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

AND ONE FOR ALL

K. Walshe

Health Service Journal, Vol.114, Oct. 28th 2004, p.18-19

The government's reform agenda for the public services, including the NHS, is guided by the principles of setting national standards, devolving power and responsibility for provision, modernising delivery, and providing choice for users. The NHS can therefore learn from how other sectors such as education and housing have implemented the reforms. Joined-up working is also being fostered by the growing trend for public service managers to move from sector to sector, having careers which span health, local and central government.

ANNUAL REPORT 2003/04- INDEPENDENT ADVISORY GROUP FOR SEXUAL HEALTH AND HIV

London: Department of Health [2004]

The report calls for sexual health to be moved up the agenda to address soaring rates of sexually transmitted infections and high levels of teenage pregnancy and to reduce national variations in abortion provision. Recommendations include:

  • increased availability of free condoms through the NHS;
  • removing VAT on over-the-counter contraceptives;
  • NHS funding for 90% of abortions;
  • tailored sexual health services for minority ethnic people;
  • cutting waiting times to 48 hours for appointments at genito-urinary medicine clinics.

BEGINNING TO REINVIGORATE THE WORKFORCE

L. Benson and others

British Journal of Healthcare Management, Vol.10, 2004, p.274-279

The article examines the "Delivering the Workforce" project in Greater Manchester. This aims to recruit and train over 2000 assistant practitioners in a major attempt to contribute to the redesign of the health and social care workforce. Assistant practitioner is a new generic care support worker role tailored to specific clinical and social settings and based on a generic educational and work-based training programme.

THE BENEFITS OF PROVIDING TRANSPORT TO HEALTH-CARE IN RURAL AREAS: REPORT TO THE COUNTRYSIDE AGENCY

CAG Consultants and the TAS Partnership

2004

Benefits identified by the research include:

  • helping to free up hospital beds;
  • reducing "did not attend" rates for appointments;
  • encouraging early treatment;
  • improving access to GP services in the face of branch closures;
  • reducing the need for home visits by helping patients get to surgeries;
  • enabling hospital visits by friends and relations.

BRAIN TEASER: HOW TO FIND A CURE FOR DIAGNOSTICS' ILLS

D. Carlisle

Health Service Journal, Vol.114, Oct.14th 2004, p.14-15

Diagnostic services are proving a bottle-neck on the patient pathway through treatment. Often the only way for quick access to tests is for the patient to be admitted (unnecessarily) to hospital. The solution may be to move diagnostic services out of hospital and locate them in primary care, to use independent sector services to increase capacity, and to develop point-of-care testing in hospitals.

BRITTLE BATTLE

J. Bryan

Health Service Journal, Vol.114, Oct. 7th 2004, p.30-31

NICE guidelines recommend that women aged 75 and over with fractures should get bone-saving treatment straight away. Women aged 65-75 with fractures will need a DEXA scan before treatment can start. Specialists are concerned that women under 75 will lose out because scanning is patchy around the UK.

EVENING THE ODDS

R. Shields and E. Dyson

Health Service Journal, Vol.114, Oct.28th 2004, p.26-27

In six months, Manchester Royal Infirmary's Nuclear Medicine Department has dramatically reduced waiting times for heart scanning by introducing evening clinics. Unfortunately it took three years to introduce this small change.

HEALTHCARE-ACQUIRED INFECTIONS: SPECIAL REPORT

N. Edwards (Ed.)

Health Service Journal, Vol.114, Oct. 7th 2004, p.41-46

The article surveys innovative approaches by NHS Trusts to controlling MRSA infections and presents case studies showing good practice.

HEALTH CONSUMER GROUPS IN THE UK: A NEW SOCIAL MOVEMENT?

J. Allsop, K. Jones and R. Baggott

Sociology of Health and Illness, Vol.26, 2004, p.737-756

The article looks at the development of the health consumer movement over the past few decades. It examines the differences between health consumer groups and protest groups and considers people's motives for setting up and joining them before exploring the influence such groups have on health care politics.

HUNDREDS MORE A&E DOCTORS NEEDED

J. Meikle

The Guardian, Oct. 25th 2004, p.7

Hospital A&E departments would need three times the number consultant doctors that they have at present to offer patients the best possible treatment, the NHS Director of Emergency Care has conceded. Sir George Alberti suggested it might be another eight years before staffing was up to scratch.

IMPROVING EMERGENCY CARE IN ENGLAND

National Audit Office

London: TSO, 2004 (House of Commons papers, session 2003/04; HC 1075)

Reports that NHS Accident and Emergency Departments are likely to meet the government's target of treating, admitting or discharging 98% of patients within four hours by December 2004. It warns of three risk factors which may prevent success:

  • an unexpected flu epidemic;
  • changes to GP out-of-hours services;
  • the working-time directive.

Reduction of waiting times is due to re-engineering of services rather than financial investment. However, some groups of patients with complex needs, such as the elderly, are still facing prolonged waits.

MORE NHS CASES TO GO PRIVATE

J. Carvel

The Guardian, Oct. 12th 2004, p.12

Tony Blair has disclosed that the number of patients being treated by the private sector will double to 500,000 a year during a third Labour term. He promised a second wave of independent treatment centres to operate on patients from the NHS waiting list.

MORE THAN SKIN DEEP

N. Burrows and P. Norris

Health Service Journal, Vol.114, Oct. 21st 2004, p.24-25

Modernisation of Addenbrooke Hospital's dermatology services has cut waiting lists by two-thirds. A 360-degree review of services has led to continuous service improvement. GPs and hospital nurses have received specialist training, freeing up consultant time and enabling more patients to be seen.

PRODUCTIVITY IN NHS SHOWS DECLINE ON ALL MEASURES DESPITE INCREASED SPENDING

S. Briscoe and C. Giles

Financial Times, Oct. 19th 2004, p.1

Productivity in the health sector has fallen consistently since 1997, according to figures published by government statisticians. This conclusion follows six months of intensive efforts by the Office for National Statistics, government departments and academics to derive the sector's first official measure of productivity. The researchers concluded it fell between 4 and 8 per cent, depending on how it was measured, in the years to 2003. Productivity fell in each of the 10 variants set out by the ONS. John Reid, the Health Secretary, said the figures were absurd because they did not take account of quality improvements in the NHS.

See also (The Independent, Oct. 19th 2004, p.49; The Times, Oct. 19th 2004, p.2; Guardian, Oct. 19th 2004, p.6)

QUESTIONING THE NEW PUBLIC MANAGEMENT

M. Dent, J. Chandler and J. Barry

Aldershot: Ashgate, 2004

This book contains case studies of New Public Management (NPM) in practice in the UK, exploring the enactment of NPM in specific organizational contexts. A range of public services are covered including local government, education, social work and the police, with particular attention paid to the National Health Service. The book points to the complex, fluid and negotiated character of NPM, as well as its centrality in reconfiguring occupational identities and relations within public service organizations.

SAVING LIVES, VALUING DONORS: A TRANSPLANT FRAMEWORK FOR ENGLAND ONE YEAR ON

Department of Health

London: 2004

Report describes progress made since the launch of the Transplant Framework in July 2003. Key successes include:

  • 2,867 transplants carried out - the highest number of organ transplants ever performed;
  • organs from 772 people who died were used to save or dramatically improve many people's lives through 2,396 transplants;
  • the highest number of patients for 14 years received a kidney only transplant, with living donation now representing one in four of all kidney-only transplants;
  • A further 2,365 people had their sight restored through a cornea transplant - the highest number for seven years;
  • more than 800,000 people added their names to the NHS Organ Donor register

THOSE WHO SCAN

A. Dix

Health Service Journal, Vol.114, Oct.14th 2004, p.28-29

Because of a national shortage, sonographers at Peterborough and Stamford Hospitals Foundation Trust are performing 95% of ultrasound scans previously performed by radiologists. Using a team approach and flexible working, waiting lists have gone down from 20-24 weeks to 4-6 weeks for most procedures. The model could be applied to other radiology departments.

TORIES GIVE CHOICE A BLUE RINSE AND A SPIN

H. Mooney

Health Service Journal, Vol.114, Oct. 14th 2004, p.16-17

Outlines Conservative Party policies on patient choice in the NHS, public health and GP fundholding as presented at their annual conference. Explores how Conservative policies differ from those of New Labour.

TRANSFORMING EMERGENCY CARE IN ENGLAND

G. Alberti

London: Department of Health, 2004

The paper reports a dramatic improvement in delivery of emergency care, with 96% if patients now spending less than four hours in Emergency Departments. Improvements are due to workforce changes, including expansion of the roles of nurses, paramedics and allied health professionals. These have been complemented by changes in acute hospitals which include better bed management, the development of assessment units, and the rebirth of acute medicine as a speciality.

TWO SIDES OF THE FENCE

J. Higgins

Health Service Journal, Vol.114, Oct. 7th 2004, p.20-21

The article introduces the work of the Patient Information Advisory Group (PIAG), a statutory body which is concerned with who should have access to patient-identifiable data for research use and in what circumstances. The PIAG can allow access to patient information where consent has not been given, but it is firmly committed to "the consent culture", to anonymisation, and to patient empowerment.

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