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

BACK ON TARGET

A. McLellan

Health Service Journal, vol.113, Aug.14th 2003, p.10-11

Report of an interview with Audit Commission Chair James Strachan on its growing alliance with the new Commission for Healthcare Audit and Inspection.

CLINICS "COULD BE OVERWHELMED BY FREE IVF CLIENTS"

C. Hall

Daily Telegraph, Aug.27th 2003, p.8

The National Institute for Clinical Excellence (NICE) has proposed that women aged 23 to 39 should be eligible for free IVF treatment through the NHS if they have failed to conceive for three years. Doctors fear that the NHS and private clinics could be overwhelmed by demand for IVF treatment, while opposition MPs have argued that the high cost of fertility treatment will lead to money being diverted from treatment of life-threatening conditions.

(See also Times, Aug. 27th, 2003, p.4; Financial Times, Aug.27th 2003, p.3; Independent, Aug. 27th 2003, p.15)

COMETH THE HOURS …

S. Grant

Health Service Journal, vol.113, Aug.14th 2003, p.10-12

Discusses progress with implementation of the European Working Time Directive in UK hospitals and the consequent reduction in junior doctors' hours. There is confusion between the provisions of the Directive and those of the 12-year-old NHS New Deal on hours and accommodation.

CONFIDENTIALITY: NHS CODE OF PRACTICE

Department of Health

[London]: 2003

The Code is a guide to required practice for those who work within or under contract to NHS organisations concerning confidentiality and patients' consent to use of their health records.

HIP REPLACEMENTS: AN UPDATE

National Audit Office

London: TSO, 2003 (House of Commons papers, session 2002/03; HC956)

Finds that most surgeons use prostheses which meet National Institute for Clinical Excellence guidelines, but more than 10% do not. There also remain variations in access to surgery. Waiting times for hip replacements remain unchanged since 2000, and a significant minority of consultants prioritise patients mainly to meet waiting list targets.

INEQUALITIES IN ACCESS TO MATERNITY SERVICES

Health Committee

London: TSO, 2003 (House of Commons papers, session 2002/03; HC 696)

Identifies barriers to access to maternity services for homeless mothers, travellers, domestic violence victims, and people with severe disabilities or mental health problems. Found that while innovative and effective services targeted on particular groups have been developed in some localities, good practice is not being shared. In some parts of the country there are insufficient beds in specialist units for mothers with severe mental health problems. Communication difficulties were also found to be widespread, with notes being lost when mothers moved and no continuity of care. Mothers' experiences vary according to the attitudes of individual members of staff, and some are victims of prejudice in relation to race, class and disability.

MADE TO MEASURE

T. Haggar

Health Service Journal, vol.113, Aug. 21st 2003, p.26-27

Much of the emergency pressure faced by hospitals results from patients with acute exacerbations of chronic conditions. Pressure could be reduced with better management of such conditions in the community. Whipps Cross Hospital and Waltham Forest and Redbridge primary care trusts have developed a new model for the management of chronic disease throughout its life cycle, termed "comprehensive care co-ordination". Pilot schemes for managing asthma and heart failure have reduced hospital admissions and improved patients' quality of life.

OUT IN THE FIELD

A. Moore

Health Service Journal, vol.113, Aug. 7th 2003, p.10-11

Discusses difficulties faced by English health care providers in delivering NHS modernisation in rural areas. Argues that funding allocations do not reflect the higher costs of delivering health care to scattered rural populations. Some approaches, such as assertive outreach to the mentally ill, are simply impracticable in rural communities.

PATIENT AND PUBLIC INVOLVEMENT IN THE NHS

Health Committee

London: TSO, 2003 (House of Commons papers, session 2002/03; HC697)

Discusses the new framework for patient and public input into the delivery of NHS services. Covers the introduction of Patient Advisory and Liaison Services (PALS), local authority Oversight and Scrutiny Committees, the Independent Complaints and Advocacy Service, and Patient and Public Involvement Forums.

PEACE WORK

N. Edwards

Health Service Journal, vol.113, Aug.7th 2003, p.22-23

Report of an interview with Dr. Peter Barrett, Chair of the Independent Reconfiguration Panel, which was set up to mediate in disputes over local hospital restructuring.

A PRICE TO PAY

N. Edwards and E. Forrest

Health Service Journal, vol.113, Aug.28th 2003, p.10-11

A survey of 24 out of 28 strategic health authority local delivery plans show that only ten make any mention of sexual health and none have any improvement commitments or earmarked investment in this area. Sexual health services are being sidelined partly because they do not feature in primary care trusts' planning and priorities framework.

PRIVATE FIRM TO RUN NHS HOSPITAL

J. Meikle

The Guardian, August 20th 2003, p.8

An NHS hospital in the West Midlands was yesterday handed to private management in the first deal signed since last year's announcement that firms could tender against NHS trusts to run failing hospitals. Good Hope Hospital in Sutton Coldfield will be under the charge of a chief executive from Secta, a company at the forefront of private-public partnerships.

PRIVATE SURGERY CENTRES 'MAY DESTABILISE NHS HOSPITALS'

N. Timmins

Financial Times, August 19th 2003, p.4

Plans for privately-run 'fast track' surgery centres, staffed initially by overseas doctors from South Africa, the US and elsewhere, could destabilise local National Health Service hospitals, the Royal College of Surgeons has warned.

REID ASKS NHS TO BE CONSUMER FRIENDLY

J. Carvel

Guardian, Aug.29th 2003, p.10

Health Secretary John Reid has embarked on a programme of visits to NHS hospitals to persuade staff to accept changes in working practices. He wants them to tailor services to suit the preferences of individual patients and to treat them with promptness and respect as consumers.

STROKE OF LUCK?

C. Meek

Health Which?, Aug. 2003, p.16-17

Care for stroke victims in the UK is lagging behind the rest of the European Union. Basic early care is often neglected, and there is a shortage of specialist stroke units in hospitals in England and Wales. Some hospitals may claim to have introduced a stroke unit without having made any genuine improvements.

TELLING TALES

T. New

Health Service Journal, vol.113, Aug. 7th 2003, p.24-27

United Lincolnshire Hospitals Trust piloted a tracking exercise to gather data on patient experiences in emergency care. The exercise prompted rapid and dramatic improvements in clinical governance, ward processes and medical protocols.

THIS WAY NOW

D. Carlisle

Health Service Journal, vol.113, Aug.7th 2003, p.12-13

By December 2005 patients should be able to choose from a list of up to five treatment options at the point of referral. This choice may be delivered by increasing NHS capacity. GPs could refer patients directly for surgery without their having to see a hospital consultant, or chronic disease could be managed in the community, avoiding a hospital referral altogether.

WATCHING AND WAITING: WHY A LONDON PILOT SCHEME HOLDS THE KEY TO MAKING THE NHS RESPONSIVE AND EFFICIENT

N. Timmins

Financial Times, August 19th 2003, p.15

Shorter waiting lists and more choice are at the centre of the government's modernisation plans. This article examines the London Patient Choice project, a £75m groundbreaking attempt to put those ideas into practice. It has two main aims:

  • by the end of 2005 no patient, once placed on a waiting list, will have to wait for more than six months.
  • patients will get a choice over where and when they are treated.

The London Patient Choice pilot scheme has shown some of the strains hospitals will face as choice becomes more widespread. It has revealed, for example, that patients are willing to travel (over 70% polled indicated they were prepared to travel). It has also revealed that, because of shortages of doctors, nurses and beds, choice will often be limited and real choice will only be possible if there is some spare capacity. Patient choice is going national from next April.

WORLDS OF HEALTH: EXPLORING THE HEALTH CHOICES OF BRITISH ASIAN MOTHERS

K. Reed

Westport, Conn.: Praeger, 2003

This book aims to try and explore the links between ethnicity, identity and health choices. More specifically, the book explores the influence of ethnicity, gender, and generation on the health choices of British Asian mothers. Based on a study that focused on interviews with thirty British Asian women in Leicester, the author asks how, when Western and non-Western products and services are widely available in both the local and global marketplaces, does ethnicity, gender and generation affect access and use of a plurality of health goods and systems?

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