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Welfare Reform on the Web (November 2010): National Health Service - Reform - General

Coalition considers 'charter for NHS whistleblowers'

O. Wright

The Independent, Oct. 13th 2010, p. 6

Doctors and nurses would be given a contractual right to blow the whistle on malpractice in hospitals without fear of being sacked or disciplined under plans being drawn up by the government.

DH turns a blind eye to working time rules

C. Santry

Health Service Journal, Oct. 14th 2010, p. 4-5

The Department of Health has stopped monitoring whether NHS trusts are complying with the European Working Time Directive, which restricts workers, including junior doctors, to a 48 hour working week. Trusts are increasingly taking the hint from the Department and reducing compliance with the directive.

Health reforms create risk of failures in care, say NHS managers

R. Ramesh

The Guardian, Oct. 12th 2010, p. 14

The biggest shake-up of the NHS in 60 years represents a 'hazardous journey' with 'a real danger of failure in the quality of care or finances' says the NHS Confederation, the body representing the health service establishment, in its submission to the Department of Health's consultation on the future of the national health system.

I feel like we're being watched

M. Britnell

Health Service Journal, Oct. 7th 2010, p. 16-17

This article reflects on the future of NHS foundation trusts. They need greater governance, fiscal and legal autonomy to enable them to become more agile and responsive. In the meantime the foundation trust movement can set new industry standards for care quality and productivity, start to establish new shared service organisations between themselves, and explore the potential for forming national chains.

Liberating the NHS: an information revolution: a consultation on proposals

Department of Health


This consultation looks at how information technology can help people take more control of their health and make the best choices for themselves. Patients may be able to view their medical records online, email their GP and compare services offered by doctors and hospitals across Britain. They may be able to choose which GP to register with and whether to be treated in an NHS hospital or a private institution, within certain cost limits. They will also be asked to rate the service and treatment they receive from different hospitals and clinicians. It is hoped that this approach will drive up standards as patients choose not to use the services of poorly performing doctors, who will then lose funding.

Little guys versus the big guns

P. Corrigan

Health Service Journal, Oct. 28th 2010, p. 16-17

Voluntary organisations lack the skills and financial resources to compete for NHS contracts against large private healthcare providers. The third sector is now developing a consortium of voluntary healthcare providers that will bid for work from the NHS. The consortium will be able to buy in the skills and defray the incurred costs needed to win contracts in competition with large private sector organisations.

Ministers veto one-week cancer test pledge

R. Smith

Daily Telegraph, Oct. 25th 2010, p. 17

A one-week target to test patients for suspected cancer announced before the 2010 general election will not be introduced because of the cost and concerns that there is not enough clinical evidence to justify it. The two-week target from GP visit to seeing a cancer specialist will remain.

NHS revolution backed by only one in four doctors

D. Campbell

The Guardian, Oct. 25th 2010, p. 1-2

A survey by the King's Fund think tank has found that only 23% of doctors believe that the government's proposed shake-up of the NHS will lead to higher standards. Five hundred GPs and five hundred hospital doctors took part in the survey, which found that 38% of doctors disagree or strongly disagree with the statement 'the proposed reforms will improve the quality of patient care'. 31% are neutral and 7% don't know.

Optimising waiting: a view from the English National Health Service

A. Harrison and H. Appleby

Health Economics, Policy and Law, vol. 5, 2010, p. 397-409

Recent authors have proposed that waiting times for elective treatment should be reduced to the point where the costs of doing so exceed the benefits. This paper considers how this criterion could be put into effect. Taking benefits first it argues that these could be estimated in three different ways - social cost benefit, clinical and user valuation - that would not necessarily produce consistent results and hence a choice has to be made between them. It then considers the costs of reducing waits and argues, citing relevant evidence, that these may range widely according to whether or not reductions can be achieved through simple management measures or whether more long-term capacity is required. It concludes therefore that the apparently simple criterion proposed for defining the point where waiting times are optimal is hard to establish. Choice of criterion must be made in the light of the overall values that a given health care system is intended to promote.

Patient information delivery: a clinical protocol (1)

S. Brocklesby

British Journal of Healthcare Management, vol. 16, 2010, p. 482-488

Patient information is an established part of clinical practice, with clear guidelines regarding the production of written patient information. However, no clear clinical protocols could be found regarding how to deliver oral information to patients most effectively. NHS South Gloucestershire wished to ensure cost effectiveness by maximising patient outcomes from information-giving within the constraints of limited clinical time. This article describes the research behind the construction of a multidisciplinary clinical protocol for the oral delivery of health information to patients.

Tracing experiences of NHS change in England: a process philosophy perspective

R. McMurray

Public Administration, vol. 58, 2010, p. 724-740

The English NHS has over the past decades been subject to a series of radical restructurings driven by the introduction of New Public Management. Reform has emphasised radical transformational change, limited consultation, targets, monitoring and quantification. It has left professionals on the ground feeling overwhelmed and disillusioned. This article uses Chia's account of the metaphysics of processual change to explain why these attempts to restructure the NHS have been unsuccessful in their aim of improving the service.

Trusts get a run for their money

D. Pruce

Health Service Journal, Oct. 14th 2010, p. 16-17

The new coalition government has signalled that it will enable private and voluntary sector healthcare providers to compete with NHS trusts, and allow patients to choose who treats them on the basis of good comparative data. Monitor in its new role of economic regulator will be responsible for creating a level playing field, and will have power to take action against commissioners who behave anti-competitively.

'Unpolished' data to support patient choice

D. West

Health Service Journal, Oct. 21st 2010, p. 4-5

Acute trusts will be obliged to offer elective patients a choice of consultant led team from April 2011. In order to help patients choose, data on teams which is currently collected by the NHS Information Centre for internal use will be put into the public domain, even though it is in places incomplete and often not immediately comparable between teams and organisations. For example, it may not be adjusted for different case mixes, ages or co-morbidities of patients.

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