Health Service Journal, vol.117, Oct. 4th 2007, p. 5
Spot checks on 43 hospitals by the Healthcare Commission have revealed concerns that boards are not regularly discussing opportunities for improving infection control or ensuring that data are analysed effectively. In an interim report on hygiene code compliance, the Commission said that most boards needed to do more to outline their collective responsibility for minimising risk of infection or to incorporate the code fully into the trust's governance and performance frameworks.
J. Tooke (Chair)
This is the interim report of an independent inquiry into the failure of the Medical Training Application Service (MTAS) launched in 2007. MTAS was launched to match junior doctors to specialist training posts, but was scrapped after critics said it left thousands of excellent candidates without jobs. The report is deeply critical of the decision to devolve responsibility for workforce planning to strategic health authorities, but says that changing this after only 18 months would be too disruptive. Instead it recommends that regional workforce plans should be overseen and scrutinised by a national committee with service, professional and employer representatives. The report also says that:
Health Service Journal, vol.117, Oct. 25th 2007, p. 16-17
Patient deaths from Clostridium difficile at Maidstone and Tunbridge Wells hospital trust were the subject of a damning Healthcare Commission report. Problems with hygiene and cleanliness arose in old buildings which were not fit for purpose and from incompetence among some nursing staff. The trust board, under pressure from its strategic health authority, was focused on meeting government waiting time targets and achieving financial balance. It also claims to have been fed misleading information by the chief executive.
British Journal of Healthcare Management, vol. 13, 2007, p. 377-388
This special supplement looks at the future of cancer care in the NHS as the disease becomes a long term condition rather than a terminal one. It covers costs of new cancer drugs, increasing efficiency through competition between services, the impact of a new vaccine to protect against cancers caused by HPV, disease incidence, public perceptions of cancer, improvements in screening and drug treatments, and workforce development.
J. Woodin and J. MacDonald
British Journal of Healthcare Management, vol. 13, 2007, p. 371-376
Commissioning in the NHS is to be strengthened through the creation of a market environment in which commissioners will use the tools of competition, choice and payment by results to achieve results. This article considers the impact of stronger commissioning on healthcare service providers, focusing on:
Health Service Journal, vol.117, Oct. 18th 2007, p. 26-28
Many in the NHS are unwilling to discuss the impact of the influx of migrant workers from Eastern Europe since 2004 on services, either for fear of accusations of racism or because they do not have accurate data. Uncertainty about numbers means that planning for demand on NHS services will be challenging, and funding allocations to primary care trusts may be inadequate in areas of rapid population growth. The arrival of a cohort of young people in an area will increase demand for sexual health, maternity and abortion services, and they are likely to have higher rates of communicable diseases such as tuberculosis. The NHS also needs to face up to the challenge of overcoming language barriers.
Health Service Journal, vol.117, Oct. 25th 2007, p. 18-19
Some talented new chief executives have been appointed to take charge of failing trusts as their first job, have experienced serious difficulties, and been summarily removed, suffering severe reputational damage in the process. In other cases, incompetent chief executives receive lavish compensation payments when they move on. Neither of these scenarios is acceptable, and the NHS needs to take more care of its managerial talent.
N. Edwards and W. Dunlop
Health Service Journal, vol. 117, Oct. 4th 2007, p. 22-23
The NHS Confederation and the Joint Medical Consultative Council interviewed a sample of doctors about their vision for practising in a reformed health service. Doctors said that they wanted to work in a well coordinated system based on reliable data and not in a set of disorganised services. They wanted to see the barrier between primary and secondary care broken down, and a system that provided an early diagnosis and treatment plan. They also felt the need to be valued by their organisations, the NHS hierarchy and the Department of Health.
This report of an investigation into Clostridium difficile outbreaks at Maidstone and Tunbridge Wells trust in which 90 patients died over two and a half years details a catalogue of failings:
A. Barker and N. Timmins
Financial Times, Sept. 26th, 2007, p.2
At the Labour Party conference, Health Secretary Alan Johnson promised an end to 'permanent revolution' in the health service. Although government sources stressed that structural changes will still be made when clinical need demands them, Johnson's statement has been interpreted as signalling an end to market-style reforms of the NHS. The Health Secretary emphasised that he wanted reform to be 'clinically-led, locally-driven'
(See also The Independent, Sept 26th, 2007, p.40)
Health Service Journal, vol.117, Oct. 18th 2007, p. 5, 6-7
The Healthcare Commission's annual health check 2006/07 shows an overall improvement in performance over the previous year, but more than half of trusts are still rated fair or weak for financial management and quality of services. Hospital trusts have also failed to hit targets for reducing MRSA, and many are not meeting basic hygiene and cleanliness standards. Primary care trusts are struggling to improve as quickly as other sectors and have seen a decline in the quality of their services. However, waiting times for operations and treatment have improved since 2005/06.
Deoartment of Health, 2007
This interim report on Darzi's review of the NHS focuses on improving access and infection control. To improve access it calls for:
On infection control, the report calls for all patients coming into hospital to be screened for MRSA as soon as possible. Other recommendations include setting up a Health Innovation Council to promote the take up of new technologies and techniques, and better alignment between training and service delivery. This would avoid scandals such occurred in 2006, when large numbers of NHS trained physiotherapists were unable to find posts.
Health Service Journal, vol.117, Oct. 25th 2007, p. 28-30
A target for all NHS hospital trusts to be ready to apply for foundation status by December 2008 has proved unrealistic. The future of the 140-odd trusts which have not made the grade is uncertain. The regulator has said that some trusts will never be financially viable. This may include specialist trusts. Options for those left behind include closure or merger.
British Journal of Healthcare Management, vol. 13, 2007, p. 390-392
Argues that hitting centrally imposed performance targets such as improved waiting times can cause a loss of focus on other aspects of healthcare services, such as patient safety. The imposition of targets, which often measure the wrong things, has also led to apathy among clinical staff. The article calls on doctors to re-engage and find a stronger political voice. Morale could also be improved by a system of awards to NHS staff for exceptional service.
Journal of Integrated Care, vol. 15, Oct. 2007, p. 26-33
When NHS bodies consult on proposals which affect people from more than one local authority area, councils may form a joint health oversight and scrutiny committee to consider them. This article describes how a group of local authorities operated a specific joint health scrutiny committee. It highlights some of the benefits of health scrutiny, but suggests that engaging more fully with patients and the public in such reviews could result in a more influential and inclusive process.