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

4,000 births outside maternity wards

K. Devlin

Daily Telegraph, Aug. 26th 2009, p. 2

The Conservatives have obtained figures showing that in 2008 almost 4,000 women were forced to give birth outside maternity wards, up from 3,500 in 2007. Mothers gave birth in hospital lifts, corridors, lavatories, car parks and midwives' offices, as well as in other wards such as accident and emergency units.

CQC names high death rate trusts

C. Santry

Health Service Journal, Aug. 20th 2009, p. 4-5

Hospital trusts with unusually high death rates which have triggered alerts have been publicly named for the first time by the Care Quality Commission in a move aimed at promoting accountability and patient safety. However, few of the trusts were found to have problems with quality of care and there are concerns that publishing the information will unfairly stigmatise them as 'bad apples'.

Extending specialist palliative care to people with heart failure: semantic, historical and practical limitations of policy guidelines

S. Chattoo and K.M. Atkin

Social Science and Medicine, vol. 69, 2009, p. 147-153

This paper explores the continuities and discontinuities in recent policy initiatives to extend specialist palliative care to people with heart failure in the UK. It focuses on how two major disciplines, cardiology and specialist palliative care, negotiate their disciplinary boundaries within the context of recent policy shifts. It draws out tensions between the core values of cardiology, which focuses on 'living with heart failure' and those of specialist palliative care, which focuses on 'dying with heart failure' It is argued that these tensions lead to different engagements with the wider cultural script of 'aware dying', underpinning the specialist palliative care philosophy based on clinical and cultural representations of cancer. Representations of heart failure and its association with sudden death do not quite fit within the privileged script of aware dying associated with cancer.

Fertility

D. Carlisle (editor)

Health Service Journal, July 30th 2009, supplement, 9p

Studies estimate that around one in six couples seek specialist help with fertility problems, but currently the amount and type of treatment available on the NHS varies dramatically in different primary care trusts. However, progress is being made. Patchy policies across NHS East of England have been replaced with a region wide promise of up to three IVF treatment cycles. The supplement also offers articles on the difficulties involved in commissioning infertility services, and the risks and rewards of single and multiple embryo transfer.

From boundary concept to boundary object: the practice and politics of care pathway development

D. Allen

Social Science and Medicine, vol. 69, 2009, p. 354-361

Care pathways are multidisciplinary care management tools that map out chronologically key activities in a healthcare process. In the UK, they are advanced as a mechanism for enacting the changes called for under clinical governance and as agents of service improvement even though they remain under-conceptualised and their generative mechanisms are poorly understood. However, the looseness and imprecision of care pathway methodology makes it highly effective in aligning management, clinical and user interests. On the other hand, the process of care pathway development brings to the surface many of the tensions which they are designed to resolve. Drawing on a qualitative case study of a mental health safety care pathway in the UK, this paper examines the processes by which originators negotiated and settled upon a given design.

Management stars need a leg-up to rise to the top

C. Santry

Health Service Journal, Aug. 20th 2009, p. 10-11

All strategic health authorities were expected to submit talent and leadership plans to the Department of Health by the end of July 2009. An analysis of those plans by the HSJ shows an undersupply of managers ready for promotion to director level, but an over-abundance of directors clamouring for promotion to chief executive level. There is increasing interest among private sector managers made redundant in the recession in moving into the NHS and positioning themselves for top roles. There is also concern that NHS senior managers are predominantly white males.

NHS project on the critical list

N. Timmins

Financial Times, Aug. 20th 2009, p. 12

This article provides a progress update on the NHS electronic patient records database in the light of the Conservative Party pledge that they would scrap the project, if they win the next election.

Patients.not numbers, people.not statistics

Patients' Association

Harrow: the Association, 2009

This report presents case studies of elderly patients suffering appalling care in NHS hospitals. It presents a horrifying catalogue of patients left in pain, in soiled bed clothes, denied adequate food and drink, and suffering repeatedly from cancelled operations, missed diagnoses, and dismissive staff.

Patients to rate NHS hospitals online

R. Smith

Daily Telegraph, Aug.11th 2009, p. 2

Announces the creation of a new website that will enable patients to compare hospitals on clinical measures such as mortality rates and superbugs, as well as facilities such as car parking and quality of food. They will also be able to read reviews by previous patients and post their own comments. The site should help patients make informed decisions about where they wish to be treated.

See http://www.nhs.uk

Read your medical records on Google

J. Kirkup

Daily Telegraph, Aug. 10th 2009, p. 4

The Conservatives are proposing allowing patients to read their medical records online and add questions about treatment. The records could be held and managed by private companies such as Google or Microsoft. Products such as Microsoft Health Vault and Google Heath could be bought 'off the shelf' to hold patient records at a fraction of the cost of a bespoke system.

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