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

BOOST FOR FOUNDATION HOSPITALS

J. Carvel

The Guardian, Mar. 17th 2005, p.20

John Reid, the Health Secretary, has increased competition in the NHS by giving foundation hospitals in England an opportunity to attract extra patients from outside their normal catchment area. Building on the Chancellor's confirmation of a £23bn increase in the health budget by 2007/8, he will offer patients the right to be treated at any foundation hospital, starting in 2006.

BURSTING OUT ALL OVER

N. Edwards

Health Service Journal, vol.115, Mar. 31st 2005, p.16-17

Report of an interview with National Institute for Clinical Excellence chief executive Andrew Dillon about its merger with the Health Development Agency.

CONTROVERSIAL PROMPTS SYSTEM DUMPED OVER "TARGET" CONCERNS

I. Lloyd

Health Service Journal, vol.115, Mar. 31st 2005, p.5

The 472 prompts proposed for the new NHS performance rating system have been abandoned by the Healthcare Commission because of fears they could turn into a set of must-do targets. They will be replaced by national guidance for trusts to consider when undertaking self-assessment. Additionally, the public declarations trusts will have to make confirming they are meeting 24 core standards have been postponed until April 2006.

CUT OUT FOR THE TASK

H. Davidson

Health Service Journal, vol.115, Mar. 24th 2005, p.18-19

A devolved NHS will need to work productively with and alongside local government and a range of voluntary organisations. It will need leaders who can institutionalise a capacity for change at all levels of the organisation, so that frontline teams can seize the opportunities presented by the devolution of power. In order to seek interesting and imaginative financing vehicles, the NHS will have to recruit accountants from the private sector. In sum, in the new competitive environment, the NHS will need to grow or recruit talented transformational leaders.

DOCTORS TO QUIT NHS OVER PENSIONS

N. Hawkins

The Times, Mar. 11th 2005, p.28

Doctors could desert the NHS in their thousands over plans to alter their pension scheme, the British Medical Association reports. The Government has indicated that it expects the pension age to rise from 60 to 65. The BMA said that the proposals had created "a huge sense of injustice", and hinted at industrial action to protect benefits. `

(See also Daily Telegraph, Mar. 11th 2005, p.10)

HOSPITAL TARGETS MAKING PATIENTS SUFFER

C. Hall

Daily Telegraph, Mar. 14th 2005, p.1

Doctors in one in four accident and emergency departments say the care of seriously ill and injured patients has suffered as a result of government waiting time targets, according to a report from the British Medical Association. The report, based on information from 163 A&E departments in England, also suggests official waiting times are being deliberately distorted in an effort to meet government targets .

(See also The Times, Mar. 14th 2005, p.4)

HOSPITALS DENY PATIENTS FACTS ON DEATH RATES

S. Boosley, J. Carvel and R. Evans

The Guardian, Mar. 16th 2005, p.1, 10-11

Ten years after the Bristol babies scandal, patients are still being denied the information they need to make an informed choice about heart surgery. Adult heart surgeons should have made their death rates public by last year, but many hospital trusts are still not collecting adequate data.

HOSPITALS TO BE ALLOWED TO ADVERTISE FOR PATIENTS

J. Carvel

The Guardian, Mar. 18th 2005, p.9

NHS hospitals will be allowed to advertise to attract patients in a competitive market in which doctors and nurses will never be sure how many people will choose to use their services, the Department of Health has revealed. Under the new patient-led service developed over the next three years:

  • hospitals will no longer contract with local NHS trusts or GPs to carry out an agreed number of non-emergency operations in any given year. Their activity will depend on patient choice;
  • patients will be entitled to choose to be treated at any hospital which can meet NHS quality and cost standards;
  • a target to give private hospitals 8% of work will be dropped and they will be able to compete for all they can get. Those providing services for the NHS will be expected to display the NHS logo.

INFECTION CONTROL

N. Edwards (editor)

Health Service Journal, vol.115, Mar. 31st 2005, p.25-32

England has the highest MRSA rates in Europe. MRSA is expected to be a key battleground in the upcoming general election. In 2004 the Matron's Charter charged all NHS staff with responsibility for controlling hospital-acquired infections. Other initiatives to fight the spread of infection include a broader role for infection control nurses. There are also complex new regulations for clinical waste disposal, which introduce distinctions between the treatment of hazardous and non-hazardous wastes. Report goes on to offer best practice advice on reducing infections and to defend private cleaning contractors blamed by the government for the spread of MRSA.

"MONITOR WOULD DO THINGS DIFFERENTLY TODAY"

H. Mooney

Health Service Journal, vol.115, Mar. 10th 2005, p.18-19

Report of an interview with Sue Slipman, Director of the Foundation Trust Network, in which she reflects on the regulatory regime and the implementation of payment by results.

ORGANISATIONAL DEVELOPMENT IN HEALTHCARE: APPROACHES, INNOVATIONS, ACHIEVEMENTS

E.Peck

Oxford: Radcliffe, 2005

This book introduces the practical ways in which change in health services can be promoted. It includes descriptions of all the most important approaches to change currently being used in the NHS, discussion of when they work best and details of the evidence of their impact.

A PATIENT-LED NHS: DELIVERING THE NHS IMPROVEMENT PLAN

Department of Health

London: 2005

Among the proposals set out in the policy document are:

  • allowing independent providers like BUPA to "bid" to be included on the choice menu offered by primary care trusts (PCTs);
  • a development programme which could see the introduction of regional or even national NHS contracts with providers. This would save providers from having to negotiate contracts with individual PCTs;
  • an end to volume contracts with all independent treatment centres;
  • a decision to move all acute trusts to the foundation trust accounting regime.

RESEARCHING HEALTH CARE CONSUMERS: CRITICAL APPROACHES

J. Burr and P. Nicolson

Basingstoke: Palgrave MacMillan, 2005

The UK National Health Service continues to undergo a series of reforms with an increasing emphasis upon consumer 'choice' and 'empowerment'. These reforms imply a requirement that all aspects of health care should operate from an 'evidence' or 'knowledge' base. This text offers a critical and systematic overview of the current state of consumer health research in the NHS, providing an outline of contemporary research methodologies used for eliciting consumers' views, with specific reference to their strengths and limitations. Drawing from NHS funded research, the contributors critically examine research from a variety of angles, including historical and social care perspectives.

SPOT CHECKS TO REPLACE STAR RATING PROGRAMME IN HOSPITALS

C. Hall

The Daily Telegraph, Mar. 31st 2005, p.10

Routine hospital inspections are to be abandoned in favour of spot checks, the Healthcare Commission has announced. The commission, the NHS regulator, is changing the much-criticised star rating system, governed by national targets, into a "risk-based" system that will measure the services that patients and staff think are important.

SURGEONS FEAR FOI-EMPOWERED MEDIA WILL END UP FIRING BLANKS

D. Carlisle

Health Service Journal, vol.115, Mar. 10th 2005, p.14-15

In response to requests under the Freedom of Information Act from the media, hospital trusts have been publishing crude mortality data for individual surgeons. There are concerns that surgeons acting in self-defence may refuse to operate on high-risk patients.

TACKLING CANCER: IMPROVING THE PATIENT JOURNEY

National Audit Office

London: TSO, 2005 (House of Commons papers, session 2004/05; HC288)

NAO carried out a survey of patients with breast, lung, bowel and prostate cancer to gauge progress since the introduction of the Cancer Plan in 2000. Cancer patients were broadly positive about their experience with GPs, the speed of diagnosis, and how they were informed they had cancer. Experience of hospital care was found to have improved since 2000, but there are still gaps in supportive and palliative care. Most patients were content with the support they received after discharge and as outpatients, but hospice provision and end-of-life choices could be enhanced. Prostate cancer patients continued to have a worse experience than those with other cancers, and people's experiences of services in London remained less positive than elsewhere in England.

TACKLING CANCER IN ENGLAND: SAVING MORE LIVES

Committee of Public Accounts

London: TSO, 2005 (House of Commons papers, session 2004/05; HC166)

Committee examined the Department of Health on improving the prevention and early detection of cancer, improving the quality of cancer treatment and reducing variations in cancer survival rates between different parts of England. In particular, report calls for reductions in waiting times for diagnostic tests and elimination of the "postcode lottery" of chemotherapy and radiotherapy treatment.

TELEMEDICINE AND THE "FUTURE PATIENT"? RISK, GOVERNANCE AND INNOVATION (PDF format)

C. May and others

2005

ESRC study has shown that, despite high expectations, telemedicine systems which enable doctors to interact remotely with patients via video links, digital imaging and electronic data transmission have had a limited impact on the NHS. Resistance from professionals is blamed, but the real reason is often a failure to address the organisational problems involved in integrating new technology into everyday NHS activity. While telemedicine is on the wane, new "telecare" systems for monitoring people with illnesses such as diabetes and asthma are under development. However, patients are seldom consulted in any meaningful way about development and implementation of these new systems, and it is often assumed that their needs are the same as those of NHS service providers.

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