A. Darzi, E. Oborn and P. Howitt
British Journal of Healthcare Management, vol. 13, 2007, p. 468-472
The authors examine the process and products of the recent review of healthcare in London in which they were involved, and point out its lessons for the development of regional strategy in general. The strategic health authority for London sought to inform its strategic thinking by commissioning A Framework for Action, a clinical review of projected needs and directions of change in greater London over the next 10 years. The Framework is built on seven care pathways and seeks to integrate a cradle to grave perspective. Developing it has involved extensive consultation with clinical and frontline staff and the public. The strategic health authority now faces the challenge of producing appropriate community level translation of the city-wide vision.
J. Woodin and J. MacDonald
British Journal of Healthcare Management, vol. 13, 2007, p. 478-482
This article considers the potential impact of stronger commissioning on NHS trusts, and identifies six strands of development activity that may arise for them as a result. Providers will need to cope with:
Health Service Journal, vol. 117, Dec. 13th 2007, p. 16-17
The government’s new Cancer Reform Strategy focuses on prevention through improved education, further reductions in smoking and increased access to screening. The preferred treatments are surgery and radiotherapy, rather than expensive new drugs. The strategy also calls for a reduction in the time between a decision to treat being made and treatment starting. By 2010, no patient should be waiting more than 31 days for treatment to start. Government will invest £270m up to 2010 to implement the strategy. It sets out two central approaches to improve prevention and achieve earlier diagnosis: an emphasis on good data collection and a concerted effort to address health inequalities prevalent in cancer, including age, gender, deprivation and ethnicity.
Health Service Journal, vol.117, Dec. 6th 2007, p.16-17
The 13 'early achiever' trusts hope to be either hitting or to be very close to the target of treating 90% of patients admitted to hospital and 95% of those treated as outpatients within 18 weeks of referral by December 31st 2007. They are reaching the target a year ahead of the rest of the NHS. This article reports on the challenges involved in eliminating waiting list backlogs. It is important: 1) to set up systems to track 'referral to treatment' times; 2) to avoid inappropriate hospital referrals; and 3) to clear the backlogs of those who have already been waiting more than 18 weeks.
E. Annandale and others
Evidence and Policy, vol. 3, 2007, p. 463-486
This critical interpretive synthesis of the literature on gender and access to healthcare identified that research in this area has proceeded in a piecemeal manner. Genuinely comparative research that takes into account the experiences of both men and women is rare. An answer to the question of whether access to healthcare is characterised by gendered patterns of advantage and disadvantage is not possible given the current research base. However, this analysis suggests that access to services by men and women cannot be defined as either easy or difficult in any straightforward way, but that accessibility appears to be relative, variable and contingent on many other factors and circumstances, one of which is gender. It is concluded that gender equality in healthcare is best fostered through what the authors term 'critical gender awareness'.
British Journal of Healthcare Management, vol. 13, 2007, p. 465-467
A patient-centred NHS can only come with the transformation of attitudes and behaviours among frontline staff. People cannot be persuaded to change through a command and control approach. They need to be made to understand that it is time to change their behaviour, using techniques such as simulation, storytelling, after action reviews and coaching, underpinned by information, communication and networking.
Chronic Illness, vol. 3, 2007, p. 181-193
People with chronic diseases tend to be old and frail, to have other co-morbidities, and to use a lot of services (thereby incurring high costs). Effective care for this group aims to avoid emergency hospital admissions through improved management of the condition(s) in the community. This paper examines reforms introduced into the NHS in England with a view to improving care for people with chronic illness. There is mixed and weak evidence for the effectiveness of interventions used in England to reduce the risk of emergency hospital admission for people with chronic illnesses. This is because they do not accurately identify a target population of individuals at highest risk and because NHS institutions are not offered sufficient financial and other incentives to work together to improve care continuously.
R. Allmark (editor)
Health Service Journal, vol. 117, Dec. 20th 2007, p. 27-34
This special report includes:
Health Service Journal, vol. 117, Dec. 20th 2007, p. 16-17
This article comments on the NHS Operating Framework for 2008/09. The framework introduces 60 new or extended centrally imposed targets, excluding the full list of indicators (vital signs) against which NHS organisations will be judged. These vital signs will be published by the Department of Health in due course. A further set of pre-existing national targets remain in place. Additionally, primary care trusts will be expected to develop local targets based on community needs. There is also concern that primary care trusts have only been informed of their funding allocations for 2008/09, instead of for the full three years to 2010/11, because the distribution formula is still under review. However, there are hints that the minority of trusts in real financial difficulties may be bailed out by their strategic health authorities.
Public Finance, Oct. 26th- Nov. 1st 2007, p. 12-13
People in the North of England are in poorer health than those in the South in almost all cases. However, performance assessments by the Healthcare Commission show that Northern patients receive better NHS services than their counterparts in the South. This appears to be due to superior use of resources and better financial management in Northern trusts.
A. Coulter and D. Redding
Health Service Journal, vol. 117, Dec. 6th 2007, p. 20-21
There is research evidence that health services tailored to individual patient needs are more effective. Examples of improved outcomes can be found in patient-centred telecare for those with chronic conditions, use of patient decision aids, patient education for self-care, and patient involvement in safety campaigns. Policies to promote personalised healthcare include improving patients’ health literacy, shared decision making between patients and professionals, and patient and public involvement in service development.
Health Service Journal, vol.117, Dec. 6th 2007, p. 5
The government’s focus on cutting waiting times may now be diverting resources away from treatments for those in greatest clinical need. For example, the waiting lists for cataract surgery are now so short that patients are having the operation while they can still see to drive a car. Research indicates that current policy on waiting list reduction is bringing limited added value to patients.
A. Nolan (editor)
Health Service Journal, vol.117, Dec. 20th 2007, Supplement, 13p
Many trusts are failing to meet the Hygiene Code standards for cutting infections. While MRSA infection rates are falling, those for Clostridium difficile are rising. Over the past year, the government has introduced numerous policies and programmes to try to force trusts to reduce infection rates. The supplement presents a case study of how Royal Wolverhampton Hospitals trust has successfully tackled these infections, followed by guidance on how using a balanced scorecard and root cause analysis could help reduce them.