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

ACHIEVING IMPROVEMENTS THROUGH CLINICAL GOVERNANCE: A PROGRESS REPORT ON IMPLEMENTATION BY NHS TRUSTS

National Audit Office

London: TSO, 2003 (House of Commons Papers, session 2002/03; HC1055)

The report argues that too much external inspection of the NHS is hampering the implementation of key clinical governance strategies. Clinical governance functions that "serve some statutory or external requirement" such as risk management or complaints are more robust. However, newer functions, which may not be seen as essential, such as patient and public involvement, are less well developed in many trusts. Few trusts have developed internal indicators to monitor progress in implementing clinical governance and in up to a third of hospitals there is no connection between Board policies and what happens on the front line.

ARE YOU TALKING TO ME?

T. Kelsey

Health Service Journal, Volume 113, October 16th 2003, p.18-19

The article argues that the NHS needs to communicate with its users in language they understand if it is to increase the numbers of people who understand the value of self-help and prevention. Managers and clinicians need to learn to listen to those they serve.

AS GOOD AS NEW

C. Lewis

Health Service Journal, Vol. 113, October 16th 2003, p.28-29

Community hospitals are finding a new role as diagnostic and treatment centres.

BLAIR DEFEAT OVER NHS REFORM

J. Blitz and C. Adam

Financial Times, October 2nd 2003, p. 1

At yesterdays' Labour party conference the biggest trade unions joined forces to inflict a symbolic defeat on the Labour leadership over the government's NHS reforms. The four unions, GMB, Unison, TGWU and Amicus, worked together to pass the motion to scrap plans for foundation hospitals. The vote does not imperil the legislation but Tony Blair unable to present a united front.

(See Also The Times, October 2nd 2003, p.1)

DATA ENVELOPMENT ANALYSIS AS A MEASURE OF EFFICIENCY IN THE NHS

B. Hollingsworth and D. Parkin

Journal of Health Services Research & Policy, Vol. 8, 2003, p.230-236

Although the NHS has numerous ways of measuring efficiency these methods are unreliable, producing results that can be misused and making them unpopular with potential users. This study investigate the benefits of using data envelopment analysis (DEA), a user-friendly product that has been widely used in health care in other countries, to calculate efficiency in the NHS. Routine data was taken from health providers and purchasing organisations and used to create information on efficiency based on DEA. Their views on the procedure were than sought. More than 80% felt that the technique could potentially be very useful, and the report concludes that the DEA method should be implemented on an experimental basis, to see if its potential value can be achieved.

A FIGHTING CHANCE

H. Mooney and A. McLellan

Health Service Journal, Vol. 113, October 9th 2003, p.12-13

New Labour is currently promoting patient choice as a way of achieving equity of access to healthcare. They argue that the old monolithic NHS is necessarily inequitable because it is dominated by vested interests and open to behind-the-scenes manipulation. Giving patients greater control through the ability to exercise choice is regarded as the best way to counter this systemic inequity.

FOUNDATION REQUESTS MADE BY 32 NHS TRUSTS

N. Timmins

Financial Times, October 8th 2003, p.2

The Health Department said yesterday that applications to become foundation hospitals had been made by 32 of the 38 NHS trusts that had won three-star status this Summer.

HAVING A SAY IN HEALTH: INVOLVING YOUNG PEOPLE WITH A CHRONIC ILLNESS OR PHYSICAL DISABILITY IN LOCAL HEALTH SERVICES DEVELOPMENT

J. Lightfoot and P. Sloper

Children and Society, vol. 17, 2003, p.277-290

Involving users, including young people, in NHS service development is increasingly emphasised in policy and practice. Paper presents findings of the second stage of a study which aimed to investigate involvement of young people with a chronic illness or physical disability in local health service development. Through an investigation of initiatives in six trusts, study sought to identify factors which can support involvement in ways which young patients find appropriate.

HEALTH CHIEFS ADVERTISE TO ATTRACT PATIENTS

N. Timmins

Financial Times, October 15th 2003, p.4

A health authority has advertised for National Health Service patients because surgeons were reluctant to refer them to an overseas team. Pearse Butler, Chief Executive of the Cumbria and Lancashire Strategic Health Authority, acted as overseas teams are being brought in to run most of the independent surgical treatment centres the government is commissioning from the private sector. He acted as too few patients came through.

HOSPITAL CONSULTANTS AGREE TO A NEW DEAL

N. Timmins

Financial Times, October 21st 2003, p.6

Hospital consultants yesterday voted for a new contract amid doubts over whether it will prove good value for money for the National Health Service. After rejecting a previous deal a year ago consultants voted in favour of deal in which they will do out-of-hours non-emergency work only by agreement.

(See also Guardian, October 21st 2003, p.6; The Times, October 21st 2003, p.1)

IN FOR THE LONG HAUL

S. Grant

Health Service Journal, Vol. 113, October 16th 2003, p.15

The article discusses the application of patient choice to services for people with chronic conditions. It emphasises the need to think about the whole person rather than the disease. Multi-disciplinary team assessment and collaborative working between professionals in different disciplines are essential.

LOOKING GOOD? THE ATTRACTIVENESS OF THE NHS AS AN EMPLOYER TO POTENTIAL NURSING AND ALLIED HEALTH PROFESSIONAL STAFF

J. Arnold and others

Loughborough University Business School, 2003

Research investigated perceptions of the NHS as an employer for the nursing and allied health professions (represented by physiotherapy and radiography). A total of 1356 people provided data. The study found that the best thing about working in the NHS was contact with patients. Job security, a good pension, task variety and team working were also valued. Understaffing and associated work pressures were the strongest barriers to working for the NHS. Issues to do with convenience, flexibility, length of working hours and low pay were also mentioned. Working for the NHS as a nurse or allied health professional was thought to be a rewarding career, but starting pay levels were often underestimated.

NETWORK SOLUTIONS

C. Lewis

Health Service Journal, Vol.113, October 9th 2003, p.28-29

Sexual health appears to be an ideal candidate for a managed clinical network, although there are doubts about whether networks deliver better patient care. The article describes the development of the South West London HIV and Genito-Urinary Medicine Clinical Services Network set up in 2002.

NHS GROUP OFFERS FAST-TRACK SURGERY

N. Timmins

Financial Times, October 16th 2003, p.2

Four NHS "fast-track" surgery centres have banded together to market potentially tens of thousands of operations a year to health service patients in a challenge to the private sector and new overseas independent treatment centres. Central Middlesex Hospital and Ravenscroft Park in West London have joined together with day care units at Kidderminster and Weston-Super-Mare to form NHS Elect, a trading organisation that offers operations to every health authority and trust in the country at NHS rates. In the future the alliance may advertise its services direct to patients.

PATIENT CHOICE: A TASTE OF THINGS TO COME?

M. Pownall

Primary Care Report, Vol. 5, No. 15, September 24th 2003, p.14-17

From April 2004, any patient waiting longer than six months for an operation will have to be offered treatment at an alternative site. This could be at another NHS trust or a private hospital. The aim of the initiative is to incentivise trusts to reduce waiting times. The article explores how NHS bodies are planning to implement this change.

PREPARATION FOR PATIENTS' FORUMS IN CRISIS

H. Muir

The Guardian, October 27th 2003, p.8

Reforms to sweep away Britain's Community Health Councils are facing crisis, following claims that the system of patient representation is being handed over to groups with little experience of how to run it. Up to 4,560 patients are needed for 575 new patients' forums around the country but few inside the government believe that the quango in charge, the Commission for Patient and Public Involvement in Health, will have an effective system in place by the deadline, despite the introduction of the new arrangements being delayed by three months, until Dec 1. The Commission is refusing to reveal how many forum members have been recruited so far.

PRODUCERS AND CONSUMERS IN HEALTH SERVICES RESEARCH

E. Ferlie and M. Wood

Journal of Health Services Research & Policy, Vol. 8, Supp. 2, October 2003, p.51-57

This study investigates the mode of knowledge production in health services research, how the research is linked to users, the extent to which it is influenced by its funding base and the development and dissemination strategies of investigators. It is based on case studies of four contrasting health service research groups.

PROMOTING CHILDREN'S INTEREST IN HEALTH: AN EVALUATION OF THE CHILD HEALTH PROFILE

M. Hill and P. Morton

Children and Society, Vol. 17, 2003, p.291-304

A recent initiative in Scotland sought to engage children's interest in health matters and encourage them to take greater responsibility for their own health by means of a child health profile. This is a loose-leaf booklet containing personal data, health promotion material and space for recording discussions about an individual's health. The article describes the implementation of the profile on a pilot basis across three health boards and presents data obtained from children about their understanding, usage and views.

REDESIGNING WORK PROCESSES IN HEALTH CARE: LESSONS FROM THE NATIONAL HEALTH SERVICE

C. Ham, R. Kipping and H. McLeod

Milbank Quarterly, vol.81, 2003, p.415-439

NHS policymakers have focused on changing work processes in order to improve performance. Article analyses and uses the NHS's experience to identify lessons for future quality improvement initiatives. Focuses on one recent initiative, the national booked admissions programme, which illustrates both the opportunities and the challenges of introducing and sustaining change.

ROUND OBJECTIONS TO CRITICS OF THE CHOICE AGENDA

A. Cowper

British Journal of Health Care Management, vol. 9, 2003, p.329-332

Report of an interview with Lord Hunt of Kings Heath, formerly government health spokesman in the House of Lords, covering primary care trusts, foundation trusts, the patient choice agenda, star ratings and financial flows within the NHS.

SINGLE ASSESSMENT IN ACUTE HOSPITALS

D. McNally and J. Peet

Working with Older People, Vol. 7, September 2003, p.18-21

Describes a project in Whiston and St Helens Hospitals to improve older people's experience of acute care and discharge through implementing the single assessment process.

THOUSANDS SET FOR FREE SURGERY ABROAD AFTER NHS RULING

J. Laurance

The Independent, October 2nd 2003, p.5

Tens of thousands of hospital patients facing long waits for NHS care could be eligible to travel abroad for treatment and be reimbursed for the cost afterwards, a landmark judgement said yesterday. Mr Justice Munby ruled that a patient waiting "significantly" longer than three months for a hip operation had a legal right to have it free elsewhere. He admitted that his decision would have a profound impact on the health service, but said the EU was clear that member states could not refuse to pay for foreign treatment for patients facing "undue delay".

(See also The Times October 2nd 2003, p.1)

UK'S FIRST PRIVATE CASUALTY CLINIC GIVES A QUICK FIX

J. Ezard

The Guardian, October 2nd 2003, p.11

Article notes the first patients at Britain's first purpose-built, walk-in private casualty unit, Casualty Plus, in Brentford, West London. The article lists the cost of basic treatment.

WILL DIAGNOSTIC AND TREATMENT CENTRES SUCK THE NHS DRY?

N. Bostock

Primary Care Report, Vol. 5, No. 15, September 24th 2003, p.5-7

Private firms under contract to the NHS will run new diagnostic and treatment centres. There are concerns that they will siphon profitable routine surgery off from NHS acute hospitals, denying them a vital source of income. There are also fears they may poach staff.

WINNERS AND CHOOSERS

M. Print

Health Service Journal, vol.113, Oct. 23rd 2003, p.29

Foundation trusts will be established as public benefit corporations with attendant corporate duties and potential liabilities for directors. This means that the proposed long-term contracts with commissioning bodies will be legally binding. Article discusses the impact of patient choice on this framework. Patients may choose treatment outside of the local area and have a legitimate expectation of compliance with their choice, potentially leading to the destabilisation of the local health economy.

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