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

BALANCE OF POWER "MUST SHIFT IN FAVOUR OF PATIENT"

N Timmins and D Firn

Financial Times, Jan 30th 2001, p.4.

Reports government plans for information on NHS death and survival rates, cancelled operations and patient complaints to be published independently by the Audit Commission and the Commission for Health Improvement.

CHC CONCESSIONS SIGNIFY FIRST DEVIATION FROM NHS PLAN

T Shifrin

Health Service Journal, vol. 111, Feb 15th 2001, p.4.

Reports tabling of two amendments to the Health and Social Care Bill which address concerns raised over the abolition of Community Health Councils. The first amendment provides for the creation of Patients’ Councils to act as umbrella bodies grouping together local patients’ fora. The second amendment ensures statutory provision for independent advocacy services to support patient complaints.

CLINICAL GOVERNANCE: EXPERIENCE FROM A HEALTH DISTRICT

R Madhok et al

Journal of Clinical Excellence, vol.2, 2000, p.139-146.

Paper describes the approach adopted by East Riding and Hull Health Authority area to promoting clinical governance. A model was developed in which clinical governance was defined as "Doing things that matter", and which incorporated the three elements of research, audit and training. The aims were to make clinical governance part of every day business, adopt a systematic approach linked to the local health improvement programme, support individuals and work to maximise value for money from available resources.

COMMUNITY TEST

L Kendall and R Clarke

Public Finance, Jan 26th – Feb 1st 2001, p.24-25.

Presents a critical overview of the three bodies which will replace Community Health Councils: a Patient Advocacy Liaison Service, a Patients’ Forum and an Independent Local Advisory Forum.

DEATH RATES REVEAL WORST HOSPITALS

R Waterhouse

Sunday Times, Jan 14th 2001, p.1, etc.

Research shows that death rates in hospitals, adjusted to take into account patients’ ages, sex and diagnoses, vary by 75%, with 17 people dying in the worst performing hospital for every 10 that die in the best. Study indicates that the number of doctors per bed is the biggest factor in the difference in death rates, with hospitals with the lowest rates employing more than six times as many as some others. Research also reveals the hospitals that meet best practice standards for the treatment of heart attacks and breast cancer; the hospitals trusted most by patients; and the level of emergency cover in private hospitals.

DIRECTORY INQUIRY

C Laurent

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

The publication "Your guide to the NHS" replaces the Patients Charter. The new guide is a straightforward account of what to do when you are ill. It does not address patients’ rights.

THE GENERATION CLAIM

S McIver

Health Service Journal, vol. 111, Jan 25th 2001, p.24-26.

There is a growing perception that support for the NHS is falling among young people. The evidence for this is not conclusive. Dissatisfaction with the NHS is more likely to be linked to increased expectations than lack of social solidarity.

HANDLE WITH CARE

A McGauran

Health Service Journal, vol. 3, Jan 18th 2001, p.16-17.

By April 2001, Health Trusts are expected to have made a public commitment to implementing the Improving Working Lives standard for human resource management issued by government last Autumn. By April 2003 they are expected to be accredited as putting the standard into practice. They will have to provide detailed evidence of their performance on a range of issues including child care strategies, local recruitment drives, career breaks and tackling the long hours culture.

HEALTH CARE: MODERNISING THE LEVIATHAN

J Dixon

Political Quarterly, vol. 72, 2001, p.30-38.

New Labour's reforms of the NHS have concentrated on making the service more responsive to patients wishes as consumers. Three main themes were stated in the white paper "The New NHS: Modern, Dependable" issued in December 1997. These were:

  • the abolition of the internal market
  • the institution of primary care groups
  • improving the quality of clinical care through imposition of national standards and the introduction of clinical governance.
The NHS Plan published in July 2000 signalled a large injection of funding into the NHS and announced a concordat with private sector to allow the NHS to buy more care provided in private hospitals. Government has so far relied on a centralised "command and control" approach in implementing its reforms which is alienating local managers and stifling initiative.

HERE’S LOOKING AT YOU, KID

P Corrigan

Health Service Journal, vol. 111, Feb 8th 2001, p.30-31.

Bringing NHS organisations under the scrutiny of local government, as proposed by the NHS plan, will strengthen democratic monitoring. The proposed arrangements give an opportunity for greater integration of services. NHS organisations can also gain from local authority experience in areas such as best value.

HOSPITAL WAITING TIMES "DISTORTED"

J Carvel

Guardian, Feb 1st 2001, p.13.

Community Health Councils have accused government of covering up the extent of lengthy trolley waits in hospitals by failing to count the time patients were "warehoused" in accident and emergency departments before a doctor decided whether to admit them. The Department of Health has said that from 2002 it will start calculating waiting times from arrival in A & E.

IMPLEMENTATION OF EVIDENCE-BASED MEDICINE: EVALUATION OF THE PROMOTING ACTION ON CLINICAL EFFECTIVENESS PROGRAMME

S. Dopson et al

Journal of Health Services Research and Policy, vol. 6, 2001, p.23-31.

Summarises findings from an independent evaluation of the Promoting Action on Clinical Effectiveness programme, a national initiative in England that sought to demonstrate how practice could successfully be changed to bring it into line with research evidence. The most influential factors were found to be strong evidence, supportive opinion leaders and integration within a committed organisation. Without these factors, projects had little chance of success. Other factors (context analysis, professional involvement and good project management) emerged as important, supporting processes; their presence might be an additional help, but on their own they would not be enough to initiate change.

IMPROVING HEALTH IN WALES: A PLAN FOR THE NHS AND ITS PARTNERS

National Assembly for Wales.

Cardiff: National Assembly, 2001.

Proposes abolition of Welsh health authorities. Local Health Groups (Welsh primary care organisations) will be strengthened and developed to take on new responsibilities for commissioning and delivery of healthcare. Membership of Local Health Groups will be extended to include local councillors, while at national level the Assembly will assert direct democratic control of its health responsibilities. Other proposals include retention of community health councils, a commitment to free nursing care only, establishment of an "expert patients" network by 2003, and publication of clinical governance indicators this year.

INPATIENT ADMISSION, BED MANAGEMENT AND PATIENT DISCHARGE IN NHS ACUTE HOSPITALS

Committee of Public Accounts.

London: TSO 2001 (House of Commons papers, session 2000/01; HC 135).

Concludes that bed blocking by elderly patients is causing last minute cancellation of operations. This could be tackled by improved provision of domicilary services and long term residential care. Measures to improve collaboration between NHS agencies and social services departments in planning for the discharge of hospital patients are discussed.

LONG AND WINDING ROAD

B Millar

Health Service Journal, vol. 111, Feb 8th 2001, p.26-29.

Reports launch of a government initiative to help refugee doctors resume their medical careers in the UK. The project will fund the setting up of a voluntary database of medically qualified refugees in the UK and the provision of a national information pack.

MANUAL OF CANCER SERVICES STANDARDS

Department of Health

2001.

Sets out 426 benchmarks against which NHS cancer treatment centres will be assessed by teams of inspectors. Failing centres will be suspended while they try to improve staffing, facilities or systems. If centres fail to improve they will be closed.

MINISTERS HAIL FALL IN HOSPITAL WAIT LISTS

J Carvel

Guardian, Jan 12th 2001, p.12.

Figures published by the Department of Health show that waiting lists for hospital in-patient treatment have fallen by 137,000 since the 1997 general election.

(See also Independent, Jan 12th 2001, p.6).

NHS WAITING LIST TIMES "NO SHORTER"

N Hawkes

Times, Feb 13th 2001, p.4.

Analysis of NHS waiting list figures published in February 2001 shows that, while the lists have fewer names, people on them are waiting just as long for treatment.

THE PILOT APPRAISAL SYSTEM FOR CONSULTANTS AT THE NORFOLK AND NORWICH HEALTH CARE NHS TRUST

M Stamp and J Sanger.

Journal of Clinical Excellence, vol.2, 2000, p.183-186.

The pilot appraisal system for consultants at ‘the Norfolk and Norwich Health Care NHS Trust’ comprises a 360 degree approach to all aspects of a consultant’s professional practice.

A PRETTY LITTLE SUM

R Jones

Health Service Journal, vol. 111, Feb 1st 2001, p.28-29.

Achieving the government’s targets of a maximum wait of 13 weeks for a first outpatient appointment requires a greater appreciation of randomness in the GP referral rate and the non-attendance rate. It is possible to estimate the effect of randomness on waiting times. The number of GP referrals received in December is a critical factor in determining end-of-year performance in meeting the 13-week target.

SISTERS WILL GET POWERS OVER WARD CLEANING

D Charter

Times, Jan 17th 2001, p.5.

In order to improve hygiene standards in hospitals ward sisters will be given powers to:

  • direct hospital cleaners;
  • replace inefficient contractors;
  • have payment withheld if work is poor.

(See also Times, Jan 18th 2001, p.8).

TEARS FOR FEARS

L Donnelly

Health Service Journal, vol. 111, Jan 18th 2001, p.12-13.

Reports on the morale of NHS managers six months after the launch of the NHS Plan. Managers are happy with the commitment to increased spending but fearful of its draconian performance management framework.

TIME TO TALK ONE-STOP SHOP

B Hudson

Health Service Journal, vol. 111, Jan 25th 2001, p.20.

Recent initiatives involving the NHS suggest one-stop shops are seen as a generic public sector panacea for addressing complexity and fragmentation in service delivery. These initiatives include healthy living centres, NHS Direct and Care Direct, and long-term care charters.

TOP OF THE LEAGUE

Anon

Health Which?, Feb 2001, p.24-27.

As they are currently published, NHS hospital performance indicators are not useful for patients. They are not detailed enough to highlight differences in performance in a meaningful way.

TURNING THE TABLES

L Donnelly

Health Service Journal, vol. 111, Feb 1st 2001, p.12-13.

Following the publication of contentious hospital league tables by private sector companies, article argues that the NHS needs to build its own expertise in collating and benchmarking clinical and performance data.

YOUR GUIDE TO THE NHS

Department of Health

London: 2001

Successor to the patients’ charter, the guide sets out in simple terms what you can expect from the NHS today and what you can expect in the future as improvements to health services are made.