Welfare Reform on the Web (February 2003): National Health Services - Reform - General

ALL CHANGE ON THE CENTRAL LINE

J. Yates

Health Service Journal, vol 112, Dec 5th 2002, p.24-25

Policies to cut waiting times for outpatient appointments following GP referrals appear to be working. However, there is a continued slight increase in numbers of people waiting over six month for inpatient treatment. Author proposes that, instead of relying on the enforcement of maximum waiting-time guarantees, government should revert to a method first used in England in 1989. This involves negotiating a contract between the government and individual hospitals that guarantees additional workload and reduced waiting times.

CONSULTANTS: MANAGING THEM MEANS MEASURING THEM

K. Bloor and A. Maynard

Health Service Journal, vol. 112, Dec. 19th 2002, p.10-11

The Department of Health is to supply acute trusts with detailed information on the activity rates of their consultants, extracted from the Hospital Episode Statistics (HES). The charts show considerable variation in individual consultant activity rates. Authors go on to discuss various possible explanations.

FIRMS TO BID FOR NHS SURGERIES

J. Meikle

The Guardian, December 23rd 2002, p.5

Private health companies are to be invited to compete for multi-million pound contracts to own fast-track units designed to help meet government promises to cut waiting lists. Twenty-three new diagnostic and treatment centres to perform routine operations will be announced today and private health care companies will be invited to operate 11 of them.

GAUNTLET THROWN DOWN TO THREE HOSPITALS

J. Carvel

The Guardian, December 19th 2002, p.5

The government will today declare three NHS hospitals to be failing patients so badly they must be taken out of normal health service management and be run by contractors, possibly from the private sector. They will include the Royal United Hospital in Bath, and United Bristol Healthcare. The third is understood to be a Midlands hospital that won a star, but then caused ministers serious concern

(See also Financial Times, December 19th 2002, p.2)

GENDER AND HEALTH CARE IN THE UNITED KINGDOM: EXPLORING THE STEREOTYPES

B.C. Hayes and P.M. Prior

Basingstoke: Palgrave Macmillan, 2003

This book provides a historical account of health care in the UK and gives an empirical overview. It examines stereotypes such as gender and physical health; marriage is good for health; and older women are most vulnerable. It also discusses stereotypes that are rejected such as gender and mental health; women as the madder sex; and young men as reluctant help-seekers.It concludes by looking towards the future at issues such as the financing of health care systems in the UK; implications of new trends for the publicly funded health care system; and the possibility of a privatised system.

GOVERNMENT FACES BIG BACK BENCH REVOLT OVER FOUNDATION HOSPITALS

K. Guha

Financial Times, Dec 13th 2002, p.4

Discusses the revolt of backbenchers over foundation hospitals based on the fact that there were not adequate safeguards in place "to prevent foundation hospitals poaching staff from ordinary hospitals."

A GUIDE TO NHS FOUNDATION TRUSTS

Department of Health

London: Department of Health Publications, 2002

NHS Foundation Trusts will be part of the NHS, and subject to NHS systems of inspection, but they will be controlled and run locally, not nationally. They will be independent public interest organisations, modelled on cooperative societies. Their ownership will be lodged in the local community they serve. They will be run by a Board of Governors comprising staff from the Foundation Trust itself, from the Local Primary Care Trusts and elected community representatives. There will be a legal lock on their assets to prevent any moves towards demutualisation or any future threat of privatisation.

HARMFUL ERRORS "IN ONE IN 200 PRESCRIPTIONS"

O. Wright

Times, Dec 5th 2002, p.6

A study which monitored prescribing at a London teaching hospital has shown that doctors made 135 prescription errors every week. Of these 34 were potentially serious. Experts believe that error rates are probably the same in other hospitals.

HEALTH MINISTRY COULD FACE SCRUTINY

N. Timmins

Financial Times, December 24th 2002, p1

Alan Milburn, the Health Secretary, has been told his department and its agencies should themselves face scrutiny from a powerful new healthcare inspectorate. The new body, the Commission for Healthcare Audit and Inspection will become the NHS inspectorate in 2004.

HOPE SPRINGS ETERNAL

A. Mclellan

Health Service Journal, vol. 112, Dec 12th 2002, p. 20-21

Reports interview with David Fillingham, the head of the NHS Modernisation Agency. Describes the role of the Agency in triggering whole system change in the NHS. Argues that redesign of the clinical process must become the main way in which access targets, a safe culture and quality improvement are delivered. Expects Strategic Health Authorities to become the main drivers of change at local level.

HOSPITAL REFORMS FACE FRESH ATTACK FROM WITHIN NHS

D Charter

The Times, Dec 23rd 2002, p.4

Doctors and nurses will launch a series of damaging attacks on the government's plans for new style foundation hospitals in the New Year as attitudes harden in the NHS against the reforms.

KNOWLEDGE MANAGEMENT AND COMMUNITIES OF PRACTICE IN THE PRIVATE SECTOR: LESSIONS FOR MODERNISING THE NATIONAL HEALTH SERVICE IN ENGLAND AND WALES

S. P. Bate and G. Robert

Public Administration, vol. 80, 2002, p. 643-663

Paper explores how private sector knowledge management concepts and practices might contribute to the further development of public sector quality improvement initiatives in general and to the reform of the NHS in particular.

LABOUR ALARM AT NHS 'HANDOVER'

J. Carvel

The Guardian, December 20th 2002, p.8

Alan Milburn, the Health Secretary yesterday named eight private companies as candidates to take over failing hospitals. The firms, including BUPA and BMI Healthcare, the UK's biggest private healthcare chains, will be asked to compete for contracts to manage NHS hospital trusts that persistently fail to reach government targets. They will not, however, be allowed to own the assets or charge patients for treatment.

(See also Financial Times, December 20th 2002, p. 4)

LAY EVALUATION OF SERVICES FOR CHILDHOOD ASTHMA

M. Dixon-Woods and others

Health and Social Care in the Community, vol. 10, 2002, p.503-511

Authors conducted semi-structured interviews with 20 families recruited from responders to a respiratory symptoms questionnaire and from two general practices. Children and young people identified outcomes of care, quality of care, communication and the professional-patient relationship, and organisation and access to healthcare as the key dimensions of their experience of health services. They were active and critical, judging the performance and delivery of health services against standards that drew on lay knowledge and experience. Parents also emphasised outcomes, quality, organisation and access to healthcare as important, and drew attention to the complex and challenging nature of the professional-parent relationship. They also drew on lay standards to evaluate care.

LEARNING FROM DEVOLUTION: UK POLICY SINCE 1999

R. Freeman and K. Woods

British Journal of Health Care Management, vol. 8, 2002, p.462-466

Discusses the impact of political devolution on the NHS in the UK since 1999. Early experience of devolved government suggests that there remains considerable inertia carrying forward inherited policy, founded on common values and a well-established identity. Goes on to interpret trends in health policy in the UK in the light of Weick's is theory of loosely coupled systems.

MAKING PHARMACY AN ATTRACTIVE PROFESSION TO STEP INTO

K. Hassell

Primary Care Report, vol 4, Dec 11th 2002, p.8-9

Student numbers are falling, leading to a serious recruitment crisis in both hospital and retail pharmacy. Article discusses how the pharmacist's role could be redesigned and expanded to make the profession more attractive.

NICE CLINICAL GUIDELINES PROGRAMME

C. Adams

Community Practitioner, vol. 75, 2002, p.460

Clinical guidelines are recommendations for the care of individuals by health care professionals based on the best available evidence. Introduces the first two clinical guidelines produced by the National Institute for Clinical Excellence, the first covering diabetes and the second presenting an audit tool for coronary heart disease.

NHS TRUSTS KEEN TO FORM FOUNDATION HOSPITALS

N Timmins

Financial Times. December 9th 2002, p.4

The leading health trusts are gearing up to be in the first wave of planned "foundation hospitals". The Financial Times has contacted more than half of the 40 "three-star" NHS trusts that are eligible to apply, and most are keen to explore the idea

OFF THE FAIR WAY

D. Carlisle

Health Service Journal, vol. 112, Dec. 5th 2002, p.12

In the latest wave of restructuring, the NHS has paid Senior Managers, six figure sums to leave the service, while recycling middle managers into other jobs. They have been denied the opportunity to take voluntary redundancy.

ONE IN THREE HOSPITALS FIDDLES WAITING LISTS

A. Norfolk

The Times, December 23rd 2002, p.1

One in three National Health Service trusts is deliberately distorting hospital waiting list figures. The inaccuracies were exposed when Audit Commission teams carried out unannounced spot checks at 45 of the 186 acute and specialist trusts in England which are covered by the targets.

PERPETUAL MOTION

J. Trueland

Health Service Journal, vol. 112, Dec. 5th 2002, p.15

Unified health boards were introduced in Scotland in 2001 to bring together the management of the defunct traditional health boards with that of local acute and primary care trusts. There is also extensive local authority, patient and staff representation. Article reports on progress.

RAISING STANDARDS ACROSS THE NHS: A PROGRAMME OF RWARDS AND SUPPORT FOR ALL NHS TRUSTS

Department of Health

London: 2002

Document clarifies the support that all parts of the NHS will get to improve the performance of local health services. Details the mix of incentives, support and intervention that will be offered. Three and two star trusts will be offered a package of rewards on the principle of "earned autonomy". One-start trusts are giving some cause for concern against particular key targets. They will be subject to close oversight by the relevant Strategic Health Authority, and will receive support from the Modernisation Agency. Zero-star trusts will be able to access funds from the NHS Bank, and to benefit from the targeted programme delivered by the Modernisation Agency. As a last resort, the management of a failing zero-star trust may be franchised.

REGISTERING THE PROBLEMS

P. Dinsdale

Community Practitioner, vol. 75, 2002, p. 458-459

Discusses administrative chaos facing nurses and health visitors trying to register with the new Nursing and Midwifery Council.

RICH PICKINGS

L. Lambert

Health Service Journal, vol. 112, Dec. 5th 2002, p.26-27

A recruitment drive in Germany led to the appointment of three consultant anaesthetists and one consultant orthopaedic surgeon to a small acute trust in North East England, at a cost of about £10,000. The initiative involved the Senior Management Team making several visits to Germany to talk to prospective applicants. Short-listed applicants were then invited for a familiarisation tour of the local area. The initiative met with early opposition from within the trust but the appointed doctors are now well-integrated. Trusts planning to recruit from abroad should not underestimate the level of practical support needed by those moving from other countries.

TACKLING HEALTH INEQUALITIES: 2002 CROSS-CUTTING REVIEW

Department of Health

2002

Assesses progress so far in reducing health inequalities and sets out priorities for future action

TIED IN KNOTS

P. Smith

Health Service Journal, vol. 112, Nov. 28th 2002, p.10

Foundation hospitals will be owned and controlled by local communities through directly elected stakeholder councils. These will elect the trust chair and the non-executive board members, and approve the appointment of the chief executive.

WOMEN SUES NHS TO WIN TREATMENT ABROAD

J. Laurence.

The Independent, December 6th 2002, p1.

A women is suing the NHS after she was refused permission to seek hip replacement surgery in France in a test case that could determine the right of British patients to go abroad for treatment. In what is believed to be the first action of its kind, Yvonne Watts, 72, is suing her local NHS primary care trust for the right to be treated straight away by doctors on the Continent under new European Union Rules.