improve the health of the people of London by influencing health policy and stimulating good practice in service provision
Status/funding Independent health charity. Prudent investment of the reserves accumulated from the original appeal for funds continue to generate considerable income. Other sources of income include: course fees; fees to support policy research and analysis; sales of publications; and conference facilities
Key personnel Director of Primary Care: Dr Stephen Gillam
  Head of Public Affairs: Andrew Bell
  Chief Executive: Rabbi Julia Neuberger
  Director of Public Affairs: Michelle Dixon
Contact details Address: 11–13 Cavendish Square, London W1G 0AN
  Tel: 020 7307 2400
  Fax: 020 7307 2801
  Website: http://www.kingsfund.org.uk

Guidelines in Practice, March 2001, Volume 4(3)
© 2001 MGP Ltd
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