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

ACTIVE SERVICE

C. Harris

Health Service Journal, vol. 113, May 1st 2003, p. 14-15

A draft report from the Office for Health Economics (OHE) suggests that current NHS data collection which focuses on hospital activity is failing to give an accurate picture of improvements in the NHS. Activity formerly hospital-based has now shifted to primary cure, but data on this sector is not collected or reported nationally.

ANGER MANAGEMENT

M. Gould

Health Service Journal, vol. 113, May 1st 2003, p. 12-13

NHS hospital trusts have been instructed by the Health Secretary to implement the new consultants' contract locally, in spite of its having been rejected by them in a ballot. It is thought that local deals can be thrashed out despite threats of industrial action by the British Medical Association.

CATCH UP, KEEP UP

J. Appleby and others

Health Service Journal, Apr. 3rd 2003, p. 24-27

Trusts vary greatly on their progress to achieving waiting list targets, particularly for 2005. A study of trusts with a range of performances indicated four key criteria. Information use, managerial focus, capacity and long term efficiency. Actions that help a trust "catch up" rarely help them "keep up"; strategies may need to change once waiting lists have fallen markedly. Flexibility, forward planning and "expecting the unexpected" are characteristics of successful trusts.

THE CHOSEN PEOPLE

A. McLellan

Health Service Journal, vol. 113, Apr. 17th 2003, p. 14-15

Reports on a King's Fund Seminar discussing the impact of patient choice on the NHS. For primary care trusts, patient choice will require ownership of waiting lists and put them in a position to buy capacity up front. As a result, hospitals will have to manage capacity to respond to demands of commissioners. When treating people with chronic illnesses, the NHS will have to learn to listen to, and respond to, patients' wishes about what treatment they receive and how it is provided.

FINANCIAL INCENTIVES, COMPETITION AND A TWO TIER SERVICE: LESSONS FROM THE UK NATIONAL HEALTH SERVICE INTERNAL MARKET

R. G. Milne and B. Torsney

Health Policy, vol. 64, 2003, p. 1-12

Examines the impact of general medical practitioner (GP) fundholding in Scotland in relation to the development of consultant outreach. Finds fundholding had little impact on this development. Suggests an explanation for this maybe an aversion to creating a two-tier service which favoured patients from fundholding practices.

GETTING THE RIGHT START: NATIONAL SERVICE FRAMEWORK FOR CHILDREN: STANDARD FOR HOSPITAL SERVICES

Department of Health 2003

The new standard for children's services calls on hospitals to ensure that they focus on the whole child rather than on treating particular illnesses. They should also ensure that children get high quality evidence - based care from well-trained staff and develop safe physical environments suited to children's needs. Among the standards are plans for dedicated children's units within accident and emergency departments, separate facilities for children and teenagers, and special training for staff dealing with children.

(For comment see Health Service Journal, vol. 113, Apr. 17th 2003, p.12-13)

HEALTH AND SOCIAL CARE (COMMUNITY HEALTH AND STANDARDS) BILL

Department of Health

London: TSO, 2003

The health and social care bill says foundation hospital trusts will be set up as "public benefit corporations", governed by boards that will be elected by local people and staff. Foundation trusts would be owned and controlled by local communities, rather than central government and supervised by a regulator.

Main points:

  • bill enables new type of foundation hospital, providing free care to NHS patients but without Whitehall's direct control;
  • Foundation hospitals will be not-for-profit "public interest corporations";
  • they will not be allowed to reduce their commitment to the NHS by taking on private patients;
  • the bill will set up together inspectorates.

INDEPENDENCE SAY

L. Donnelly

Health Service Journal, vol. 113, Apr. 17th 2003, p. 20-21

Former Junior Health Minister Lord Hunt attacks people complaining about reform overload in the NHS. Supports foundation hospitals and defends the abolition of community health councils and the introduction of fines for delayed discharges.

THE INFLUENCE OF HEALTH CARE ORGANISATIONS ON HEALTH SYSTEM PERFORMANCE

K. Hauck, N. Rice, P. Smith

Journal of Health Services Research and Policy, vol. 8, 2003, p. 68-74

Study used performance data from approximately 5000 small geographical areas with average populations of 10,000. Multi-level statistical models were used to attribute variation in the indicators to three hierarchical levels (small areas, district health authorities and regional health authorities) after controlling for socio-demographic characteristics. Variations in indicators attributable to district or regional level gave an indication of the extent to which health authorities may influence performance. Results showed that the proportion of variation in performance attributable to district health authorities varied from about 8% (for standardised mortality rates) to about 76% (for waiting time for elective surgery). Warns against holding managers accountable for measures of performance beyond their control.

INTERPROFESSIONAL EDUCATION IN MATERNITY CARE: SHARED LEARNING FOR WOMEN-CENTRED CARE

K. Crozier

International Journal of Sociology and Social Policy, vol. 23, 2003, p.123-138

Examines interprofessional education in maternity care in the UK. Reviews the literature and finds barriers to the interprofessional education of doctors and midwives and little evidence of successful implementation. Identifies key areas for curriculum development.

JUST THE JOB

M. Pyrah

Health Service Journal, vol. 113, May 1st 2003, p. 28-29

By encouraging long-term unemployed people and school leavers to join the NHS through work experience schemes, Wolverhampton Health Care Trust has solved some of its recruitment problems and raised the profile of the NHS as a potential employer.

MODERN MATRONS: IMPROVING THE PATIENT EXPERIENCE

Department of Health

London: 2003

Sets out plans for extending the role of modern matrons in A&E departments to improve patients' experience of NHS emergency care. Matrons in charge of A&E departments will each have a £10,000 budget to spend on extra cleaning, providing drinks and snacks machines, improving children's play areas, and redesigning reception areas. Report also presents a series of case studies showing how matrons are modernising NHS services.

MULTIPLE ROLES? NURSES AS MANAGERS IN THE NHS

S. C. Bolton

The International Journal of Public Sector Management, vol. 16, 2003, p. 122-130

Looks at nurses as managers in the NHS (National Health Service). Examines the balance between the nurse's role as a manager and as a caring professional. Presents the results of a study in a North West trust hospital.

NEW NURSE FIGURES DON'T ADD UP CLAIMS UNION

O. Wright

The Times, Apr. 29th 2003, p. 4

The Royal College of Nursing said its latest data showed the growing demand for nurses in the NHS meant that, wards were still badly understaffed and district nurses had actually declined. Government claims that numbers have increased by 48,000 in five years.

NHS MAY BE DOING BETTER THAN DATA SUGGEST

N. Timmins

Financial Times, Apr. 22nd 2003, p. 4

Health Service statistics no longer fully reflect what the NHS is doing, the Office of Health Economics has warned. As a result, the government might well be unable to prove that its NHS plan is working. Traditional measurers of NHS hospital activity and productivity have been falling and are likely to continue to do so. However the service may be doing better than the figures suggest. The reason is that both quality and activity need to be picked up and measured.

NHS SAYS YES TO MODERN MATRONS

J. Carvel

The Guardian, Apr. 8th 2003, p. 14

Incentives to encourage every hospital to appoint a "modern matron" in its accident and emergency department were offered by Alan Milburn, the health secretary, following the matrons' success in raising standards elsewhere.

NHS USE OF INDEPENDENT HOSPITALS HAS HARDLY RISEN

N. Timmins

Financial Times, Apr. 3rd 2003, p. 7

The National Health Service has barely increased its use of the private sector to treat NHS patients, despite pressure to end waiting lists and government calls for a 'mixed economy' of healthcare provision.

NOISES OFF

C. Betts

Health Service Journal, vol. 113, Apr. 17th 2003, p. 14-15

Discusses party manifesto commitments on health in advance of the Welsh Assembly elections due on May 1st 2003. Focuses on promises to restore free prescriptions and to increase NHS capacity.

PARTNERS IN TIME

A. Moore

Health Service Journal, vol. 113, Apr. 24th 2003, p. 12-13

Progress on the development of long-term contracts for private hospitals to carry out NHS work has been patchy since the signing of the Concordat between the NHS and the independent sector in 2000.

PATIENTS LEFT IN CARE OF TRAINEE NURSES

J. Carvel

The Guardian, Apr. 28th 2003, p. 9

NHS hospital are routinely putting patients' lives at risk by leaving them in the care of student nurses without support from qualified staff, the Royal College of Nursing warned at the start of its annual conference in Harrogate. It said more than a third of the 75,000 student nurses in the UK had been left in sole charge of patients.

(See also Daily Telegraph April 28th 2003, p.1)

PEOPLE CARRIER

T. Shifrin

Health Service Journal, Apr. 3rd 2003, p. 20-21

Andrew Foster, NHS human resources director, discusses career progression through the skills escalator, the rejected consultants contract, the rejected consultants contract, the new GP contract and the new "Agenda for Change" pay system.

PERSPECTIVES ON MODERNISATION: PROGRESS OR STASIS?

A. Cowper (editor)

British Journal of Health Care Management, vol. 9, 2003, p. 132-140

Presents views of a range of commentators on the progress of NHS reform. Issues covered include impact of primary care trusts, partnership working with the independent sector, the Modernisation Board's recent report, the emerging Conservative Party health policy, patient choice, and improvements in mental health services.

A PLACE APART

J. Trueland

Health Service Journal, vol. 113, Apr. 10th 2003, p. 12-13

In the light of the 2003 elections to the Scottish Parliament, article examines healthcare reform in Scotland since devolution and summarises the manifesto commitments of the main parties.

POWER SHARING

R. Jobanputra and J. Buchan

Health Service Journal, vol. 113, May 1st 2003, p. 26-27

Foundation trusts will in theory have more local control of pay and conditions for staff, although details are still unclear. They are likely to differ in their use of these powers, partly out of desire partly because of practical limits. Taking advantage of the new powers for short-term gain at expense of other trusts will have negative effects if not part of a wider development of HR practice.

REDESIGNING HEALTH CARE: NEW WINE FROM OLD BOTTLES?

L. Locock

Journal of Health Services Research and Policy, vol. 8, 2003, p. 120-122

Service redesign is emerging in the NHS as the latest panacea for improving quality. It consists of a paymatic blend of elements of total quality management and business process re-engineering. Early evidence suggest that service redesign has achieved some limited quality improvement, but that this has not been as extensive as anticipated. It may prove to be one more in a succession of discarded management fads.

SYSTEM DECAY

R. Prasad

Guardian Society, Apr. 23rd 2003, p. 10

Patched up NHS dentistry, which costs that drive many people from care, remains on the critical list. Article asks whether the latest plans to revive it will be enough to save the nation's teeth.

TEAMWORK TO A TEE

M. Gould

Health Service Journal, vol. 113, Apr. 17th 2003, p. 12-13

Hospital trusts, which have met their waiting time targets, did so through active co-operation between doctors and managers.

TECHS - BOOK STUFF

A. Moore

Health Service Journal, vol. 113, Apr. 10th 2003, p. 14-15

Looks at moves to train people as medical technicians to take over routine tasks from doctors and nurses.

THINK-TANK ISSUES WARNING OVER FOUNDATION HOSPITALS

N. Timmins

Financial Times, Apr. 7th 2003, p. 8

Foundation hospitals could bring real benefits to patients but will fail unless key issues are addressed according to the institute for Public Policy Research.

A TOUGH ONE TO TACKLE

J. Trueland

Health Service Journal, Apr. 3rd 2003, p. 12-13

Discusses disarray in the outpatient appointments system in NHS Scotland, which is leading to long delays for patients in some areas. There are wide variations in waiting times by geographic region and by speciality.

WAIT FOR SURGERY 'TO GET SHORTER'

J. Carves

The Guardian, April 2nd 2003, p. 11

The maximum wait for an operation on the NHS in England will fall from 12 to nine months by next March. The government's promise came as ministers sought to justify higher National Insurance charges being introduced this week to pay for better healthcare.

WHOSE NHS IS IT ANYWAY?

F. Porritt

Health Which? Apr. 2003, p. 16-19

Discusses and comments on the Labour government's NHS reforms, focusing on national standardisation, monitoring and inspection, patient involvement, and the role of primary care trusts.

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