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

THE HEALTH ACTION ZONE INITIATIVE: LESSONS FROM PLYMOUTH

M. Cole

Local Government Studies, Vol. 29, No. 3, Autumn 2003, p. 99-117

Labour established Health Action Zones (HAZ) as part of their public sector reform agenda. They were envisaged as a catalyst and mechanism to improve the delivery of local health services, providing a framework within which the NHS, local government and a wide range of local stakeholders could combine to address health issues. This study focuses on the HAZ in Plymouth, evaluating the impact of a wide range of projects in the zone.

HOW FASTER A&E HAS HELPED TEN MILLION PEOPLE

K. Howard

British Journal of Health Care Management, vol.9, 2003, p.370-371

Describes the work of the Emergency Services Collaborative in promoting improvements in the emergency care experience for both carers and patients through enhanced working practices.

HUFFING AND PUFFING

J. Osmond

Public Finance, Nov. 14-20 2003, p.24-27

The Welsh Assembly has developed a highly distinctive approach to health policy. In its first term it abolished prescription charges for 16-25 year olds and the over 60s and froze them for the rest of the population. It abolished dental charges for the same age groups and eye test charges for the over 60s. In its second term, it intends to phase out all prescription charges. The NHS in Wales has been reorganised into 16 trusts and 22 local health boards which are co-terminous with the 22 local government unitary authorities creating a structure completely different from elsewhere in the UK. Community Health Councils, to be abolished in England, are retained in Wales. However, these reforms have not addressed the issue of waiting lists and times, which are soaring in Wales compared to England

HEART ACT TO FOLLOW

C. Lewis

Health Service Journal, Vol. 113 Nov. 20th, 2003 p 28-29

Areas taking part in the original coronary heart disease management programme have seen a four-fold reduction in deaths from heart attacks. Practices involved in the programme established a register of CHD patients implemented agreed protocols for care, used computerised templates for collecting information, identified systems for call and recall, and developed nurse led care. It is planned to apply the methodology to the management of other chronic diseases.

INJURY TIME

A. Moore

Health Service Journal, Vol. 113, Oct. 30th 2003, p.15

The article discusses how patient choice could be exercised in emergency care through access to a range of providers such as NHS Direct, minor injuries clinics, walk-in clinics and GP out-of-hours services.

LOCALISING THE NATIONAL HEALTH SERVICE: GAINING GREATER EQUITY THROUGH LOCALISM AND DIVERSITY

J. Reid

London: New Local Government Network, 2003

Presents proposals for making the NHS more locally owned and accountable within a framework of national targets and standards.

THE MISSING LINK

G. Craig and T. Hall

Health Service Journal, vol.113, Nov.6th, 2003, p34-35

Current TB services fail to reflect the changing epidemiology of the disease. Patients now present with multiple and complex health and social problems. However, services concentrate on providing a microbiological cure but ignore the underlying social problems. In contrast Middlesex Hospital's TB link project focuses on joint working with housing and social care providers to offer a more responsive service

MORE NURSES, WORKING DIFFERENTLY?

J. Buchan and I. Seccombe

London: Royal College of Nursing, 2003

Review of the UK nursing labour market found that over 20,000 nurses are leaving the workforce annually. The proportion of nurses over 55 has increased from 9% to 15% between 1991 and 2001. Between 1999 and 2002 numbers of managers and healthcare assistants grew by 33% and 46% respectively, while numbers of nurses grew by only 12%. Calls for an intensification of efforts to increase nursing capacity within the UK and the development of a 10-year recruitment and retention action plan covering the whole country.

MOVERS AND SHAPERS

M. Brewer

Health Service Journal, Vol. 113 Nov. 6th, 2003 p.41

Discuss the impact of the new NHS pay and grading system introduced by Agenda for Change on staff transferred to the private sector under the TUPE Regulations. Looks in particular at the position of staff transferred before their re-grading under Agenda for change

NETWORK PREMIERE

C. Lewis

Health Service Journal vol. 113, Nov. 6 2003, p 32-33

Tayside has set up a managed clinical network for diabetes care. The system includes an advanced patient auditing function which highlights risks, a clinical governance peer support system to help GP practices hit targets, and diabetes resource centres for patient education and training

NHS MANAGERS' VIEW OF THEIR CULTURE AND THEIR PUBLIC IMAGE: THE IMPLICATIONS FOR NHS REFORM

F Merali

International Journal of Public Sector Management, vol. 16, 2003 p549-563

An examination of the managers' perceptions of the existing NHS culture shows that the majority of the 28 interviewees believed that all NHS workers share altruistic care values. They thought that these values had remained unchanged in spite of previous and current reforms. The managers generally saw the recent NHS reforms as being compatible with this altruistic culture, which should contribute positively to their successful implementation. However, they believed that the public did not see managers as being part of this altruistic culture, a view which they felt was unfair. Furthermore, they did not appear to have allowed this perceived negative public view to undermine their commitment to their altruistic values and ethos.

NHS QUALITY DRIVE 'MOST AMBITIOUS IN THE WORLD'

N. Timmins

Financial Times, November 27th 2003, p. 7

The drive to improve National Health Service care is the most ambitious and comprehensive in the world, an independent assessment has concluded. But the data the NHS produces is too poor to indicate how much the quality of care has improved, says the study, published by the Nuffield Trust.

NICE WORK: THE FIRM RESOLVES OF RAWLINS

N. Bostock

Primary Care Report, Vol. 5, no.18, Nov. 12th 2003, p.22

Interview with Sir Michael Rawlins, Chair of the National Institute for Clinical Excellence, in which he discusses progress in bringing cohesion to the NHS through his organisation's treatment guidelines.

ON THE RECORD

A. Silverman

Public Finance, Oct. 31st-Nov. 6th, 2003, p.28-29

By the end of 2005, it is intended that every patient in England will have an electronic record. Article reports on progress with the procurement of the IT systems that will support the electronic patient record. There are concerns that in the present focus on procurement, the needs of users are being ignored

ON TRACK

S. Grant

Health Service Journal, vol. 113, Nov. 20, 2003 p.24-25

Cancer Czar Prof. Mike Richards discusses plans to investigate the persistence of postcode prescribing of drugs and claims that geographical variations in funding have become more pronounced since primary care trusts took over service commissioning

OUTRAGE AS REID DOUBLES FIRST WAVE OF FOUNDATION HOSPITALS

J. Carvel

The Guardian, November 26th 2003, p.10

The Health Secretary, John Reid, infuriated his Labour backbench critics yesterday by more than doubling the number of NHS hospitals that will gain foundation status next year. To avoid defeat in the Commons last week, he promised an independent review of the policy before allowing a second wave of hospitals to gain independence as foundation trusts. But yesterday he named 32 hospitals which will become foundations in October 2004, six months after the first group of 25 in April.

PATH OF ENLIGHTENMENT

C. Lewis

Health Service Journal, Vol. 113, October 30th 2003, p.28-29

The article describes how three distinct pathology services in Kent merged into a single network. By working under a single directorate they have achieved cost and efficiency benefits. The new service has also improved the recruitment and retention of biomedical staff through the availability of better training.

PHARMA FOCUS

Health Service Journal, Vol. 113, Nov. 27th 2003, Supplement, 8p

Covers reform of the pharmaceutical price regulation scheme, asthma management, medicines tailored to patients' genetic make-up and inappropriate influence of large pharmaceutical companies on doctors and patient groups.

THE QUEST FOR QUALITY IN THE NHS

S. Leatherman and K. Sutherland

Nuffield Trust, 2003

Reviews the government's progress in delivering improvements in quality of care since 1997. Finds that there are significant weaknesses in data collected about the NHS that mean carrying out a robust, definitive, transparent and defensible assessment of progress is impossible. To solve this problem calls for the creation of a national quality information centre under the aegis of the Commission for Healthcare Audit and Inspection. However the report does attempt to show what the NHS has achieved across the five areas of capacity, access, public perception, effectiveness and equality, which the authors believe combine to form a definition of quality. Concludes that the greatest threat to progress on the quality agenda is the unrelenting politicisation of the NHS

SCOTLAND'S A FRONTRUNNER IN DELIVERING ON DIABETES

P. Scott

Primary Care Report, vol. 5, no.18, Nov. 12, 2003 p.13-15

Article compares the English National Service Framework for Diabetes with its Scottish counterpart. The Scottish diabetes framework is based on an agreed set of standards from the Clinical Standards Board and consensus guidelines. It contains specific targets for service development and delivery. On the other hand the English Diabetes NSF is vague and accommodates local variation in services

SHOULD WE PLACE OUR TRUST IN SHAKY FOUNDATIONS?

J. Shapiro

Primary Care Report, vol.5, no.17, Oct. 29th 2003, p.26

Argues that foundation hospitals, as they respond to their local markets, will introduce unacceptable variations in provision across England.

TRAVELLERS' CHEQUES

T. Blythe

Health Service Journal, vol.113, Nov. 20th, 2003, p. 33

The High Court judgement in the case of Watts v. Bedford Primary Care Trust has established that prior authorisation for treatment overseas is justifiable under the EU law to ensure a financially stable and efficient NHS. However, the criteria involved in deciding whether to authorise treatment overseas must be objective and non-discriminatory and known in advance. The process should be easily accessible and administered objectively and impartially within a reasonable time. It must also be possible to challenge refusals in the courts.

WHAT ARE THE COSTS AND BENEFITS OF PATIENT CHOICE?

A. Maynard

British Journal of Health Care Management, vol.9, 2003, p.362-364

Discusses whether the patient choice initiative will improve NHS efficiency and help reduce health inequalities between social classes.

WHOSE BRIGHT IDEA

P. Shelton and M. Syrett

Health Service Journal, vol. 113, Nov.27th 2003, p26-27

Describes how the managers at the Royal National Orthopaedic Trust support doctor let clinical redesign. They have found that successful projects need an innovator or clinical champion, a 'shaper' who acts as gatekeeper to trust backing and resources, and an implementer. Using this model the trust has pioneered voice-activated endosuites, CD-ROM training and cartilage transplant

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