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

The beat goes on

H. McIntyre and A. Dix

Health Service Journal, vol.115, May 19th 2005, p.30-32

Heart failure accounts for about 5% of all admissions to general medical and acute wards and 10% of hospital bed occupancy. Once patients are stabilised, specialist nurse-led support services in the community offer major benefits. However, improvements in care need to encompass both primary and secondary services.

The case for interprofessional collaboration

G. Meads & J. Ashcroft

Oxford: Blackwell, 2005 (Promoting partnership for health)

This book is the first in a series entitled Promoting Partnership for Heath. The series emanates from the UK Centre for the Advancement of Interprofessional Education and explores partnership working in healthcare from policy, practice and educational perspectives. Whilst strongly advocating collaboration in healthcare, the series alerts readers to the pitfalls and how to avoid them.

Creating a patient-led NHS: delivering the NHS Improvement Plan

Department of Health London: 2005

Document sets out how the NHS will:

  • Promote more choice in acute care, with Primary Care Trusts offering a choice of four or five local NHS providers, together with all NHS Foundation Trusts and nationally procured independent treatment centres
  • Encourage primary care bodies to develop new services and new practices
  • Ensure that there are networks of safe and secure emergency and specialist services
  • Concentrate more on health improvement and developing better services for patients rather than on contract administration.
  • Understand patients and their needs better, using new techniques to collect data on patient preferences and satisfaction.

Designed for life: creating world class health and social care for Wales in the 21st century

Health and Social Care Department, Welsh Assembly Government Cardiff: 2005

Document sets out a ten year plan for the NHS in Wales. Capital spending will be tripled over the next three years, rising to 309m in 2007/08, but there will also be major secondary care rationalisation. Specialist services will be centralised. The plan also envisages a review of financial arrangements and a shake-up in performance management, with sharpened incentives and sanctions and the introduction of demand management strategies.

Evidence-based policy making in health care: what it is and what it isn't

R. Cookson

Journal of Health Services Research and Management, vol.10, 2005, p.118-119

Critics of evidence-based policy (EBP) see it as either vacuous (who thinks that public policy shouldn't be based on evidence?), unrealistic (the nave product of ivory-tower thinking) or conservative (an excuse to delay reform). It need be none of these things. EBP should be thought of as a set of rules and institutional arrangements designed to encourage transparent and balanced use of evidence in public policy-making. Unfortunately much of the evidence on which NHS reform has been based under New Labour has not been published. Nor have there been rigorous post-implementation evaluations of the results of the reforms.

Managing patient care: are pathways working?

S. Kelsey

Practice Development in Health Care, vol.4, 2005, p.50-55

An integrated care pathway determines locally agreed, multidisciplinary practice, based on guidelines and evidence where available, for a specific patient group. It facilitates clinical governance and continuous care improvement, but may be inimical to patient-centred care and clinical freedom.

Needed by the NHS but denigrated by the politicians

D. Carlisle

Health Service Journal, vol.115, May 5th 2005, p.12-13

The NHS would collapse without the immigrant workers who staff it at all levels. However, many doctors and nurses are recruited from Third World countries, whose health services are being decimated by the loss of trained staff.

Nervous energy

A. Dix

Health Service Journal, vol.115, May 5th 2005, p.20-22

Neurological conditions account for a fifth of all acute hospital admissions. The long-term neurological conditions NSF takes a structured approach to improving the patient journey. However, its success will depend on rigorous implementation of its quality standards.

On listening to patients

L. Llewellyn

Health Service Journal, vol.115, May 19th 2005, p.17

Discusses different approaches to helping patients make a choice of elective treatment provider. This could be done by GPs or by using a booking management service.

Pragmatic 'caretaker' leaves behind a service with values

T. Agnew

Health Service Journal, vol.115, May 12th 2005, p.16-17

Article assesses John Reid's record as Health Secretary from 2003 to 2005. Having little personal interest in the NHS, he, unlike his predecessor Alan Milburn, did not attempt to micromanage the service. However his "broad brush" approach allowed his ministerial team and the NHS Chief Executive a more prominent role. His pragmatic approach made him someone the medical profession could work with.

Quality-adjusted life years are too rigid a yardstick for the NHS

N. Bosanquet and M. Rawlins

Health Service Journal, vol.115, May 26th 2005, p.20-21

The authors debate the question of whether use of quality adjusted life years to ration access to treatment discriminates against older patients and those with long-term conditions.

Rank and file

A. Cowper

Health Service Journal, May 5th 2005, p.33-40

The HSJ analysed the Healthcare Commission's March 2005 staff survey results to produce a list of acute, primary care and ambulance trusts which demonstrated best practice in human resource management. Article then reports brief interviews with senior human resource managers in a selected trust in each category on what sets them apart.

Social value judgements: guidelines for the Institute and its advisory bodies

National Institute for Health and Clinical Excellence 2005

The Institute consults on what socio-economic factors, such as age and lifestyle, it should consider when developing guidance on the promotion of good health and the prevention and treatment of ill health.

Suspicious minds

N. Plumridge

Health Service Journal, vol.115, May 5th 2005, p.15

Government tends to assume that clinicians are purely motivated by self-interest when they oppose reform and therefore ignores their expert opinions. Author argues that this assumption is flawed.

Treatment for elderly not always worth it, say advisers

S. Lister

The Times, May 6th 2005, p.28

Elderly patients could be denied some treatments because of their age under new proposals set out by the Government's national health advisory body. The National Institute for Health and Clinical Excellence, which provides guidance on treatment cost-effectiveness for England, confirmed yesterday that it had set out the controversial ideas in a consultation paper. Members of the Institute's Citizens' Council said that in cases in which age could affect the benefits or risks of treatment, medical staff would be justified in discriminating.

(See also The Independent, May 6th 2005, p.14)

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