M. McHugh, K. Johnston and D. McClelland
International Journal of Public Sector Management, vol. 20, 2007, p. 314-324
Reforms within the NHS have exposed tensions between managers and the medical profession arising from the changing balance of power between the two groups. The authors argue that service delivery and the implementation of government reforms could be improved if the medical professions accepted the potential of HRM (human resources management) to help clinicians develop their careers through the enhancement of the work experience of doctors and through the provision of counselling and advice. The contribution of HRM to the management of doctors has hitherto been dismissed as purely administrative and often irrelevant.
I. Gilmore and A. Harrison
Health Service Journal, vol.117, Aug. 23rd 2007, p. 18-19
The Department of Health is promoting better management of patients with long term conditions in the community, the transfer of routine elective surgery to alternative providers, the creation of large specialist centres for complex care, and the establishment of polyclinics. Measures are being put in place to reduce hospitals' emergency workloads. The authors debate the role of the district general hospital in the new structure.
N. Harrop and A. Gillies
International Journal of Public Sector Management, vol. 20, 2007, p. 272-284
In recent years there has been public dissatisfaction with the operation of hospital accident and emergency departments (A&E) in the UK due to long waits for treatment and overcrowding. The government successfully tackled the problem by imposing a challenging performance target which limited length of patient stay in accident and emergency departments to four hours. This target has reduced the number of patients spending longer than four hours in A&E from more than 20% in 2002/03 to less than 2% in 2005/06. This paper seeks to draw lessons from the implementation of the four hour target in A&E for the roll out throughout the NHS of the National Programme for Information Technology, now re-branded as Connecting for Health.
Health Service Journal, vol. 117, Aug. 23rd 2007, p. 5
Leading cardiac surgeon Prof. Sir Bruce Keogh has been appointed as the first medical director of the NHS. The post of medical director was created in May 2007 as part of a new health service top team which separates the running of the health service from the Department of Health. The role of the Chief Medical Officer for England, Sir Liam Donaldson, will be scaled back and will focus on wider public health issues.
E. Bradley, B. Hynam and P. Nolan
Social Science and Medicine, vol. 65, 2007, p. 599-609
Community nurses in the UK have been able to prescribe from a limited formulary for over 20 years and prescribing rights were extended to nurses working in other specialities in 2003. The Medicines and Human Use (Prescribing) (Miscellaneous Amendments) Order 2006 will enable nurses who have successfully completed a nurse independent prescribing course to prescribe any licensed medicine, including some controlled drugs, for any medical condition within their clinical competence. However, the cost of drug errors are huge and they can have serious implications for staff and patients. In the context of the extension of nurse prescribing, this paper explores how a group of recently qualified prescribers perceived the safety of their practice. It examines how they rate their competency to prescribe, how safe they feel their prescribing decisions are, and how safe they feel the non-doctor prescribing initiative is in general. The paper explores how nurse prescribers could be supported in their prescribing practice, and how prescribing competencies could be assessed and reviewed.
R.E. Davis and others
Health Expectations, vol. 10, 2007, p. 259-267
Patients can potentially play an important role in reducing medical errors, through, for example, helping to avoid mistakes with drug administration. This literature review sought to identify factors that could affect the participation of the patient in ensuring their own and others' safety. Results suggest that patient participation in safety will be dependent on a complex interplay of patient-related, healthcare professional-related, illness-related and healthcare setting-related factors. Patients' and healthcare professionals' knowledge and beliefs will undoubtedly influence patient involvement in safety-related behaviours. To bring about the active involvement of the patient in safety, it is important to foster a working partnership between patients and professionals. This requires that patient involvement in safety-related behaviours is perceived by all to be beneficial to the medical encounter rather than challenging the healthcare professionals' clinical skills.
Department of Health
London: TSO, 2007 (Cm 7015)
This report deals with enhancements to the systems in place in healthcare organisations to identify, investigate and respond to actions by health professionals that could put the safety and well-being of patients at risk. It covers recruitment and screening processes, the role of clinical governance, the complaints system, dealing with issues of sexual assault on female patients, and information sharing.
Health Service Journal, vol. 117, Aug. 16th 2007, p. 5
A legal challenge to NICE's decision not to recommend certain drugs to treat patients with Alzheimer's disease has failed. This article presents a range of expert comment on the High Court judgement.
Health Service Journal, vol.117, Aug. 16th 2007, p. 12-13
This article explores the scope for the Internet to impact on the NHS. The Department of Health has recently launched the NHS Choices web site, which gives patients clinical and service information to help with decisions about where to have treatment. Patients are also expected to eventually get online access to their medical records through the 'HealthSpace' web site. However there is concern that NHS web sites aimed at patients are difficult to navigate and provide only basic clinical information. Non-NHS health web sites may actually mislead patients by conveying inaccurate information.