J. Hibbs and T. Womersley
Daily Telegraph, Mar. 27th 2000, p. 8
Reports disclosure by a Cabinet colleague of Gordon Brown's that the 10,000 new nurses promised in the budget were in fact already in the pipeline and financed by a previous comprehensive spending review.
British Medical Association Board of Science and Education
Paper examines the six clinical indicators published in June 1999 to compare individual trusts and health authorities. Argues that the data are too complicated for the public and insufficiently specific to be of much use to individual doctors. They are also statistically flawed for the purposes of comparing trusts.
Health Service Journal, vol. 110, Mar. 30th 2000, p. 22-23
Argues that the role of the royal medical colleges in the training and governance of doctors should be independently reviewed. The colleges have extensive influence on the NHS which may not be used to benefit the patient.
E. Ferlie, L. Fitzgerald and M. Wood
Journal of Health Services Research and Policy, vol. 5, 2000, p. 96-102
Studied the relationship between research evidence and clinical behaviour change in the NHS in the period 1995-1997 by examining the "careers" of change issues designed to reshape clinical practice, the impact of such change efforts, and the factors shaping change outcomes. Results showed a weak relationship between the evidence base and its diffusion. The diffusion and take-up of scientific evidence was shown to be socially constructed. Different forms of evidence were differentially accepted by individuals and groups. Specific organisational and social factors affected this pattern of impact. The general management hierarchy of the NHS played a very limited role in enabling evidence-based clinical change.
Guardian, Mar. 24th 2000, p. 21
Argues that NHS modernisation depends on getting a grip on doctors, and changing the way that they work.
K. McPherson and A. Metcalfe
Health Service Journal, vol. 110, Mar. 30th 2000, p. 26-27
Little research has been done on the number of intensive care beds the UK needs, and provision varies widely across the country. There is no indication of systematic under-provision, but there is confusion about appropriate referrals and admissions. Research suggests that with present levels of provision there are 2,100 - 2,500 avoidable deaths a year, but is unclear how many of these would have been prevented by increasing bed numbers.
Daily Telegraph, Mar. 24th 2000, p. 28
Argues that care standards in the NHS could be dramatically improved if nurse training was made less academic and more practical, with emphasis on hygiene and high standards.
Independent, Apr. 10th 2000, p. 2
Announces the appointment of seven review teams, each headed by a minister, to produce plans for sweeping reforms of the NHS. The teams will look into: partnership, performance and productivity, the professions, patient care and prevention.
Daily Telegraph, Apr. 6th 2000, p. 17
National standards are to be introduced to clean up dirty hospital wards in an attempt to cut the number of nosocomial infections. The level of cleanliness has deteriorated following the contracting out of domestic services.
(See also Daily Telegraph, Apr. 7th 2000, p. 28)
Department of Health
Consultation document proposes a radical shake-up of disciplinary procedures for doctors. It recommends that the General Medical Council should have power to:
Times, March 13th 2000, p. 9
Many nurses are to be given powers to prescribe drugs without a doctor's consent. It will allow nurses to treat minor injuries and chronic illnesses such as diabetes and asthma. The changes mark a breakdown of barriers between doctors and nurses and will allow doctors to deal with more serious cases.
Health Service Journal, vol. 110, Mar. 23rd 2000, p. 16-17
Expert opinion on NHS cancer services is divided into those who are impressed by the government's attempts to tackle years of under-investment and neglect, and those who want much more done faster. All agree that extra cash and manpower are needed.
Community Practitioner, vol. 73, 2000, p. 525-526
Explores the idea of developing health services by looking at the needs of both providers and users through partnership.
Independent, Mar. 27th 2000, p. 8
Announces plans to introduce a hotel-style star rating system for hospitals as part of the drive to raise NHS standards. Hospitals would be awarded up to 5 stars on 20 different criteria, including cleanliness, waiting lists and the proportion of patients successfully treated. Failing hospitals would be starved of cash unless standards improved.
(See also Financial Times, Mar. 27th 2000, p. 2)
Times, 3rd Apr. 2000, p. 8
Reports results of a survey showing that staff shortages have overtaken pay as the main concern of nurses. Despite government attempts to lure more people into nursing there are still 15,000 vacancies in English hospitals. Any gains in recruitment are being wiped out by the fact that nurses are still leaving the NHS in droves.
(See also Daily Telegraph, Apr. 3rd 2000, p. 5; Independent, Apr. 3rd 2000, p. 9; Guardian, Apr. 3rd 2000, p. 6)
Financial Times, March 13th 2000, p. 21
While Labour's attitude to private healthcare provision is shifting, serious practical constraints remain. The issue of quality of private healthcare is being addressed by the introduction of a new private sector inspectorate. But there are to even larger constraints on a big expansion in private provision paid for by the NHS. The first is the limited number of doctors and consultants in Britain and the second is the fact that most consultants work both for the NHS and privately which complicates the issues of future payments for private healthcare provision.
C. Adams, S. de Lusignan and S. Hoult
Community Practitioners, vol. 73, 2000, p. 553-554
Describes the national electronic library for health that will go online in the summer of 2000. The library will offer clinical information, methodologies for its utilisation, tools for auditing and evaluating practice, and access to clinical guidelines such as NICE.
Health Service Journal, vol. 110, Mar. 31st 2000, p. 31
Any structural reform of the NHS following chief executive Sir Alan Langland's departure will need to address the tension between central control and the need of local service providers for sufficient freedom of movement to develop a local community leadership role.
A. Lack, A. T. Edwards, A. Boland
Journal of Health Services Research and Policy, vol. 5, 2000, p. 83-95
Paper describes a waiting list patients' points scheme under development in Salisbury, Wilts., for the fair management of elective inpatient and day case waiting lists. Paper illustrates how points can be assigned to patients on a waiting list to indicate their relative unmet need, and shows the impact on case mix and resource use of the implementation of the points system versus "first come, first served".