Welfare Reform on the Web (January 2005): National Health Service - Reform - General

BETTER HEALTH THROUGH PARTNERSHIP: A PROGRAMME FOR ACTION (PDF format)

Healthcare Industries Task Force

London: Department of Health, 2004

Task Force aimed to identify opportunities where closer co-operation between government and healthcare companies would bring about benefits for patients, the NHS and social care while also improving the industry's performance. The Task Force investigated four key areas:

• how to speed up NHS adoption of useful new products and procedures;
• how to improve support for innovation in the home market and enhance the UK's reputation as an attractive location for healthcare manufacturers;
• improving opportunities for UK companies in overseas markets;
• maximising the UK's influence in regulatory matters in the EU and overseas.

BETTER INFORMATION, BETTER CHOICES, BETTER HEALTH: PUTTING INFORMATION AT THE CENTRE OF HEALTH

Department of Health

London: 2004

The strategy is a three-year programme of action, at both national and local level, to improve access for all to the quality general and personalised information people need and want to empower them to exercise choices with regard to their personal health and treatment.

CHANGING ORGANSIATIONS: A STUDY OF THE CONTEXT AND PROCESSES OF MERGERS OF HEALTH CARE PROVIDERS IN ENGLAND

N. Fulop and others

Social Science and Medicine, vol.60, 2005, p.119-130

Paper used documentary analysis and in-depth interviews with stakeholders to report on stated and unstated drivers in nine mergers of NHS trusts. Goes on to present four in-depth case studies of the process of merger in the second and third years post-merger. Merger is a process without the boundaries, and the study shows problems persisting three years after the event. Loss of management focus and control led to delays in service development. Difficulties in the merger process included differences in organisational culture and perceptions of takeover which limited sharing of good practice across newly merged organisation. Merger policy was based on overly simplistic assumptions about processes of organisational change.

CHOICE: RHETORIC AND REALITY: INTRODUCING PATIENT CHOICE IN THE NHS

D. Roche

New Economy, vol.11, 2004, p.189-194

Article points to the relative lack of an evidence base on what kind of choices people actually want, and explores the impact of choice on efficiency and equity, the consequences of capacity constraints and the impact of the new payment-by-results system. Author emphasizes the need for patients to have access to more information on which they can base informed choice.

DEMAND FOR PRIVATE HOSPITALS SLOWS

N. Timmins

Financial Times, Dec. 21st 2004, p.4

Fewer patients paid for private treatment out of their own pockets last year as the National Health Service succeeded in cutting out the very longest waits for treatment. The so-called self-pay market had grown rapidly in recent years but in 2003 it dropped by between 10 and 20 per cent, according to the annual review by analysts Laing and Buisson.

EU HEALTHCARE PLAN 'IS THREAT TO PATIENTS'

J. Carvel

The Guardian, Dec. 6th 2004, p.11

A proposed EU directive that would let European health companies run clinics in Britain outside national regulatory controls threatens the safety of patients, the Royal College of Nursing said last night. It voiced concerns about plans to allow EU service companies to trade in any member state if they meet the safety and quality standards set by their home country. The EU directive is supported by the DTI because it will give thousands of British companies a better chance of competing in Europe.

THE FUTURE IS PUBLIC HEALTH

D.J. Hunter

New Economy, vol.11, 2004, p.201-206

Discusses the influences of the Wanless reviews of 2002 and 2003 in propelling public health to the top of the political agenda. At the heart of this debate are fundamental issues about state interference in people's lives and the role of politicians in leading public opinion rather than just following it

GLARING OMISSIONS

M. Hunter

Community Care, Dec.16th 2004-Jan. 5th 2005, p.24-25

The recent public health White paper Choosing Health focuses on the encouragement of self-help and healthy lifestyles. However there are no proposals for a strategy for mental health improvement or for addressing the physical health needs of mental health service users. Other commentators have voiced disquiet about a lack of concrete proposals on sexual health improvement.

A HEALTHIER FUTURE: A TWENTY YEAR VISION FOR HEALTH AND WELL-BEING IN NORTHERN IRELAND 2005-2025.

Department of Health, Social Services and Public Safety

Belfast: 2004

Strategy includes:

• greater emphasis on prevention of illness;
• more emphasis on community-based services;
• closer team working across health and social care;
• proposals for a ban on smoking in public places.

HEALTHY CHOICES

N. Pauling

Public Finance, Nov.19th-25th 2004, p.26-27

For patient choice to work, people need the basic literacy skills to read and understand information on the basis of which they can make informed decisions. Article introduces the Skilled for Health pilot programme, under which six demonstration projects are seeking ways to improve basic health and literacy skills.

HIV AND AIDS IN AFRICAN COMMUNITIES: A FRAMEWORK FOR BETTER PREVENTION AND CARE

Department of Health, National Aids Trust and African HIV Policy Network

2004

HIV and AIDS have disproportionately affected African communities in England. This framework sets out actions to improve the effectiveness of HIV prevention and health promotion, and treatment and care services for African communities affected by HIV. Identifies problems and needs including:

• late diagnosis of the disease, limiting the effectiveness of drug treatment;
• social care needs of African children and families affected by HIV;
• the dispersal of asylum seekers with HIV.

HSJ INTELLIGENCE

N. Edwards (editor)

Health Service Journal, vol.114, Dec.9th 2004, suppl., 16p

Focuses on the application of ICT to the health service. Covers progress in implementation of the national IT programme, e-prescribing, innovation in management information provision, and computerised cognitive behaviour therapy.

AN IMPLEMENTATION FRAMEWORK FOR RECONFIGURING DH ARM'S LENGTH BODIES: REDISTRIBUTING RESOURCES TO THE NHS FRONTLINE

Department of Health

London: 2004

The new arm's length bodies (ALB) structure will:

• establish a health and social care information centre to co-ordinate the collection and dissemination of data;
• bring together the work of the NHS Modernisation Agency, the Leadership Centre and the NHS University into a single NHS Institute for Learning, Skills and Innovation;
• produce a minimum of £100m in savings from more efficient procurement led by the NHS Purchasing and Supply Agency;
• build on the work of the new Health Inspection Concordat by reducing the number of inspection days in the NHS and using more self-assessment.

IMPROVING SERVICES FOR DISADVANTAGED CHILD BEARING WOMEN

L. D'Souza and J. Garcia

Child, vol.30, 2004, p. 599-611

Tackling health inequalities is high on the agenda of the Labour government, the health of childbearing women and their babies being priority areas for action. The review found limited evidence of effective and promising interventions for child bearing women from minority ethnic groups, women experiencing domestic violence, women with mental health problems and HIV infected women. Few studies were well designed or powered to detect effectiveness. There were no studies of interventions for women prisoners, homeless women and travellers.

MRSA

J. Laurance and C. Brown

The Independent, Dec. 7th 2004, p.1, 4-5

Each year, 100,000 people catch an infection in hospital. Of these, 5,000 die - more than are killed on the roads. It is one of the worst rates in the world. The article asks if there is a cure?

MAJORITY OF HOSPITALS TOO DIRTY TO BEAT MRSA

J. Laurance

The Independent, Dec. 8th 2004, p.19

Less than half of hospitals have the high standards of cleanliness necessary to defeat MRSA and other infections, a government survey has shown after publishing the results of inspections of 1,184 hospitals and units in England. The survey showed that 574 hospitals (48 per cent) were rated good or excellent for cleanliness. The remainder scraped through as "acceptable", with 24 rated "poor" and three "unacceptable". Britain has the highest rate of MRSA in Europe.

(See also The Guardian, Dec. 8th 2004, p.6; The Independent, Dec. 8th 2004, p.16; The Daily Telegraph, Dec. 8th 2004, p.2)

NHS REVOLUTION: NURSES TO TRAIN AS SURGEONS

J. Laurance

The Independent, Dec. 6th 2004, p.1

Ministers are planning a revolution in the NHS under which nurses will be trained to perform surgery to help reduce hospital waiting lists. John Reid, the Secretary of State for Health, is desperate to increase the surgical workforce to meet a government pledge that no one will wait longer than 18 weeks for treatment from GP referral by 2008. Under the government's plans, a wide range of operations, including hernia repair, vasectomies and arthroscopies, will be performed by surgical care practitioners - nurses, physiotherapists and operating department assistants - after two years of training. Between 4,000 and 5,000 will be appointed over the next decade, depending on demand.

NURSE POACHING LOOPHOLE CLOSED

J. Carvel

The Guardian, Dec. 9th 2004, p.10

A crackdown on hospitals and care homes poaching nurses from developing countries was announced by the government after pressure from the nursing unions. John Hutton, the Health Minister, said he would close a loophole that allowed NHS hospitals to evade controls by recruiting overseas nurses and therapists on temporary contracts. He has also secured agreement from the leading private hospitals, homes and recruitment agencies to stop active recruitment in South Africa and other developing countries with shortage of medical staff.

RUNNING ON EMPTY

S. Ward

Public Finance, Dec.3rd-9th 2004, p.22-25

Government has invested in fast-track diagnostic and treatment centres to increase NHS capacity and reduce waiting times. Some are run by the NHS and some have been contracted out to overseas healthcare companies. Private providers are guaranteed patient numbers and income over five years. This is leading to patients being directed to the private facilities, while NHS treatment centres are under-used and running at a loss.

SHIPMAN: HOW THE DOCTORS' WATCHDOG FAILED PATIENTS

R. Jenkins

The Times, Dec. 10th 2004, p.8-9

The General Medical Council (GMC) should be stripped of its right to hear disciplinary cases against doctors, the Shipman inquiry has urged. The statutory body which regulates the medical profession has been all too ready to look after its own at the expense of patients, Dame Janet Smith, the inquiry chairman, concluded. She had built a picture of the GMC which "tends to favour the interests of doctors". Where there is a conflict between patient and doctor, she said the GMC does what the "profession thinks is right". She called for the culture of self-interest that continues to pervade the GMC to be swept away. Prescription for change includes:

• GMC'S right to hold disciplinary hearings should pass to independent body;
• its constitution should be changed so that appointed lay members outnumber those elected by doctors;
• proposals to appraise GP's skills every five years should truly act as promised as an MOT for doctors;
• a telephone helpline should be set up to encourage whistleblowers;
• there should be a central database of information about doctors available to primary care trusts;
• GMC should be directly accountable to Parliament and should publish an annual report which should be scrutinised by MPs.

(See also The Daily Telegraph, Dec. 10th 2004, p.1, 5; The Guardian, Dec.10th 2004, p.4; The Independent, Dec. 10th 2004, p.18)

SUPPORTING LOCAL DELIVERY: NATIONAL SERVICE FRAMEWORK FOR CHILDREN, YOUNG PEOPLE AND MATERNITY SERVICES

Department for Education and Skills [and] Department of Health

Nottingham: DfES Publications, 2004

Document sets out the national support that will be provided to local health agencies to help them to implement the National Service Framework for Children, Young People and Maternity Services. It also identifies how the NSF, and the wider health agenda, fit into the Every Child Matters: Change for Children programme, and what this means for health organisations.

THREAT TO BLAIR PLAN FOR NHS

J. Carvel

The Guardian, Dec. 13th 2004, p.1,10

A survey showing that the chief executives of foundation trust hospitals are finding the system too restrictive has cast doubt on Tony Blair's plan for all NHS hospitals in England to gain foundation status in a third Labour term. In responses to a survey conducted by the Guardian, the foundation trust chief executives said they were tied up in red tape and denied the commercial flexibility they needed to prosper.

TOO MUCH OF A GOOD THING: OVER-INVESTING IN PUBLIC INVOLVEMENT IN THE NHS

R. Klein

New Economy, vol.11, 2004, p.207-212

Discusses public involvement in the NHS, with particular reference to foundation hospitals. Formal consumer involvement used to be necessary to counter the technocratic paternalism of the traditional NHS, but may not be needed in the era of patient choice. In the new internal market, providers must compete for patients.