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Welfare Reform on the Web (May 2006): National Health Service - Reform - General

F. O’Neill, P. Morris and J. Symons

Practice Development in Health Care, vol.5, 2006, p.26-29

Paper explores the challenges of involving patients as equal partners in the education of health professionals. Professional education today should provide opportunities for patients, health professionals and educators to support and learn from each other.

M.-L. Harding

Health Service Journal, vol.116, Apr.27th 2006, p.14-15

Report of an interview with Department of Health workforce director Andrew Foster, in which he claims that deep divisions have emerged between the Department, the NHS and the unions. He argues that pay reform in the NHS is not responsible for financial deficits as claimed in the media. He blames the NHS’s current difficulties on a series of major policy changes introduced without consultation by Health Secretary John Reid.

I. Lloyd

Health Service Journal, vol.116, Apr. 6th 2006, p.9

Trust chief executives say that the focus on achieving financial balance in the NHS by April 2007 will leave them with little capacity to work towards the December 2008 target of a maximum wait of 18 weeks for patients from GP referral to treatment.

R. McSherry

Practice Development in Health Care, vol.5, 2006, p.42-44

Article introduces the work of the Developing Practice Network that exists to promote the development of practice in health care settings. It is a multi-professional network that aims to be inclusive. It aims to provide a “virtual community” of interested collaborators committed to sharing knowledge and skills.

S. Lister

Times, April 5th 2006, p.23

More efficient discharge is called for as analysis highlights the discrepancy between hospital trusts with fast post-operative turnaround and those reportedly offering no extra care but taking longer to discharge patients receiving the same procedure. The article also reports on the latest job loss announcements, and other sources commenting on health service reform.

S. Hall

Guardian, April 19th 2006, p.11

Pfizer’s Exubera inhaler, cited as a “fantastic advance” reportedly costs an extra £500 per year per patient but offers a good alternative way of administering insulin to diabetics fearful of needles. It has been licensed by the European Medicines Evaluation Agency, but the National Institute for Clinical Excellence has rejected the drug on cost grounds, saying that needles would still be in daily use for glucose testing.

[See also Financial Times, April 19th 2006, p.4; Times, April 19th 2006, p.1&2]

A. Nolan (editor)

Health Service Journal, vol.116, Apr. 27th 2006, supplement, 9p.

Supplement looks at the work of the Information Centre for Health and Social Care a year after its launch, focussing on its role in data collection, service improvement, facilitating joint working between health and social care services for adults, and implementation of payment by results.

M. Palmer

Financial Times, April 11th 2006, p.2

Although the National Audit Office is to report on the project, leading IT professors have asked for an independent audit of the struggling £6bn programme to update the NHS IT system. Accenture, BT and Fujitsu Services, and software suppliers IDX and ISoft have all been involved in this regionally divided project described as the world’s biggest civil IT scheme.

[See also Times, April 11th 2006, p.4; Daily Telegraph, April 11th 2006, p.2]

Next steps for reform: where do we go from here?

A. Cowper

British Journal of Health Care Management, vol.12, 2006, p.105-116

A range of experts give their views on achieving financial balance in the NHS, radical restructuring of services, moving towards a primary care led NHS, improving staff survival skills in times of organisational change, reduction of political meddling in the NHS, increasing personal spending on health, improving leadership at all levels within the NHS, extending informed patient choice, and the impacts of marketisation and the private finance initiative.

J. Laurance

Independent, April 19th 2006, p. 16

Prime Minister Tony Blair has announced a switch of policy focus to public health and the encouragement of healthy lifestyles, has insisted that the NHS is being transformed into a demand-led service, and defended large increases doctors’ incomes. Officials are reported as saying that the 18 month old public health white paper has not delivered results

[See also Daily Telegraph, April 19th 2006, p.2; Times, April 19th2006, p.6]

J. Trueland

Health Service Journal, vol.116, Apr.13th 2006, p. 18-19

Report of an interview with Scottish Health Minister Andy Kerr, in which he discusses his vision for NHS reform. He plans a shift to anticipatory care, a focus on self-care for long-term conditions, treating patients closer to home and a separation, where possible, of elective and unscheduled care. He is committed to fully costing and thoroughly planning the implementation of all new policies, but is against radical structural change, which he sees as unnecessary and disruptive.

P. Toynbee

Guardian, March 28th 2006, p.29

Despite the current debt issues, the NHS is better than ever according to Toynbee. The 1997 inherited debt of 1.4% of budget, and annual winter crises are compared with today’s debt level which stands at 1% of the budget and no winter bed crisis. The article:

  • explains the relationship between cutting waiting lists and resultant debts,
  • asks about rationing and prioritisation and whether Labour will open the debate to the public,
  • looks at the health reforms, Blair’s fourth NHS reorganisation, asking whether the market being created is fit for purpose,
  • suggests that the outcome will depend on how much battering Labour can withstand before bailing out.

N. Edwards (editor)

Health Service Journal, vol.116, Apr 6th 2006, supplement, 17p.

As part of the implementation of the Gershon review, the NHS is expected to make efficiency savings of £6.5bn a year by 2008. Part of this will be achieved through productive time initiatives, which involve redesigning systems to make the best use of staff time. Supplement looks at various aspects of productive time initiatives, including lean thinking, listening to patients, reduction of staff sickness absence, and performance measurement.

N. Timmins

Financial Times, April 3rd 2006, p.2

Leadership allowing doctors to take advantage of new technologies and processes would have been preferable to pay rises according to director of clinical governance Halligan whose reported interview touches on:

  • the leadership void
  • never challenged capacity issues - “working patterns, practice and custom”
  • blinkered healthcare management, targets becoming an end in themselves rather than the intended means
  • distorted healthcare priorities.

N. Hawkes

Times, April 7th 2006, p.1&2

Hospitals will receive no payment for treating patients who should have gone to GPs according to leaked documents. The London wide “demand management” plans, which reportedly place limits on the number of GP to hospital, and consultant to consultant referrals, run against the “patient choice” agenda according to critics.

J. Le Grand and H. Stoate

Health Service Journal, vol.116, Apr. 27th 2006, p.22-23

The authors state their views on health service reform. Le Grand argues in favour of promotion of patient choice and competition between providers as the only way of empowering patients and embedding incentives for improvement within the system. Stoate calls for a radical slimming down of the acute sector and a redirection of resources into primary care.

N. Timmins

Financial Times, April 3rd 2006, p.13

At the end of the NHS’ best operational year ever, Timmins asks whether the results justify all the extra spending, what went wrong and whether a unique opportunity has been lost. The article touches on hospital staffing, including the implications of new technology and the location of treatment, exposure of underlying deficits and political will.

H. Mooney

Health Service Journal, vol.116, Apr.27th 2006, p.5

The Department of Health has been forced to scrap a large swathe of its second-wave independent treatment centre programme nearly a year after it invited private sector healthcare organisations to bid for the contracts. It has been forced to acknowledge the correctness of claims by Strategic Health Authorities and Primary Care Trusts that more elective capacity was not needed in their regions.

J. Carvel

Guardian, April 5th 2006, p.11

Rejecting the Doctors for Reform proposals, most doctors want a service which is free at point of access according to the British Medical Association chair Johnson. Increasing throughput and reducing unit costs of treatment are offered as one possible solution, giving two years to “get the service right.

[See also Daily Telegraph, April 5th 2006, p.2]

M. Rayner, P. Scarborough and S. Allender

Journal of Health Services Research and Policy, vol.11, 2006, p.67-73

This paper has used the analysis of the discourses within the National Service Framework to identify the aspirational values within it. Three discourses were identified: managerial, clinical and political. The managerial discourse was found to be dominant. Each discourse has its own values. The main aspirational values identified are efficiency, effectiveness, choice, universalism and equity. Some values, particularly equity, appear to be largely rhetorical and lead to few practical recommendations. Others such as compassion and democracy are notable for their absences from the framework.

N. Timmins

Financial Times, April 5th 2006, p.2

A Health Department strategy head doubts whether ministers will be prepared to live with the “creative destruction” which will follow the introduction of competition between providers into the NHS according to this article which recalls Labour’s election failure following the closure of the Accident and Emergency Department in Kidderminster.

Who is entitled to NHS continuing healthcare?

P. Grose

Caring Times, April 2006, p.10 +19

The High Court decision in the case of R (Grogan) v Bexley NHS Care Trust has highlighted the ongoing uncertainty over how ill you need to be to be entitled to continuing free NHS care as opposed to means-tested social care. Author calls for national eligibility criteria to be introduced to eliminate the current postcode lottery for NHS continuing care.

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