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

AMBULANCE QUEUES HIGHLIGHT A&E CRISIS

S. Boseley

The Guardian, September 16th 2003, p.7

Patients are having to wait for up to six hours in ambulances outside hospitals before they are admitted to A&E, according to a report by the Commission for Health Improvement. Government targets, which state that no patient should have to wait more than four hours from arriving in A&E for admission, transfer or discharge, are blamed for the problem.

BABIES AT RISK FROM MIDWIFE SHORTAGE

S. Bosley

The Guardian, September 12th 2003, p.12

A chronic shortage of midwives is putting babies lives at risk despite their "exemplary dedication", according to a report in the British Medical Journal. The report states that numbers of midwives are inadequate, that midwives are poorly deployed and that they cannot take opportunities to train or to update their skills.

(See also The Independent, September 12th 2003, p.2; The Daily Telegraph, September 12th 2003, p.13)

A BETTER DEAL FOR NEONATAL CARE AT LAST

A. Green

The Journal of Family Healthcare, 2003 vol. 13 no. 4, p.87-88

A Year 2000 Department of Health review concluded that, despite a dramatic increase in demand, neonatal care was in crisis and that mothers and babies were being put at risk. The resulting consultation document, "The Neonatal Intensive Care Review - Strategy for Improvement", included a number of recommendations and also promised £70 million over three years to aid implementation. Under these proposals neonatal services will be transformed into coherently managed clinical networks, with differing types of neonatal units working together, allowing the necessary concentrations of skills and expertise for longer, more complex care. Mothers will also have greater opportunity to give birth locally. However, staffing is critical to the success of this scheme and at present there is a crisis of recruitment and retention. Neonatal training places are also limited. Although the review offers the best way forward long term funding and staffing issues must be addressed if its vision is to be realised.

ALL OF A RUSH

C. Lewis

Health Service Journal, Vol. 113, September 11th 2003, p.30-31

The national service framework for coronary heart disease has spurred hospitals to find new ways of getting life-saving thrombolytic drugs to heart attack patients. Schemes to speed up care include paramedics administering these drugs and quicker admissions procedures.

BORN FREE

H. Mooney

Health Service Journal, Vol. 113, September 25th 2003, p.12

Discusses the implications of patient choice for the maternity services. Emphasises the importance of better informing women about birth options available and attendant risks. In future women may be able to choose between giving birth at home, in hospital, in a free-standing midwife unit or in an alternative birth centre.

CHAMPING AT THE BIT

S. Grant

Health Service Journal, Vol. 113, September 11th 2003, p.14

The article introduces new Accident and Emergency patients czar Jonathan Ashridge. His remit is to improve the patient experience in four areas of concern:

  • the A&E environment
  • the availability of children's services
  • patient information
  • the relationships between staff and patients.

DOBSON INCITES HOSPITALS REVOLT

J. Carvel

The Guardian, September 8th 2003, p.2

Frank Dobson, the former Health Secretary, has launched an attack on foundation hospitals in an unprecedented memorandum to the House of Lords. He stated that foundation hospitals would destroy the fundamental values of the health service and that the majority of NHS workers opposed the plan.

DOCTORS 'ON DUTY EVEN WHEN THEY ARE ASLEEP'

J. Laurance

The Independent, September 10th 2003,p.8

The European court ruled yesterday that the time junior doctors spend on call at their place of work should count as standard working time - even when they are asleep. The decision is a blow to ministers who had hoped that an overrule would avert the looming staffing crisis in Britains hospitals. The Royal College of Physicians said that full compliance with the directive could lead to the "collapse of acute hospital services".

DROWNING, NOT WAVING

J. Steele

Health Service Journal, Vol. 113, September 18th2003, p.18-19

Many lay members of boards of NHS bodies are ineffective and unsure of their roles and responsibilities. They are kept at arms length by senior executives and in practice lack the information, support and authority to shape strategy and hold executive colleagues to account.

web linkFAIR FOR ALL, PERSONAL TO YOU: CHOICE, RESPONSIVENESS AND EQUITY IN THE NHS AND SOCIAL CARE: A NATIONAL CONSULTATION (PDF format)

Department of Health and NHS

London: 2003

Considers how maternity services, children's health, primary care, emergency care, elective care, mental health, services for people with chronic conditions and services for older people can be made more responsive. Offering choice is not an end but a means to improving the patient and user experience by enabling them to share decision-making with professionals. Real choice includes decisions about where and when care is received as well as about what services are needed and how a patient wishes to be treated or to manage their condition.

FULL TEAM AHEAD

C. Lewis

Health Service Journal, Vol. 113, September 4th 2003, p.28-29

The diabetes team in Peterborough is being revolutionised by the addition of new professionals - a diabetes care technician and a diabetes learning facilitator. The redesigned team has been able to hit national service framework targets. The trained technician has proved as adept in the diabetes review role as clinicians. The role of technician could be adapted for use in other specialisms, such as asthma management.

HALF OF ALL NEW NURSES RECRUITED FROM ABROAD

O. Wright

The Times, September 19th 2003, p.11

A study by the Royal College of Nursing has revealed that while recruitment of new British nurses has dropped, foreign-trained nurses are arriving in ever increasing numbers. The age of nurses is also increasing, with numbers under 30 dropping by 17%.

HEALTHY CONNECTIONS

S. Ward

Public Finance, September 19-25, 2003, p.24-26

In three months time the NHS will attempt to procure a major IT infrastructure. It is an ambitious initiative, which includes e-prescribing and e-medical records as well as an electronic appointment booking service, and there are fears that the project may not have the stability necessary to succeed. A National Audit Office investigation has been launched, and there are rumours of high profile bidders dropping out as too hard a bargain is been driven. However, despite having concerns, the NHS Confederation is positive about the scheme and considers that although it is large it is not over ambitious.

HEARING VOICES

A. McLellan

Health Service Journal, Vol. 113, September 25th 2003, p.24-5

A report of an interview with patients' czar Harry Cayton on the current consultations on patient choice in the NHS. The main thrust of the exercise is to identify best practices and to decide on priorities which will improve the patient experience. He expects many recommendations emerging from the consultations to have no resource implications because they will involve changes in attitude, behaviour and culture. He finally reminds consumers of the need to consider equality of provision alongside choice.

HEART SURGEONS CUT QUEUES AND RUN OUT OF WORK

J. Laurence

The Independent, September 22nd 2003, p.1

Long queues for heart surgery have almost been eliminated, with only 375 patients waiting over 6 months, following a huge drive to increase the number of patients treated. However, specialist units are now under threat as there is not enough work and although lower waiting times are good for patients, there are fears that they could destabilise a health service unused to a rapid pace of change.

HOSPITALS CAN'T COPE WITH NEW HOURS, SAY DOCTORS

C. Hall

The Daily Telegraph, September 5th 2003, p. 10

Doctors fear hospitals will not be able to cope when the European Working Time Directive reduces junior doctors' hours from a maximum of 72 hours a week to a maximum of 58, beginning next August. Over two thirds have expressed their concern, claiming that less work will be done during the day as staff struggle to provide safe cover at night.

IT TAKES ALL SORTS

P. Smith

Health Service Journal, Vol. 113, September 4th 2003, p.10-11

Health Secretary John Reid has pledged to reform the NHS by extending the patient choice agenda beyond elective care. In an extensive consultation exercise, eight expert task groups on areas ranging from maternity services to mental health will explore what true patient choice could mean.

"MAKING AMENDS": MEDIATING MEDICAL MATTERS

T. Allen

British Journal of Health Care Management, vol.9, 2003, p.301-304

Article examines the role of mediation in settling clinical negligence claims in the NHS in the light of a recent report by the Chief Medical Officer.

MAKING PARTNERSHIP WORK FOR PATIENTS, CARERS AND SERVICE USERS

Department of Health

London: 2003

A consultation on a proposed strategic partnership agreement between the Department of Health, the NHS and the Voluntary and Community Sector (VCS). It aims too show how partnerships working at national and local level can support the twin aims of:

  • optimising the VCS's contribution to patient-centred care delivery in a reformed NHS where patient choice is the driving force of change;
  • adopting and applying the principles of the compact on relations between the government and the VCS in England in all working arrangements between the NHS and the VCS.

NEW CLINICS' RELIANCE ON NHS STAFF UNDER FIRE

N. Timmins and D. Turner

Financial Times, September 11th 2003, p.4

There are reports that up to 70% of staff in the new "fast track" diagnostic and treatment centres could be seconded from the NHS. If true this could cripple NHS hospitals. However, the government insists that the centres will recruit staff from outside of the health service, including clinical staff from overseas.

NHS 'IS FAILING TO GIVE NURSES VITAL EQUIPMENT'

P. Johnston

The Daily Telegraph, September 1st 2003, p.8

Up to two thirds of nurses do not have the equipment they need to treat and care for patients - including ECG machines, cardiac arrest trolleys and wheelchairs - according to a survey in Nursing Times. A third also said that they had been expected to use equipment without training, with half claiming the training they had received had been inadequate.

NHS MUST TAKE FULL ADVANTAGE OF HUGE CASE INJECTION, REID WARNS

J. Laurance

The Independent, September 3rd 2003, p.10

The Health Secretary John Reid has admitted for the first time that the huge level of investment going into the NHS cannot be sustained indefinitely. He stressed the NHS had a unique opportunity to transform itself into a service that met twentieth century expectations, including giving patients a degree of power over their own treatment. He warned that if this did not occur ammunition would be given to critics who want the NHS to be replaced.

NURSES OVER 50: OPTIONS, DECISIONS AND OUTCOMES

R. Watson, J. Manthorpe and J. Andrews

Bristol: Policy Press, 2003

The report is based on interviews with 84 nurses over 40 working within the NHS and other settings. It reveals that too little attention is paid by managers to issues such as pension rights, professional development, occupational stress and flexible working. It also emphasises that the NHS is in a dangerous situation as it employs 145,000 nurses over fifty who will retire in the next ten years.

OBSTACLES TO LEARNING FROM EXPERIENCE

A. Maynard

British Journal of Health Care Management, vol.9, 2003, p.297-299

Policy makers and managers have ignored medical practice variations, tolerated inappropriate treatment and failed to measure outcomes since the foundation of the NHS. Politicians have shied away from reforms likely to be unpopular with voters, while providers have been mainly concerned with guarding their vested interests.

OLD HABITS DIE HARD

T. Harvey

British Journal of Health Care Management, vol.9, 2003, p.314-315

Argues that the continuing consolidation of power in the hands of hospital consultants is a major obstacle to NHS reform.

PRESSURE OF TARGETS "HITTING HEALTHCARE"

R. Blitz

The Financial Times, September 17th 2003, p.6

Pressure on health trusts to meet national targets is harming their attempts to improve clinical care. A report by the National Audit Office says that the government's programme for raising standards is being undermined by a lack of resources, cultural difficulties and conflicting priorities.

PRIZE FIGHT

M. Gould

Health Service Journal, Vol. 113, September 25th 2003, p.14-5

The £1bn health campus project in Paddington will bring together St Mary's acute trust, the lung and heart specialist skills of the Royal Brompton and Harefield Trust and academic research facilities from Imperial College

REID ADMITS NHS TARGETS MAY NOT BE MET

N. Timmins

The Financial Times, September 4th 2003, p.6

The Health Secretary has admitted that not all the targets for cutting waiting times and increasing staff numbers will be met, despite significant progress.

REID SEEKS SUPPORT FOR NHS REFORM

P. Webster

The Times, September 17th 2003, p.4

The NHS will not achieve the aims to its founders - to provide equal access to all patients - unless it changes radically, according to the Health Secretary. In a move to convince the Labour party to back his plans, John Reid warned that failing to reform the NHS would be failing to defend it.

REID TO PRESS ON WITH NHS HOSPITAL REFORMS

N. Timmins

The Financial Times, September 3rd 2003, p.3

The Health Secretary John Reid made it clear yesterday that the government was standing firm on its plans for foundation hospitals despite a warning from the Transport and General Workers Union that the move could become this governments poll tax. Such hospitals will have extra financial freedom and Mr Reid said that would give staff the ability to develop services more quickly.

ROW AS PRIVATE CLINICS GET NHS STAFF

J. Carvel

The Guardian, September 10th 2003, p.1-2

New fast track treatment centres, to be run by private corporations, are to be staffed by NHS doctors and nurses, despite an original ruling that employees must be recruited from outside the NHS. The centres are supposed to provide extra capacity for treating patients at public expense, but there are now fears that they could lead to "covert privatisation" and cause staff shortages within the NHS.

SCREENING FOR CANCER IS HELD UP BY NHS

J. Laurence

The Independent, September 16th 2003, p.6

Screening for bowel cancer, which could halve the number of deaths caused by the disease, is not occurring because the NHS lacks the capacity to cope. Professor Alex Markham, the new chief executive of Cancer Research UK, said that the benefits of screening had been proved beyond dispute, but that more specialist doctors, nurses and new facilities were needed before a national programme could be launched.

SPECIAL REPORT: RECRUITMENT AND RETENTION

N. Edwards (Ed.)

Health Service Journal, Vol. 113, October 2nd 2003, p.37-44

This section includes reports on recruiting GP's from overseas, diversity in the workforce and retaining older workers.

TAKES YOUR BREATH AWAY

J. Bryan

Health Service Journal, Vol. 113, September 4th 2003, p.31

Asthma management is at risk of being sidelined in primary care trusts due to the lack of a national service framework. This means that recent progress in reducing asthma mortality and morbidity could soon be ended.

WILL IT BE GROUNDED AS CRITICS PREPARE TO SWOOP

N. Bostock

Primary Care Report, Vol. 5, No. 14, September 10th 2003, p.5 & 7

Reports that progress with the implementation of the £2.3bn National Programme for IT in the NHS is to be investigated by the National Audit Office, amid fears that the scheme is descending into chaos.

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