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Welfare Reform on the Web (March 2001): National Health Service - Reform - General

ASSURING THE QUALITY OF MEDICAL PRACTICE: IMPLEMENTING "SUPPORTING DOCTORS, PROTECTING PATIENTS"

Department of Health

2000

Presents a new patient protection strategy that will include: independent advocacy services to support complainants, patient forums operating as independent statutory bodies, and the establishment of a National Clinical Assessment Authority to tackle the problem of poorly performing doctors.

THE CANCER SERVICES COLLABORATIVE: TWELVE MONTHS ON

[Department of Health], 2000

The Cancer Services Collaborative is a national programme involving 51 project teams across nine cancer networks. It seeks to improve the experience and outcomes of care for people with cancer by optimising the way care is delivered. Report assesses progress to date 12 months into the 16 month programme. Improvements described by project teams include: wait time for radiology reduced by 60%; guaranteed bed availability for patients going into hospital; and diagnostic processes which used to require three hospital visits carried out in a single visit.

DRIVE TO CUT THE WAIT FOR CANCER CARE GETS RESULTS

C. Hall

Daily Telegraph, Jan. 3rd 2001, p. 12

Waiting times for diagnosis and treatment of various types of cancer have been cut in nine pilot areas by doctors and managers working together to cut bureaucratic delays and inefficiencies. In Birmingham, waiting times for results of tests for bowel cancer fell from eight weeks to 14 days. In Leicestershire, the practice of making patients go to hospital three times for bowel cancer tests has been reduced to a single visit. In West London, waiting times for patients with possible breast cancer was reduced from up to 11 weeks to the next available clinic.

(See also Times, Jan. 3rd 2001, p. 11; Guardian, Jan. 3rd 2001, p.4)

EXPLORING THE POWER OF CHI

H. Brown

Public Finance, Jan. 5th-11th 2001, p. 14-16

Explores the likely effectiveness of Chi, the Commission for Health Improvement, in raising standards in the NHS. The exacting performance management culture heralded by Chi could damage NHS staff morale. However Chi's lack of formal sanctions means that the main incentive to change behaviour is fear. At the individual level, the current strategy for health improvement relies on whistle blowers and at the organisational level on a precarious earned autonomy, which by definition can be taken away at any time. Attempting health improvement on this basis alone is unlikely to be successful; more investment in the sector is needed to raise standards.

FAILING SURGEONS COULD BE NAMED AND SHAMED

C. Hall

Daily Telegraph, Jan. 15th 2001, p. 172

Reports that negotiations between the Department of Health and a private company. Dr. Foster, could lead to the publication of league tables measuring the performance of doctors and hospitals in the NHS and the private sector.

(See also Guardian, Jan. 15th 2001, p. 1+2; Independent, Jan. 15th 2001, p. 4+6)

"FIELD SURGERIES" COULD EASE NHS PRESSURE

P. Marsh

Financial Times, Dec. 12th 2000, p. 8

Reports that mobile surgical units, based on those normally used by the Army, may be rented out to the NHS to increase hospital capacity.

HEART PATIENTS SUFFER LOTTERY OF CARE IN NHS

J. Laurence

Independent, Jan. 3rd 2000, p. 4

Results of a patient survey in 1998 show wide variations in quality of care in heart units in the NHS on the measures of access to care, physical comfort, the hospital environment, information and communication, patient involvement, co-ordination and continuity, and discharge and transition.

IMPORT DUTIES

Y. Sawbridge

Health Service Journal, vol. 111, Jan. 4th 2001, p. 20-21

A large city trust which had 120 nurse vacancies for more than two years has solved its recruitment difficulties by bringing in nurses from the Philippines, Malaysia, Finland and South Africa. A total of 170 nurses were recruited from overseas over six months and only four left subsequently. The overseas recruits had a very positive effect on morale in the trust and a programme of support ensured their integration.

AN INSPECTOR CALLS ON HEALTH CARE MANAGEMENT

J. Edmonstone

British Journal of Health Care Management, vol. 7, 2001, p. 16-20

Article describes the new NHS inspection agencies and their work, with particular reference to the inspection-development continuum, reviews the experience of the earlier Health Advisory Service, and examines the workings of other non-NHS inspection regimes. It considers the agencies' information and staffing needs and suggests that the openness to challenge that inspection brings will have profound effects on health organisation.

LET'S DRINK TO THAT

J. Higgins

Health Service Journal, vol. 111, Jan. 11th 2001, p. 22-24

Article comments on the provisions of the Concordat between the NHS and the private sector. The latter will be subject to the NHS complaints procedure, the provisions of the National Service Frameworks and National Institute for Clinical Excellence guidelines. Points out that the uneven spread of private facilities across the country undermines partnership. The issue of medical staffing for private hospitals needs to be addressed, since these rely almost exclusively on NHS consultants. Finally, the reduction in NHS waiting lists brought about by the Concordat may reduce the demand for private medical insurance.

MATERNITY CARE 'NEEDS 1300 MORE DOCTORS'

N. Martin

Daily Telegraph, Dec. 29th 2000, p. 15

The Royal College of Obstetricians and Gynaecologists has said that 1300 extra consultants are required to provide a full service in hospitals and reduce the potential for litigation should complications arise during childbirth.

(See also Times, Dec. 29th 2000, p. 9)

MILBURN GIVES COUNCILS NEW POWERS TO CONTEST HEALTH SERVICE CHANGES

S. Schaefer

Independent, Jan. 11th 2001, p. 8

In order the defuse a growing backbench rebellion against the abolition of Community Health Councils, government has offered to strengthen local authorities' powers instead. Proposes that councils would have the power to raise patients complaints about changes in NHS provision with newly set up Scrutiny Committees. These Committees could then refer contested proposals on to the independent national reconfiguration panel.

(See also Times, Jan. 9th 2001, p. 13)

MINISTERS SHELVE BAN ON PRIVATE WORK FOR DOCTORS

A. Grice

Independent, Dec. 20th 2000, p. 4

Reports that the government may shelve its plans to ban new NHS consultants from working in the private sector for seven years in the face of fierce opposition from the British Medical Association.

MP WANTS NEW SYSTEM TO TACKLE NHS BUNGLES

P. Webster

Times, Jan. 9th 2001, p. 6

David Davis, Chair of the Public Accounts Committee, has proposed establishing two new bodies to deal with medical errors in the NHS. An Institute for Medical Safety to which doctors or nurses could confidentially report on medical mistakes would draw general lessons from errors notified to it. He also recommended an Independent Medical Inspectorate with powers to investigate where errors have caused concern. Under these plans the public would lose its blanket right to sue the NHS for damages in exchange for the protection afforded by these bodies. A new compensation system would help families who had lost a breadwinner or needed to meet the costs of raising a damaged child.

(See also Daily Telegraph, Jan. 9th 2001, p. 2)

MUTINY THREAT ON HEALTH COUNCILS

J. Carvel

Guardian, Dec, 28th 2000, p. 9

Reports concern among Labour back bench MPs about plans to replace Community Health Councils with a new patient advocacy and liaison service. The root of the problem is that the advocates would be employed by NHS trusts and might be reluctant to expose their mistakes.

(See also Daily Telegraph, Dec. 28th 2000, p. 7)

OUR NATIONAL HEALTH: A PLAN FOR ACTION, A PLAN FOR CHANGE

Scottish Executive Health Department

Edinburgh: TSO, 2000

Scotland's plan for NHS reform proposes: 1) abolition of the internal market and return of hospital trusts to health board control; 2) facilitation of joint working across traditional boundaries; 3) retention of local health councils; 4) reform of the complaints system; 5) moves towards patient-held records; 6) roll-out of the Scottish equivalent of NHS Direct, NHS24, in 2001; and 7) reduction in bureaucracy.

SMART CARD SCHEME TO DETECT BAD DOCTORS

J. Laurance

Independent, Jan. 9th 2001, p. 5

Announces plans for the creation of a new National Clinical Assessment Authority, a rapid response team to investigate concerns about individual doctors' performance. Doctors are also to be issued with smart cards carrying details of their career histories to speed checks by NHS Trusts and to protect patients from incompetent practitioners.

(See also Times, Jan. 9th 2001, p. 6)

TORIES HIT A "BIG LIE" OVER THE NUMBER OF NURSES

J. Carvel

Guardian, Dec. 12th 2000, p. 8

The Tories have accused the Labour government of misleading the public by giving the impression that the 20,000 extra nurses to be recruited by the NHS by 2004 would be all full-time. In fact the target figure of 20,000 is a head count and includes part-timers.

(See also Times, Dec. 12th 2000, p. 17; Daily Telegraph, Dec. 12th 2000, p. 13)

WITH PALS LIKE THESE…..

A. Moore

Health Service Journal, vol. 111, Jan. 11th 2001, p. 14-15

Reports progress in planning the new Patient Advocacy and Liaison Services which will replace Community Health Councils.