scholarly journals The future of social care funding: who pays?

2016 ◽  
Vol 22 (1) ◽  
pp. 10-44 ◽  
Author(s):  
T. Kenny ◽  
J. Barnfield ◽  
L. Daly ◽  
A. Dunn ◽  
D. Passey ◽  
...  
Keyword(s):  
Phase 1 ◽  
List Type ◽  
Political Debate ◽  
Term Care ◽  
Means Testing ◽  
Financial Products ◽  
Funding System ◽  
The Government ◽  
The Uk ◽  
Care Costs

AbstractWith the UK population ageing, deciding upon a satisfactory and sustainable system for the funding of people’s long-term care (LTC) needs has long been a topic of political debate. Phase 1 of the Care Act 2014 (“the Act”) brought in some of the reforms recommended by the Dilnot Commission in 2011. However, the Government announced during 2015 that Phase 2 of “the Act” such as the introduction of a £72,000 cap on Local Authority care costs and a change in the means testing thresholds1 would be deferred until 2020. In addition to this delay, the “freedom and choice” agenda for pensions has come into force. It is therefore timely that the potential market responses to help people pay for their care within the new pensions environment should be considered. In this paper, we analyse whether the proposed reforms meet the policy intention of protecting people from catastrophic care costs, whilst facilitating individual understanding of their potential care funding requirements. In particular, we review a number of financial products and ascertain the extent to which such products might help individuals to fund the LTC costs for which they would be responsible for meeting. We also produce case studies to demonstrate the complexities of the care funding system. Finally, we review the potential impact on incentives for individuals to save for care costs under the proposed new means testing thresholds and compare these with the current thresholds. We conclude that:∙Although it is still too early to understand exactly how individuals will respond to the pensions freedom and choice agenda, there are a number of financial products that might complement the new flexibilities and help people make provision for care costs.∙The new care funding system is complex making it difficult for people to understand their potential care costs.∙The current means testing system causes a disincentive to save. The new means testing thresholds provide a greater level of reward for savers than the existing thresholds and therefore may increase the level of saving for care; however, the new thresholds could still act as a barrier since disincentives still exist.

The ‘Pillared-Privatisation’ of Pension Provision in the European Union: The Case of the United Kingdom

2002 ◽  
Vol 4 (1) ◽  
pp. 5-24 ◽  
Author(s):  
Patrick Ring ◽  
Roddy McKinnon
Keyword(s):  
European Union ◽  
World Bank ◽  
The European Union ◽  
Means Testing ◽  
The Road ◽  
The United Kingdom ◽  
The World Bank ◽  
The Government ◽  
The Uk ◽  
National Governments

Across the European Union, national governments are re-assessing the institutional mechanisms through which pension provision is delivered. This articles sets the debate within the wider context of the ‘pillared’ structural analysis often adopted by international institutions when discussing pensions reform. It then sets out a detailed discussion of developments in the UK, arguing that the UK is moving towards a model of reform akin to that promoted by the World Bank – referred to here as ‘pillared-privatisation’. The themes of this model indicate more means-testing, greater private provision, and a shift of the burden of risk from the government to individuals. An assessment is then made of the implications of UK developments for other EU countries. It is suggested that while there are strong reasons to think that other countries will not travel as far down the road of ‘pillared-privatisation’ as the UK, this should not be taken as a ‘given’.

scholarly journals Profiles of registrant dentists and policy directions from 2000 to 2020

BDJ Open ◽  
2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Latha S. Davda ◽  
David R. Radford ◽  
Sasha Scambler ◽  
Jennifer E. Gallagher
Keyword(s):  
United Kingdom ◽  
Health Care Access ◽  
Annual Reports ◽  
Immigration Policies ◽  
Freedom Of Information ◽  
List Type ◽  
The European Union ◽  
The United Kingdom ◽  
The Government ◽  
The Uk

Abstract Introduction The National Health Service’s reliance on overseas doctors and nurses, unlike dentists, has been widely reported. As the United Kingdom (UK) leaves the European Union, an understanding of the migration trends and possible influences are important to inform future planning. Aim To examine trends in the profile of UK registered dentists in the context of key events and policy changes from 2000 to 2020. Method Data were obtained from the General Dental Council via annual reports, and under ‘freedom of information’ communications; details of policy initiatives were obtained from the government and professional websites. Results Over a 20-year period (2000–2019), the number of registered dentists increased from 31,325 to 42,469, a net increase of 36% (11,144 dentists), the majority of whom were international graduates (58%; n = 6,416) such that by December 2019, 28% of all registered dentists had qualified outside of the UK. Similarly, regarding new registrants, there were increases of graduates from UK (18%), EEA countries (214%) and, via the Overseas Registration Examination route (621%); and a decrease from countries with bilateral agreements for recognition (43%), in line with changes in health and immigration policies. Conclusions International dental graduates increasingly contribute to the UK dental workforce and there is an urgent need for research into dentist migration and retention in the UK in support of patient access to dental care. Impact The United Kingdom (UK) dental workforce is increasingly reliant on international dental graduates representing 28% of current registrants compared with 18% in 2000. Health policies and immigration policies were the main drivers that influenced dental workforce migration to the UK along with wider events, such as EU expansions, global recession and Brexit. Pre-existing lack of research into dental workforce could add to the uncertainties of post COVID-19 oral health care access and delivery.

scholarly journals 506 IGNYTE: an open-label, multicenter, phase 1/2 (Ph 1/2) clinical trial of RP1 ± nivolumab in patients with advanced solid tumors

2021 ◽  
Vol 9 (Suppl 3) ◽  
pp. A538-A538
Author(s):  
Mark Middleton ◽  
Mohammed Milhem ◽  
Francesca Aroldi ◽  
Joseph Sacco ◽  
Ari VanderWalde ◽  
...  
Keyword(s):  
Solid Tumors ◽  
Response Rate ◽  
Phase 1 ◽  
Survival Rates ◽  
Complete Response ◽  
List Type ◽  
Advanced Solid Tumors ◽  
Open Label ◽  
The Uk ◽  
Simplex Virus

BackgroundRP1 is an enhanced potency oncolytic HSV-1 which expresses a fusogenic glycoprotein (GALV-GP R-) and granulocyte macrophage colony stimulating factor (GM-CSF).1 In pre-clinical studies, RP1 demonstrated potent GALV-GP R-enhanced anti-tumor activity and immunogenic cell death. This Phase 1/2 (Ph 1/2) study was designed to evaluate the safety and efficacy of RP1 ± nivolumab (nivo) in patients (pts) with advanced solid tumors, including pts whose disease failed prior anti-PD-1/PD-L1 therapy and has reported promising interim data in a number of tumor types including cutaneous squamous cell carcinoma (CSCC) and anti-PD1 failed melanoma to date.2MethodsThis is a multi-center, first-in-human, open label, multi-cohort, non-randomized Ph1 study of RP1 alone and combined with nivo followed by Ph2 in combination with nivo in pts with recurrent advanced solid tumors including those that progressed after prior anti-PD-1/PD-L1 therapy. The Ph 1 monotherapy dose escalation (n=14) and RP-1 combination expansion (n=22) cohorts are fully enrolled. Approximately 260 pts are expected to be enrolled in the ongoing Ph 2 portion across five cohorts; melanoma (n=30, enrollment complete), non-melanoma skin cancer (n=45, to include 15 pts with anti-PD-1/PD-L1 failed disease), anti-PD-1 failed MSI-H/dMMR tumors (n=30), anti-PD-1/PD-L1-failed non-small-cell lung cancer (n=30) and a registration-directed cohort in anti-PD-1 failed cutaneous melanoma (n=125). Pts in the Ph 2 portion receive up to 10 mL of RP1 intratumorally into one or more superficial or deep seated/visceral lesions at the recommended Ph 2 dose (1x10^6 PFU/mL × 1 followed by 1x10^7 PFU/mL × 7, Q2W). Following the first dose of RP1, nivo (240 mg IV Q2W for 4 months then 480 mg IV Q4W for up to 2 years) is subsequently administered in combination. Pts may receive up to 8 additional doses of RP1 if they meet protocol-specified criteria. Tumor assessments are performed Q8W. The primary objectives of the Ph 2 part of the study are to assess the safety, tolerability, and overall response rate (ORR) of RP1 in combination with nivo, by independent review for the anti-PD1 failed melanoma cohort. Secondary objectives include duration of response, complete response rate, disease control rate, PFS, 1-year and 2-year survival rates. Exploratory objectives include biodistribution and shedding analysis of RP1 and biomarker studies, including analyses of tumor biopsies and blood samples. Enrollment is currently ongoing in the UK and US, with additional sites in the EU (including France and Spain) are expected to open in 2021.Trial RegistrationNCT03767348ReferencesThomas S, Kuncheria L, Roulstone V, Kyula JN, Mansfield D, Bommareddy PK, Smith H, Kaufman HL, Harrington KJ, Coffin RS. Development of a new fusion-enhanced oncolytic immunotherapy platform based on herpes simplex virus type 1. J Immunother Cancer 2019;7(1):214.Coffin R, Astley-Sparke P, and Middleton M (2021, June 3rd). Retrieved from https://ir.replimune.com/static-files/f4fe3349-e082-4d41-94a1-106ce7e78a23Ethics ApprovalThe study was approved by institutional review board or the local ethics committee at each site. Informed consent was obtained from patients prior to enrollment.

scholarly journals The UK Economy

2018 ◽  
Vol 246 ◽  
pp. F2-F2
Keyword(s):  
Financial Markets ◽  
List Type ◽  
Medium Term ◽  
The Future ◽  
The Government ◽  
The Uk ◽  
Term Objective ◽  
The Eu

The future relationship between the UK and the EU remains unclear. Despite that uncertainty the economy has gained momentum over the last few months, fiscal outturns have been better and financial markets appear to be sanguine about the uncertainty. It is against this backdrop that the Chancellor will have announced the Budget on 29 October, after this Review went to press.Our main forecast is conditional on a ‘soft’ Brexit, but we also describe the consequences of an orderly no-deal Brexit. Under our soft Brexit scenario, the Chancellor will have the necessary space under the fiscal mandate to borrow on average an additional £16 billion per year between 2019–20 and 2022–23 compared with the OBR spring forecast. This, together with better revenues, provides room for the Chancellor to spend an average of around £30 billion more over the same period. Under the no-deal Brexit scenario, borrowing would be an average of £14 billion higher than in the soft Brexit case.Even though the government complies with the fiscal mandate under the soft Brexit scenario, it is unlikely to meet its medium-term objective to balance the budget unless it chooses to tax more.

Assessment of older people in the community: from ‘75-and-over checks’ to National Service Frameworks

2004 ◽  
Vol 14 (4) ◽  
pp. 257-267
Author(s):  
Steve Iliffe ◽  
Vari Drennan
Keyword(s):  
Older People ◽  
Population Aging ◽  
Age Discrimination ◽  
National Service ◽  
The European Union ◽  
Term Care ◽  
The Government ◽  
The Uk

Population aging, escalating costs in pensions, health care and long-term care have prompted the emergence of a new policy agenda for active aging and quality of life in old age across the European Union. In the UK, the government has made a commitment to improve services for older people through combating age discrimination, engaging with older people, better decision-making for services for older people, better meeting of older people's needs and promoting a strategic and ‘joined-up’ approach. A raft of policy initiatives not only sets the tone for service reconfiguration but also specifies objectives and time scales.

Habitus and Cultural Capital in the Field of Personal Finance

1998 ◽  
Vol 46 (1) ◽  
pp. 1-23 ◽  
Author(s):  
Alan Aldridge
Keyword(s):  
Cultural Capital ◽  
Service Providers ◽  
Personal Finance ◽  
Financial Service ◽  
Financial Products ◽  
The Arts ◽  
Financial Scandals ◽  
The Government ◽  
Private Investors ◽  
The Uk

Key concepts drawn from the work of Pierre Bourdieu – in particular, habitus and cultural capital – which have been widely used to analyse the fields of education and the arts, are applied here to the sociologically neglected field of personal finance. The cultural project to promote marketization has not created an informed public of sovereign consumers rich in cultural capital. On the contrary, the development of commodified mass-market financial products and services implies a lowering of the threshold not just of economic but also of cultural capital needed for their acquisition. Financial scandals, such as the widespread misselling of personal pensions in the UK from the mid-1980s, typically involve in Bourdieu's terms an ‘objective complicity’ between a wide variety of stakeholders – including the government, employers, financial service providers, industry regulators, and financial advisers – and private investors whose habitus and lack of cultural capital prepare them for cooperation in their own exploitation.

scholarly journals The UK Economy: Forecast Summary

2018 ◽  
Vol 245 ◽  
pp. F2-F2
Keyword(s):  
Rate Increase ◽  
White Paper ◽  
Current Level ◽  
Gdp Growth ◽  
List Type ◽  
The Government ◽  
The Uk ◽  
New Framework ◽  
The Eu

The UK economy is facing an unusual level of uncertainty because of Brexit. This uncertainty primarily stems from the yet to be defined relationship between the UK and the EU but also from the economy's response to the new framework once it emerges. The UK government's White Paper, which set out its preferences for that new relationship, has failed to unite the government or Parliament, leaving open an entire spectrum of possible outcomes.Our central forecast under a ‘soft Brexit’ scenario is that the economy will grow at a pace that is consistent with its potential. This translates to annual GDP growth of 1.4 per cent this year and 1.7 per cent next year, which is broadly unchanged from our previous forecast. The risks to our GDP growth forecast are wider than before and tilted to the downside.As before, we condition our forecast on a gentle path of monetary policy normalisation with the next 25 basis point rate increase this month. On the fiscal side, we recommend that the government maintains its current level of spending (as a share of GDP) and raises the quality of public services.

Brexit and Britain’s Changing Constitution

2020 ◽  
Vol 23 (1) ◽  
pp. 400-417
Author(s):  
Rainer Grote
Keyword(s):  
Conservative Party ◽  
The European Union ◽  
Political Debate ◽  
Political Class ◽  
Parliamentary Elections ◽  
Conservative Government ◽  
Critical Junctures ◽  
The Government ◽  
Run Up ◽  
The Uk

The Brexit saga which culminated in the sweeping victory of the Conservative Party in the parliamentary elections of December 2019 and the British withdrawal from the European Union the following months caused a major upheaval in the relationship between Britain’s main constitutional actors, especially between the government and the judiciary. In the course of the long-winded and acrimonious Brexit debate, the courts were repeatedly asked to intervene at critical junctures of the withdrawal process, first to secure a central role for Parliament in discussing and approving the terms of withdrawal and then to protect Parliament against attempts by the government to curtail and render ineffective this role through the questionable use of its prerogative powers. This development reached its climax with the UK Supreme Court’s judgment of 24 September 2019 on the unlawfulness of the prorogation of Parliament decided by the Queen on the advice of the Prime Minister in the run-up to Brexit, an unprecedented interference by the courts with the exercise of prerogative powers in the name of a functioning parliamentary democracy. While the reasoning of the Court does not appear entirely convincing, there can be no doubt that the ruling was crucial in upholding the central role of Parliament in the Brexit negotiations and, by implication, of the authority of the courts which had defined that role at the beginning of the negotiations. That the Supreme Court felt it necessary to take the unprecedented step of confronting the executive over the use of its prerogative powers in a highly polarized political debate also demonstrates the extent to which the political consensus which in former times had underpinned the functioning of Britain’s flexible constitutional democracy has broken down as a result of the Brexit debate, and the divisions it has engendered within Britain’s political class and in the public at large. This gives rise to the concern that the reforms announced by the Conservative government following its sweeping victory in the parliamentary elections of December 2019 will destroy any progress which had been made in the UK prior to the Brexit referendum towards a modern practice of parliamentary majority government based on incomplete but genuine checks and balances.

scholarly journals 417 Design and rationale of a phase 1 study evaluating AMG 256, a novel, targeted, IL-21 receptor agonist and anti-PD-1 antibody, in patients with advanced solid tumors

2020 ◽  
Vol 8 (Suppl 3) ◽  
pp. A443-A443
Author(s):  
Gregory Durm ◽  
Sophia Frentzas ◽  
Erik Rasmussen ◽  
Saltanat Najmi ◽  
Nooshin Sadraei
Keyword(s):  
Solid Tumors ◽  
Tumor Immunity ◽  
Renal Cell ◽  
Phase 1 ◽  
List Type ◽  
Solid Organ ◽  
Advanced Solid Tumors ◽  
Phase 1 Study ◽  
Drug Study ◽  
Interleukin 21

BackgroundCheckpoint inhibitors are a promising therapy for patients with solid tumors; however, many patients require additional therapies to maximize clinical benefit or overcome resistance.1 The type-1 cytokine interleukin-21 (IL-21) is a promising candidate for combination and has shown clinical activity in melanoma and renal cell cancer.2 IL-21 has also shown improved efficacy when combined with anti-programmed death (PD)-1 antibodies in preclinical models.3 4 AMG 256 is a mutated IL-21 cytokine fused to an anti-PD-1 antibody to combine IL-21 pathway stimulation with checkpoint inhibition—a strategy that is designed to prime and extend the activity of cytotoxic and memory T cells and induce anti-tumor immunity. This first-in-human (FIH) study will assess safety, tolerability, and estimated dosing of AMG 256 monotherapy in patients with advanced solid tumors.MethodsThis is a FIH, multicenter, non-randomized, open-label, phase 1 study (NCT04362748) of AMG 256 in patients with advanced solid tumors. The planned sample size is approximately 100 patients in two parts: part 1 will evaluate safety, tolerability, pharmacokinetics (PK), pharmacodynamics, and determine the maximum tolerated dose (MTD), part 2 will evaluate the MTD determined in part 1 to further characterize the safety profile and preliminary tumor response. AMG 256 will be delivered by intravenous (IV) infusion. Enrollment criteria include adults with life expectancy of > 3 months, ECOG performance status ≤ 2, histologically or cytologically confirmed metastatic or locally advanced solid tumors not amenable to curative treatment with surgery or radiation, and at least one measurable lesion ≥ 10 mm that has not undergone biopsy within 3 months of screening scan. Exclusion criteria include primary brain tumor, untreated or symptomatic brain metastases, currently receiving treatment in another investigational device or drug study, or less than 28 days since ending treatment on another investigational device or drug study, history of solid organ transplantation or major surgery within 28 days of study day 1, live vaccine therapy within 4 weeks prior to study day 1, and active infection requiring oral or IV therapy. The primary endpoints are incidence of dose-limiting toxicities and adverse events, MTD, and recommended phase 2 dose. Secondary objectives will evaluate PK parameters, preliminary antitumor activity (objective response, duration of response, progression-free survival, disease control rate, duration of stable disease, overall survival), and immunogenicity of AMG 256 via incidence of anti-AMG 256 antibodies.ResultsN/AConclusionsN/AAcknowledgements• The authors thank the investigators, patients, and study staff who are contributing to this study.• The study was sponsored and funded by Amgen Inc. • Medical writing support was provided by Christopher Nosala (Amgen Inc.).Trial RegistrationNCT04362748Ethics ApprovalThe study was approved by all institutional ethics boards.ReferencesKluger HM, Tawbi HA, Ascierto ML, et al. Defining tumor resistance to PD-1 pathway blockade: recommendations from the first meeting of the SITC Immunotherapy Resistance Taskforce. J Immunother Cancer 2020;8:e000398.Thompson JA, Curti BD, Redman BG, et al. Phase I study of recombinant interleukin-21 in patients with metastatic melanoma and renal cell carcinoma. J Clin Oncol 2008;26:2034–2039.Lewis KE, Selby MJ, Masters G, et al. Interleukin-21 combined with PD-1 or CTLA-4 blockade enhances antitumor immunity in mouse tumor models. Oncoimmunology. 2017;7:e1377873.Shen S, Sckisel G, Sahoo A, et al. Engineered IL-21 cytokine muteins fused to anti-PD-1 antibodies can improve CD8+ T cell function and anti-tumor immunity. Front Immunol 2020;11:832.

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