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Welfare Reform on the Web (January 2010): National Health Service - reform - general

Cancer reform strategy: achieving local implementation: second annual report

Department of Health

2009

Study shows that more than nine out of ten hospital trusts in England are failing to provide a good standard of cancer care compared with other countries. Just 15 of 152 NHS hospital trusts matched the highest survival rates in Europe for patients suffering from the three most common forms of the disease. In England, 95% of patients live for at least a year after being diagnosed with breast cancer compared with the European survival rate judged good of 97%. For colorectal cancer, 71% of patients were still alive a year later, compared with the 'good' European standard of 79%. In lung cancer, just 28% of patients lived for a year after diagnosis, compared with the 37% considered good in Europe. There are also regional variations in survival rates, with patients found to be three times more likely to survive in some areas than in others.

Change at the top could kill local shake-up plans

A. Moore

Health Service Journal, Nov. 26th 2009, p. 14-15

The Conservatives have said that they will scrap Labour government plans to cut accident and emergency and maternity services which are not supported by evidence that patient access and care will be improved. Many areas will now be reluctant to enter into consultations about changes for fear that policy will change if the Conservatives are elected to govern in 2010.

How safe is your hospital?

Dr Foster Intelligence

2009

This guide ranked 148 hospital trusts in England on patient safety based on 13 criteria, including mortality rates, surgical errors and infection control measures. A total of 27 were identified as having mortality rates above the average in 2008/09, while 32 had rates that were significantly low. The report found that 82 patients had had surgery on the wrong part of their body and 209 foreign objects such as gauzes were left inside patients after operations.

(See also Health Service Journal, Nov. 26th 2009, p.4-5)

An in depth investigation into causes of prescribing errors by foundation trainees in relation to their medical education. EQUIP study.

T. Dornan and others

General Medical Council, 2009

In this study, 124,260 prescriptions written by doctors in 19 hospital trusts in north-west England were checked by pharmacists and 11, 077 errors were detected. The mistakes included omitting drugs, wrong doses, not taking account of patients' allergies, illegible handwriting and ambiguous orders. When interviewed about their mistakes, some doctors admitted that they used pharmacists or nurses as a 'safety net' to correct errors. Many of the errors were associated with drug charts with which doctors were unfamiliar, as each NHS hospital may use a different version.

Mixed-sex wards to be scrapped by next summer

R. Smith

Daily Telegraph, Dec.16th 2009, p. 2

Ministers have claimed that a 100m investment will mean that all hospitals will provide single-sex sleeping areas by June 2010 or face fines. Only patients needing specialist of emergency treatment will be placed in mixed-sex wards. The Labour Party originally pledged to abolish mixed-sex wards in 1997, but in 2009 one in seven trusts still used them.

MPs back doctors' right to help their patients die

R. Bennett

The Times, Dec. 16th 2009, p. 1

A recent poll by IPSOS MORI has revealed that 53 per cent of MPs are in favour of doctors being spared from prosecution for assisting terminally ill patients who request to die. The Director for Public Prosecutions has been ordered to issue guidelines by the law lords, who have said that the considerable lack of clarity in the law can lead to violations in human rights. Final guidelines will be issued to the British Medical Council in March 2010.

New NHS jobs help stabilise employment

A. Seagar and K. Hopkins

The Guardian, Dec 17th 2009, p. 28

The extra 23,000 jobs created in the NHS in the three months from July to October 2009 have contributed to stabilising unemployment figures for the UK. The biggest increase overall (not just in the NHS) was in the number of women taking part-time jobs.

NHS 2010-2015: from good to great: preventative, people-centred and productive

Department of Health

2009

This five-year plan aims to reshape the NHS to meet the challenge of delivering high quality care in tough financial times. It proposes that frontline NHS staff should be offered an employment guarantee locally or regionally in exchange for flexibility, mobility and sustained pay restraint. It presents practical measures to meet the demands of an ageing population and the increased prevalence of lifestyle diseases. The vision is for the NHS to be organised around patients whether at home, in a community setting or in hospital. There will be a renewed emphasis on prevention and the delivery of high quality care across the service.

The operating framework for the NHS in England 2010/11

NHS Finance, Performance and Operations Directorate, Department of Health

London: 2009

This document sets out the specific business and financial arrangements for the NHS during 2010/11. The Operating Framework for 2010/11 describes the national priorities for the year and describes how system levers and enablers will ensure that the momentum from High Quality Care for All can be maintained despite a tighter economic climate through a process which focuses on quality, innovation, productivity and prevention

Reducing healthcare associated infection in hospitals in England

Public Accounts Committee

London: TSO, 2009 (House of Commons papers, session 2008/09; HC 812)

Every year over 300,000 patients in England acquire a healthcare associated infection whilst in hospital. These infections are caused by a variety of organisms and lead to a range of symptoms from minor discomfort to serious disability. For some they can be fatal, and in 2007, there were 9,000 deaths recorded with Meticillin resistant Staphylococcus aureus (MRSA) or Clostridium difficile infections as the underlying cause or a contributory factor. The Department of Health's hands on approach to the problem has been successful in reducing MRSA bloodstream and C. difficile infections. Hospital cleanliness has improved and the priority given to reducing these two targeted infections has started to have an impact on hospital trusts' overall infection prevention and control. This progress has not, however, been matched on other healthcare associated infections. The best available evidence from voluntary reporting of other healthcare associated bloodstream infections suggests that these infections may be increasing. Indeed, as a result of the Department's decision to disregard a key recommendation from previous Committee of Public Account reports-to introduce mandatory surveillance of all hospital acquired infections-there is still no robust comparable data on the extent and risks of at least 80% healthcare associated infections. There has also been limited progress in improving information on, and understanding of, hospital antibiotic prescribing and the evidence that is available on other bloodstream infections, which can be just as serious as MRSA, suggests the problem may be growing and that antibiotic resistant organisms are increasing.

Rheumatoid arthritis: from policy to action

J. Taylor (editor)

Health Service Journal, Dec. 10th 2009, supplement, 9p.

Forward planning can help to reduce the physical, financial and societal costs of rheumatoid arthritis. Early diagnosis is critical to effective treatment. It is then possible to not only treat the symptoms, but to prevent joint damage. This reduces sick leave and enables patients to keep their jobs. However, treatment often begins too late because of low public awareness and GPs' difficulties with diagnosis. Moreover, early referral and treatment increases NHS costs in the short term, especially when expensive new drugs are required. Services should, however, improve in 2010 thanks to implementation of new NICE guidelines on treating the disease, promotion of joint working between the health service and employers, and more training for GPs. It is finally argued that the appointment of a musculoskeletal czar is needed to make improving services for patients with rheumatoid arthritis a government priority.

The risks of managing uncertainty: the limitations of governance and choice, and the potential for trust

P. Brown and M. Calnan

Social Policy and Society, vol. 9, 2010, p. 13-24

A series of high-profile scandals led government to the conclusion that clinicians could not be trusted to be left alone to practise their craft autonomously. It therefore sought to assure quality of medical care through the introduction of clinical governance and the quasi-market mechanisms of competition and patient choice. This article argues that these alternatives to trust are just as dysfunctional as the old system of trusting fallible professionals. A new, qualified form of trust is proposed in resolution.

Tory pledge on targets might not hit the spot

A. Moore

Health Service Journal, Dec. 10th 2009, p. 12-13

The Conservatives are proposing phasing out NHS targets and replacing them with outcome measures and improvements in patient satisfaction with their healthcare experience. In this article, a number of experts comment on the plans.

Working well: tools and measures for finance and workforce management

D. Carlisle (editor)

Health Service Journal, Nov. 26th 2009, supplement, 13p

The NHS is entering a new phase in which resources will be tighter, demand will continue to rise, and quality and productivity must be driven up. None of this can be achieved without access to high quality information. The NHS Information Centre has a key role to play in supporting NHS organisations to meet these challenges. This supplement sets out how the Centre is fulfilling its role in relation to provision of financial and workforce data.

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