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

ACHIEVING THE NHS PLAN

Audit Commission

Audit Commission Publications, 2003

Report calls into question the reliability of the "star rating" of NHS trusts. Analysis found that several highly starred trusts had weak management and poor financial arrangements. Some had hit government targets by using special measures that were not sustainable. There were also weaknesses in data collection in nearly all trusts, which made it impossible to decide whether targets such as maximum waiting times had been hit or not.

ARTICULATING GENDER IN THE CONTEXT OF ICTs IN HEALTH CARE: THE CASE OF ELECTRONIC PATIENT RECORDS IN THE MATERNITY SERVICES.

F. Henwood and A. Hart

Critical Social Policy, vol. 23, 2003, p.249-267

Midwives define their work in opposition to computers, seeing IT as antithetical to the core "women-centred" philosophy of midwifery. Articles proposes the development of the role of the IT midwife to overcome the divisions that exist between the IT and midwifery worlds. The IT midwife would be clinically trained and would work with computer professionals to design systems which are acceptable to maternity services' staff and clients.

'BEST' HOSPITALS HAVE WORST DEATH RATES

O. Wright

The Times, May 12th 2003, p.1

Patients are more likely to die in hospitals rated as outstanding by Government than in those labelled as failed. According to analysis by The Times, the government's system of measuring hospital performance has fundamental flaws. According to figures provided by the Dr Foster Unit at Imperial College, a third of the English hospital trusts with the highest mortality rates have been commended by ministers as the best performers. By contrast, three hospitals judged by the Department of Health to be failing had some of the lowest death rates. These figures call into question the basis for choosing the first wave of foundation trusts.

(See also The Times, May 12th 2003, p.5)

BLAIR SEES OFF LABOUR REBELS OVER FOUNDATION HOSPITALS

J. Blitz and C. Adams

Financial Times, May 8th 2003, p.1

Although around 120 Labour MPs had expressed opposition to the principle of freeing the best-performing hospitals from state control, Tony Blair's efforts to diffuse a backbench rebellion succeeded last night when just 63 Labour MPs backed a motion opposing plans to set up foundation hospitals.

(See also The Guardian, May 8th 2003 p1; The Times, May 8th 2003, p1; The Independent, May 8th 2003, p.2; The Daily Telegraph, May 8th 2003, p1)

BLAIR PUTS NHS OUT TO TENDER

J. Carvel

The Guardian, May 14th 2003, p.11

Tony Blair told private-sector healthcare executives that he wanted to open the whole of the NHS to outside competition.

BLUNDERS STILL COMMON IN NHS, SAYS SURVEY

S. Boseley

The Guardian, May 6th 2003, p.9

Medical mistakes, inefficiency and poor communication between doctors and their patients are still common in the NHS, according to a survey comparing patients' experiences in the UK with those in the US, Australia, New Zealand and Canada

CANCER PATIENTS FORCED TO WAIT MONTHS FOR SCANS

J. Meikle

The Guardian, May 27th 2003, p.7

Hospital staff shortages are causing people with cancer to wait months for scans or radiotherapy treatment, a survey by the Society of Radiographers has revealed.

CHANGE OF HEART

D. Carlisle

Health Service Journal, vol. 113, May 15th 2003, p.12-13

The Society of Cardiothoracic Surgeons has announced it will publish star ratings for its members, to the horror of the British Medical Association and the Royal College of Surgeons.

COMPLAIN AND SIMPLE

L. Greenwood

Health Service Journal, vol 113, May 29th 2003, p.24-25

Describes how Barnsley District General Hospital involved patients who had formally complained in improving the service. Many have become volunteer members of patient involvement groups. Since the initiative was launched, complaints have dropped significantly. The approach has been to nip problems in the bud.

THE DEATH OF NURSING (AGAIN)

T. Harvey

British Journal of Health Care Management, vol. 9, 2003 p.184-185

The NHS is increasingly reliant on nurses brought in from overseas. Failure to attract local recruits into the profession may be due to the highly academic and theoretical nature of the training programmes introduced since 1990. They give new entrants insufficient involvement with the patient on the ward, and fails to equip them with practical skills.

DOCTORS TO BE GIVEN A SAY IN FUTURE OF THE NHS

O. Wright.

The Times, May 21st 2003, p.4

Doctors are to be given more say in the direction of the NHS. Doctors will be asked to help draw up a mission statement setting out new principles for the NHS. It will codify how much information patients should expect to receive from doctors and investigate success rates as well as examining targets and waiting times.

FOUNDATION HOSPITALS WILL KILL THE NHS

A. Pollock

The Guardian, May 7th 2003, p.22

The author, Head of Health Policy at University College London, believes foundation trusts are simply a fig leaf for privatisation below board level. Trusts will have unlimited powers to raise finance or enter into clinical service contracts with companies such as Boots.

FOUNDATION TRUSTS

Health Committee

London: TSO, 2003 (House of Commons papers, session 2002/03; HC 395)

Committee found that the proposed foundation hospital trusts pose a threat to equity of service provision, one of the founding principles of the NHS. Their introduction has the potential to lead to wage inflation and the aggressive poaching of staff. There is concern that there are insufficient incentives for foundation hospitals to maintain their good performance. Stronger safeguards will be needed to ensure continued co-operation between primary and secondary care. There are also a range of concerns about the accountability framework for foundation hospitals.

GRUEL INTENTIONS

L. Whitfield

Health Service Journal, vol. 113, May 22nd 2003, p.20-22

Report of an interview with the Liberal Democrats' health spokesman Dr Evan Harris. The Party proposes to transfer responsibility for commissioning of NHS services to local authorities, and to allow councils to raise local income tax to partially fund them. Dr Harris also argues that rationing should be made explicit, with voters openly being told what treatments and services are and are not available locally.

IMPROVING SERVICES FOR PEOPLE WITH EPILEPSY: DEPARTMENT OF HEALTH ACTION PLAN IN RESPONSE TO THE NATIONAL CLINICAL AUDIT OF EPILEPSY-RELATED DEATH

London: 2003

Ideas for improving epilepsy services include:

  • development of shared care protocols between GPs and hospital specialists to help reduce treatment failures;
  • ensuring that patients with on-going seizures are aware of the risks of epilepsy;
  • the development of clinical networks and clinical leaders to encourage the spread of best practice;
  • the development of more epilepsy nurse specialists;
  • tailored services to meet the needs of particular groups with epilepsy, such as women and children.

IN THE NAME OF NYE

P. Smith

Health Service Journal, vol. 113, May 8th 2003, p.10-11

Reports on Health Secretary Alan Milburn's claims that the concept of foundation trusts is consistent with Bevan and Beveridge's original vision for the National Health Service.

JUST THE TICKET

N. Edwards

Health Service Journal, vol. 113, May 29th 2003, p.18-19

Report of an interview in which Professor Ara Darzi discusses the proposed Diagnosis and Treatment Centres and other innovative approaches to reducing waiting times for elective surgery. These include better use of NHS facilities through fee-for-service work carried out at weekends by a mix of local consultants and overseas clinicians.

MILBURN EARMARKS FIRST 29 FLAGSHIP FOUNDATION HOSPITALS

J. Laurance

The Independent, May 15th 2003, p.4

The government has named the first 29 candidates to become foundation trusts. They will now prepare a business case, setting out how they plan to use the new freedoms. Successful trusts will be granted foundation status in April 2004.

NHS WAITING LIST DIPS BELOW 1M MARK FOR FIRST TIME IN DECADE

N. Timmins

Financial Times, May 16th 2003, p.4

The National Health Service waiting list dipped below 1 million at the end of March - the first time it has been below that politically sensitive figure in a decade. At the same time the government will claim it has hit its target that no one should wait more than 12 months for an in-patient admission

(See also The Times, May 16th 2003, p.2)

NHS WATCHDOG WARNS OVER SCALE OF CHANGE

N. Timmins

Financial Times May 9th 2003, p1

The National Health Service is improving, but risks getting worse because of short-term waiting time targets and the scale of organisational change, according to the Commission for Health Improvement. In its first annual report on the state of the NHS, based on the 770 inspections it has carried out so far, the Commission said that "the NHS, as a whole, is getting better". But it added: "We are also concerned that the improvement we see is at risk".

(See also the Independent, May 9th 2003, p.8)

THE NICE GUY

L. Whitfield

Health Service Journal, vol. 113, June 5th 2003, p.20-21

Andrew Dillon, chief executive of the National Institute for Clinical Excellence, describes its procedure for reviewing treatment effectiveness. Reviews are carried out by advisory groups of independent experts. He strongly refutes accusations that NICE is overly influenced by pressure groups and pharmaceutical companies. He also rebuts countercharges that it ignores patient and drug company views.

NURSES FROM ABROAD STILL LURED TO UK DESPITE BAN

J. Laurance

The Independent, May 12th 2003, p.5

Britain is continuing to loot the poorest nations of the world of their skilled medical staff to shore up the NHS in defiance of the government ban on the practice imposed in 2001, according to new figures from the Nursing and Midwifery Council

OVERVIEW AND SCRUTINY OF HEALTH: GUIDANCE

Department of Health

London: 2003

Clarifies the primary and secondary legislation that provides local authority overview and scrutiny committees with the power to scrutinise health services. It also provides advice and recommendations on the undertaking of scrutiny of health services for both local authority overview and scrutiny committees and NHS organisations.

PATIENTS' FORUMS: CONSULTATION ON THE DRAFT REGULATIONS

Department of Health

London: 2003

The main functions of patients' forums are to:

  • monitor and review NHS services;
  • report on the views of patients and carers on health services;
  • provide advice to both the NHS trust and its users;
  • commission independent complaints advocacy support services;
  • encourage public involvement in consultations.

The draft regulations offered here for consultation provide the legal framework within which patients forums will operate.

THE PRICE OF KNOWLEDGE IS HIGH, BUT THE COST OF IGNORANCE IS GREATER!

A. Maynard

British Journal of Health Care Management, vol. 9. 2003, p.169-171

Attacks the NHS for failing to collect basic data on clinician activity levels and treatment outcomes.

RAISING STANDARDS: IMPROVING PERFORMANCE IN THE NHS

Department of Health

London: 2003

Outlines a new NHS improvement programme that will be targeted on two star and one star hospitals and primary care trusts (PCTs). It will have four elements for each hospital or PCT:

  • a clear assessment of problems and remedial action needed;
  • tailored support from the Modernisation Agency to address particular weaknesses;
  • leadership development for managers and clinicians, importing new local leaders if necessary;
  • directing resources to help underperforming trusts improve.

SKELETON STAFF

B. Stevenson

Health Service Journal, vol. 113, May 8th 2003, p.28-29

Describes a project in which Peterborough Hospital Trust engaged a team of French orthopaedic surgeons to fly in to carry out operations under contract over weekends.

STRENGTHENING ACCOUNTABILITY: INVOLVING PATIENTS AND THE PUBLIC: PRACTICE GUIDANCE: SECTION 11 OF THE HEALTH AND SOCIAL CARE ACT 2001

Department of Health

London: 2003

Guidance is for all staff responsible for involving patients and public in the development of NHS services. It includes best practice baseline measures to use as a self-assessment tool; a wide range of helpful information, suggestions and approaches; and help to understand what is meant by on-going public and patient involvement.

VOICING CONCERNS

L. Donnelly

Health Service Journal, vol. 113, May 22nd 2003, p.14-15

Community Health Councils (CHCs) will be abolished on September 1st 2003 when interim Independent Complaints Advocacy Services go live. However CHCs have been told to cease taking complaints from July 31st, leaving patients with nowhere to turn to for support for at least a month.

WARD HOUSEKEEPERS: IMPROVING THE PATIENT EXPERIENCE

Department of Health

London: 2003

Ward housekeepers work to ensure a clean, warm and comfortable environment for patients, with appetising food and a personalised service. They use hospitality skills in a clinical environment, and release nurses from basic care tasks. Report reinforces the service standards for ward housekeepers based on what patients want to see.

WATCHDOG WARNS POOR MANAGEMENT THREATENS HEALTH SERVICE REFORMS

N. Timmins and C. Newman

Financial Times, May 27th 2003 p.1

James Strachan, Chairman of the Audit Commission, warns that some new super hospitals may lack the management skills needed to push ahead with public service reforms. The watchdog chairman warns that in its haste to improve public services the government is moving from one extreme to the other too quickly and too indiscriminately.

(See also Financial Times, May 27th, 2003, p.4

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