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Welfare Reform on the Web (April 2002): National Health Service - Reform - General

ACUTE ANXIETIES

M. Pollard

Health Service Journal, vol. 112, Feb. 14th 2002, p. 22-23

District general hospitals have suffered at least 15 years of neglect and underfunding. Little attention has been given to the key role of non-clinical support services such as catering. The structure of hospital trusts hinders the development of clinical networks, and the way consultants are employed hampers their involvement in the modernisation agenda.

ASSESSING THE OUTCOMES OF DAY HOSPITAL CARE FOR OLDER PEOPLE: A REVIEW OF THE LITERATURE

J. Bentley, J. Meyer and K. Kafetz

Quality in Aging, vol. 2, 2002, p. 33-41

Current policy context demands that health service providers demonstrate effectiveness, efficiency, value for money and good quality. Findings from this review suggest that the outcomes of day hospital care are especially difficult to appraise because of the variable nature of individual facilities and the needs of patients attending. Three problems in particular are hard to assess: comparability; defining outcomes; and determining complete costs. The review suggests more user-focused research is needed.

CUT TO THE CHASE

L. Donnelly

Health Service Journal, vol. 112, Feb. 14th 2002, p. 12

Explores the background to the discovery that 2,700 non-maternity ultrasound scans requested by GPs had not been carried out at Chase Farm Hospital. GPs had not raised the alarm because long delays in dealing with referrals were the norm at Chase Farm.

A DAY IN THE LIFE

S. Will and A. Will

Health Service Journal, vol. 112, Feb. 14th 2002, p. 24-25

Many NHS consultants are working more than their contracted hours. Diaries kept by 32 consultants in one trust showed they worked on average 50 hours a week. A pilot scheme rescheduling work patterns in the Royal Manchester Children's Hospital Haematology Directorate to include a rest day has reduced the number of hours worked. The scheme is popular with consultants and could be transferable to other teams.

DIABETES AND YOUNG PEOPLE

C. Lyons

Community Practitioner, vol. 75, 2002, p. 48-49

Discusses the potential impact of the new National Service Framework for Diabetes on young patients. Diabetes UK is urging measures to train teachers and to foster local support and advisory groups. Argues that there needs to be on-going education and training for all involved in diabetes care, which will increase awareness and improve identification. Early identification and good control will lead to a reduction in complications. The patient centred approach required by the Service Framework should also result in the empowerment of young patients to take control of their condition.

DOBSON FEARS PATIENTS WILL SUFFER IN NHS REFORMS

N. Morris

The Independent, Jan. 28th 2002, p. 2

Government plans for a radical overhaul of the NHS have come under attack from the former health secretary Frank Dobson. Mr Dobson believes patients will suffer because hospital managers will be distracted by new NHS structures.

(See also Independent Review, Jan. 28th 2002, p. 4)

DRUGS WATCHDOG TO BE FREED FROM POLITICAL CONTROL

P. Waugh

Independent, Jan. 31st 2002, p.8

Reports that the Health Secretary is to announce proposals that would remove the government's veto over decisions made by the National Institute for Clinical Excellence on new drugs and treatments for the NHS. The Institute is also to be given powers to choose the drugs and treatments it assesses, change its internal committee structure and make its own appointments without having to consult government.

EXCLUSION ZONES

R. Gupta, J. Chattin and S. Lingam

Health Service Journal, vol. 112, Feb 7th 2002, p. 24-26

The UK has a lower ratio of doctors to population than most other developed countries. The government's pledge to increase the number of doctors by 9,500 by 2004 will represent only a marginal increase. Reliance on recruiting doctors from other parts of Europe, as envisaged in the NHS Plan, is not realistic. Historically, European countries have provided few doctors for the UK. Instead, non-European doctors already working in the NHS need to be encouraged to attain consultant status. The institutional racism which may be holding them back must be addressed. Future work force planning must provide opportunities for doctors from developing countries to acquire skills and knowledge which will benefit their own people when they return.

EXPLORING MIDDLE MANAGEMENT IN THE NHS

A. Hewison

British Journal of Health Care Management, vol. 8, 2002, p.52-57

Middle management is essential to the effectiveness of the NHS, but little is known about it Article reports the results of an ethnographic study of middle managers involving extensive observation of their work and in-depth interviews. Concludes that middle managers are striving to deliver in difficult circumstances where they are judged on their financial performance in a situation in which budgetary processes lack precision; where they are expected to "manage" when the "authority" lies elsewhere; and where they have to compete for resources with colleagues in order to develop their service.

THE FUTURE OF THE NHS : A FRAMEWORK FOR DEBATE

Futures Group

London: Kings Fund, 2002

Proposes that the NHS should be turned into a decentralised and depoliticised system of financially autonomous hospitals, with a legal status similar to universities, funded by an independent health board insulated from directed ministerial control, in the manner of the Housing Corporation.

GO WITH THE FLOW

A. Mitchell

Health Service Journal, vol. 112, Jan. 31st 2002, p. 26-27

A project to reduce referrals of Lanarkshire patients to Glasgow has shown that GPs have less effect on hospital activity than originally thought. A high proportion of the referrals were for procedures not carried out in local hospitals. The issues involved are complex and scope for reducing these referrals turned out to be more limited than at first believed.

GREEKS OFFER "TEMPLE OF HEALTH" FOR NHS

N. Hawkes

Times, Jan. 30th 2002, p. 6

The Interbalkan European Medical Centre in Salonika, Greece, has the capacity to do 25,000 operations a year at a competitive price. It hopes to attract NHS patients.

(See also Guardian, Jan. 30th 2002, p. 12)

HAPPY CLAPPY

L. Eaton

Health Service Journal, vol. 112 Feb. 14th 2002, p. 9-10

Discusses the role of the New Health Network in NHS modernisation. Its members are regarded as keen New Labour supporters with strong links to the government. The stated aim of the network is to promote positive change in the NHS and to bring together health professionals from different disciplines. The concern is that the Network may replace the unions in representing professional and staff interests to government.

HIT SQUADS TO TARGET FAILING HOSPITALS

S. Boseley

Guardian, Feb. 12th 2002, p. 2

Four hospitals at the bottom of the NHS league tables which have failed to improve their performance are to have their management franchised out to high-flyers from elsewhere in the Health Service.

(See also Independent, Feb. 12th 2002, p. 8, Times Feb. 12th, 2002 p. 10; Daily Telegraph Feb. 12th 2002, p. 11; Financial Times, Feb. 12th 2002, p. 4)

INDEPENDENT HEALTH CARE: NATIONAL MINIMUM STANDARDS REGULATIONS

Department of Health

London : TSO, 2001

Standards cover information provision, quality of care, complaints procedures, risk management procedures, records and information management, and premises, facilities and equipment. There are service specific standards for acute hospitals, mental health establishments, hospices, maternity hospitals, abortion clinics, and private doctors.

LABOUR PLANS TO OVERTURN PRINCIPLE OF A FREE NHS

B. Russell

Independent, Feb. 7th 2002, p.1 + 13

Describes the content of a leaked draft Labour Party discussion document. The paper proposes putting limits on NHS services and introducing charges for those able to pay. It includes plans for "mutual" or "public interest" companies to operate independently within the NHS and proposes more use of the private sector to increase capacity.

(See also Times, Feb. 7th 2002, p. 1+13; Daily Telegraph, Feb. 7th 2002, p. 6)

LONG WAITS IN CASUALTY BLOT WHITTINGTON'S GOOD MARKS

J. Vasager

The Guardian, 25th Jan. 2002, p. 5

The Whittington hospital, North London, whose Accident and Emergency Department found itself at the centre of a political row over the state of the NHS, was warned in a report published last Thursday by the government's Commission for Health Improvement about the length of time patients had to wait in its casualty department.

(See also The Times, Jan. 25th, 2002, p. 5; Daily Telegraph, Jan. 25th 2002, p. 5; The Independent, Jan. 25th 2002, p. 1)

LUXURY BREAK

T. Shifrin

Health Service Journal, vol. 112 Feb. 7th 2002, p. 14-15

Describes a visit to the private Interbalkan European Medical Centre in Salonika, Greece, which is hoping to treat British patients under contract to the NHS.

MODELLING THE DEMAND FOR SAME-DAY APPOINTMENTS

M. Jiwa

British Journal of Health Care Management, vol. 8, 2002, p. 66-68

Analysis of data from four general practices in North Nottinghamshire showed that demand for same day and urgent GP appointments out-of-hours had a seasonal pattern with definite peaks and troughs. Preliminary data suggest that surges in demand may reflect the impact of darkness and/or viral infections among other factors. Managers need to ensure that staffing levels are maximised during peaks in demand.

NEGLIGENCE IN HEALTHCARE: CLINICAL CLAIMS AND RISK IN CONTEXT

V. Harpwood

London: Informa Publishing Group, 2002

This book provides up to date information for healthcare professionals, potential claimants and students of medical law on the basic legal framework relating to clinical negligence. It explores issues such as changes in the standard of care in clinical negligence, trends in law on consent to treatment, and the relationship between NHS complaints and litigation. It also provides a chapter on the Human Rights Act 1998 and its likely impact on clinical litigation.

NHS DIRECT IN ENGLAND

National Audit Office

London : TSO, 2002 (House of Commons papers. Session 2001/02; HC 505)

Finds that the NHS Direct service is operating safely and effectively. It has also reduced demands on GP out-of-hours services. However it is used less by ethnic minorities, people aged over 65 and disadvantaged groups than by the general population.

NHS INVESTIGATION

Daily Telegraph, Jan. 14th 2002, p 18-19

The Daily Telegraph in a three day report examines the future of the NHS. Articles cover how the NHS was set up and investigate its funding crisis. Also look at how the treatment compares in Britain, France and the Netherlands, and how NHS funding compares to European systems.

(See also Daily Telegraph Jan 15th 2002 p 16-17 and Jan. 16th 2002, p. 18-19)

NHS PATIENTS SET TO BE TREATED IN GERMANY BUT AT £3000 EXTRA COST

N. Timmins, H, Simonian and R. Bennett

Financial Times, Jan. 30th 2002, p.2

Reports that 30 NHS patients are due to be treated at the Lütterhaus Hospital in Germany this financial year. However the operations will cost £3,000 more than in the NHS.

ON THE WAY TO MARKET AGAIN?

P. Smith

Health Service Journal, vol. 112, Jan. 24th 2002, p. 13-15

Discusses reaction from managers, academics, politicians and the media to the Health Secretary's plans to bring in private management for failing hospitals and grant independent status to successful ones.

PLAN TO WITHDRAW TREATMENT FROM RACIST PATIENTS

J. Carvel and J. Vasagar

The Guardian, Jan. 25th 2002, p. 4

Racist hospital patients who persistently refuse care from doctors and nurses of a different ethnic origin will lose their right to treatment under the NHS, according to guidelines being prepared by the Department of Health. Last year the department published research showing nearly half the ethnic minority staff in the NHS had experienced racial harassment over the previous 12 months.

THE ROAD TO CONSENSUS

L. Eaton

Health Service Journal, vol. 112, Jan. 24th 2002, p. 16-17

Discusses the practical difficulties involved in successful patient participation in the development of treatment guidelines, based on case studies of groups looking at the treatment of chronic fatigue syndrome and schizophrenia.

SEASONAL CYCLES

N. Proudlove and C. Brown

Health Service Journal, vol. 112, Jan. 31st 2002, p. 24-25

Looking at historical patterns can make it possible to forecast emergency hospital admissions and bed requirements with considerable accuracy, up to a year in advance. A model under development at the University of Manchester Institute for Science and Technology analyses the effects of weather, flu epidemics and different surges in demand on emergency admissions. The model has revealed a rush by hospitals to discharge patients by the weekend that could give rise to concerns about appropriate care.

SECRET MEMO URGES GOVERNMENT TO KEEP THE LID ON NHS SCANDALS

L. Smith and M. Kite

Times, Feb. 7th 2002, p. 8

In a secret memo to Health Ministers, the Chief Medical Officer has warned that up to 50 reports a year of problem doctors could emerge. He urges government to resist public inquiries into incidents of malpractice because of their disastrous effect on the NHS.

STAFF MAY BE GIVEN SEATS ON HOSPITAL GOVERNING BODIES

P. Wintour

The Guardian, Feb. 8th 2002, p. 13

Local communities and hospital workers may be given seats on the government bodies of the new foundation hospitals proposed by Alan Milburn, the Health Secretary, as part of his plan to devolve power within the NHS.

SUITS YOU SIR?

S. Ward

Public Finance Feb. 1st-7th 2002, p. 26-28

Government is planning to bring in private sector managers to help improve the performance of failing hospitals. Article argues that private sector companies and managers have neither the skills nor the inclination to run large and complex public hospitals.

SUPPORTING THE IMPLEMENTATION OF PATIENT ADVICE AND LIAISON SERVICES: A RESOURCE PACK

Department of Health

London: 2002

Patient advice and liaison services are central to the new system of patient and public involvement in the NHS. Providing information and on the spot help for patients and their families, they are intended as a lever for change and improvement.

TEENAGE HANG-UPS

J. Taylor, C. Fell and N. Day

Health Service Journal, vol. 112, Feb. 7th 2002, p. 28-29

Cadet training schemes could be a way to boost nurse recruitment, but lack of standardisation may impede progress. A survey of schemes in England showed wide variations in entry requirements and qualifications offered. Most schemes offered successful students a place on a nurse training scheme, but at present a student could complete cadet training in one part of the country and not be eligible for nurse training elsewhere.

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