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Welfare Reform on the Web (August 2010): National Health Service - primary and community care

Barriers to dying at home: the impact of poor co-ordination of community service provision for patients with cancer

M. O'Brien and B. Jack

Health and Social Care in the Community, vol. 18, 2010, p.337-345

For patients dying of cancer, there is an emphasis on giving choice regarding preferred location of care, with the option of dying at home, which is integral to UK government initiatives such as the End of Life Care Programme. However, terminal patients continue to be admitted to hospital when they have expressed a wish to die at home. Data gathered from two focus groups with a purposive sample of district nurses and community specialist palliative care nurses revealed that poor discharge planning, difficulty in obtaining additional equipment and services, and inadequate out-of-hours medical provision were all factors contributing to hospital admissions for patients dying of cancer in the last days of life, and thus were barriers to dying at home.

Investigation into the out-of-hours services provided by Take Care Now

Care Quality Commission


Foreign doctors working as out-of-hours GPs have risked the lives of patients by mistakenly giving them drug overdoses. As well as Dr Daniel Ubani, who killed pensioner David Gray by administering 10 times the normal dose of a painkiller, the investigation found that German doctors employed by the same company, Take Care Now, had given overdoses of the same painkiller to two other patients. Managers at Take Care Now had failed to heed at least three warnings about the use of the painkiller before the death of Mr Gray in 2008. The report concludes that the NHS must ensure that the competency of all foreign doctors is properly tested before they are employed.

Understanding leadership in community nursing in Scotland

E. Haycock-Stuart and others

Community Practitioner, vol. 83, July 2010, p. 24-28

There is limited evidence concerning leadership in community nursing. NHS policy also fails to clarify and define what leadership is, though regarding it as key to developing safe and high quality care. This paper reports the findings of a research study that aimed to identify how leadership is perceived and experienced by community nurses, and to examine the interaction between recent policy and leadership development in community nursing.

We won't work for out of hours clinics, say British doctors

K. Devlin

Daily Telegraph, July 2nd 2010, p. 15

Doctors' leaders have warned that British GPs are refusing to work for poorly funded out-of-hours services that are putting patients at risk. Organisations are therefore forced to rely on medics from abroad, some of whom struggle with English. Complaints are said to be falling on deaf ears.

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