bluuebunny/crossref_metadata_2025 huggingface dataset:
Ulcer unionists identify ‘weak links’ in trust care
Authors: Moffatt Robert
Published: May 2014

Pressure sores are a serious problem for health care professionals and the NHS. The Department of Health estimates that 10 per cent of the adult population are affected by them at an annual cost of £60 million to the NHS. This article examines recent guidelines issued by the European Pressure Ulcer Advisory Panel (EPUAP) and the various management options available.
Getting ahead through total bed management
Authors: Preece Jane , Tracey Clive
Published: May 2014

Twelve months ago, King's Healthcare NHS Trust opted for a Total Bed Management (TBM) contract as a way of enhancing its pressure area care and reducing the likelihood of manual handling injuries. This article uses evidence from the trust's latest audit to assess the success of this approach.
Dobbo's legacy - will it all add up for the man from the Treasury?
Authors: Maynard Alan
Published: May 2014

At the recent Labour Party Conference Jack Straw demonstrated that he could not count, asserting that 5,000 more policemen was an increase in staffing. But a leaked memo from a Treasury minister, Alan Milburn, pointed out that earlier announced cuts more than cancelled this out. In other words, the ‘increase’ might actually be a decrease. So Milburn can obviously count better than Straw, but does this incident tell us anything more about these disingenuous coves?!
Unlocking the power of the world wide web
Authors: Lindsay Bruce
Published: May 2014

The internet is poised to become the primary source of research information for health professionals. Yet recent UK research suggests that access to this resource within the NHS is patchy at best. This article explores how the much lauded ‘Internet Revolution’ will impact upon research and dissemination and discusses its implications for health care provision.
New opportunities for partnership flowering in primary care
Authors: Bosanquet Nick
Published: May 2014

Primary care remains popular with the public, but there are more doubts about its future than was the case a few years ago. In fact, the next six months will be a critical period. Will the threatening clouds change the weather and carry away general practice? The mourning period for fundholding has got to end; it can't be as long as Queen Victoria's.
Service-based training pivotal in primary care
Authors: Drage Stewart
Published: May 2014

Primary care is fundamental to the success of clinical governance. Now that most PCG leads have been appointed, this article examines what processes need to be implemented, and resources allocated, to ensure the initiative maintains momentum.
Promises, pledges and propaganda: Labour's 99
Authors: Webster Charles
Published: May 2014

Bravely hacking through layers of cloying political spin, top NHS historian Dr Charles Webster reflects on the year's events and find himself amazed at the government's consummate ability to dissipate the large fund of goodwill it inherited.
User charges not the right solution
Authors: Maynard Alan
Published: May 2014

At a time when the London Millennium fireworks display is costing £20 million (how many hip operations is that?), we are entering a period of seasonal discontent about the NHS. Familiar declarations of ‘underfunding’ and of £1 billion deficits are mixing with carols and news of further millennium ‘junkets’.
Milburn nurses a grievance?
Authors: Stone Malcolm
Published: May 2014

So we've had our first real taste of what life under the new Secretary of State for Health, Alan Milburn, will be like. The MP for Darlington gave his first keynote speech since taking up the post at the joint NHS Executive and Committee of Vice-Chancellors and Principles (CVCP) conference last month. Announcing the establishment of a new training centre to provide more clinical responsibility for the 300,000 nurses working in the NHS, he made it quite clear to the audience at King's College Hospital that he sees untangling the jumbled mess that is contemporary nursing education as fundamental to driving forward the government's ambitious modernising agenda.
Channelling existing commitment is challenge facing managers now
Authors: Mills Ian
Published: May 2014

Examining integration from the NHS Executive's perspective, Ian Mills explains why this latest drive looks set to succeed.
Implementing innovative policies: the ‘levers’ available to managers
Authors: Statham Daphne
Published: May 2014

The issues that need addressing, possible solutions, and the tools available to managers.
Frontline workers: research fills in gaps between rhetoric and reality
Authors: Benaim Rosie
Published: May 2014

Recent government thinking is outlined and evaluated in the light of research conducted at the frontline between health and social care.
The hard facts about Viagra
Authors: Halpern Stephen
Published: May 2014

In the ‘Carry on up the Department’ world of Secretary of State, Frank Dobson, the drug Viagra, appears to be something largely sought by middle aged businessmen to further some kind of illicit pursuit. In the real world, both doctors and the general public seem to have a far tighter grasp of both the reality and the substance of the treatment for erectile dysfunction.
Cuckoos in the nest
Authors: Hoeksma Jonathan
Published: May 2014

Will the new public-private sector partnerships prove as benign as the government claims? Are the objectives of private finance and the egalitarian principles of the NHS really compatible? We investigate.
Falling for fool's gold
Authors: Fitzpatrick Maurice
Published: May 2014

A product of the fiscal circumstances of its time, is the PFI still necessary? This article outlines its development and asks whether there are any viable alternatives.
Impulses to converge: lessons from Europe
Authors: Howorth Chris
Published: May 2014

What combination of features from the different EU health care systems might be of most benefit in developing the NHS, and in the creation of a federal European health and social care structure?
Distilling the essence of professionalism
Authors: McFadyen John , Armitage Claire
Published: May 2014

Concluding our exploration of clinical governance in relation to mental health, this paper assesses the contribution directors of clinical governance will be expected to make in terms of professionalism and quality.
The legal logistics of independent inquiries
Authors: Eldergill Anselm
Published: May 2014

This article seeks to guide managers through the often arduous task of facilitating an independent inquiry.
Terms of engagement for community clinics
Authors: Connor Carole
Published: May 2014

How a new model of care devised by the anticoagulant team at Birmingham Heartlands and Solihull NHS Trust, shortlisted in the Golden Helix awards, radically improved the hospital outreach service and successfully engaged the community.
Is the party over for Dobson?
Authors: Stone Malcolm
Published: May 2014

Once again its seems that the Government lacks the courage of its convictions. The bold, optimistic stance it adopted towards the NHS in the wake of the Comprehensive Spendi last year struck the righ Even the most embattle jaded managers felt defensive shields of cyni thawing in the al warmth of robust, se political mandates.
The denying game - politics vs economics
Authors: Royce Robert G
Published: May 2014

The final installment of our in-depth assessment of the philosophies and prejudices stimulating the rationing debate. Is evidence based medicine a workable rationing device?
On target Mr Blair gets priorities right
Authors: Halpern Stephen
Published: May 2014

One was almost feeling ever so slightly sorry for them. After all the hard work by Frank Dobson and Tessa Jowell in getting health priorities into some kind of order, along comes the Prime Minister from the left of field (or should that be right of field?) and upsets it all by setting targets to reduce the number of deaths from all cancers by 20 per cent by the year 2010.
Benefits of oncology revolution could end up ‘gone with the wind'
Authors: Bosanquet Nick
Published: May 2014

Last year, at an American Society of Clinical Oncology meeting, American and British concerns seemed to be converging. This year, however, there were signs that the US is forging off ahead alone.
Risks associated with single-use devices
Authors: Wilson Jo
Published: May 2014

Trusts owe a duty of care to patients, staff, the public and the environment. This article considers the risk issues associated with the reuse of medical devices. A practice which must be carefully considered by managers and clinicians responsible for clinical procedure and patient safety.
21st century toy?
Authors: Leete Barry
Published: May 2014

The Government has backed up its belief in the potential of telemedicine with a pledge to spend £1 billion over the next seven years. This article focuses on the field of telepathology, outlining recent trials and the potential patient care benefits.
Mapping the public's health in London
Authors: Halpern Stephen
Published: May 2014

Environment and Health in London is an excellent background primer which was produced to mark the Third Ministerial Environment and Health Conference held in London in June. The authors, Mark McCarthy and Jake Ferguson, give a comprehensive snapshot of the major links between the environment and health by mainly using clearly produced maps as well as the results of various public surveys.
Cost benchmarking - utilities show the way
Authors: Sussex Jon
Published: May 2014

The cumulative experience of the regulators in the water and electricity supply industries has yielded important insights into the use of cost benchmarking. This article draws lessons of direct relevance to the NHS.
Unfair dismissal: The new legal landscape
Authors: Exten-Wright Jonathan
Published: May 2014

A raft of new legislation for workers’ rights has been introduced by the Government. A key issue is the new legal landscape for unfair dismissal, which will have an impact on all employers. What are these changes and what can employers do to protect themselves?
Plight of the navigator
Authors: de Lusignan Simon
Published: May 2014

Drawing on experiences gained orchestrating the ‘Doctors Desk’ project, the author explains how to use the new National electronic Library for Health (NeLH) to your advantage within a primary care setting.
Paradigm lost or paradigm regained?
Authors: Halpern Stephen
Published: May 2014

With over four million Britons visiting complementary practitioners annually, the conventional medical establishment is under increasing pressure to re-evaluate its relationship with alternative health care providers. This is the first of two article examining the issues.
Gaining extra purchase through group buying
Authors: Rosamond-Lanzetta Damon , Shakespeare Charlotte
Published: May 2014

This article examines the collaborative approach to procurement, outlining how to avoid potential contractual pitfalls, and ensure maximum commercial advantage.
Medical interventions during pregnancy
Authors: Rodgers ME
Published: May 2014

The right of the medical profession to intervene during childbirth, contrary to the wishes of the patient, has been the subject of considerable legal debate during the 1990s. However, recent judicial comment in R vs Louize Collins and others (1998) seems to have reached a clear conclusion on the rights of the pregnant woman, and also the steps that can be taken to treat when a pregnant woman has refused intervention.
Government steps up public health drive
Authors: Halpern Stephen
Published: May 2014

So after having insisted in the Green Paper, Our Healthier Nation, that public health targets stop at age 65, the Government has decided that to extend the targets to 75 years in the White Paper, significantly called Saving Lives: Our Healthier Nation.
Rheumatoid Arthritis - new drugs ring changes
Authors: Greener Mark
Published: May 2014

A change in the managerial approach to Rheumatoid Arthritis (RA) is urgently required in order to address issues such as economic burden and the entry of new drugs in both primary and secondary care settings.
Fat cat surgeons: the enemy within?
Authors: Maynard Alan
Published: May 2014

Dobbo and his cobber, David Hinchcliffe, who is Chairman of the House of Commons Select Committee on Health, are old style socialists recently ‘teflon’ coated into Blurism. Way back in their youth they probably read the selected works of that vicious old mass murderer, Mao Tse-Tung. Mao told the faithful ‘to know your enemy’. Only if you studied your enemy, he argued, could you understand his ways and defeat his evil intent. Surely it is time for Dobbo and Dave to know their ‘enemy’ in private practice?
Collaboration no longer a luxury but a necessity
Authors: Shepherd Tony
Published: May 2014

Drawing on personal experiences of working both within and outside the NHS, the author argues that both sectors will have to work closer together to ensure a comprehensive service is sustained.
Shining a light on the plight of Community Trust users
Authors: Meads Geoff
Published: May 2014

Those south of the border who doubt that the advent of Primary Care Groups (PCGs) has serious ramifications for the future of NHS Community Health Services (CHS) Tr usts should take a short visit to Scotland. Any such doubts or opinions would be quickly dispelled.
MRSA - the demise of the antibiotic miracle?
Authors: Greener Mark
Published: May 2014

Tackling antibiotic resistance is something you might be tempted leave to your infection control teams and microbiologists. But it only takes a couple of ward closures due to an outbreak of a resistant ‘super bug’ to realise that nothing could be further from the truth.
Pollution and poverty real threats to public
Authors: Blatt Barry
Published: May 2014

The public health White Paper was finally released on 6th July under the optimistic title Saving Lives (Department of Health [DoH], 1999). The problem is that it is far from clear how many lives this raft of legislation will save and, more disturbingly, the beginnings of a political argument over whether those it is intended to help really deserve it.
Staff safety: the legal liabilities of employers
Authors: Wilson Jo
Published: May 2014

With the increase in the number of employer liability claims there is a need for all health care organisations to demonstrate that they can meet the requirements of NHS health and safety issues (HSG(97)6).
Chain reaction - joined up supply management
Authors: Sutton Roxanne
Published: May 2014

Touching on research conducted by NHS Supplies’ Strategy Directorate with the Centre for Research in Strategic Purchasing and Supply (CRiSPS), this article describes new ways of looking at NHS procurement issues, and the role envisioned for the new Purchasing and Supply Agency.
Electric schemes - the benefits of e-commerce
Authors: Hoeksma Jonathan
Published: May 2014

The integrated complexity of health makes it particularly suitable for electronic business solutions. This article looks at ways in which the NHS is starting to utilise the benefits offered by e-commerce.
Price is right in new PPRS deal
Authors: Stone Malcolm
Published: May 2014

This summer we have been given another reason to be grateful that Tony Blair didn't insist that Frank Dobson leave health and run for Major of London. As the government continues its Herculean task of modernising the NHS, he is starting to prove exactly the kind of pragmatic, hard-nosed negotiator needed.
Local managers are likely to be key to organisational changes in 2000
Authors: Bosanquet Nick
Published: May 2014

What does the outlook hold for 200 in the NHS? It is going to be the year of future hope but present difficulties. There will be a bank up of urgent priorities for spending just when the spending constraints get most serious. The political cycle will be out of line with the public spending three year programme. Pressure to spend will include the first wave of reports from the NICE, together with the political concern about postcode rationing. There will also be an increase in National Service Frameworks with new calls on the Modernisation Fund.
Public sector ethos still alive but undervalued
Authors: Steele Jane
Published: May 2014

This report draws on a recent Public Management Foundation study which analysed what 400 senior managers in the public, private and voluntary sectors said about the goals that drive them, about job satisfaction and about the things that increase and hamper their effectiveness at work.
Children deserve better
Authors: Glasper Edward Alan
Published: May 2014

Given the scale of abuse which is perpetrated on children in contemporary Britain, with at least one child dying per week following abuse and neglect, some 35,000 on child protection registers and at least 350,000 children living in families which are low in warmth and high in criticism (NSPCC, 1999), the rights of children who have died may appear inconsequential in comparison.
How the NHS broke the fuel blockade
Authors: Roth Andrew
Published: May 2014

I knew the NHS was strong on therapy. However, until very recently, I did not realise that it could cure a situation whereby 55 million Britons were being held to ransom by two thousand loosely-organised fuel pickets, comprising an alliance of hauliers and farmers.
Measuring and modelling patient flow
Authors: Millard Peter , Christodoulou Georgina
Published: May 2014

As the winter preparations continue apace, this article examines statistical methods of analysing and modelling patient flow in a geriatric ward. The lessons and outcomes of this project could hold some valuable lessons for the wider issues of managing demand. Will these lessons be learnt, or indeed heard?
Fostering the spirit of innovation in PCTs
Authors: Ayres Ian , Sang Bob
Published: May 2014

This article is based on the innovative organisational design work conducted to support the creation of the Nelson and West Merton Primary Care Trust.

The project, funded by the NHS Executive, and conducted in co-operation with the King's Fund, sought to test the potential of PCTs as ‘new paradigm’ modern learning organisations, capable of delivering a modernised NHS at a locality level.
The electronic future for the NHS
Authors: Hoeksma Jon
Published: May 2014

One of the most important elements in delivery of The NHS Plan will be to imaginatively harness information technology.

This article suggests that the NHS is beginning to embrace a wired future, that could transform the management and delivery of services.
Private finance, public headache: the PFI future
Authors: Boyle Sean , Harrison Anthony
Published: May 2014

The ‘Provocations’ series continues after a summer holiday. Labour came to power in May 1997 and embraced Private Finance Initiative funding with unexpected enthusiasm.

This has been done with virtually no consideration of the strategic direction which the NHS is taking, and without clear evidence that better value for money and better design is resulting from the first schemes.
Changing the culture
Authors: Harvey Trevor
Published: May 2014

‘Knowledge is still power. At a provincial level, a commitment to computers still seems alien to “hands-on” care.’
The NHS Purchasing and Supply Agency
Authors: Eaton Duncan
Published: May 2014

This article looks at the history, establishment and methodology of the NHS Purchasing and Supply Agency (PASA).

PASA's Chief Executive Duncan Eaton looks at the possibilities for better management in this vital area.
Book Review
Authors: Harmond Kate
Published: May 2014

This book’s target audience includes ‘GPs, other members of the primary care team and Primary Care Groups’, and the content reflects the concerns expressed by many practitioners in these roles during the mid-1990s planning and development of new arrangements for primary care.
Book Review
Authors: Baker Mark
Published: May 2014

After almost ten years of the NHS Research and Development Strategy, and the best part of £4 billion of NHS funds invested in research, ministers are beginning to ask what discernible return on the investment has been delivered and how have patients benefited.
Personal Medical Services pilots: two years on
Authors: Jenkins Clare , Lewis Richard , Gillam Steve
Published: May 2014

Last year in the British Journal of Health Care Management, we published an article looking at early learning from a local evaluation of four London Personal Medical Services pilots (Jenkins, Lewis, & Gillam 1999).

We now return to examine how these pilots are now faring in their third year of operation. How far have they achieved the aims and objectives set for them of improving accessibility, initiating new roles and increasing skill-mix?
Healthy debate: medics and economists joust on
Authors: Kernick David
Published: May 2014

The ‘Provocations’ series concludes for 2000 with another salvo in the battle between health economists and medics.

Dr David Kernick, author of May's ‘Provocations’ piece, prompted a response in this series by Professor Alan Williams last month. Here Dr Kernick rejoins the debate.
How managers can avoid some white hairs: 2000 formula
Authors: Bosanquet Nick
Published: May 2014

The Budget speech set out a spending increase for the NHS of a kind for which ‘even the ranks of Tuscany could scarce forbear to cheer’. Greeted with acclaim by the BMA and Unison, it seemed to herald a new dawn, but are there reasons for doubting whether this will be quite the massive change from the bad old ways of the past?
No discrimination: part-time employees in law
Authors: Exten-Wright Jonathan
Published: May 2014

The Government's proposals for the forthcoming legislation with regard to part-time employees are considered here. The effects of these new regulations could prove far-reaching, and the areas likely to require consideration and forward-planning are examined.
The future of the NHS debate: 'Do Not Resuscitate'
Authors: Cowper Andy
Published: May 2014

Few easier editorials could be written than the predictable ‘whither the NHS?’/‘wither the NHS!’ crop that pass for discussion on the future of health care provision in Britain. The heart of this is the question every manager asks themself every day: how can we afford this? The debate is essential to getting health care provision right: the question is, where is it?
Permanent revolution, Treasury-style
Authors: Roth Andrew
Published: May 2014

I have to apologise to my cousin the consultant at ‘Jimmy's’ in Leeds. When we met for dinner at the beginning of Labour's reign, he complained of the ‘permanent revolution’ from which the medical professions had suffered under the Tories. Since I had recently dined with the (then) new Health Secretary, Frank Dobson, I felt I could assure my cousin that Frank would work with the grain of the professions.
A bitter pill or a spoonful of sugar?
Authors: Woolfrey Salisbury , Asghar MN
Published: May 2014

Pharmacy practice in the UK is in transition. Due to significant NHS changes by the current Government, pharmacists are experiencing a change in their work environment. Here we describe the challenges, obstacles and the effort needed to ensure that the profession contributes fully to the new agenda and to shaping the future of pharmacy practice.
Should health economists carry a health warning?
Authors: Kernick David
Published: May 2014

In the third of our ‘Provocations’ series, we have a view from primary care. Dr David Kernick, a GP from Exeter, gives his interpretation of the value of the work of health economists.
Not fire-fighting or rocket science: not just managing
Authors: Cowper Andy
Published: May 2014

The end of May brought a collective sigh of relief from health care managers throughout the country. This was not so much to do with the safe arrival of the Prime Minister's fourth child at the Chelsea and Westminister Hospital as with the announcement that the Government's target to cut waiting lists below 100,000 had been met (Department of Health, 2000). The sigh was not just about that achievement, however.
‘Fresh thinking': what it means for the NHS
Authors: Thornton Stephen
Published: May 2014

A special introduction to our preview of the NHS Confederation Conference and Exhibition 2000, which is to be held in Glasgow SECC 28th-30th June
Put it on your intranet
Authors: Harvey Trevor
Published: May 2014

‘Desks or our minds clogged with superfluous detail make us liable to lose the big picture.’
Appeal Court ruling on general damages awards
Authors: Jaycock Clare
Published: May 2014

The Court of Appeal handed down its judgement on increases to the level of awards for general damages in March this year, following a series of test cases. This article considers the reasons behind the Court's decisions, which has inevitable financial consequences for health care providers.
Blame culture? Clinical / medical self-regulation
Authors: Foster Andrew , Hawker Peter
Published: May 2014

The Forum series on ethical and professional issues continues with the charged topic of clinical and medical self-regulation.
Information overload: wheat from the chaff
Authors: Maynard Alan
Published: May 2014

‘The electronic jungle has the potential to inform and confuse’
Stress and tensions in general practice administration
Authors: Calnan Michael , Wainwright David , Forsythe Malcolm , Wall Barbara
Published: May 2014

With the formation of Primary Care Groups and Trusts, a new level of responsibilities has passed on to practice managers in general practice. This article considers the implications for levels of stress and job satisfaction for this important group: a subject not reported previously.
Book Review
Authors: Walker Robert
Published: May 2014

The principles governing GP continuing education have undergone a radical change in the last 3 years. At long last, the realisation dawned that traditional methods of education (usually the ‘bums-on-seats’ principle) have not really contributed either to addressing learning needs or to the development of the NHS as a whole.
Chicken run: they're coming home to roost
Authors: Maynard Alan
Published: May 2014

‘The reform, or abolition of the GMC should be accompanied by the radical reform, if not abolition of the Royal Colleges’
The NHS Plan: is it right and can it succeed?
Authors: Bamford Terry , Bosanquet Nick , Harmond Kate , Halpern Stephen , Neuberger Julia , Hunter David , Pollock Allyson , Walker Robert , Webster Charles , Wall Andrew , Edwards Nigel
Published: May 2014

A panel of health service commentators, experts and professionals give us their considered reviews of various aspects of The NHS Plan and its chances for success.
The NHS Plan: staffing strategies needed
Authors: Bell Andy
Published: May 2014

The success or failure of The NHS Plan will largely rest on the adequate preparation and provision of new staff to enable the commitments and objectives to be met. Andy Bell of The King's Fund considers the strategic implications for managers and human resources, with particular regard to nurses.
Creating a quality culture in ‘The New NHS'
Authors: Hewison Alistair
Published: May 2014

The creation of a ‘quality culture’ has been identified as a central feature of the Government's approach to managing the new NHS. Is this a realistic aim?

This article examines the role of mission statements in this enterprise, and questions the effectiveness of some attempts at culture management. Has the mission (statement) been accomplished?
The growing divide between rhetoric and reality
Authors: Halpern Stephen
Published: May 2014

Primary care trusts (PCTs) could become dysfunctional organisations which fail to make best use of their resources, according to a NHS Alliance policy document on PCTs and health improvement.
Waving or drowning?
Authors: Baker Mark
Published: May 2014

It now appears overwhelmingly probable that the NHS will fall over during the next couple of years. The only uncertainty concerns what will provide the trigger, or be the last straw. There is a disturbingly long list of candidates.
The Five Giants: a biography of the welfare state
Authors: Webster Charles
Published: May 2014

This study of the welfare state by Nicholas Timmins first appeared in 1995. No other book covered the entire history since Beveridge with anything like its confidence and accessibility. Across the whole scope of its coverage Timmins provided a great deal of basic technical detail, but this was effortlessly blended in with a lively political narrative. Naturally, the large and enthusiastic readership of this book looked forward to this second edition, which contains the commentary of Timmins on the action-packed events of the last six years.
Why the public service ethos is still (just) working
Authors: Harvey Trevor
Published: May 2014

A conflict of philosophies is presently brewing. As Right and Left become passé concepts, we find little useful political debate ensuing at a time of military involvement abroad: indeed, we have seen the acquiescence of the governing party's own conference in awe of the proclaimed statesmanship of its leader. So, do we have a Government that might try to slip in a major change to its modus operandi under the cover of a crisis? Presently, it may impossible for them to find the necessary parliamentary time, but following such a conflict, history suggests there is usually a period of opportunity for a government to take advantage of the afterglow to advance difficult policies.
The shifting balance: that was the year 2001
Authors: Webster Charles
Published: May 2014

Dr Charles Webster, the Official Historian to the NHS, reviews the past year's major events in health care.
‘Mind the gap!’ Managing across boundaries
Authors: Hunter David J , Kernick David
Published: May 2014

Based on Professor Hunter's speech to the IHM Conference in Belfast in October 2001, this article examines the distance between the desirable theory and difficult realities of collaborative working.

A commentary follows from Dr David Kernick, an advocate of a postmodern approach to managing health care, in which he considers Professor Hunter's views in the light of relevant critical theory.
Making the right connections in modernisation
Authors: Harrison Anthony
Published: May 2014

This article considers the impact of NSFs in the context of the modernisation agenda on the provision of a joined-up service. Have we been taking one step forward and two steps back?
Dr Foster went to Coventry (& Bristol)
Authors: Bell Andy
Published: May 2014

This has been a bad month for people living in Coventry. Their hospital, it appears, is not up to scratch. Its death rates after heart bypass surgery are higher than anywhere else in the country.
Irresistible pressure from the top tough cop
Authors: Roth Andrew
Published: May 2014

The NHS is just about to experience what happened to me over 50 years ago, when I was being interrogated by 2 ‘G-men’ (or FBI agents). This happened after I had been followed by a group (‘The G-Team’?) of Feds for three months, with my phone being tapped and my flat being bugged. First the ‘tough cop’ threatened; and then the ‘soft cop’ tried coaxing.
The NHS: still standing or standing still?
Authors: Cowper Andy
Published: May 2014

As the General Election rears its head, we speak to representatives of the three main parties at Westminister, beginning with Nick Harvey, health spokesman for the Liberal Democrats.
Calling for health advocacy and accountability
Authors: Elizabeth Susan
Published: May 2014

As the move away from Community Health Councils and towards Patients Advocate and Liaison Service (PALS) continues, Susan Elizabeth of the King's Fund considers how a ‘patient-centred’ NHS can respond to the needs of ethnic users of its services, based on research carried out in London.
Managing surgical wounds: two dressings reviewed
Authors: Moore Peter J , Foster Lorraine
Published: May 2014

The cost-effectiveness review series continues with an appraisal of two dressings used in the treatment of acute surgical wounds. The cost efficiency and clinical value of these products are considered.
Waiting lists, dirty hospitals, and other red herrings about improving health
Authors: Bell Andy
Published: May 2014

With a winter crisis in hospitals singularly failing to materialise so far, media attention has turned to other matters. Hospitals, as ever, have taken centre stage.
All change in web site design
Authors: Harvey Trevor
Published: May 2014

‘From now on the web will continue to emulate televisual media’
Working time directive: legal implications
Authors: Exten-Wright Jonathan , Hannon Jane
Published: May 2014

This article considers the implications of the European Working Time Directive for health care managers.

What have the test cases to date made of the law?
Saving money through good nutrition
Authors: Holmes Susan
Published: May 2014

One of the hardiest perennials in the garden of health care is the management of nutrition.

This article presents an overview of the problem, and an outline of the true cost.
It all depends … exploring values in health care
Authors: Wall Andrew
Published: May 2014

This paper discusses the experience of exploring values with groups of health service clinicians and managers.

Asking participants to rank a list of six patients has provided a worthwhile opportunity to help them develop their vocabulary for discussing their own values and how these are expressed in their work.
Bureaucratic chaos?
Authors: Maynard Alan
Published: May 2014

The Opposition appears to be so incompetent that the proliferation of bureaucracy in the NHS seems to go unnoticed. Whilst the Scots are going for the abolition of the purchaser-provider split, the English are going for duplication of purchasers (health authorities and primary care trusts) as well as acute trusts and workforce groups: the latter may be a rest home for exhausted managers!
Shadow Health Secretary announces slim and shadowy policy
Authors: Halpern Stephen
Published: May 2014

One of the best guarantees of good government is good opposition. The announcement by Shadow Health Secretary Dr Liam Fox of the Conservative Party's new health policy falls far short of offering any serious alternative to government policy.
Nurses and nursing: influencing policy
Authors: Harmond Kate
Published: May 2014

The publication of this very readable book is timely, as nurses and nursing are seen to be playing such a central role in national health policy through the modernisation of the NHS.
New beginnings for old
Authors: Halpern Stephen
Published: May 2014

One of the most difficult things is to detect profound social change when it is actually happening.
Adverse events or patterns of failure?
Authors: Higgins Joan
Published: May 2014

Why do organisations set up to protect sick and vulnerable people sometimes do them harm?

We now have a mass of data, from a series of Enquiry Reports, which illustrates that there are typically 6 conditions present when serious failures of care take place in the NHS.

This article suggests that it may be misleading to refer to them as ‘adverse events’ or ‘untoward incidents’ when clear patterns of failure can be identified.
The New Jerusalem in the ‘information age’ …
Authors: Harvey Trevor
Published: May 2014

‘Health is a huge market, and broad enough in concept to encompass the kind of interactivity that will be required to repay the initial investment’
Major challenge of NSF for older people
Authors: Halpern Stephen
Published: May 2014

Perhaps history will eventually explain the shameful treatment of elderly people in the latter half of the 20th century.
Public involvement in primary care
Authors: Beenstock Jane , Tyler Suzanne , Evans Martin
Published: May 2014

Public involvement is widely discussed and acknowledged to be ‘a good thing’. However, when we unravel what exactly we mean by public involvement and what is being done in its name, examples of good practice seem few and far between. This article looks at possible approaches.
What, no magic bullet? Reflecting on record reform
Authors: Sang Bob
Published: May 2014

This month's Provocations feature is inspired by a recent series of seminars with the prominent American thinker Dr Stephen Pollak on transferable learning via individual medical records and its potential application across health and social care in the UK.
W(h)ither the private sector?
Authors: Maynard Alan
Published: May 2014

The ‘blessed’ Margaret Thatcher argued that if her internal market reforms had succeeded, the NHS would be efficient and there would be no need for the private sector. Her reforms were meant to reduce waiting lists and waiting times; and the effect of this would have been that, unless punters wanted to go for the superior hotel facilities and ‘smooth’ doctors in the private sector, the demand for private care would have withered.
Myopia and longsight
Authors: Cowper Andy
Published: May 2014

Life's certainties seem to be growing at an exponential rate. To death and taxes, we can now add ‘reality’ television shows and greater involvement of the private sector in managing the NHS. Actually, these two could be combined in an entertaining and doubtless profitable manner.
When the whips come down
Authors: Halpern Stephen
Published: May 2014

The last-minute, pre-election changes in the Health and Social Care Bill might be far more significance than first appears. In themselves, the changes were relatively minor.
Assembly-line medicine, or ‘any colour, so long as it's in the black'
Authors: Roth Andrew
Published: May 2014

You would not expect someone with seven doctors in the family, including three consultants, to come out for assembly-line medicine. But I'm considering it. It is because of the reaction of my optician when i told him that, like my mother at the same age, I am troubled with cataracts. He snorted, ‘If I put your name and condition forward, they will say,‘Come back in 18 months’ time when the situation is much more seri-ous When I asked what the cost of a private operation would be, he said,‘It was £1,000 an eye when I last asked at Whipps Cross!’
Sweden today, Britain tomorrow?
Authors: Woods Kevin J
Published: May 2014

In the context of the UK Government's concordat with the private sector in England, this paper describes some recent policy initiatives to privatise the delivery of hospital clinical services in Stockholm. Are there lessons for the development of health services in the UK? Could what is happening in Sweden today happen in Britain tomorrow?
Assessing the satisfaction of health service users
Authors: Green Gill , Glover Lucy , Doe Linda
Published: May 2014

The satisfaction of health service users is an increasingly important concern to service providers, yet there is little guidance about how it should be assessed. This study compares three different methods of collecting service users’ views (postal questionnaire; face-to-face interview; focus groups) to identify the strengths, weaknesses, usefulness, and what the service user thinks of each method.
NHS reform: real change to follow the new rhetoric?
Authors: Dewar Steve
Published: May 2014

This month's Provocations feature looks at the content of Secretary of State Alan Milburn's speech launching the Modernisation Agency. What does it all mean?
Big Brother: guarding internet use and abuse?
Authors: Harvey Trevor
Published: May 2014

‘ We are on the mere fringes of the information age. Our policies today will set a trend for tomorrow.’
Planning for key changes to employment law
Authors: Exten-Wright Jonathan , Hannon Jane
Published: May 2014

New laws governing employment conditions are coming into effect this year. We take a topical overview of the area.
Pilot assessments for Primary Care Groups
Authors: Royce Robert , Needle Gary
Published: May 2014

This article examines the pilot strategy used by Brighton and Hove Primary Care Group (PCG) to reflect on its own deficiencies and efficiencies. How can primary care organisations best go about self-assessment?
Medical Assessment Units: a realistic solution?
Authors: Wald David , Batty Kenneth , Dewhurst Graeme , Holman Roy
Published: May 2014

The number of medical admissions to hospital is increasing inexorably year-on-year. Pressure to develop strategies that either avoid or alleviate the effects of this trend has lead to the development of Medical Assessment Units (MAUs). Whether MAUs can achieve reductions in acute medical admissions to hospital and improve the efficiency of acute admission procedures remains to be demonstrated.
EPR review: Elan Technologies’ Oasis software
Authors: Harvey Trevor
Published: May 2014

Everybody is aware of the importance of the computerisation of patient records to achieving a modernised health service. Yet the NHS’ record on IT implementation to date is poor. We review one of the new electronic patient record (EPR) formats, and look at its adaptability.
Leasing within NHS Trusts: getting the gains
Authors: Kontzle Geoff
Published: May 2014

With the growth of operating leasing within NHS Trusts, the potential pitfalls of entering into such agreements are becoming more apparent. Increasingly, NHS Trusts are calling upon the services of experienced advisors who can guide them through the ‘cradle-to-grave’ approach: necessary to not only evaluate competitive leasing bids but also the ‘whole-life’ cost implications.
Post-electoral tension
Authors: Baker Mark R
Published: May 2014

While there are many advantages in reaching the other side of a general election with practically no political change, not least a sense of continuity and the relative dearth of new policy initiatives, one is left with a certain unease about the Government's long-term intentions for the National Health Service.
New primary care, new information resources
Authors: Crouch Peter , Ingledew Terry , Thacker Mike
Published: May 2014

The need for clinicians and managers to keep up-to-date and to work efficiently requires a new approach to information management and practice support. We examine a new information tool aimed at primary care.
Funding issues in Hepatitis C: the cost-benefit ratio
Authors: Madden Vicky
Published: May 2014

Our cost-effectiveness eries considers the potential challenges of treating a significant rise in the rate of Hepatitis C infection.
Women's cancer screening: time for some honesty
Authors: Lea Ruth
Published: May 2014

This month's Provocations looks at the costs and benefits of cancer screening for women. Is the screening system letting everybody down?
Who cares about P-PPs anyway?
Authors: Bell Andy
Published: May 2014

Since the day Labour returned to power with a barely-dented majority last month, few public policy topics have been the subject of so many column inches in the national press than public-private partnerships (P-PPs).
The Oregon Health Plan: rhetoric, rationing & reality
Authors: Oberlander Jonathan , Marmor Ted , Jacobs Lawrence
Published: May 2014

The call for more explicit and systematic priority-setting and rationing of what health care should be provided free is not uncommon. This article considers the implementation of such a scheme in the USA.
Managing chronic renal disease: the patients’ view
Authors: Grace John , Statham Timothy
Published: May 2014

As the modernisation agenda proceeds towards creating a more patient-centred service, we examine a survey which considers how renal patients perceive the management of their conditions.
Ups and downs, ins and outs
Authors: Bell Andy
Published: May 2014

Another summer, another silly season. Not surprisingly, considering the high political profile the service has ‘enjoyed’ in recent months, there has been plenty of news, or at least news coverage, about the NHS during the past month or so. Looking at it all together, though, it would appear that the health service is travelling in a thousand different directions all at the same time.
Working with the pharmaceutical industry
Authors: Brzezicki A J
Published: May 2014

This month's Provocations suggests that the involvement of pharmaceutical industry support in the NHS should be seen as a good thing, and indeed as a way to maximise outcomes for patients.
Contracting out of expansion
Authors: Cowper Andy
Published: May 2014

Myths abound in the commentary on the management of health care. Motivated by politics, prejudice and personalities, they can successfully render opaque trivial or serious developments. They provide easy narratives for the incurious and the lazy.
Milburn's bump from Brown's glass ceiling
Authors: Roth Andrew
Published: May 2014

My recent visits to the Members’ Lobby have, unfortunately, not coincided with those of Alan Milburn. I have not therefore been able to see just how he conceals the bump incurred when he came full tilt into contact with the Brown glass ceiling. I hear his spin doctors have concealed it by acclaiming his three-head meeting with Tony Blair and Gordon Brown as a triumph for the ‘foundation hospitals’ favoured by Blair and Milburn.
Monitoring national clinical outcomes: a challenging programme
Authors: Vallance-Owen Andrew , Cubbin Sally
Published: May 2014

This article considers the myriad challenges involved in implementing a national clinical outcomes programme.
NHS managers’ new code of professional conduct
Authors: Wall Andrew
Published: May 2014

The Department of Health's new Code of Conduct for NHS Managers is reviewed and its crucial differences from the Institute of Healthcare Management code are considered.

A symbolic gesture, or something more?
Career progression pathways in radiography: a sociological enquiry
Authors: Henwood Suzanne , Benwell Martin , Palarm Tim
Published: May 2014

There is evidence to suggest that universities and the NHS are experiencing difficulties in recruiting and retaining diagnostic and therapeutic radiographers. This paper investigates the issues that influence individuals initial choice of career and subsequent progression within the profession.
A pound of flesh
Authors: Harvey Trevor
Published: May 2014

Prince Charles, you will recall, was recently outed for his penchant for writing to Ministers (Prime and otherwise) complaining about various aspects of modern British life. One of his gripes concerned our so-called ‘compensation culture’.
On incomprehensibility and safety
Authors: Maynard Alan
Published: May 2014

This year, the Department of Health in England has blessed us with over 400 press releases announcing and re-announcing old and new initiatives. Our good friend Golden Wonder (Nigel Crisp) sends us weekly newsletters about plans to decentralise the NHS by increasing central control of all aspects of NHS employees’ activities (have you filled in your tick-box survey on bodily functions yet?). We all strive to avoid paralysis by poor analysis.
Clinical directorates: stakeholders’ knowledge
Authors: Dunnion Mary , Dunne Elizabeth A
Published: May 2014

Achieving the goal of clinicians-in-management operationalised in the ‘clinical directorate’ structure, requires a more systematic, research-based approach to change than is usual in health care management.

We describe the pre-intervention knowledge and expectations of clinical directorates of representatives of the professions most affected by the move to a directorate structure, and note key issues that can impact on its successful introduction.
The public's perception of GPs: policy implications
Authors: Thomas Meurig , White Sara , Chmielowski Richard , Rowlands Gill
Published: May 2014

This article looks at using the of the Importance-Performance analysis (Martilla & James, 1977) to capture the public's perception of their family doctor services . It considers whether this is a model to inform the directional policy for primary care organisations.
A matter of life or death
Authors: Harvey Trevor
Published: May 2014

When Chester curate Joanna Jepson combed through records of late abortions, she was eager to demonstrate an example of the breaching of an ethical code which, as a practicing Christian, she shares with many who do not express a specific personal faith; namely, the right to life.
Silence is golden
Authors: Ainsworth Steve
Published: May 2014

I'd w orked for the NHS for some ten years before I had risen through the ranks sufficiently high enough to make a pilgrimage to the offices of what was then the Regional Health Authority. When I did, I was shocked.
Best wishes for a challenging 2004!
Authors: Maynard Alan
Published: May 2014

Well, here we are in 2004 and the General Election in 2005 is now getting very near. As New Labour clear the decks to pursue a third term, what are the health care challenges?