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Welfare Reform on the Web (February 2009): National Health Service - reform - general

18 weeks

I. Torjeson (editor)

Health Service Journal, Jan. 29th 2009, Supplement, 13p

The National Health Service has successfully reduced the time that patients wait from referral to treatment to 18 weeks. This supplement looks at how investment in new technologies, integration of diagnostic tests into the patient pathway, emphasis on correct referrals, and improved data capture have contributed to success. It also presents two case studies, and patient reaction to the experience of the 18 week pathway.

A&E patients often left in pain, survey shows

J. Carvel

The Guardian, Jan. 14h 2009, p. 8

A report produced by the government's health watchdog, the Healthcare Commission, has revealed that millions of patients were left in pain in NHS accident and emergency departments last year because staff did not provide prompt medication. While patients were largely positive about the overall standard of care provided in A&E in England, with 88% rating it excellent or good, a survey of 50,000 patients also found serious concerns about particular aspects of the service. These included dissatisfaction with how quickly pain relief was provided, failure to give patients enough information when being discharged from A&E and patients not being given enough privacy to discuss their condition.

Britain has fewer hospital beds than most European countries

K. Devlin

Daily Telegraph, Jan. 13th 2009, p. 6

Figures compiled by the Conservatives show that Britain has fewer hospital beds per head of population than almost any other European country, with half as many as Lithuania and Hungary. Britain is ranked 25th out of 32 European countries. The Conservatives accuse the government of cutting too many beds and leaving the NHS ill-equipped to deal with pressure from epidemics such as flu outbreaks.

Don't forget your toothbrush

A. Moore

Health Service Journal, Jan. 15th 2009, p. 18-20

Estimates suggest that as many as 150,000 Britons will travel abroad for medical treatment in 2009. At present, a major reason for seeking treatment abroad is lower costs for work not funded by the NHS. However, an EU directive will make it easier for patients to have overseas treatment paid for by the NHS. This article considers the impact of health tourism on the NHS, including patients suffering complications once they return home and women travelling for fertility treatment experiencing multiple pregnancies.

Effective quality improvement: recognising the challenges

A. Powell, R. Rushmer and H. Davies

British Journal of Healthcare Management, vol. 15, 2009, p. 17-21

Quality improvement is a high priority for healthcare organisations, but defining quality is complex and addressing problems through changes in routine practices is challenging. A range of quality improvement approaches have been imported into the NHS. However, healthcare organisations present managers with a challenging environment, no matter which approach is used.

Hospitals must abolish mixed-sex wards by 2010

K. Devlin

Daily Telegraph, Jan. 29th 2009, p. 12

The Health Secretary has announced a 100m fund to help hospitals improve facilities and ensure that all accommodation is single-sex. Hospitals will be fined if they treat patients in mixed-sex wards from 2010. Certain wards will be exempt from fines, including intensive care units.

Issues highlighted by the 2008 emergency department survey

Healthcare Commission


A survey of 50,000 patients has revealed that four in ten in accident and emergency departments were left without adequate pain relief. One in eight patients who asked for pain relief had to wait more than half an hour to get it and 9% said they never received any. There has been no improvement in cleanliness from previous surveys, and the number of patients saying they were always treated with dignity and respect has fallen since 2004. However, the percentage of patients who rated their care in accident and emergency as good or very good increased from 66% in 2003 to 71% in 2008.

MPs say managers lack skills to boost NHS care

N. Timmins

Financial Times, Jan. 13th 2009, p. 2

The Commons Health Committee, a cross-party committee of MPs, has published a report which says the NHS lacks the leadership and commissioning skills necessary to provide high quality care. The report has been welcomed by Lord Darzi, the health minister.

NHS constitution is bitter pill to swallow for critics

N. Timmins

Financial Times, Jan. 22nd 2009, p. 4

A 12-page 'constitution' for the NHS which sets out rights and responsibilities of patients and staff was published yesterday. There is also a 140-page booklet which gives more detail. It brings together the rights and duties created by years of NHS legislation. Some patient groups and NHS bodies have welcomed it, but others such as The Patients' Association, criticised the move, saying it will make no difference to the quality of care patients receive.

NHS starts inquiry into deaths of patients with learning difficulties

D. Campbell

The Guardian, Jan. 19th 2009, p. 9

The health secretary, Alan Johnson, is launching an inquiry into why people with serious learning difficulties have died while under NHS care, after allegations surfaced that neglect led to at least six fatalities. The move is part of an overhaul of how the NHS treats those with learning difficulties after a government commissioned independent inquiry last year uncovered evidence of serious failings in care.

NHS trust considers abandoning electronic records

N. Timmins & A. Barker

Financial Times, Jan. 27th 2009, p. 2

Worthing & Southlands Hospitals NHS Trust is thinking of ditching its patient record software and going back to a 20-year old system. This, it is suggested, shows continuing problems with the NHS IT project.

Panel to judge on competition rows

S. Gainsbury

Health Service Journal, Jan. 29th 2009, p. 7

Announces the launch of the new Co-operation and Competition Panel, which will make judgements on claims by private companies and NHS bodies that they are victims of discrimination in the NHS market.

Quality improvement: theory and practice

R. Boaden

British Journal of Healthcare Management, vol. 15, 2009, p. 12-16

Quality improvement approaches from industry are increasingly being applied in healthcare and this article considers what evidence exists of their effectiveness and applicability. It covers the Play-Do-Study-Act (PDSA) cycle, statistical process control, six sigma, lean thinking, theory of constraints and mass customisation.

Role redesign in the National Health Service: the effects on midwives' work and professional boundaries

J. Prowse and P. Prowse

Work, Employment and Society, vol. 22, 2008, p. 695-712

Midwives' work and professional boundaries are being challenged from within the profession, by the medical profession and by the government's agenda for modernising working practices within the NHS. This article explores these issues and uses the concept of closure to analyse the effects of the current NHS human resource management strategies on midwives' work and professional boundaries. Using a case study approach, the researchers examine midwives' views of their key skills and the effects of work redesign on their roles and autonomy. Results show that role redesign is transforming the professional boundaries of midwifery and their traditional social and emotional skills are being eroded or replaced as they take on more technical tasks previously undertaken by doctors. At the same timer, the role of maternity support worker is expanding to incorporate some of the midwives' traditional social and caring skills.

Saving carbon, improving health: NHS carbon reduction strategy for England

NHS Sustainable Development Unit

Cambridge, 2009

The NHS accounts for 25% of all public service carbon emissions in England, and 5% of all road traffic. The strategy proposes a package of measures to make the NHS 'greener', including encouraging patients to consult their GP by phone, re-using some instruments currently thrown away after a single use, and bringing consultants to local surgeries. The routine purchase of bottled water will be avoided, and there will be more fish and less meat, eggs and dairy products on menus. NHS staff are to be 'exemplars' in active travel such as walking and cycling. Sustainability and carbon governance are to be made the responsibility of all chief executives and directors.

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