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

As doctors, we see the cancer that eats away at the NHS

J. Davis

The Guardian, June 27th 2005, p.18

The author, a consultant radiologist and a member of the National Health Service Consultants' Association, comments that the medical profession is not deceived by the rhetoric about patient choice and believes that, as the NHS is being privatised bit by bit, patients are already suffering.

(See also The Guardian, June 27th 2005, p.5)

Building a health service fit for the future: a national framework for service change in the NHS in Scotland

NHS Scotland Edinburgh: Scottish Executive, 2005

This ambitious 20-year plan for the NHS in Scotland proposes:

• Concentration of specialist care on fewer sites
• Separation of planned and emergency care, with day-case surgery the norm and better access to community-based diagnostics
• Acceleration of the development of regional planning for hospitals
• Emphasis on caring for people with long-term conditions in the community, avoiding hospital admission where possible.
• Development of "anticipatory care", particularly in deprived communities, to prevent illness and reduce health inequalities.
• Implementation of a single national ICT system, including an electronic patient record
• Development of networks of rural hospitals.

URL: http://www.scotland.gov.uk/Publications/2005/05/23141307/13104

Building a health service fit for the future. Vol.2, A guide for the NHS

NHS Scotland

Edinburgh: Scottish Executive, 2005

In planning the future of the NHS in Scotland we need to:

• Ensure sustainable and safe local services, redesigning where possible to meet local needs and expectations
• Switch emphasis and funding from hospital to primary care
• Prioritise preventative, anticipatory care rather than reactive management, avoiding health crises where possible.
• More fully integrate the NHS (including the contributions of hospitals, general practice teams, social care providers and patients) to meet the current challenges
• Use new technology to improve the standard of care, connect clinicians and involve patients in planning their own care.

URL: http://www.scotland.gov.uk/Publications/2005/05/23141500/15035

Complacent NHS fails in fight with superbugs

J. Laurance

The Independent, June 23rd 2005, p.10

The NHS is losing the battle against soaring rates of hospital infection because of a combination of inertia and complacency. The Commons Public Accounts Committee says ministers, officials and NHS trust managers have failed to get to grips with bugs including MRSA which cause widespread suffering and death and undermine public confidence. Edward Leigh, the chairman of the committee, said the research the estimates of infections was based on was over 10 years old and the issue was "shrouded in a fog of ignorance".

(See also The Times, June 21 2005, p.1; The Guardian, June 23rd 2005, p.9; The Daily Telegraph, June 23rd 2005, p.1)

Diagnostic imaging

A. Nolan (editor)

Health Service Journal, vol.115, June 23rd 2005, supplement, 9p

Reducing waiting times for diagnostic tests is key to the NHS being able to meet the government's key target of 18 weeks from GP referral to treatment by 2008. The supplement discusses a range of approaches, including use of the private sector to increase capacity, transfer of diagnostic services to GP practices and community pharmacies, devolving simple testing to paraprofessionals, and training advanced practitioners to work across specialisms.

Doctors condemn Labour’s NHS plans

J. Carvel

The Guardian, June 27th 2005, p.5

Doctors' leaders launched a rebellion against government plans to turn the NHS into a competitive market in which hospitals that fail to attract enough patients will go to the wall. The British Medical Association published a poll at the start of its annual conference in Manchester showing that patients are anxious to have cleaner hospitals, but have little interest in ministers' plans to let them choose where to have an operation.

(See also The Guardian, June 27th 2005, p.18; The Times, June 27th 2005, p.12)

Future health organisations and systems

S. Dawson and C. Sausman (editors)

Basingstoke: Palgrave, 2005

This book addresses some of the most important questions being asked in relation to health in the future. What will the health system look like, how much will it cost, what ethical framework will underlie future health policy and can we really have a system that is designed to improve on health as well as provide healthcare? Based on the 'Policy Futures for UK Health' project based at the Judge Institute of Management, this collection explores the future shape of the health system and its key components, taking a multidisciplinary approach to health policy questions.

Hatched and batched

Anon.

Health Service Journal, vol.115, June 16th 2005, p.36-38

The extensive multidisciplinary working involved in the provision of cancer services makes them the hardest areas in which to involve the independent sector. Article describes a successful joint venture between Manchester's Christie Hospital and Baxter Healthcare for the supply of chemotherapy drugs. The partnership has delivered large benefits, including leaving hospital pharmacists more time to spend with patients and clinicians.

Hewitt: 'I’m keeping my foot on the reform accelerator'

L. Donnelly

Health Service Journal, vol.115, June 16th 2005, p.5-7

In the first interview since her appointment as Secretary of State for Health, Patricia Hewitt:

• Calls for a broad debate on the reform of primary care
• Says she is acutely conscious that many staff are alienated by the reforms
• Admits that there is a real risk that patients will be "sucked into hospital" needlessly under payment-by-results.
• Explains that she is developing a code of practice on how health communities should manage failure so that key services are protected.

High house prices force nurses to quit NHS

L. Smith

The Guardian, June 20th 2005, p, 7

Nurses are being forced to leave their profession because they cannot afford to buy their own homes, The Royal College of Nursing said yesterday. Government schemes to help nurses get on the property ladder were having an impact, the organisation said, but too many were still excluded from applying for help and were having to look for better paid jobs or take on extra work.

Home truths for the DoH as the service tells it straight

I. Lloyd

Health Service Journal, vol.115, June 9th 2005, p.14-15

Summarises the results of an internal survey of staff views on key NHS reforms, including foundation trusts, independent treatment centres, decentralisation, and tensions between GPs and their primary care trusts.

Hospitals face MRSA spot checks

A. Sparrow

The Daily Telegraph, June 20th 2005, p.2

Health inspectors will begin surprise visits to hospitals this week to check that they are taking the right precautions against the MRSA superbug. About 100 hospitals will be checked during the summer, with staff having no warning that Healthcare Commission specialists are on their way.

(See also The Independent, June 20th 2005, p.1)

Informed choice and public health screening for children: the case of blood spot screening

K.M. Hargreaves, R.J. Stewart and S.R. Oliver

Health Expectations, vol.8, 2005, p.161-171

Study involved interviewing health professionals and parents from across the UK to explore their views about information provision and choice relating to the screening of newborn babies via "heel prick" blood spot tests. Both parents and midwives had found that the screening was virtually compulsory, with little information provision and assumed consent. However, they recognised a tension between public health considerations and informed choice. Authors recommend the provision of clear, brief, accurate information to parents, combined with effective communication between health professionals and parents, tailored to local needs. LAW A. Nolan (editor) Health Service Journal, vol.115, June 9th 2005, p35-40 Special report covers financial reporting by foundation trusts, clinical governance, child protection responsibilities of doctors who suspect abuse, protection of workers from bullying, and how NHS bodies are collaborating to make cost and efficiency savings.

Law

A. Nolan (editor)

Health Service Journal, vol.115, June 9th 2005, p35-40

Special report covers financial reporting by foundation trusts, clinical governance, child protection responsibilities of doctors who suspect abuse, protection of workers from bullying, and how NHS bodies are collaborating to make cost and efficiency savings.

'Mediocre' healthcare ranked 9th in Europe

N. Hawkes

The Times, June 16th 2005, p.26

Healthcare in Britain is rated as mediocre in a report by a Brussels-based company. Britain ranks ninth out of 12, with a score of 36 out of 60, in a survey designed to show how consumer-friendly health services are in a dozen countries.

More NHS patients to get private treatment

N. Timmins

Financial Times, June 16th 2005, p.1

NHS patients will account for almost half the total admissions to private hospitals within five years as shorter NHS waiting times lead to sharp declines in private medical insurance and the number of patients paying out of their own pocket, a study has found. By 2010, private hospitals are likely to be treating 150,000 private patients a year if the NHS achieves its goal of cutting waiting times by 2008, says the study for the Healthcare Commission, the NHS Inspectorate.

The NHS IT project: the biggest computer programme in the world… ever!

S. Brennan

Oxford: Radcliffe, 2005

The NHS computer project is the biggest and most expensive IT project in world history, but why is it needed? What does it aim to achieve? This book spells out the real objective of the programme. This is not simply a plan to computerise our medical records, it is a project to transform the way the NHS works. The IT project has evolved from government strategies, pilots and initiatives that date back over a quarter of a century or more. The NHS is home to a startling legacy of IT systems ad processes that have each made their mark on the service. The book examines these often ill-fated initiatives and looks at how their patchwork legacy will shape the way the new computer systems will operate.

NHS trusts building 'unwanted monuments'

J. Carvel

The Guardian, June 9th 2005, p.9

The biggest hospital building programme in the history of the NHS may be producing expensive "monuments" that will no longer be needed in the new era of patient choice, a senior Department of Health official has warned. Bob Ricketts, head of a programme to accelerate patients' access to treatment, raised fears about the inflexibility of about £18bn worth of contracts given out under the private finance initiative (PFI) that will lock NHS trusts into paying for the new facilities for at least 30 years.

(See also Financial Times, June 10th 2005, p.2)

Private deals are a danger, say doctors

N. Hawkes

The Times, June 9th 2005, p.8

Leading doctors have attacked the Government's policy of using private companies to treat NHS patients, saying that it is putting lives at risk. Five hospitals have already pulled out of contracts to buy magnetic resonance imaging (MRI) scans for patients from the private company Alliance Medical Ltd over allegations of inaccurate reports and excessive delays in diagnosis.

Quality criteria for patient advice and liaison services: what do patients and the public want?

S. Abbott and others

Health Expectations, vol.8, 2005, p.126-137

All NHS and primary care trusts in England have patient advice and liaison services (PALS) which provide an identifiable person to whom service users can turn if they have a problem or need information while using the service. Authors worked with PALS service users and representatives of local user associations to identify criteria for assessing PALS. The emergent criteria were: responsiveness, accessibility to all, provision of clear information, effective collaboration, adequate resourcing and working to create a more patient-centred service. These were broadly similar to government defined standards, but with some key differences which the authors discuss.

Site for sore eyes? The IT project struggles to build momentum

J. Hoeksma

Health Service Journal, vol.115, June 23rd 2005, p.16-17

Reports on progress of the NHS IT modernisation programme. Progress has been slow to date, but should now begin to pick up speed. SKILLS DEVELOPMENT N. Edwards Health Service Journal, vol.115, June 2nd 2005, supplement, 9p Reports on the progress of Skills for Health, which has just completed its first full year as the licensed sector skills council for health. Its main role is to create and disseminate competency frameworks, but it also manages the skills escalator programme and oversees educational quality.

Skills development

N. Edwards

Health Service Journal, vol.115, June 2nd 2005, supplement, 9p

Reports on the progress of Skills for Health, which has just completed its first full year as the licensed sector skills council for health. Its main role is to create and disseminate competency frameworks, but it also manages the skills escalator programme and oversees educational quality.

Stuck in the middle and friendless: the lot of an SHA

K. Walshe, D. Bradshaw and J. Higgins

Health Service Journal, vol.115, June 2nd 2005, p.14-15

Strategic health authorities are under threat of abolition or reorganisation. They have succeeded in moving the NHS away from a command and control style of management, towards a decentralised or devolved model. Research suggests that their role is likely to change from being the middle tier in a hierarchy consisting of the Department of Health, primary care and acute trusts.

Sub-optimality in NHS sourcing in the UK: demand-side constraints on supply-side improvement

A. Cox, D. Chicksand and P. Ireland

Public Administration, vol.83, 2005, p.367-392

The NHS and its Purchasing and Supply Agency (PASA) are implementing reforms for the procurement of goods and services. One aspect of the new approach creates regional confederations in order to overcome the current inability to enforce "National Framework Agreements" within individual NHS trusts. However, recent research suggests that there are fundamental problems in NHS procurement which regionally negotiated deals with suppliers will not overcome. These include failure to manage the NHS design and specification process effectively, and inability to collect information on the clinical or cost effectiveness of medical interventions.

Superbug kills 12 at spinal unit as doctors warn of new threat to NHS

J. Laurance

The Independent, June 6th 2005, p.2

An outbreak of a new lethal new bug at a leading specialist hospital has claimed 12 lives and is a posing a grave new threat to the NHS, doctors have warned. More than 300 patients have been infected with the bug at Stoke Mandeville hospital in Oxfordshire and all attempts to control the infection have met with failure. The disclosure raises new concerns about NHS hygiene following a series of scares over the superbug MRSA and the pressure on hospitals to hit waiting lists targets.

(See also The Guardian, June 6th 2005, p.9; The Independent, June 8th 2005, p. 4-5; The Independent June 10th 2005, p.4)

'There is no such thing as a financial problem'

A. Cowper

Health Service Journal, vol.115, June 23rd 2005, p.20-22

Sir Ian Carruthers, chief executive of Dorset and Somerset Strategic Health Authority, discusses best practice in organisational change in the NHS, national and local targets, and the role of strategic health authorities.

The truth is out there…

S. Stevens

Public Finance, June 10th-16th 2005, p.30-31

Article discusses the role of international comparisons and policy borrowing in NHS reform. Argues that the UK should copy the most successful aspects of other health care systems worldwide.

Warning for hospitals which miss targets

J. Carvel

The Guardian, June 17th 2005, p.8

Hospitals in England will lose their licence to treat NHS patients if they cannot meet government targets for controlling costs, improving quality and cutting waiting times, a senior Department of Health official has told trust managers. Any trust failing to reduce the maximum waiting time to 18 weeks by 2008 would lose its accreditation as an NHS supplier and be removed from the menu of hospitals from which patients could choose.

Waste on wards as patients leave 17m meals untouched

S. Lister

The Times, June 3rd 2005, p.9

More than 17 million meals are being thrown away untouched in Britain's hospitals every year - an increase of almost 50 per cent over the last three years. Patient groups called for an urgent investigation into the increase amid concerns about patient malnutrition and wasted resources in the NHS. The statistics emerged in response to Parliamentary questions on hospital food asked by Andrew Lansley, the Conservative health spokesman.