Welfare Reform on the Web (November 2000): National Health Service - Reform - General

4,000 HOSPITAL BEDS LOST SINCE LAST YEAR

Times, Sept. 8^th 2000, p. 5

One in 50 hospital beds has been lost since last year, making another winter crisis in the NHS almost inevitable. Nearly 4,000 beds have gone because of a lack of nurses or funds, government figures show. In particular the loss of 19 intensive care beds in the past six months will result in many more patients being turned away.

£100m PLAN FOR DENTISTS IN NHS

E. Judge

Times, Sept. 19^th 2000, p. 6

Plans to reform NHS dental services include:

• a reward scheme to encourage dentists away from private work;
• better patient access to information on charges;
• the establishment of centres in areas where there are shortages of NHS practices.

(See also Independent, Sept. 19^th 2000, p. 1; Financial Times, Sept. 20^th 2000, p. 9)

ACCESS AND EXCELLENCE: ACUTE HEALTH SERVICES IN WALES

Acute Services Development Group

2000

Report argues that hospital services in Wales should be planned to match "patient flows" rather than health authority and trust boundaries. The natural affiliations between clinical services and existing patient flows should be recognised and developed to create new "health economies". Each health economy would develop its own service model, with some hospitals being given a more specialised role, and others providing local services.

CREATING A QUALITY CULTURE IN "THE NEW NHS"

A. Hewison

British Journal of Health Care Management, vol. 6, 2000, p. 430-435

Article examines the role of the mission statement in creating a "quality culture" in the NHS, and questions the effectiveness of some attempts at culture management.

GET SOME IN

T. Agnew

Health Service Journal, vol. 110, Sept. 21^st 2000, p. 13-14

Government guidance will be issued next month offering a prescriptive 'model' for calculating the number of hospital beds needed in each area per head of population. The Department of Health will issue a toolkit, including a national interactive database into which trusts and health authorities will input their own data on bed capacity. Regional offices will examine the resulting data and negotiate with the DoH to agree what the distribution of 2,100 beds promised in the NHS plan will be.

HARD-UP HOSPITALS 'FORCED TO RELY ON CHARITY CASH'

D. Derbyshire

Daily Telegraph, Oct. 2^nd 2000, p. 7

NHS hospitals depend too much on charity in providing basic healthcare, the baby care charity, Bliss, said. About 80% of orders for incubators and ventilators now come from charities, not hospital managers. Medical charities provide about £322m a year for medical research, health workers and equipment.

HEALTH SECTOR REFORM AND HUMAN RESOURCES: LESSONS FROM THE UNITED KINGDOM

J. Buchan

Health Policy and Planning, vol. 15, 2000, p. 319-325

The objective of the paper is to assess the human resource dimension of the NHS reforms in the United Kingdom, and to highlight lessons for the health systems of countries undergoing reform or restructuring. The impact on the HR function of the NHS reforms is assessed in the paper by examining three central requirements of the HR function:

• to maintain effective staffing levels and skill mix;
• to establish appropriate employee relations policy and procedures;
• to be involved in pay determination.

IT LOOKS LIKE TROUBLE

L. Greenwood

Health Service Journal, vol. 110, Sept. 14^th 2000, p. 13-14

Reports that one single clinical software support system will be used for the whole of NHS Direct instead of the three currently in use. The contract has been awarded to AXA Assistance, which is not one of NHS Direct's existing suppliers.

KNOCK, KNOCK

T. Agnew

Health Service Journal, vol. 110, Oct. 5^th 2000, p. 18

The Royal College of Nursing has dropped its previous opposition and has begun a process that will lead to the granting of associate membership to Health Care Assistants.

LAST CHANCE SALOON FOR HEALTH SERVICE

R. Martell

Community Practitioner, vol. 73, 2000, p. 742

Expresses concern that the Labour government's latest plan to reform the NHS focuses on the acute sector at the expense of community health services.

MINUS SIGN

A. MacFarlane and S. Kerrison

Health Service Journal, vol. 110, Sept. 28^th 2000, p. 32-33

The government's plans for multi-agency health care will be hampered by the variability of data available in different sectors. Data collection from private hospitals, clinics and nursing homes lags far behind the NHS. Unless data collection improves, no information will be available on the care provided to the 270,000 people expected to receive rehabilitation or intermediate care in nursing homes under the NHS plan. This lack of essential data will weaken mechanisms for control.

NERVOUS TICK

M. Gould

Health Service Journal, vol. 110, Sept. 7^th 2000, p. 13-14

Despite its protestations to the contrary, results of a survey of health managers show that the Commission for Health Improvement is perceived as being about punishment and censure. Inspections are feared, and it is felt that they will increase stress, distract from the delivery of patient care, and not lead to developmental change.

NHS CANCER PLAN

Department of Health

2000

Includes the following key targets:

• £50m extra to be spent on hospices and palliative care, including more support to help the terminally ill stay at home;
• a maximum wait of one month from diagnosis to treatment for all cancers by 2005;
• smoking among manual groups to be cut from 32% in 1998 to 26% by 2010;
• improvements in cervical screening and breast screening to be extended to age 70;
• testing for prostate cancer to be available in 2001, and trials for colorectal and ovarian screening to be underway;
• a new National Cancer Research Institute to be established.

THE NHS PLAN: 1S IT RIGHT AND CAN IT SUCCEED?

T. Bamford et al

British Journal of Health Care Management, vol. 6, 2000, p. 406-412

A panel of health service commentators give their views of various aspects of the NHS Plan, including Care Trusts, patient empowerment, centralisation and the use of performance indicators, the role of primary care, charging for personal services, and political aspects.

THE NHS PLAN: STAFFING STRATEGIES NEEDED

A. Bell

British Journal of Health Care Management, vol. 6, 2000, p. 428-429

The success or failure of the NHS Plan will largely rest on the recruitment, training and retention of new medical staff to enable the commitments and objectives to be met. Managers will need to work to improve the pay and conditions of staff, particularly nurses, in order to attract young people.

NOT A FOND FAREWELL

A. Coote

Community Care, no. 1338, 2000, p. 14

Welcomes the abolition of Community Health Councils under the government's NHS plan, but expresses concern that the multifarious bodies created to replace them will not be able to work together to achieve a consistent, integrated approach to public involvement.

ON THE STRAIGHT AND NARROW

C. Laurent

Health Service Journal, vol. 110, Oct. 5^th 2000, p. 13-14

Criticises make up of the NHS modernisation board. For all the government's emphasis on partnership working, the membership of the newly appointed board essentially reflects acute hospital issues.

ONE IN THREE GPs GOES PRIVATE TO BEAT DELAYS

D. Doran

Independent, Sept. 25^th 2000, p. 8

Reports results of a survey which shows that 33% of GPs have taken out private health insurance to avoid delays. Only 57% of GPs would use the NHS if they needed major surgery and only 59% would recommend it to a friend, even for routine surgery.

(See also Times, Sept. 25^th 2000, p. 4)

PATIENTS TO BE OFFERED OPERATION BOOKING SYSTEM IN SOME HOSPITALS

J. Carvel and S. Boseley

Guardian, Sept. 28^th 2000, p. 6

Reports announcement of a raft of NHS reforms, including implementation of booked appointments; increase in the number of chest pain clinics from 50 to 84 by April 2001; abolition of compulsory competitive tendering for ancillary services; and investment in cancer services.

(See also Times, Sept. 28^th 2000, p. 8)

PHARMACY IN THE FUTURE: IMPLEMENTING THE NHS PLAN

Department of Health

2000

Proposes routine use of electronic prescriptions by 2004; referral by NHS Direct to a local pharmacist where appropriate by 2002; establishment of one-stop primary care centres where pharmacists work alongside GPs, dentists, opticians and social workers; improvement in out of hours pharmacy provision; institution of local pharmaceutical services pilots to test new ways of organising community pharmacy; and empowering pharmacists to issue repeat prescriptions by 2004.

PLEDGE ON CANCER "STILL LEAVES £200m SHORTFALL"

J. Sherman and N. Hawkes

Times, Sept. 27^th 2000, p. 9

Reports government pledges that cancer patients will all be treated within one month of diagnosis, that the number of cancer specialists will increase by 1,000 within the next six years, that £300m will be spent on 295 new scanners and radiotherapy machines, and that by 2003 government will match pound for pound charity funding for cancer research. In fact the 1,000 new cancer specialists are included in the 7,500 extra consultants announced as part of the NHS Plan in July, and the government's commitment to match charity funding for cancer research appears to involve no spending not already announced.

(See also Guardian, Sept. 27^th 2000, p. 7)

RAISING THE STAKES

M. Mower

Health Service Journal, vol., 110, Sept. 7^th 2000, p. 26-27

Reports results of a survey of who health authorities are consulting over planning and by what methods. The survey of 25 health authorities showed that user groups, professional fora, newsletters, complaint schemes, road-shows and focus groups were the most extensive means of consultation. The majority of health authorities had identified the parties to be consulted over strategic planning. Results suggested that consultation is being used more for service planning than strategic purposes. Many health authorities plan to include police and fire services, the media, unions, and the private sector and schools in consultations.

SCREEN AND HEARD

P. Dick

Health Service Journal, vol. 110, Oct. 5^th 2000, p. 37

Reports on the potential of digital TV for the dissemination of health information to the public and for the support of NHS organisational activities such as professional development and staff recruitment.

SEEKING CLARITY WITH CONFUSION

D. Hunter

Health Service Journal, vol. 110, Sept. 14^th 2000, p. 22-23

Argues that government imposition of a plethora of performance indicators on the NHS diverts effort and creates perverse incentives. Its addiction to centralised control stifles local initiative and demoralises staff who feel powerless.

SOMETHING COMPLETELY DIFFERENT

M. Gould

Health Service Journal, vol. 110, Aug. 31^st 2000, p. 9-10

Speculates about the future of NHS regional offices. The NHS plan's promises of "earned autonomy" for health authorities and trusts and the prospect of "progressive devolution" point to a reduced role for the regions in the longer term. On the other hand, they will have an enhanced performance management role running the "traffic light" system of grading NHS organisations.

SOUTHERNERS 'WAIT LONGEST FOR SURGERY'

H. Rumbelow

Times, Sept. 1^st 2000, p. 12

Results of research by the Independent Centre for Economics and Business Research show that the average NHS patient now waits nearly seven and a half months for treatment after seeing their GP. There are huge regional variations, with patients in the South often waiting a month more than those in the North. Longest waiting times occur for non-urgent procedures in orthopaedics and ophthalmology, such as hip replacements and cataract removal.

(See also Independent, Sept. 1^st 2000, p. 8)

SPENDING ON PRIVATE HOSPITALS WOULD RISE

M. Woolf

Independent, Oct. 4^th 2000, p. 8

Explains Conservative proposals to expand private sector health care and insurance and to use private hospitals to treat NHS patients. Waiting times would be cut by prioritising patients and treating the most seriously ill ahead of people with minor ailments.

(See also Times, Oct. 4^th 2000, p. 8)

TORIES PROMISES MORE FOR HEALTHCARE

P. Webster

Times, Oct. 3^rd, 2000, p. 1

The Conservatives are planning to spend more than Labour on health through expansion the private sector. They also hope to encourage companies, trade unions and other organisations to invest in private health insurance. The party is planning to reverse changes made by Gordon Brown which mean that companies have to pay national insurance employer's contributions on the private health plans they offer to employees. Another move under consideration is the restoration of tax relief on private health insurance for the elderly.

(See also Daily Telegraph, Oct. 3^rd 2000, p. 1 & 2; Guardian, Oct. 3^rd 2000, p. 2; Independent, Oct. 3^rd 2000, p. 1)

UP, UP AND AWAY

A. McGauran

Health Service Journal, vol. 110, Sept. 14^th 2000, p. 14-15

Reports plans for mobile doctors to be employed by the NHS Modernisation Agency to provide clinical leadership and, where appropriate, direct patient care in trusts with enduring performance problems.