Click here to skip to content

Welfare Reform on the Web (March 2003): National Health Service - Reform - General

ALIEN CONCEPT

J Lyall

Health Service Journal, vol. 113, January 23rd 2003, p.24-25

There is evidence that understanding of the Labour government's modernisation agenda for the NHS among frontline staff is poor. At the same time, doctors are being alienated by what they see as attacks on their professional autonomy. There is need of a more collaborative approach to engage doctors in the reform process.

ANNUAL APPRAISAL AND LIEGE HOMAGE: WHY THE BRITISH NHS IS FUNDAMENTALLY A FEUDAL ORGANISATION

L Tyler and A Evans

Journal of Health Services Research and Policy, vol. 8, 2003, p.57-59

Draws parallels between the NHS and medieval feudalism. Both systems are hierarchical and in both a strong element of central control co-exists with significant day-to-day delegation of responsibility. Ceremony plays a key role in relationships, such as through swearing liege homage in feudal society and through formal assessment and appraisal in the modern NHS.

CENTRES OF ATTENTION

S Ward

Public Finance, January 17th-23rd 2003, p.20-22

Diagnostic and treatment centres are central to the government's plans to boost NHS capacity and reduce waiting lists. The centres will offer only short-stay and day-case elective operations, as well as outpatient testing. Some will be run by private sector providers.

COMPLAINTS ABOUT DOCTORS UP FROM 36 TO 558 IN 11 YEARS

N Timmins

Financial Times, January 9th 2003, p.4

The Medical Defence Union, which provides insurance for doctors, reports that complaints against its members have risen from 36 in 1990 to 558 in 2000. Complaints about clinical care have risen from about 25% in the early 1990s to over 80% in 2000.

(See also Times, January 9th 2003, p.12; Daily Telegraph, January 9th 2003, p.11)

CRY FREEDOM

P Smith

Health Service Journal, vol. 113, January 30th 2003, p.11-12

There is concern that the freedoms on offer to NHS foundation trusts may be watered down to placate critical Labour backbench MPs. It has been confirmed that there will be strict limits on the number of private patients a trust can treat, and any borrowing will need the approval of a new independent regulator. Trusts may also be subject to the same star-rating system as other NHS hospitals, limiting their clinical freedom.

DELIVERING 21ST CENTURY IT FOR THE NHS: NATIONAL PATIENT RECORD ANALYSIS SERVICE: STRATEGIC OUTLINE CASE

Department of Health

London: 2002

The National Patient Record Analysis Service is intended to support delivery of the NHS Plan by improving the management and delivery of health services through the provision of good quality data to support performance and resource management, clinical governance and audit, planning, research and surveillance activities. The strategic outline case aims to gain common agreement to:

  • the proposed investment outcomes for NPRAS;
  • the options for data which could be managed through NPRAS;
  • the options for services which could be provided through NPRAS;
  • the potential options for delivering NPRAS.

DELIVERING 21ST CENTURY IT SUPPORT FOR THE NHS: NATIONAL SPECIFICATION FOR INTEGRATED CARE RECORDS SERVICE: NATIONAL SERVICE FRAMEWORKS: DRAFT

Department of Health

2002

Consultation document outlines the requirements for the integrated care records service to support the provision of care to the standards set out in the national service frameworks for diabetes, cancer, mental health and older people.

DOWN THE LINE

J Lloyd, D Dillon and K Hariharan

Health Service Journal, vol. 113, January 9th 2003, p.22-23

A Welsh hospital with a three year wait for orthopaedic outpatient appointments introduced a telephone booking system. This involved the patient telephoning to make an appointment instead of being allocated a date. The new system has cut non-attendance from 17% to 5% and has reduced waits by one year.

FEAR OF FLYING

R Gollop

Health Service Journal, vol. 113, January 23rd 2003, p.28-29

Interviews with senior managers and clinicians involved in the national booking programme and cancer care collaborative showed that scepticism, particularly among doctors, was a barrier to implementing change. Regular feedback and clear evidence of improvement emerged as key factors in persuading sceptics of the benefits of new ways of working. Getting sceptics on board can be a long process and time spent talking to them is not wasted. Consultants' support is key for endorsing change.

FROM IMPROVEMENT TO AUDIT AND INSPECTION

A Cowper

British Journal of Health Care Management, vol. 9, 2003, p.11-15

Peter Homa, the chief executive of the Commission for Health Improvement (CHI), answers questions on the performance and role of CHI, and on the forthcoming Commission for Healthcare Audit and Inspection.

INNOVATION IN THE NATIONAL HEALTH SERVICE: THE ACQUISITION OF THE HEART HOSPITAL

National Audit Office

London: TSO, 2002 (House of Commons Papers, session 2002/03, HC157)

In September 2001, to improve capacity for cardiac treatment in London, University College Hospitals Trust purchased the Heart Hospital from its private owners. The report concludes that acquisition was a good deal for the NHS. The Trust acquired the hospital at a knock down price, managed the transition period successfully and used it to deliver the planned benefits to NHS patients.

INVOLVING DISABLED AND CHRONICALLY ILL CHILDREN AND YOUNG PEOPLE IN HEALTH SERVICE DEVELOPMENT

P Sloper and J Lightfoot

Child: Care, Health and Development, vol. 29, 2003, p.15-20

Data were collected by a postal survey of health authorities and NHS Trusts as to the extent and nature of involvement of physically disabled and chronically ill children in local health service development. Results showed that the involvement of this group of children in health service development is limited. This may be due to the failure of policy documents on user participation to make the case for children's involvement, and the lack of people with designated responsibility for increasing child participation in NHS decision-making.

IS PUBLICLY FUNDED HEALTH CARE REALLY DISTRIBUTED ACCORDING TO NEED? THE EXAMPLE OF CARDIAC REHABILITATION IN THE UK

R Raine, A Hutchings and N Black

Health Policy, vol. 63, 2003, p.63-72

Study examined the association between use of cardiac rehabilitation and gender in a sample of 1064 patients under 70 admitted to 94 hospitals in the UK. Results demonstrated that male and female hypertensive patients with equal needs were not treated equally. Moreover, although patients with hypertension were treated differently to normotensive patients, this treatment difference was not the same for men and women.

A JOB WITH PROSPECTS

N Edwards

Health Service Journal, vol. 113, January 30th 2003, p.20-21

Report of an interview with NHS Emergency Access Czar, Sir George Alberti. He is developing a 10 year plan to create an integrated system of emergency care that should reduce pressure on hospitals' A&E departments. The plan will require a doubling of A&E consultants but will also involve service redesign in the form of walk-in centres, nurse-led minor injury units, etc.

MANAGERIAL VALUES AND RATIONALITY IN THE UK NATIONAL HEALTH SERVICE

A Hewison

Public Management Review, vol. 4, 2002, p.549-579

The introduction of the new public management into the NHS in the 1980s has faced middle managers with conflicts between managerial and professional values. These reflect wider conflicts in health policy concerning the allocation of resources and appropriate responses to patient need. Article reports a study of how middle managers responded to this challenge. The views of middle managers concerning the values that guide their work were explored in the context of the reformed NHS.

MILBURN SET TO INCREASE LOCAL CONTROL OF HEALTHCARE

K Guha and N Timmins

Financial Times, January 15th 2003, p.2

Local communities will be given control of the organisations that buy care in the National Health Service under plans signalled yesterday by Alan Milburn, the Health Secretary. The move to make primary care trusts locally accountable marks a radical extension of the plan to give top-performing hospitals foundation trust status. It would mean the government giving up control of the purchasing side of the NHS as well as the supply side.

NHS CHIEF SACKED FOR EXPOSING "FIDDLE"

N Hawkes

Times, January 9th 2003, p.12

The finance chief at St George's Hospital, Tooting has been sacked after supporting a junior member of staff who was ordered to send in what she believed to be inaccurate figures for the number of cancelled operations.

(See also Guardian, January 9th 2003, p.8)

NHS CRISIS MAY FORCE QUICKER THINKING

J Meikle

The Guardian, January 21st 2003, p.2

Training for some hospital consultants is likely to be cut by a year in an attempt to speed the recruitment and appointment of senior staff in hard pressed hospitals.

NHS TO GET £45M UPGRADE TO TECHNOLOGY NETWORK

N Timmins

Financial Times, January 17th 2003, p.5

The government is to spend £45m on immediate improvements to the National Health Services communications infrastructure in a step towards launching one of the biggest civil IT procurements in the world. The enhancement to NHSnet, due to be in place by March 2004, will give hospitals, doctors and managers broadband connections.

NOTHING TO IT

P Stephenson

Health Service Journal, vol. 113, January 30th 2003, p.12-13

Reports that hospital trusts are confident of meeting the government's 21-week outpatient waiting time target by the end of March 2003. This is due to better management of lists and to reorganising clinics so that staff other than consultants are used to see patients.

NURSES AGENCIES: NATIONAL MINIMUM STANDARDS [AND] NURSES AGENCIES REGULATIONS

Department of Health

London: 2002

Standards form the basis on which the National Care Standards Commission will determine whether nurses agencies provide appropriate safeguards for their clients. They cover recruitment and supply of nurses, complaints procedures, and management and administration.

PATIENTS WAITING SIX MONTHS CAN SWITCH HOSPITAL

G Jones

The Daily Telegraph, January 24th 2003, p.6

Patients facing lengthy delays for NHS operations will have the right to choose another hospital from next year. The right will be introduced across London this summer and nation-wide a year later, the Prime Minister said in a speech on public service reform. It could include the choice of an operation in either a private or another NHS hospital.

A PIECE OF THE ACTION

A Moore

Health Service Journal, vol. 113, January 9th 2003, p.10-11

Strategic Health Authorities have produced capacity plans based on information from primary care trusts. The plans were supposed to map out current capacity and identify gaps needing to be plugged. However there are doubts about the reliability of the information supplied by the primary care trusts.

PILOT FRIGHT

M Kupicek

Guardian Society, January 15th 2003, p.10

The new Commission for Patient and Public Involvement in Health starts work this month, aiming to put people "at the heart of decision making in local NHS services". But getting the public interested is proving difficult. The author examines the scheme's progress so far.

A PUNISHING PACE

P Smith

Health Service Journal, vol. 113, January 23rd, 2003, p.10

The NHS is on track to meet its target of no patients waiting more than 12 months for inpatient treatment by April 2003. The target has been hit through regular evening and weekend working and purchase of operations in the private sector.

REDUCING JUNIOR DOCTORS' HOURS

Anon

European Industrial Relations Review, no. 347, 2002, p.26-28

The extension of the EU Working Time Directive to junior doctors in UK hospitals will lead to a drastic reduction in their working hours. Article goes on to discuss how Kings College Hospital, London, coped with the change, through extra recruitment and delegation of some work.

STATE OF EMERGENCY

T Shifrin

Health Service Journal, vol. 113, January 16th 2003, p.10-12

By March 2003, trusts are expected to ensure that 90% of patients wait no longer than four hours from arrival at Accident and Emergency to admission, transfer or discharge. Some hospitals are struggling to meet this target and a few may have been falsifying their figures.

STILL GETTING THE MESSAGE?

L Genkeer and S Dewar

Public Finance, January 10th-16th 2003, p.26-27

Government has sharply reduced the number of circulars sent out to NHS managers and replaced them with an electronic communication: the Chief Executive's Bulletin. The change has not so far reduced central control of the NHS, or given more autonomy to frontline staff.

SURGE IN CONSULTANTS RETIRING HITS NHS REFORM

J Laurance

The Independent, January 27th 2003, p.5

Plans to expand the NHS have suffered a serious setback with a sudden 23% rise in the number of senior hospital consultants retiring from the service. The exodus has wiped out the gains from the Department of Health's international recruitment drive launched in August 2001 with more than twice as many consultants taking early retirement in 2001 as have joined the NHS from abroad in the last 10 months.

A TRICKY OPERATION

J Carvel

Guardian Society, December 17th 2002, p.10

The article considers the progress being made by Labour to create an NHS university. As the institution prepares to launch next autumn, it has run into difficulty. It has to operate within Privy Council rules, stopping just any organisation calling itself a university. Ministers have solved the problem for the moment by calling the NHS university the "NHSU"

UP AGAINST A BRICK WALL

P Smith

Health Service Journal, vol. 113, January 23rd 2003, p.14

Reorganisation of hospital services may be necessary due to crumbling infrastructures but is often very unpopular with the public. Article presents a case study of St Helier and Epsom hospitals, which the Trust wishes to replace with a single new establishment paid for by a private finance initiative deal. At the same time six to ten local care centres run by Primary Care Trusts would be created. These would offer outpatient services, diagnostics, intermediate care beds and GP out-of-hours services.

WARNING ON NHS GOALS COMES AS MPs REBEL

N Timmins and K Guha

Financial Times, January 9th 2003, p.2

An internal Department of Health report has warned that the NHS is highly unlikely to hit its target of having no-one wait more than six months for inpatient treatment by 2005. At the same time there is growing opposition among Labour MPs to plans for foundation hospitals.

(See also Daily Telegraph, January 9th 2003, p.14)

"WHAT NEW NHS?"

A Curley and others

Health Service Journal, vol. 113, January 23rd 2003, p.26-27

A 2001 survey of 203 doctors, nurses and midwives at a Belfast teaching hospital revealed a poor understanding of the government's modernisation agenda. Seventy-nine per cent were unaware that there was a new NHS. Only 44% felt that the principles of the new NHS were of any value in clinical practice. Only 51% could name the Health Secretary. Authors conclude that much work needs to be done to bring home the importance of the government's reform agenda to clinical staff.

WIDENING THE GAP IN THE NHS

Anon

Labour Research, vol. 92, January 2003, p.16-18

Argues that Labour's plans for the establishment of autonomous foundation hospitals will lead to the creation of a two-tier health service with "sink" hospitals and a demoralised workforce outside of the elite institutions.

Search Welfare Reform on the Web