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

ASSESSMENT FOR IMPROVEMENT: OUR APPROACH (PDF format)

Healthcare Commission

London: 2004

Consultation presents plans for the replacement of the NHS star ratings system. In addition to meeting the 20 existing national targets, NHS organisations would be measured against 24 core standards set by government. The document sets out 472 "prompts" organisations should use to check if they are meeting these standards. Every organisation would declare annually, in a statement checked by local partners including patient forums, whether it is compliant with the standards. Organisations would be subject to unannounced "spot checks" by the Commission of the evidence supporting their annual declaration. Local targets and assessments of "future prospect" and leadership would be added to the ratings from 2007.

CANCER CARE: FOUR YEARS OF THE NATIONAL PLAN

A. Dix (editor)

Health Service Journal, vol.114, Nov.25th 2004, Suppl., 13 p.

Covers progress in meeting key targets, redesign of diagnostic services, palliative care of the terminally ill, and some unintended consequences of service reconfiguration.

CHARITIES TO TAKE ON HEALTH WORK

J. Carvel

The Guardian, Nov. 11th 2004, p.13

John Reid, the Health Secretary, revealed plans for voluntary sector organisations to take over a large slice of healthcare and social services that were previously run by the state. He said the private sector was poised to perform 15% of operations on NHS patients by 2008. But the government believes voluntary organisations may be better placed than private companies or public bodies to carry out the work, particularly the provision of specialised services for the sick and needy .

CHOOSING HEALTH: MAKING HEALTHY CHOICES EASIER

Department of Health

London: 2004 (Cm 6374)

Just as investment and reform is transforming England's NHS, the government has a new approach to public health. The white paper Choosing Health introduces a new public health approach based on informed choice, personalisation and effective partnerships. The paper sets out some significant changes - on smoking in public places, on advertising to children and on health trainers but it also promises opportunities for individuals to make their own informed healthy choices. The main priorities are :

  • reducing the numbers of people who smoke;
  • reducing obesity and improving diet and nutrition;
  • increasing exercise;
  • encouraging and supporting sensible drinking;
  • improving sexual health;
  • improving mental health.

DIRECTING THE WORKFORCE TOWARDS 2008

A. Cowper

British Journal of Health Care Management, Vol.10, 2004, p. 297-301

The article presents an interview with Andrew Foster, Director of Workforce for the Department of Health, covering the human resources agenda for the NHS. The interview focuses on implementation of the Agenda for Change pay and grading system and the new GP and consultants' contracts.

FAST-TRACK SURGERY CENTRES PROVE SLOW TO FILL WITH PATIENTS

N.Timmins

Financial Times, Nov. 11th 2004, p.2

Most of the new NHS fast-track surgery centres - set up to slash waiting lists - are operating way below capacity despite 860,000 patients in England waiting for surgery. The arrival of overseas providers is being blamed for some of the problems. Unlike the NHS centres, they are guaranteed a set volume of patients for their first five years.

GENTLY DOES IT

J. Bevington

Health Service Journal, vol.114, Nov.11th 2004, p.28-29

Research shows that less than one in four senior managers interviewed used hard data to inform their judgments about NHS trusts. They relied instead on soft intelligence, which comprises information gathered from conversations, observation and personal first hand experiences.

HEART TO HEART

S. Bolton

Health Service Journal, vol.114, Nov. 11th 2004, p.26-27

The James Cook University Hospital in Middlesborough appointed a cardiology pathways co-ordinator to reduce waits for those with acute coronary syndromes. This approach, in line with the coronary heart disease national service framework, has reduced error, duplication and delay.

HEED THE LESSON AND GO UP A CLASS

A. McKeon

Health Service Journal, vol.114, Nov.11th 2004, p.31

Article explains how a hospital can gain and keep foundation status, covering financial performance measurement, Treasury management and payment by results.

HAS THE DoH LOST ITS CLOUT?

I. Wylie and P. Hunt

Health Service Journal, vol.114, Nov.18th 2004, p.24-25

Authors debate the proposition that the Department of Health is so bound up in its internal problems that it has lost influence in a government where it could have wielded huge power.

HOW THE GOVERNMENT BROKE ITS BRISTOL INQUIRY PLEDGE

D. Carlisle

Health Service Journal, Vol.114, Nov. 4th 2004, p.12-13

The article explains why mortality figures for individual cardiac surgeons, adjusted for risk, failed to appear in April 2004 as the government promised. Unfortunately the infrastructure for collecting the data was not in place at the time.

IMPROVING EMERGENCY CARE IN ENGLAND

National Audit Office

London: TSO, 2004 (House of Commons papers, session 2003/04; HC1075)

The report reviews the improvements that have already been made in emergency care with respect to the reduction of waiting times. It goes on to identify the obstacles to further reducing waiting times, including bottlenecks created by patients who need to be admitted to hospital and obtaining suitably qualified staff, before considering ways to modernise wider emergency care services based around patients' needs.

LEARNING TO LEAD

A. Dix

Health Service Journal, vol.114, Nov 25th 2004, p.32-35

Doctors are learning to be clinical leaders on a course which teaches them about wider NHS functions and how they fit in with them. One element of the course, the Skills Factory Workshop, aims to empower doctors to make changes to improve patient care. Participants have praised the programme for improving "their ability to influence"

A LOVE-HATE AFFAIR: WHAT HEALTH SERVICE MANAGERS REALLY THINK

Anon.

Health Service Journal, vol.114, Nov.18th 2004, p.14-17

Results of a survey of over 2000 NHS managers show that:

  • most are frustrated and stressed by their jobs, and would choose a different career given the chance;
  • about 75% think the government is still too controlling;
  • 42% think the status of their job is falling in public esteem;
  • only 23% feel they are poorly paid;
  • almost half think managerial relations with clinicians are improving.

POLICY IN THE NEXT FIVE YEARS

S. Stevens

Health Service Journal, vol.114, Nov.18th 2004, p.23

Argues that NHS reforms are now beginning to work and the service is improving. As current policies such as the purchaser-provider split, foundation trusts, patient choice and plurality of providers are supported by the Conservatives as well as New Labour, there is unlikely to be a radical

change after the next election.

SECRECY WORRIES HIT NHS SCHEME

J. Carvel

The Guardian, Nov. 23rd 2004, p.6

A £6bn investment in computer systems for the NHS was in danger of foundering last night after doctors' leaders said they would put patient confidentiality at risk. Doctors' leaders were concerned that the information was insecure and the Choose and Book electronic appointments scheme might become a back-door route to collecting personal details.

TAKE CARE, THEY DO READ ALL ABOUT IT

B. Page

Health Service Journal, vol.114, Nov.11th 2004, p.20-22

Public perceptions of local NHS services are influenced by media coverage, direct communications by trusts themselves, and staff criticising the service. In the new era of competition between NHS units, trusts which successfully market and promote their services will do better

WHAT CHANCE OF CHOICE

T. Harvey

British Journal of Health Care Management, Vol.10, 2004, p.314-315

The article argues that patient choice in the NHS is impractical largely due to lack of spare capacity, various difficulties surrounding getting an accurate diagnosis, and fearful patients being in no state to make sensible choices.

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