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

Buildings and facilities: special report

E. Forrest (editor)

Health Service Journal, vol.115, July 14th 2005, p.35-41

NHS trusts are under extreme pressure to tackle hospital-acquired infections. Special report covers the importance of clear definitions in infection control, ways in which intelligent building design can help the fight against infection, the impact of the new Corporate Manslaughter Bill on the NHS, and the challenge of complying with the new EU directives on instrument decontamination.

Can the law help Hewitt take MRSA to the cleaners?

T. Shifrin

Health Service Journal, vol.115, June 30th 2005, p.14-15

In response to public concern about hospital acquired infections, the Health Secretary has announced a Health Improvement and Protection Bill. This Bill will introduce a statutory hygiene code for the NHS and give the Healthcare Commission powers to slap "improvement notices" on bodies that fail to comply. Should hospitals still fail to mend their ways, the Commission could impose sanctions, including the threat of criminal prosecution.

An evaluation of extended formulary nurse prescribing: executive summary of final report

S. Latter and others

University of Southampton, School of Nursing and Midwifery, 2005.

Research evaluated the first two years of extended formulary nurse prescribing, using a national survey, observation of prescribing nurses and the views of stakeholders in its assessment. Results show that independent nurse prescribing is viewed positively by patients, doctors and nurses themselves, with patients citing accessibility as a major advantage when obtaining their medicine from a nurse rather than a doctor.

Foundation trusts: future thinking, challenges and change

Foundation Trust Network

London: 2005

Report recommends that:

  • Foundation trusts should be allowed to franchise their services and set up centres of excellence, like Debenham's boutiques, in other hospitals.
  • They should provide primary care services and form partnerships in primary care to deliver management of long-term conditions.
  • Most national targets should be abolished and replaced by a locally developed set.
  • There should be increased freedom for trusts to borrow from commercial lenders.
  • Trusts should be developed as all purpose regeneration vehicles and offer social as well as health care.
  • The law limiting the number of private patients they can treat should be scrapped.

Health inspectorate warns of two-tier NHS

J. Carvel

The Guardian, July 6th 2005, p10

The NHS is set to become a two-tier service with independent foundation hospitals attracting patients from less successful establishments that remain under government control, the health inspectorate warned yesterday. Anna Walker, chief executive of the independent Healthcare Commission, said it was unlikely that all NHS hospitals in England would be strong enough to apply for foundation status by 2008, as the government has promised.

The Healthcare Commissionís review of NHS foundation trusts

London: 2005

Report concludes that:

  • There is no evidence that foundation trusts are poaching the best staff, avoiding patients with complex conditions or admitting patients to hospital unnecessarily
  • NHS foundation trusts have had a positive effect on local community involvement.
  • In some trusts, governors' roles are unclear and may overlap with those of public and patient involvement forums, as both represent the public and patients.
  • There is no evidence that foundation trusts have pulled ahead or created a "two-tier" NHS.
  • There is no evidence that NHS foundation trusts are improving patient care faster than other NHS bodies.
  • Most trusts have managed their finances soundly, although four faced projected deficits of more than £3m.

Improving emergency care in England

Committee of Public Accounts

London: TSO, 2005 (House of Commons papers, session 2004-05; HC445)

Patients identify a reduction in waiting time in A&E as the improvement they would most like to see, and the Department of Health has been managing NHS trust performance to ensure that no one will spend longer than four hours waiting for emergency hospital treatment. Report believes significant and sustained progress has been made towards this target, as published performance data for July-September 2004 showed on average 95.9% of patients spent less than four hours in A&E. However a number of trusts still have some way to go. From April 2005, the four-hour maximum total wait will no longer be national target but will be part of the framework of health and social care performance standards against which hospitals will be assessed by the Healthcare Commission.

Improving patient care by reducing the risk of hospital acquired infection: a progress report

Committee of Public Accounts

London: TSO, 2005 (House of Commons papers, session 2004-05; HC554)

Report found that progress in implementing the previous Committee's 2000 report had been patchy, and that there was a distinct lack of urgency on several key issues such as ward cleanliness and compliance with good hand hygiene. Progress continues to be constrained by a lack of robust data, limited progress in implementing a national mandatory surveillance programme and a lack of evidence of the impact of different intervention strategies.

Independents' day

H. Mooney

Health Service Journal, vol.115, July 14th 2005, p.18-19

Report of an interview with Tim Elsigood, executive director of the Independent Healthcare Forum, in which he discusses his mission to help independent providers win the business available to them in the new NHS.

Knowledge to action? : evidence-based health care in context

S. Dopson and L. Fitzgerald (editors)

Oxford: Oxford University Press, 2005

Health services can and should be improved by applying research findings about best practice. Yet, in his book, the authors explore why it nevertheless proves notoriously difficult to implement change based on research evidence in the face of strong professional views and complex organizational structures. The book draws on a large body of evidence acquired in the course of nearly fifty in-depth case studies, following attempts to introduce evidence-based practice in the UK NHS over more than a decade.

Mixed reviews

N. Plumridge

Public Finance, June 17th-23rd 2005, p.22-24

The government has created a mixed economy for health care in England, and has encouraged private providers to enter the market. Private companies can bid to run independent treatment centres and provide diagnostic services. NHS foundation trusts have prudential borrowing powers and are encouraged to operate as businesses. Private sector provision may now be entering primary care, with companies poised to run out-of-hours services under contract.

Overseas nurses' motivations for working in the UK: globalization and life politics

J.A. Larsen and others

Work, Employment and Society, vol.19, 2005, p.349-368

Article presents data gathered through focus group interviews with overseas nurses in the UK and reveals their motivations for coming to work here. Nurses from developed countries came for a working holiday, because of unemployment in their home country or to access further education. Nurses from developing countries tended to come to experience life in the UK, to be exposed to the high standards of nursing practice in the UK, to gain professional advancement and to earn money to send back home. They did not come, as is commonly assumed, to escape poor socio-economic conditions in their home country.

'Put me out of a job'

I. Lloyd

Health Service Journal, vol.115, July 7th 2005, p.18-19

Health Services Ombudsman Ann Abraham discusses problems with complaints handling at local level, the backlog of complaints awaiting review by the Healthcare Commission, and the role of her office.

The quest for quality in the NHS

S. Leatherman and K. Sutherland

Radcliffe Press, 2005

The authors present a comprehensive statistical analysis that compares NHS performance with health systems in other developed countries. Data show that, although the NHS is improving, it is still performing worse than the health systems of other rich countries.

A Simple cure

M. Harris

Working with Older People, vol.9, no.2, 2005, p.37-39

A national survey of Deaf people's experiences of the NHS shows extensive communication failures between health professionals and their deaf patients. The situation could be improved by:

  • Widening the use of technology such as loop systems and video interpreting
  • Deaf awareness training for all medical and nursing students and selected frontline staff.

Strategic partnerships and relationship marketing in healthcare

G.H. Wright and A. Taylor

Public Management Review, vol.7, 2005, p.203-224

Authors argue that relationship marketing might provide a suitable framework for helping public services such as healthcare move away from their current short-term, transactional and product-oriented focus. Using the framework of relationship marketing, they identify healthcare managers' concerns about the motives, effects and benefits of implementing partnership arrangements in two regions of the NHS. Findings suggest that while managers' attitudes to partnership working and customer focus became more positive over time, they remained centred on the service process rather than the customers.

Structured patient education in diabetes

Patient Education Working Group

London: Department of Health, 2005

Report provides the NHS with guidance on equipping patients with the knowledge they need to manage their condition effectively. The document includes new ideas, examples of good practice and an outline of currently available education programmes. It also highlights gaps in provision.

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