bluuebunny/crossref_metadata_2025 huggingface dataset:
Professional integration of APs via critical incident technique
Authors: Jones Colin , Waller Caroline
Published: May 2014

It is unquestioned that the assistant practitioner (AP) is a valuable member of the healthcare team; however, some APs have reported challenges in being accepted into their roles. Using a critical incident technique, a purposive sample of 5 assistant practitioners took part in a study, which explored their experiences of working within a multidisciplinary team. More specifically, the objectives of the study were to identify examples of good practice and also to uncover those areas that could be improved. Four key themes emerged from the data:

Being acknowledged Professional put-downs Role ambiguity Expectation boundaries

Despite being small-scale, the study concluded that the integration of the AP role is fraught with challenge. The study also concluded that the critical incident technique (CIT) is a valuable method when undertaking research in this area.
Poor care of the elderly —is it inevitable?
Authors: Mullen Chris
Published: May 2014

This article provides an overview of the findings of an inquiry into the human rights of older people receiving home care. This article focuses on the findings related to the care provided by home care workers and how it resonates with recent findings in the NHS by the Care Quality Commission. Human rights principles and the NHS Constitution values are discussed as a reference framework for care workers to use in their everyday working practices.
The support worker's role in advocacy
Authors: Stonehouse David
Published: May 2014

Within this article, the author will be examining the support worker's role in advocacy, looking at exactly what advocacy is and what being an advocate means. Who should be an advocate, and when you should not be an advocate? The importance of communication to the process and the ultimate aim of the client becoming a self advocate and the formation of self-advocacy groups will be discussed.
Sexually transmitted infections (6/6): genital warts
Authors: Collins Emma
Published: May 2014

Poor sexual health has a profound effect on the individual and on society. This series of articles has explored epidemiology of, and testing for, sexually transmitted infections, as well as examining chlamydia, gonorrhoea and syphilis in more detail. This, the final article in the series, will look at genital warts. We will consider the epidemiology, aetiology, signs and symptoms, the impact upon the individual and treatment choices. The role of the healthcare assistant and assistant practitioner (HCA and AP) in supporting people with this infection, and promoting sexual health, will be discussed.
Clinical observations 1/6: assessing body temperature
Authors: Peate Ian , Wild Karen
Published: May 2014

This is the first article in a series of 6 that focuses on clinical observations. The healthcare assistant (HCA) and assistant practitioner (AP) must ensure they employ effective infection control practices and have the ability to record and report findings in line with local policy. This article details the why, when, how, what and where of temperature-taking. A discussion concerning thermoregulation is offered, providing the HCA and AP with an understanding of how body temperature is maintained between narrow ranges. Factors that impact on body temperature are discussed and a conclusion is offered.
Falls prevention: assessment and intervention
Authors: Nazarko Linda
Published: May 2014

Falls prevention is a core function of care. Certain groups of people are at great risk of falls while others are not. Assessment is vital because it enables staff to identify who is at risk of falling and work out why the person is falling. Staff can then work as a team to treat risk factors and reduce a person's risk of falling.
APs in the nursing home: caring for those at the end of life
Authors: Smith Joanne , Brown Trish , Powell Michelle
Published: May 2014

Palliative and end-of-life care must be a multidisciplinary approach and can be delivered in a range of settings. As the population ages, many older people who need palliative and end-of-life care may receive this care in a nursing home. The place a person spends their last few days varies, with most people wishing to die at home, whether that be living and dying in their own home or in a nursing or residential home ( Age UK, 2010 ; Munday et al, 2007 ).

The final article in this series of 4, with the 3 former looking at hospice care, hospice at home and day care ( Brown and Smith, 2012a , b , c ), will explore the role of the assistant practitioner (AP) in this environment. It will look at the way in which services are responsive to an ageing population and the issues of ageing, also the importance of creating a workforce that can meet this need.

Furthermore, consideration will be given to the importance of good-quality care at the end of a person's life within a nursing home setting. Legal and ethical issues will also be examined. There will also be examination of the course that has been developed around end-of-life Care, and comments from a student about her experience.
Article 6: caregivers: past present and future
Authors: Barber Chris
Published: May 2014

This last article in this series on ‘informal caregivers’ will recap the major themes and issues highlighted throughout this series, briefly visit where caregivers are now and attempt to discern what lies in store for caregivers in the years to come.
Continence series 5: managing urinary incontinence
Authors: Nazarko Linda
Published: May 2014

The person with urinary incontinence can feel embarrassed and ashamed. The person can become depressed and feel that life is not worth living (Aguilar-Navarro et al, 2012). Staff caring for people with urinary incontinence should ensure that when urinary incontinence cannot be treated it is managed well. This requires great sensitivity and skill, but the rewards in enabling the person to avoid complications and experience the best possible quality of life are among the reasons many chose to work in healthcare.

Providing quality continence care enables the person with continence problems to maintain dignity and avoid complications such as skin damage, leakage and embarrassment. This makes a huge difference to a person's quality of life.
Mentorship in action for healthcare assistants
Authors: Hayes Catherine
Published: May 2014

The process of mentorship has become one of the most topical issues in healthcare practice in recent years. This article addresses the contextual significance of the mentoring relationship alongside the core developments in relationship between the mentor and mentee. Emphasis is placed on the need to manage time effectively. The definition of what professional practice within the context of mentorship actually means is also explored.

The implications of effective communication to the mentoring relationship are also discussed and key characteristics of a mutually beneficial mentorship relationship are defined.

The documentation and record-keeping process is also highlighted as a mechanism by which processes of governance can be adhered to in formalising the mentoring relationship. The article ends with a brief resumé of how feedback on the mentorship process can provide the degree of critical reflexivity necessary for professional development as a healthcare assistant and also the significance of a contextual significance analysis of what has been achieved during the relationship.
Listening to patient stories: an essential skill of nursing care
Authors: Megson Denise Yuen
Published: May 2014

This article explores the learning that can be obtained from patients' experiences. Some of the experiences are positive as well as negative. Using the ‘six Cs’ as a framework, it demonstrates how HCAs have opportunities to learn from others' good and bad experiences. This way of involving patients could be built into the quality-of-care measures.
Men's health series 1: a simple introduction
Authors: Barber Chris
Published: May 2014

Men make up nearly half (49%) of the UK population, so why do some men apparently find it so difficult to access and engage with both their own health and healthcare services? This article is the first of a series of articles on men's health. It will cover the reasons for and outline the contents of this series, as well as introducing a number of its ‘fictional’ participants, from ‘Andrew’ to ‘Zoe’.
Soothing sounds: reducing agitation with music therapy
Authors: Clare Moira
Published: May 2014

People with dementia may display agitated behaviours that staff may not understand. At St Peter's House, a person-centred approach is taken and behaviours are seen as a resident's attempt to communicate. Rather than take a pharmacological route—only used when all else has failed—the care home adopts a range of non-pharmacological methods and complementary therapies to provide stimulation and reduce agitation.

One of the most popular therapies among the residents is music, whether recorded or live, especially when it includes them in singsong sessions. Using various measurement tools has shown that this music therapy can increase wellbeing and interaction of these residents and reduce stress and ‘problem’ behaviours, without pharmacological intervention.
Disability discrimination in the 21st century: a short introduction
Authors: Barber Chris
Published: May 2014

As a result of the Paralympic games held in England during the summer of 2012, it was hoped by many with a disability that disability discrimination would be consigned to the pages of history. This article sets out to present a number of definitions of disability and discrimination, along with reasons for a series of articles on disability discrimination.
Another worthy, but fated attempt at a public health prescription?
Authors: Blatt Barry
Published: May 2014

This article examines the Acheson report within the context of the development of public health over the last decade. In particluar, it asks whether public health initiatives can be anything other than budget and time devouring ogres.
Merger mania - politics before patients?
Authors: Wall Andrew
Published: May 2014

The recent spate of mergers is part of the latest attempt to improve the NHS through reorganisation. But are the expected benefits being delivered? Is patient care really going to improve? And has anyone accurately assessed the cost?
Essay criticises reorganisation
Authors: Halpern Stephen
Published: May 2014

‘Moving the deckchairs on the Titanic’ has often served as a quick and easy description of NHS organisational change. Not without good reason either, since, despite the almost continual state of reorganisation since 1948, we are yet to see a service capable of delivering its original goals.
Great expectations - learning from Coughlan
Authors: Best Richard
Published: May 2014

In years past many judges were reluctant to intervene when substantive promises to patients were broken, for sound reasons, by health care providers. The recent Coughlan ruling, however, has moved the law on. This article identifies some of the practical issues arising from it and ways managers can reduce the consequent litigation risks.
Post-revolutionary era for the NHS?
Authors: Roth Andrew
Published: May 2014

My consultant cousin in Leeds will be happy. He complained about the NHS changes when we dined recently:‘It's been like a Trotskyist permanent revolution...’ All that seems to be receding. After the T o ry ‘revolution’ and Labour's ‘counter-revolution’, the continuing Parliamentary pillow fight will become somewhat of a side-show. The Tories’ terrier-like spokesman, Dr Liam Fox will continue to nip at the heels of the new Health Secretary, Alan Milburn. And Milburn will try to rub his face in all the past Tory inadequacies, real and exaggerated. But Dr Fox's bites and sound-bites are not taken seriously by those who see a Tory comeback still seven years away.
Consultants appraised by trust's pilot scheme
Authors: Stamp Malcolm , Sanger Jack
Published: May 2014

This paper outlines the piloting of an Appraisal System for consultants at the Norfolk and Norwich Health Care NHS Trust. Now into its second year, the system comprises a 360° approach to the full range of aspects of a consultant's professional practice.
Last minute advice to ease those bugging fears
Authors: Harvey Trevor
Published: May 2014

It's official! The British need not fear the Year 2000 computer anomaly (a.k.a. the Y2K bug). The government has sealed the exits, patched up the leaks and our nation has, apparently, cracked it! Margaret Becket has declared it in the House and her statements are reinforced through the national leafleting campaign running from early November.
Preparing for the day the Health and Safety Executive descends...
Authors: Cooper Neil
Published: May 2014

This article outlines the role, statutory powers and penalties the Health and Safety Executive has, and what steps trusts should be taking to avoid non-compliance.
Lessons in collaboration and joint purchasing at the locality level
Authors: Peckham Stephen
Published: May 2014

This article reports on a recent study examining joint purchasing at the locality level and identifies lessons for emerging Primary Care Groups.
Commission resurrects welfare state
Authors: Halpern Stephen
Published: May 2014

Policy Editor Stephen Halpern examines recent health strategies, tackling the thinking behnid them and the implications for the NHS.
Evidence base favours mix ‘n’ match method
Authors: Moloney Rhona , Chambers Ruth , Macleod Nicky
Published: May 2014

This paper seeks to identify lessons from the previous primary care commissioning processes of Fundholding, Locality Commissioning (LC) and Total Purchasing Pilots (TPPs) in order to inform the development of PCGs.
Thin end of charges wedge
Authors: Halpern Stephen
Published: May 2014

Concern that the increase in charges for treatment to road traffic patients was going to be the thin end of a very long wedge is justified by evidence from the Department of Health to the Commons Health Committee.
Whatever happened to the consumer revolution?
Authors: Maynard Alan
Published: May 2014

The Ministers issue ponderous, well meaning statements written by bored and cynical civil servants about the ‘importance’ of the consumer in the NHS. But how seriously are these smooth statements of intent when the NHS is dominated by professions that all too often seem intent on running the Service for their own benefit.
The rhythm of quality management
Authors: Holt Peter R
Published: May 2014

This article draws on Welsh experiences to outline potential operational arrangements for clinical governance. It seeks to identify ways in which appropriate systems can be firmly embedded within day to day management.
The road to wellville
Authors: Lilley Roy
Published: May 2014

If the NHS cannot manage the demands made of it, then the demand must be managed. But how? What about making less money available and rewarding the well instead of the ill?
BOOK REVIEWS
Authors: Walker Robert
Published: May 2014

It took me about a year to eighteen months after I first became a GP to feel the full effect of ‘demanding patients’. The effect was subtle. Initially a feeling of frustration at the end of a busy surgery, a degree of general irritability and then, imperceptibly, a converging of my views of patients with those of the complainers and moaners who fill the pages of the tabloid medical press. It was at the point that I was thinking that this general practice lark was not for me and that I should return to the shelter of hospital medicine that I was rescued.
Making incisions into governance decisions
Authors: Harrison James
Published: May 2014

If clinical governance is to actually improve patient care, the potential confusion concerning individual and organisational responsibilities must be avoided. This article models these new and complex lines of accountability from an operational perspective.
‘Six of the best’ for the NHS?
Authors: Stone Malcolm
Published: May 2014

Last month the Government published its controversial clinical and high level performance indicators and took another important step down the road impelled by the disaster at Bristol. But Widdecombe doesn't sound like she is reading the last rites to the NHS, she links its problems to its successes rather than any failures. ‘Medical science is now capable of things that were complete sci-fi to Beveridge and Bevan.
Cookies part II - privacy pirates or useful utilities?
Authors: Harvey Trevor
Published: May 2014

Last month, I introduced the ubiquitous cookie, that fragment of code a visited server may leave on your hard disk to configure the site in your browser to match your preferences. In this month's column, we will consider further implications of these calling cards.
New era requires new powers for managers
Authors: Bosanquet Nick
Published: May 2014

Health care is entering a new phase and new, innovative ways of thinking need to be found to meet the new challenges. This article insists that the NHS must change and give managers new powers to use private providers more effectively if it is to deliver its goals.
Ethics vs economics
Authors: Stone Malcolm
Published: May 2014

The 1990s will be recorded by future health historians as a decade dominated by one question: how to fund long-term care? The debate took centre stage again last month when the Court of Appeal ruled on the landmark case of R v North and East Devon Health Authority, ex parte Pamela Coughlan. Although the judgement has not resolved the complexities responsible for much of the current confusion, it has, in effect, issued an ultimatum to the politicians in Whitehall to do so.
A review of child mental health services
Authors: Padki Kishor , Bywaters Jenny
Published: May 2014

Fragmentation and haphazard development are common features of mental health services for children and adolescents. This paper discusses the role of Birmingham Health Authority in developing a strategic framework for a comprehensive child and adolescent mental health service.
Managing by design: a platform for best practice
Authors: Tyler Suzanne
Published: May 2014

The Institute of Healthcare Management, formed just a year ago by the coming together of the IHSM and AMGP is celebrating it's first birthday with an innovative, mould-breaking annual conference.
Could ‘economic migrants’ add value to the NHS?
Authors: Bell Andy
Published: May 2014

Recent statements by politicians have indicated that none of the heat has gone out of the immigration debate. Andy Bell of The King's Fund sheds some light on some more productive approaches to the discussion.
Rolling back the state's role: who is responsible?
Authors: Bell Andy
Published: May 2014

As Parliament returns, Andy Bell of The King's Fund examines recent shifts in the positions of both major parties with regards to the provision of the welfare state.

The fundamental questions come around again like Christmas shopping: who pays, how and why?
Health economics, pragmatics and theatrics
Authors: Williams Alan
Published: May 2014

The ‘Provocations’ series returns to a former subject: the perception of health economics by medics.

This article takes as its starting point the programme of a recent conference organised by Dr David Kernick, author of May's ‘Provocations’ piece.
The year of The NHS Plan: a review of 2000
Authors: Webster Charles
Published: May 2014

Charles Webster casts an experienced eye over the course of events in health care over the past year.

The political and legislative movements of 2000 have been substantial, and just might lead towards grounds for cautious optimism.
Let me show you the way
Authors: Harvey Trevor
Published: May 2014

‘Information, like the ignorance it is designed to negate, predates technology’
The Alliance's modest proposal, or ‘It takes two to quango’
Authors: Halpern Stephen
Published: May 2014

When the Minister of Health orders his foreword to be ripped out of your policy document just prior to publication, you know you must be doing something right. So the NHS Alliance must have been greatly comforted by John Denham’s act of minor vandalism on their report, Implementing the Vision, especially as it guaranteed a high degree of media attention.
‘OFSICK’ to build a five-star NHS
Authors: Roth Andrew
Published: May 2014

Idon't know which journalistic vision of the Blair-Brown upgrade of the NHS amuses me more: the suggestion that the inspectorate should be called ‘OFSICK’ or that healthcare Trusts should be star-graded as if they were French hotels.
Ten steps towards organisational reform
Authors: Royce Robert
Published: May 2014

The ongoing nature of the process of organisational development and reform in the healthcare field is a given for observers of the NHS. Here is an overview of a possible strategy for the implementation of recent reforms in Primary Care
Measuring and modernising management
Authors: Maynard Alan
Published: May 2014

The Prime Minister wants to ‘modernise’ the NHS, and scolds managers for not implementing change faster. NHS managers are required to hit four or five dozen ‘targets’, of which it is assumed that waiting time and financial balance are the most important. Can NHS managers spend the Budget bonus efficiently?
E-security: implications for the internet
Authors: Barnett Steve
Published: May 2014

The importance of making electronic information secure will be paramount with the advent of Electronic Patient Records. This article considers the importance of having prepared adequately for the possibility of disruption.
Managing the deluge
Authors: Harvey Trevor
Published: May 2014

‘Time is not only money, it is the one thing of which we cannot manufacture more’
Extra patients should be stamped ‘Courtesy of the Women's Institute'
Authors: Roth Andrew
Published: May 2014

It would be suitable if the extra patients treated in the future by the NHS, whether in NHS hospitals or in private operating theatres, were stamped with ‘Courtesy of the WI’. So powerful was the impact of the Prime Minister Tony Blair's disastrous appearance before the WI conference at Wembley that the re-gearing of the NHS' throughput was advanced a decisive notch further.
EPRs: bridging health care into the 21st century
Authors: Harvey Trevor
Published: May 2014

Can the electronic patient record (EPR) change the way we work? Surely, something has to. Our present attempt to organise a cohesive, comprehensive lifetime record for the health service user is creaking and shambolic. We preach an interdisciplinary team approach to care: we practice a disjointed, hierarchical hiving-off of the tasty bits to the most powerful players.
Fox hunting foreigners’ fraud of the NHS: summertime, and the living ain't easy ...
Authors: Roth Andrew
Published: May 2014

I was vastly amused by The Times' week-long front page campaign (The Times, 2000) against the foreigners allegedly defrauding the NHS at the expense of British taxpayers. August is a slow month for news. Additional glee came from seeing Dr Liam Fox, William Hague's health spokesman, joining in like a young cub who had suffered a lobotomy.
New guidelines on managing violence
Authors: Bhui Kamaldeep , Outhwaite Jacqueline , Pereira Stephen , Strathdee Geraldine , Adzinku Francis , Dixon Paul
Published: May 2014

This paper examines the introduction of a new system to assist in the management of violence in a psychiatric in-patient environment. Challenges and successes in the implementation of clinical effectiveness guidelines are honestly discussed and presented, with important lessons about change management.
Reflection: a broken modem and internet-addiction
Authors: Harvey Trevor
Published: May 2014

‘the pattern of behaviour we are exhibiting is more a predictable response to the present spectrum of here-today-gone-tomorrow commercial alternatives, than a guided consequence of rational applications of technology. ’
Local health groups: a distinctly Welsh approach
Authors: Elliott Doug , Jones Ian
Published: May 2014

An Audit Commission briefing published last year on the progress of local health groups in Wales during their first year of operation reported a promising start on a distinctly Welsh agenda.
An inspector calls on health care management
Authors: Edmonstone John
Published: May 2014

“If there has to be a choice between being advisers to professional colleagues and inspectors, monitors or critics on behalf of the wider society, that wider society will without doubt come down on the side of an inspectorate.”
Lies, damn lies and health care outcomes
Authors: Kernick David
Published: May 2014

The ‘Provocations’ series welcomes the new millennium with a modest proposal.

Dr David Kernick looks into outcomes, and comes out with a novel method of assessing added value in health care.
Policy and other fun
Authors: Cowper Andy
Published: May 2014

Computers speak, and are spoken about, in a very particular language. Software development made use of two phrases that might have some bearing on the several reorganisations of health service management.
The two-nation search for cataract operations
Authors: Roth Andrew
Published: May 2014

By coincidence, we were talking about cataract operations just as Alan Milburn was deciding that NHS patients could have their operations abroad. I was talking to the famous exiled Iranian writer and film director Ebrahim Golestan, whom I first met in Tehran when he was the 25-year old editor of its Tudeh newspaper and I was a 27-year old foreign correspondent.
What if it had been us, not the US?
Authors: Harvey Trevor
Published: May 2014

This has been a month for navel-gazing. By the time you read this, it's to be expected that post-Manhattan events will have gathered the inevitable momentum that follows the public humiliation of a superpower on global TV. As we ruminate about the Twin Towers fall-out, we have probably all wondered,‘What if this had been Canary Wharf and not New York; Portsmouth Dockyard instead of the Pentagon?’
Izzy, whizzy, let's get busy! Is Sooty alive and well in the NHS?
Authors: Maynard Alan
Published: May 2014

Is Sooty alive and well in the NHS?
Communication breakdown
Authors: Cowper Andy
Published: May 2014

Many of you will have had the special pleasure of dealing with the Media Centre at the Department of Health. Founded in 462 BC and designed by a committee including Franz Kafka, Robert Maxwell and Eddie ‘The Eagle’ Edwards, it is as strange and sinister as the concrete exterior of Richmond House.
Treasury review to anticipate the next generation of health care needs
Authors: Halpern Stephen
Published: May 2014

As there appears to be no obvious purpose in the Treasury Review of long-term health trends, one can only conjecture as to why the former chief executive of NatWest Bank, Derek Wanless has been asked to reinvent the wheel.
Business process re-engineering: lost hope or learning opportunity?
Authors: Powell Alison E. , Davies Huw T.O.
Published: May 2014

In the 1990s, business process re-engineering (BPR) sparkled for a while as a means of transforming health service performance. While many of the implementation projects report more modest gains, there remains much to learn from the approach. The recent emphasis on developing patient-focused services has seen a re-emergence of some of the key ideas of BPR.

This article argues that we should reflect on the learning experience offered by BPR experiments in the NHS to inform current modernisation reforms.
GPs' Personal Development Plans: appraisal & revalidation
Authors: Rughani Amar
Published: May 2014

In the near future GPs will face the introduction of appraisal, following which they will be required to meet the needs of revalidation.

How doctors will prepare for these challenges has yet to be determined, but a mechanism that is coherent and feasible is urgently required.

Using the experience of GP tutors in Sheffield, where Personal Development Plans (PDP) have been successfully introduced, a model based on the PDP is described.
Beware the weekend and mandarins
Authors: Maynard Alan
Published: May 2014

Would you organise the fire brigade or the police service on a five-day week? Such a notion is laughable: fire and burglars are just as likely to strike at the weekend as during the week.
Minus points of NHS Plus
Authors: Halpern Stephen
Published: May 2014

Last month saw the launch of the latest Health Service profit centre. The occupational health service, NHS Plus, has become the newest jewel in the NHS enterprise crown.
Do the performance tables measure up?
Authors: Harvey Trevor
Published: May 2014

The old quip about surgeons burying their mistakes has long since become a historical anachronism, as the issue about league tables for surgeons has been gathering momentum over the lifetime of the present Government.
Getting help with financing IT for health
Authors: Walters Peter
Published: May 2014

September 2000 saw the announcement of £120 million (200 million euros) of newly released funds in the Fifth Call of the IST Programme. Could you get hold of some free money?

Peter Walters at the Department of Trade and Industry's UKISHELP initiative offers advice and explains why innovative UK organisations should consider bidding.
Implementing evidence-based decisions
Authors: Charny Mark
Published: May 2014

The second in our three-part series of articles looking at the issues of using evidence properly in health care considers the all-important question: how to implement evidence-based decisions.
Leadership, risk aversion & shooting the messenger
Authors: Cowper Andy
Published: May 2014

Who manages the managers? This sounds like a pat phrase, but the changes to the management structures in British health care over the past year have been considerable. The merger of the role of the Permanent Secretary to the Department of Health with that of Chief Executive of the NHS has serious implications for the vertical command structure of the health service, and also for the bottom-upwards representation of managers’ views to those at the peak altitude of command.
Milburn's next-stage permanent revolution
Authors: Roth Andrew
Published: May 2014

When I learned of Health Secretary Alan Milburn's radical plan to cut cental bureaucrats in favour of primary care on the ‘front-line’, I though of two people, as well as of Milburn's early biography.
Wanted: safe pair of hands to manage health care
Authors: Bamford Terry
Published: May 2014

Following our interviews with the representatives of the major parties at Westminister, we feature comments from figures across the health care management community.
NICE: involving managers in key estimates
Authors: Bosanquet Nick
Published: May 2014

In this paper, we set out the scale of the challenge to the National Institute for Clinical Excellence (NICE) in making longer-term estimates of the cost of new drug therapies.

Such estimates are of great importance to local managers and health professionals. They will define the local funding required and set the challenge for local workload.
Managing medical errors: another new mantra?
Authors: Maynard Alan
Published: May 2014

‘about one in 20 hospital admissions were associated with error, some minor and some fatal.’
Masters and servers: battle of the giants
Authors: Harvey Trevor
Published: May 2014

We are fast approaching a birthday. In just a few short months, the IBM PC will be twenty years old. The time is long past when IBM were the main purveyors of that familiar desktop architecture, but the term sticks. I wonder how many readers of this journal can remember the GEM interface? It wasn't always obvious that Microsoft would become the market leader, or that the stand-alone PC would determine how networks and the internet would be configured thereafter.
Treating us like schoolchildren
Authors: Bell Andy
Published: May 2014

More doctors and more nurses; schools and hospitals first. Another election campaign, another period of high-quality debate about the future of UK health policy. Or not. Yet another election campaign where the NHS was debated frequently, yet in a way that generated that venerable cliché: a lot of heat and almost no light. At the end of it, are the public any wiser, or more empowered, than before?
Tony Blair's very own D-Day landing
Authors: Roth Andrew
Published: May 2014

I had not figured Prime Minister Tony Blair as a specialist in deception. However, the way in which he has provoked Labour's trades unions allies over the alleged part-privatisation of the NHS puts him in the category of the D-Day deception geniuses. In 1944, they so deftly persuaded Adolf Hitler that the Allied were going to land in the Pas de Calais area that, at a crucial time, Hitler held back crack Panzers who might have helped push the Allies back into the sea from their precarious footholds in Normandy.
Exporting patients, importing doctors
Authors: Cowper Andy
Published: May 2014

The media will tell you that TS Eliot got it wrong: August is the cruellest month of year. By any standards, this ‘silly season’ has been an intriguing month for health care news. At last, we have had the long-awaited Shifting The Balance Of Power consultation document, about which you will find plenty of comment elsewhere in this issue.
Shifting the shibboleths, shuffling the pack
Authors: Halpern Stephen
Published: May 2014

In spite of all the protestations, Mr Milburn has been unable to resist the temptation to carry out the mandatory restructuring of the English NHS as laid out in Shifting the Balance of Power. It is a temptation that few of his predecessors we re likewise unable to resist.
Thoughts on ‘Shifting The Balance Of Power'
Authors: Bamford Terry , Sang Bob , Bosanquet Nick , Dixon Jennifer , Fermoy Peter , Goodwin Neil , Kernick David , Maple Stuart , Walker Robert , Wall Andrew
Published: May 2014

The sub-heading of the consultative document is ‘Securing Delivery’. When the Government has invested so much political capital and financial resources in securing visible improvements in the NHS, it is by that test that these proposals have to be judged.
Time for a real market?
Authors: Maynard Alan
Published: May 2014

After The Blessed Saint Margaret Thatcher of Assisi chickened out of a real market in health care ten years ago, is Our Beloved Leader Tony Blur's Government on the point of creating a real market by privatising the provider side of the NHS?
The Enlightenment of the NHS
Authors: Cowper Andy
Published: May 2014

Modernising the NHS is a difficult process, and it's arguable that nobody has ever tried it before. Yes, there have been reforms, reviews, and restructurings, from the Griffiths Report to the internal market and GP fundholding. Yet the ambition and proposed scale of the current reforms outstrip these prior attempts.
Research governance: reaching targets
Authors: Stokes Maria
Published: May 2014

This article gives a brief overview of the Research Governance Framework for Health and Social Care. It outlines the various targets that care organisations must achieve by May 2004, and includes practical examples of how research management systems can be implemented.
Complexity in health care continued: on Chaos
Authors: Kernick David
Published: May 2014

‘It is the mark of an educated man to look for precision in each class of things so far as the nature of the subject admits.’ -Aristotle.

This article continues an examination of complexity and Chaos.
Testing the health of modern primary care
Authors: Maynard Alan , Dixon Michael
Published: May 2014

Following their recent debate on BBC Radio 4's TODAY programme, Alan Maynard of the University of York and Michael Dixon of the NHS Alliance have agreed to continue their discussion on the ways forward for primary care in the NHS, and its chances to become the real leader.
Please don't franchise my one-night stands, Mr Milburn!
Authors: Roth Andrew
Published: May 2014

I worry about Alan Milburn. He does not treat one-night stands with enough reverence. Nor does he explain how they can be ‘franchised’. My single personal experience in this field should long have receded into the mists of time, had it not produced a simultaneous orgasm: unusual in my experience in a first coupling. It happened in 1948 in the old, low, mahogany Oriental Hotel favoured by Somerset Maugham and Noel Coward (not Bangkok's modern skyscraper). Returning from a hot day interviewing Laotian and Cambodian aristocratic refugees, I repaired to the hotel bar for a cooling lager. As I finished my drink, the bar's only other occupant, a young lady from the American Embassy, took me by the hand, led me to her hotel room and quickly removed my clothes. I only saw her again once, a year later, across a crowded diplomatic reception. Should I have ‘franchised’ her and operated the ‘franchise’ whenever I returned to Bangkok from Vietnam?
Privatising the supply of health care: evidence, please?
Authors: Maynard Alan
Published: May 2014

Is there a rationale underpinning NHS decision-making about the provision of health care, or are the policy trends merely the product of gurus staggering around in search of enlightenment? A combination of unjustified optimism about the effects of new technologies, in particular day case surgery, combined with a frenzy of Private Finance Initiative investments which shrank the bed stock (in part because of hopes about reductions in length of stay) has led to a large contraction in the bed stock of the NHS. Whilst there were 458,000 beds in 1980, there are only about 255,000 acute beds in the NHS now. in the 1987-97 decade, the available bed stock shrank by 34 per cent, and most NHS managers and successive Ministers did not realise what they were doing.
Heated, unenlightened debate
Authors: Bell Andy
Published: May 2014

The case of Whittington Hospital patient Rose Addis has already consumed a great deal of hot air and newsprint, much of which could have been put to better use elsewhere. At the risk of labouring the point, the case has churned up too many questions simply to be ignored. One issue that has not received a lot of attention, yet which it is illustrates perfectly, concerns the roles of the Health Secretary and his shadow.
Funding options and solutions for ambulance trusts
Authors: O'Brien John
Published: May 2014

This article considers the difficult choices awaiting ambulance trusts in the face of mounting pressure on capital funding.
The parable of the incompetent steward
Authors: Webster Charles
Published: May 2014

The ‘Provocations’ series continues with a little history lesson for the Secretary of State from the NHS’ Official Historian.
The St Valentine's Day Massacre
Authors: Cowper Andy
Published: May 2014

It is possible to remain a little naive in the face of everything that politics can throw at you. We should have expected that something of interest would be slipped out on Saint Valentine's Day. Valentine, as you may know, was a holy priest in Rome, who assisted the martyrs in the persecution under Claudius II. He was apprehended, and sent by the Emperor to the Prefect of Rome, who, finding all his promises to make him renounce his faith ineffectual, commanded him to be beaten with clubs and afterwards to be beheaded, which was executed on February 14, about the year 270 AD.
MMR vaccine and the public health Taliban
Authors: Halpern Stephen
Published: May 2014

The emergence of the measles public health crisis is a direct result of the failure by Health Secretary Milburn to take proper action following the MMR vaccine controversy 12 months ago.
I saw the light
Authors: Baker Mark R
Published: May 2014

You will be pleased to learn that I have seen the light and all has now become clear. It dawned on me like a flash of blinding light, a clarity so obvious that I cannot understand how I could not have seen it before. The Holy Grail is this:
Cancer: are the star signs wrong?
Authors: Halpern Stephen
Published: May 2014

The treatment of cancer is where this Government's performance will ultimately be judged. There is no other area in which the highest standards of treatment has greater importance for the health and well-being of the population.
Vision of the future couched in the past: the Wanless Report in detail
Authors: Halpern Stephen
Published: May 2014

Although the Wanless Report was largely set up as a pawn in the Chancellor's political manipulations, some of the assertions need careful examination in the light of their potential to be accepted as conventional wisdom.
Reforming public sector dentistry in the UK
Authors: Kernick David
Published: May 2014

Converging from disparate disciplines, the study of non-linear dynamics offers a complementary perspective on organisational analysis and is already finding application within health care. Underpinned by the quantitative study of non-linearity (more commonly known as chaos theory), the emerging science of complex adaptive systems draws on metaphors of chaos theory. It moves the emphasis away from analysis, prediction and control to a focus on the configuration of relationships amongst a system's components and an understanding of what creates patterns of order among them.
Nursing - where the greatest waste is?
Authors: Harvey Trevor
Published: May 2014

Following the Chancellor's Budget announcement, speculation on how and where the extra NHS dosh could, and should, be spent has led to horror stories about wanton waste. Tales of reckless, oak-panelled, extravagance have been rife, though in truth, we all know that the pre-exis-tent backlogs and deficits, unpaid bills and inflationary pressures could consume many times the extra cash promised.
Getting off the merry-go-round of change
Authors: Charny Mark
Published: May 2014

This series reflects on the gap between policy as it is made in the centre and policy as it is lived in the trenches.
A new mood?
Authors: Cowper Andy
Published: May 2014

If you are taking your holiday around this time of year, you may end up lazing righteously on a beach or by a pool. As you toy with a paperback and re-apply the sun tan lotion, your relaxed mind may feel free to wander and speculate.
The menagerie of visions
Authors: Charny Mark
Published: May 2014

This series reflects on the gap between policy as it is made in the centre and policy as it is lived in the trenches.
Strategic Health Authorities - the SHAviours of IT?
Authors: Bosanquet Nick , Kitney Richard
Published: May 2014

This article proposes that Strategic Health Authorities will have a key role in the co-ordination and management of modernising information technology in the NHS.
Pharmaceutical industry - friend or foe?
Authors: Cornell John , Kelly Ned , Wilson Robert
Published: May 2014

The Shorter Oxford English Dictionary defines ‘partnership’ as: ‘An association of two or more persons for the carrying on of a business, of which they share the expenses, profits and losses’. This article considers partnership in practice between the pharmaceutical industry and a health authority.
From improvement to audit and inspection
Authors: Cowper Andy
Published: May 2014

Peter Homa, Chief Executive of the Commission for Health Improvement, answers questions on the performance and role of CHI, and on the forthcoming Commission for Healthcare Audit and inspection.
Foundations: proof the NHS is the new BBC?
Authors: Cowper Andy
Published: May 2014

If you have built castles in the air, your work need not be lost; that is where they should be. Now put the foundations under them. Henry David Thoreau Thou shalt raise up the foundations of many generations, and thou shalt be called, the repairer of the breach, the restorer of paths to dwell in. Isaiah 58:12
Should Doctor Fox be snarling at immigrants?
Authors: Roth Andrew
Published: May 2014

In case readers think my preoccupation with Dr Liam Fox, the Tory health spokesman on health, is like my Guardian colleague Simon Hoggart's obsession with Michael Fabricant, it is not. Simon is fascinated by Michael's artificial orange-yellow thatch.
The culture that can kill you
Authors: Harvey Trevor
Published: May 2014

The trial, at Nottingham Crown Court, of Dr. Feda Mulhem, the Syrian registrar held to be culpable for unlawfully killing teenager Wayne Jowett in January, 2001, has finally come to an end. Although the coroner had recorded a verdict of accidental death, Dr. Mulhem was found guilty of manslaughter by the jury, who had heard how the then 35-year-old registrar had supervised a procedure involving the injection of vin-cristine into the spine of Mr. Jowett. After the verdict, the judge released Dr. Mulhem, in the light of his period spent on remand.
Following the money …
Authors: Cowper Andy
Published: May 2014

The proportion of Gross Domestic Product spent on health in the UK is going to rise from the current level of 7.5% to 9.4% by 2007. The 2% GDP rise over the next few years will represent almost £21 billion.
Why are the Gods driving the Tories mad?
Authors: Roth Andrew
Published: May 2014

If it is true that the gods first drive mad those they wish to destroy, then the Conservative Party seems destined for self-destruction in its public dispute over confidence in Iain Duncan Smith, who keeps predicting that he will be the next Prime Minister: something which not even his few loyal supporters believe.
Complementary considerations
Authors: Harvey Trevor
Published: May 2014

Being a fully-paid-up member of the Ramblers Association doesn't confer much status on a man, but it does throw up some surprises. On a recent brisk trudge across a bleakly windswept corner of Norfolk, I was surprised to find myself chatting to a former colleague from my university days. He works too hard and plays too little, and often compares himself to Boxer, the workhorse in Orwell's Animal Farm.
Getting the Bill
Authors: Bell Andy
Published: May 2014

With hours to spare, the Health and Social Care Bill finally passed through Parliament last month when the House of Lords gave way to its elected counterparts in the Commons. The result, of course, is that the first wave of foundation trusts can now begin to prepare for their new status while everyone else watches and waits. For some time.
Performance management in general practice
Authors: Jackson Sue , Bircher Richard
Published: May 2014

Lockside Medical Centre, a general practice in Manchester undertook a performance management scheme that revolutionised a run-down practice into one that is leading-edge. The details (including the hurdles, benefits, drawbacks and lessons learned) are described, so that managers can appreciate the secrets of success when striving for improved performance.
Towards a nurse-led primary care system
Authors: Maynard Alan
Published: May 2014

One of the reasons for the postponement of the announcement of the new General Medical Services (GMS) contract until late February is that the mandarins in Whitehall village wish to publish their “radical”White Paper on the future of primary care. Just how radical will the Whitehall folk dare to be, and how well-informed are their plans?
The bigger picture: how PACS fits into health care I.T.
Authors: Stay Adam
Published: May 2014

As EPR deadlines continue to loom, this article looks at some approaches to introducing Picture Archiving and Communications Systems.
Nursing managers and skills teaching on nursing courses
Authors: Pfeil Michael
Published: May 2014

This article considers how the skill literacy of newly-trained nurses can be bettered.
The Williamson Turn
Authors: Cowper Andy
Published: May 2014

Winston Churchill once returned a memo of Clement Atlee's with the comment, “This document contains every clich except God Is Love and Please Adjust Your Dress Before Leaving.” It's tempting to imagine where mainstream analysis of management would be without the heavy artillery of clichs. The authors of such masterpieces as ‘Teach Yourself Project Management in 24 Hours’ (this is a real book, by the way) would struggle.
Complexity - passing fad, or a new way of thinking?
Authors: Kernick David
Published: May 2014

This article concludes our series on complexity in health care.
The death of nursing (again)
Authors: Harvey Trevor
Published: May 2014

All the recent evidence suggests that nursing numbers are still woefully low, and such figures as we have seem massaged and simulated. For example, there is good reason to think that overseas staff, on which the service now depends, are counted as being on-board statistically when they have just stepped off the plane, and are in the necessary period of acclimatisation and induction which inevitably means they are themselves under supervision, rather than able to act as training supervisors.