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Welfare Reform on the Web (August 2004): National Health Service - Reform - General

ACUTE LITTLE IDEA

N. Plumridge

Health Service Journal, vol.114, July 8th 2004, p.27

The recent policy initiatives of patient choice, payment by results and foundation hospitals will together create a market system aimed at enhancing hospital efficiency. This conflicts with a new push towards management of chronic disease in the community, not in hospital.

BEYOND THE FRINGE

E. Ernst

Health Service Journal, vol.114, July 22nd 2004, p.28-29

Complementary medicine is popular with consumers but can be unsafe and expensive. Even accepted therapies, such as chiropractic spinal manipulation, rest on doubtful evidence. There are insufficient grounds to justify integrating these therapies into routine healthcare.

CUT IN NUMBER OF NHS TARGETS

N. Hawkes

The Times, July 22nd 2004, p.2

The number of targets in the NHS has been slashed by the Government, to be replaced by "core standards". John Reid, the Health Secretary, produced a slimmed-down list of just 20 targets rather than the 60 that NHS organisations have hitherto had to meet.

FOUNDATION HOSPITAL PLAN LEFT IN CHAOS

J. Carvel

The Guardian, July 21st 2004, p. 10

The government's plans for foundation hospitals were left in chaos after 10 of the trusts expecting to gain independent status over the next few months were blackballed by the new health inspectorate. The Healthcare Commission - the body responsible for inspecting the quality of hospitals in England - stripped them of the three-star ranking which they need to be considered for conversion into foundation trusts. It is a move that casts doubt on the government's plans for NHS reform as their rejection may be permanent. Article lists all NHS acute and specialist trusts in England star rated by their performance on 44 measurements.

(See also The Times, July 21st 2004, p.4; The Independent, July 21st 2004, p. 2; The Daily Telegraph, July 21st 2004, p.10; Financial Times, July 21st 2004, p.3)

THE FUTURE OF SKILLS

N. Edwards and others

Health Service Journal, vol.114, July 22nd 2004, supplement, 9p

The health sector workforce's needs are changing due to factors ranging from demographics to evolving service standards. Supplement looks at the work of the new sector skills council, Skills for Health, the impact of population ageing on recruitment, and how organisations are using new standards of competence to enhance practice.

GROWING PAINS

M. Taylor

Health Service Journal, vol.114, July 29th 2004, p.24-25

Commissioning of high-cost, low-volume specialised children's services, such as paediatric nephrology, by primary care trusts is not working. Staff shortages are leaving nephrology centres vulnerable to total breakdown. More trained nephrologists are becoming available, but acute trusts do not have the funding to employ them.

IMPROVING PATIENT CARE BY REDUCING THE RISK OF HOSPITAL ACQUIRED INFECTION: A PROGRESS REPORT

National Audit Office

London: TSO, 2004 (House of Commons papers, session 2003/04; HC876)

There has been progress at trust level in putting systems and processes in place and strengthening infection control teams to improve the prevention and control of hospital-acquired infections, but the NHS still has insufficient information about their extent and costs. The limited information available from the voluntary reporting on surgical site infection surveillance indicates the degree of improvement has been small, and the mandatory MRSA bloodstream infection surveillance shows that the number of these cases continues to rise.

KNIFE POINT

C. Shannon

Health Service Journal, vol.114, July 8th 2004, p.28-29

Fears of an epidemic of VCJD are leading to government calls for an urgent reform of instrument sterilisation methods. Sterilisation services are in a poor state, having been under-resourced for decades. The way forward appears to be the creation of Centralised Sterilisation Centres shared between local trusts. These centres are likely to be built, equipped and run by the private sector.

web linkLONDON CALLING? THE INTERNATIONAL RECRUITMENT OF HEALTH WORKERS TO THE CAPITAL (PDF format)

J. Buchan, R. Jobanputra and P. Gough

London: Kings Fund, 2004

Case studies of three London hospital trusts show that nurses from overseas comprise between 12% and 25% of their workforce. This extensive overseas recruitment raises questions about the effective management of a culturally diverse workforce, retention of globally mobile staff, and the ethics of poaching nurses from developed countries.

(For a summary see the Health Service Journal, vol.114, July 15th 2004, p.30-310)

MANY HAPPY RETURNS AND QUITE A FEW BUMPS AS NHS PLAN TURNS FOUR

M. Gould

Health Service Journal, vol.114, July 22nd 2004, p.12-13

The NHS Plan's signatories comment on its successes and limitations four years after its launch.

NATIONAL STANDARDS, LOCAL ACTION: HEALTH AND SOCIAL CARE STANDARDS AND PLANNING FRAMEWORK, 2005/06-2007/08

Department of Health

London: 2004

The number of national targets which NHS providers will have to meet is to be cut from 62 to 20. Existing targets that will have been met by April 2005 will become care standards that providers must maintain. The reduced targets include:

  • achieving year-on-year reductions in MRSA levels;
  • an 18 week maximum waiting time target from referral to treatment by 2008;
  • helping people manage long-term conditions so that they spend less time in hospital;
  • improving the health of black and minority ethnic populations.

NHS HIT BY CRISIS OVER DOCTORS' HOURS

J. Carvel

The Guardian, July 30th 2004, p.1

Most NHS hospitals in England will find it difficult to operate legally from Sunday when a European directive comes into force limiting doctors' hours, according to a survey by the Guardian newspaper. Many NHS trusts cannot find enough qualified house officers and registrars to staff them.

(See also The Guardian, July 30th 2004, p.4)

NHS STAFF ARE SICKEST IN COUNTRY - THEY SAY

S. March

The Times, July 5th 2004, p.8

Health service workers top the list of people who take time off work for being sick, according to a survey of 1,000 employees by the Chartered Institute of Personnel and Development. Nationwide, it is government NHS workers who top the sick league, with an average 11.6 days a year missed per person.

OVERSEAS RECRUITMENT: PLANET POACHING OR DOING A WORLD OF GOOD?

D. Carlisle

Health Service Journal, vol.114, July 15th 2004, p.8-9

Despite a code of conduct governing ethical recruitment, the NHS in England remains the world's biggest importer of healthcare professionals from developing countries. There is a growing outcry against this practice and calls for mandatory compensation of developing countries for their lost workers.

PALLIATIVE CARE

Health Committee

London: TSO, 2004 (House of Commons papers, session 2003/04; HC 454)

The report focuses on the provision of hospice and palliative care. The committee found that services which are needed most in deprived areas are concentrated in areas of social affluence. Services are disproportionately aimed at cancer patients. They are underused by black and minority ethnic communities. There is also a lack of suitable palliative care for children and young people in transition to adulthood. England is lagging behind similar countries in providing support for people to die at home.

PATIENT, HEAL THYSELF

A. U. Sale

Community Care, July 15th-21st 2004, p.34-35

The article introduces the NHS Expert Patients Programme which is training people with chronic illnesses such as asthma and diabetes to effectively manage their conditions and improve their lives.

web linkPUBLIC ATTITUDES TO PUBLIC HEALTH POLICY (PDF format)

Opinion Leader Research

London: Kings Fund, 2004

Research showed that there is support from a majority of the public for changing NHS priorities to focus more on health promotion and improvement. People also approved of government interventions to promote healthier lifestyles such as banning smoking in public places, banning TV advertising of junk food targeted at children and banning street drinking. The research also revealed different attitudes to health improvement between high and low income respondents. The poor and disadvantaged were less supportive of banning unhealthy activities and more interested in measures to tackle poverty and increase the choices available to them.

RACING TO VICTORY OR DOING THE CRAWL: PSA TARGETS SPLIT JUDGES

J. Trueland

Health Service Journal, vol.114, July 22nd 2004, p.14-15

Improving public health has been given a high profile in the Public Service Agreements published alongside the 2004 Comprehensive Spending Review. There are targets on cutting smoking, teenage pregnancy, childhood obesity and deaths from cancer and heart disease, as well as on reducing health inequalities between rich and poor. A range of public health professionals comment on the targets.

RECONFIGURING THE DEPARTMENT OF HEALTH'S ARM'S LENGTH BODIES

Department of Health

London: 2004

The number of NHS bodies that work at "arm's length" from the Department of Health will be reduced, saving at least £500m in costs and increasing resources that can be channelled directly to frontline patient care. It is proposed that:

  • the National Institute for Clinical Excellence will take on the work of the Health Development Agency, which will be abolished;
  • NHS Estates will be abolished;
  • the Health Protection Agency will take over the functions of the Public Health Laboratory Service, which will be abolished;
  • the NHS Litigation Authority will take over the functions of the Family Health Services Appeal Authority, which will be abolished;
  • a new Business Services Authority will replace the NHS Pensions Agency, the Dental Practice Board, the Prescriptions Pricing Authority and the NHS Counter Fraud and Security Management Authority.

REDUCED CIRCUMSTANCES

M. Shabbir and S. Banerjee

Health Service Journal, vol.114, July 8th 2004, p.24-25

The development of effective clinical teams is vital to the delivery of quality clinical care and reducing clinical errors. Implementation of the European working-time directive will disrupt working time dynamics and reduce training opportunities for junior doctors. Funding is needed to increase further the numbers of doctors, if the directive is not to be at the expense of patient care.

STATE OF HEALTHCARE REPORT 2004

Healthcare Commission

London: 2004

The report found many positive signs that the healthcare provided by the NHS is improving. Examples of improvements include patients typically waiting less time for treatments, falling mortality rates from cancer, and more dedicated units for stroke patients. However, the report also found wide variations in healthcare and health between different parts of the country and different groups of the population. There is concern that those most in need may be getting the worst deal.

WARNING SIGNS ARE CLEAR FOR THOSE IN BREACH OF EU DIRECTIVE

A. Moore

Health Service Journal, vol.114, July 8th 2004, p.8-9

The article describes how hospitals are planning to reconfigure services and redesign rotas to comply with the European Union Working Time Directive that seeks to reduce junior doctors' working weeks to a maximum of 58 hours. However, one in six acute trusts expects to fail to comply with the directive when it comes into force in August 2004. The British Medical Association has signalled its intention to take action against them.

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