bluuebunny/crossref_metadata_2025 huggingface dataset:
Reflections of an HCSW in a specialist palliative care team
Authors: Salvatore Susan
Published: May 2014

This article will explore the role of the healthcare support worker (HCSW) within a hospital palliative care team (HPCT). The aim is to reflect on an intervention with one patient from my practice and also to reflect on the role of the HCSW on the HPCT. I reflected on a 65-year-old patient with end stage endometrial cancer. This reflective writing enabled me to identify how I contributed to her palliative care.

Three themes emerged from this reflection: the importance of empathy, advocacy and communication skills. Empathy is a good basis to develop as a supportive relationship with a patient. Working as an advocate, the HCSW can help the patient make their own views or wishes heard. Both empathy and advocacy rely on the HCSW having good communication skills and the time to spend with the patient.
Clinical skills series/2: enemas and suppositories
Authors: Peate Ian , Gault Christine
Published: May 2014

The varied role and function of the healthcare assistant and assistant practitioner (HCA and AP) mean that they may have to care for people who require suppositories or enemas. The administration of enemas and suppositories is seen as an intimate care activity. Suppositories and enemas are used for a variety of reasons and the technique for each is slightly different.

This article provides an outline of how to care for a person pre-, peri- and post- procedure; it also outlines how to safely and effectively administer suppositories and enemas. In order to do this correctly, the HCA and AP must have an understanding of the lower gastrointestinal tract. The article provides an overview of the lower gastrointestinal tract in order to promote insight and understanding.
A healthcare support worker in interventional radiology …
Authors: Glassby Angela , Roberts Martyn
Published: May 2014

At the 2012 HCA Conference in Birmingham, at the end of the day, conference chair Tanis Hand asked if of the HCAs or APs present worked in unusual sectors. Angela Glassby of Portsmouth Hospital Trust recounted how for the past 7 years she has been working as a Band 3 in the radiology day case unit, scrubbing up and working closely with the consultants on many procedures.

Angela agreed to be interviewed and to talk about her life in healthcare in general, as well as the details of her work in interventional radiology (IR)—one example of the huge range of work undertaken by HCAs and APs in modern healthcare.
Portfolio development for healthcare assistants
Authors: Hayes Catherine
Published: May 2014

Compiling a portfolio as an integral part of professional practice is now an expected norm of continuing professional development for the vast majority of those employed in healthcare settings. The need for HCAs to demonstrate their achievements and to annotate the scope of their development within the clinical and professional environment necessitates the clear articulation of engagement with everyday practice. This article deals with the core elements of portfolio construction and how best HCAs might demonstrate their individual contribution, progressive development and commitment to working with patients and their families and carers; as well as their interaction with peers and colleagues in the context of health.
Unregistered does not have to mean unprofessional
Authors: Banks Sophie
Published: May 2014

The concept of professionalism is one that has become an expectation of healthcare workers. Of greatest difficulty is the definition of professionalism. However, we must attempt to have some understanding of the concept and what it means to us, if we are to ensure our behaviour is professional and recognise areas that may require development.
Being aware of the legal complications around death
Authors: Yeomans Paul
Published: May 2014

As people on the frontline of care, healthcare assistants (HCAs) and assistant practitioners (APs) are closely involved with patients before and after death, from signing a Will to performing the last offices for their remains. The article looks at the law's interest in the patient once they are declared dead, by means of common scenarios for the HCA or AP. Simply by being aware of potential legal problems, the HCA or AP can help point relatives towards help and advice at a time of great stress and grieving.
An introduction to dementia for HCAs and APs
Authors: Nazarko Linda
Published: May 2014

Our society has become more open in recent years, but some subjects remain taboo. Until recently, dementia was one of those subjects. Research into dementia was underfunded, certain services considered it acceptable to deny services to people with dementia and comedy programmes poked fun at people with dementia. Had these statements applied to people with other terminal diseases, such as cancer, there would have been outrage, but dementia was different. It was one of the last taboos, a disease that was rarely spoken of. Now at last, things are changing and there is a new emphasis on early diagnosis and increased support for people with dementia. This article aims to enable readers to understand how dementia affects people, what the causes of dementia are and how it is diagnosed.
The mists of middle age: preventing PCGs from suffering ‘mid-life’ crises
Authors: Bosanquet Nick
Published: May 2014

In middle age, defined generously as between 35 and 65, the development agenda for PCGs must tackle the heavy issues of cost and workload. In the same way that elderly people are the heaviest users of social services and long term care; primary care (and some kinds of acute care) is used heavily in middle age. Ironically, where the gains from prevention would be greatest.
The risk of missing the point of the quest for continuous improvement
Authors: Heard Susan
Published: May 2014

Introducing this supplement on clinical governance, Dr Heard delineates the evolution and thinking at the heart of this innovative approach to health care delivery.
Modernising mental health services: the right ACT for the wrong reason?
Authors: McFadyen John Alexander
Published: May 2014

This article explores the various options outlined in the recently launched mental health strategy.
The basics of effective information management and manipulation
Authors: Harvey Trevor
Published: May 2014

Last month, I described some basic strategies for managing information and avoiding information overload. These included the management of time, filtering of incoming information and setting priorities on tasks. I suggested that time management, information management and stress management were the three legs on the management stool.
HTM 2030 - throwing money down the pan?
Authors: Summersgill Hayley
Published: May 2014

The cost of implementing the imminent European guidelines for washer/disinfectors, outlined in HTM 2030, are likely to be considerable. This article draws on an independent survey carried out at Derby City Hospital in June to find out just how significant.
What to look for in a cleaning contractor
Authors: Smith Peter
Published: May 2014

This article outlines how to manage the outsourcing of your cleaning requirements.
Doctors in the dock - is self-regulation working?
Authors: Baeza Juan I
Published: May 2014

The Bristol case and other ‘dangerous doctors’ stories have dented the public's confidence in health care professionals, and the regulatory mechanisms in place to protect the public have been found wanting. This article argues for a coherent multiprofessional framework for professional self-regulation.
Putting IT procurement policies into practice
Authors: Hoeksma Jon
Published: May 2014

The NHS Executive's strategy document Information for Health set out a series of ambitious IM&T targets. But has its agenda been backed up with the necessary resources? This article looks at how the agenda is being tackled and identifies potential sources of best practice guidance.
Traditional solutions no longer appropriate
Authors: Connelly Peter j
Published: May 2014

Successful clinical governance in mental health can only occur if staff, managers and commissioners are prepared to accept that traditional solutions are not necessarily the most appropriate. Accurate assessment of clinical risk and the development of strong and effective clinical teams with clear leadership, multidisciplinary appraisal and clearly defined implementation plans will help to shape good practice.
Excellence model right tool for management
Authors: Jackson Susan M
Published: May 2014

This article examines why the government has endorsed the European Foundation for Quality Management‘s Excellence Model as the most expedient management tool for implementing its clinical governance agenda.
Editorial
Authors: Bamford Terry
Published: May 2014

Some words cast a rosy hue which makes it difficult to challenge their virtue. Pinker identified ‘community’ as one in his minority report to the Barclay Report on social work in 1982. ‘Partnership’ is another. Who would deny the value of agencies working together? The snag is that rosy words sometimes serve as a substitute for thought and avoid the task of understanding and overcoming the real obstacles to effective collaboration.
Learning positive, professional supervision from social services
Authors: Kearney Patricia
Published: May 2014

Custom and practice in both nursing and social work is being thrown into relief and challenged by the current raft of proposals. This paper suggests that one of the activities to benefit from such cross-fertilisation is professional supervision.
Exploding health care myths - the real threats to public health
Authors: Tremblay Michael
Published: May 2014

For many, the National Health Service can, at times, seem shackled to dogmatic beliefs and steeped in myths. This article seeks out some of the more persuasive of these in an attempt to understand and disarm them.
Great expectations: an end to the Bolam test?
Authors: Owens David , Corcoran Mark
Published: May 2014

With the Service embroiled in a litigious battle for survival, the recent High Court ruling against East Kent Health Authority has serious implications.
Alternative medicine on agenda for unleashed Tory ‘terrier’ Duncan
Authors: Roth Andrew
Published: May 2014

Ann Widdecombe, the Tories' bulldog-like Shadow Health Secretary, has given an extended lead to her tiny, terrier-like deputy, Alan Duncan. In a speech to the Social Market Foundation, Duncan has promised the Tories will significantly extend private health care, backed by tax relief for insurance and health savings plans. He also spoke up loudly about the advantages of alternative medicine, of which he has long been an enthusiast, previously gagged by the sceptical Ann.
Clinical Governance in definition and practice
Authors: McFadyen John , Armitage Claire
Published: May 2014

This, the first of two papers exploring clinical governance in relation to mental health, seeks to define the concept and determine its core principles. Next month, the author deals with operational issues, in particular, the contribution that needs to be made by the trust board director responsible.
Capital games
Authors: Manning Kingsley
Published: May 2014

This article looks forward to how public-private partnerships might be utilised to deliver the new integrated services outlined in the recent White Papers.
Scottish trust project
Authors: Cox Simon
Published: May 2014

Drawing on his experiences negotiating a major PFI hospital deal in Scotland, the author highlights the potential benefits generated and assesses the future role of such schemes in the NHS.
Dr Beck's medical agency and sofa diagnosis
Authors: Harvey Trevor
Published: May 2014

Picture this: Norwich, 2010 A.D. After another bout of chest pain, I am reclining on the sofa in my front room, with a small probe in my ear and an unobtrusive cuff strapped to my arm. My chest is covered with a pad that approximately conforms to the presented contours. On the screen my ECG is displayed and, simultaneously, the significance of its tracing is being ascertained using Cardiak, a web based diagnostic expert system.
PCGs little more than ‘purchasing puppets'
Authors: Shannon James
Published: May 2014

Announcing the results of last year's Comprehensive Spending Review, the government claimed it would save £1 billion in red tape during the lifetime of this parliament. This prize for dismantling the internal market always seemed optimistic, but recent analysis suggests it could end up seriously jeopardising the success of PCGs.
Measure for measure: but who will benefit?
Authors: Caines Eric
Published: May 2014

Eric Caines assesses the NHS Executive's recently published Performance Assessment Framework and asks whether it will prove an effective tool for managers and a meaningful way of satisfying the expectations of the public.
Society failing teens when it comes to sex
Authors: Blatt Barry
Published: May 2014

Why does Britain have the highest rate of teenage pregnancy in Europe? The author sidesteps media bias, instant political prescriptions and deep-rooted prejudices to discover children trapped by a modern society unable to deal with them.
Dr Fox blots copybook with naive and insensitive remarks
Authors: Roth Andrew
Published: May 2014

The Tories' Health Spokesman, Dr Liam Fox is, at 38, the youngest in their Shadow Cabinet. However, even if the Conservatives do return to power in the 2007 — the earliest year likely to date — few see him becoming Health Secretary. He has indelibly blotted his copybook over the role of overseas doctors in the NHS.
Credible compromise the only way forward
Authors: Halpern Stephen
Published: May 2014

Concluding our alternative medicine focus, this article looks possible future roles for the industry within the UK. In particular, how public health may help find that elusive middle ground with the conventional medical establishment.
Common rules - an end to NHS as we know it?
Authors: Greener Mark
Published: May 2014

Everyone seems to agree that increased regulation is needed. Faced with calls from all sides, the government recently launched a consultation document outlining possible changes. But would a common regulatory structure spell the end of the NHS as we know it? Mark Greener investigates.
Total FM: a treatment not suitable for all?
Authors: Bennett John
Published: May 2014

Total Facilities Management (FM) is being hailed as the solution for the 1990s, but is the ‘one stop shop’ treatment the right route for health care management?

This article argues that the sector is too specialist for a total FM approach and recommends a separate focus on hard, soft and specialist FM divisions as the way forward.
Reading de-stress signals before employees sue
Authors: Sapeat Jean
Published: May 2014

In a recent landmark ruling, Birmingham City Council was ordered to pay £67,000 to an employee who was found to be suffering excessive stress at work. Looking forward to next year's Code of Practice from the HSC, this article outlines what every employer needs to know.
... and justice for all? Clinical negligence claims
Authors: Golten David
Published: May 2014

The Civil Procedure Rules, the Pre-Action Protocol for the Resolution of Clinical Disputes, and Clinical Governance, aim fundamentally to change the way in which health care providers respond to clinical negligence claims and thus to reduce the cost of this type of litigation to the NHS.

We examine how these developments will affect the provision and cost of justice to doctors and patients.
The future of logistics in health care
Authors: Acton Peter
Published: May 2014

This article explores the importance of redefining the delivery and management of logistics for the present and the future, and suggests some possible benefits.
Watching the monitors of health care reform
Authors: Cowper Andy
Published: May 2014

The modernisation of the National Health Service and the implementation of The NHS Plan are highly reliant on external bodies and agencies to bring about reforms and improvements in health care.
From The King's Fund to the cost of crowns
Authors: Cowper Andy
Published: May 2014

Ian Wylie is Director of Corporate Affairs at The King's Fund, the independent health development foundation for London and the UK.

In January 2001, he will become Chief Executive of the British Dental Association.
It's not fair: issues of equity in NHS health care
Authors: Bell Andy
Published: May 2014

Andy Bell of The King's Fund looks at health inequalities in the NHS.

Are they inevitable? Does the political and managerial will exist to address the many issues preventing greater equality?
Fighting NHS fraud and corruption
Authors: McNeil David
Published: May 2014

Fraud and corruption are antithetical to the general purpose of the NHS. This is an overview of recent developments to combat the problem nationally under the Directorate of Counter-Fraud Services.
Whistleblowing: ethics, history and practice
Authors: Vinton Gerald
Published: May 2014

This article considers the charged subject of whistleblowing, examining its context and development over the past three decades.
Decanting the greys
Authors: Roth Andrew
Published: May 2014

Current proposals to decant elderly long-stay patients into upgraded private care homes make me think of the home for aged schizophrenics across the street from my own home in West Hampstead. It is a normal-looking suburban house on the path to Hampstead Cemetery. I thought of buying it when it came on the market 40 years ago for £2,100, which was then cheap for a three-bedroom house in our area. But the stench inside was overpowering because two elderly sisters had kept seven incontinent cats for many years. The sisters were persuaded to fumigate and repaint the house, selling it to a publisher and his bookshop-manager wife who had three children the same age as mine. We became good friends over the next quarter century until divorce and death broke up that family and the house was put up for sale.
The need to get more out of rehabilitation
Authors: Halpern Stephen
Published: May 2014

Although the NHS would certainly benefit from additional financial and clinical resources, there is mounting evidence that this is only part of the problem. The problem is also in part due to the cost of not providing services properly, requiring all kinds of ‘sticking plaster’ solutions to repair the failure.
Personal development plans: CPD in primary care
Authors: Rughani Amar
Published: May 2014

Personal Development Plans (PDPs) are being introduced across the UK as a requirement for all health care professionals. In this article the changing nature of professional development and the implications of such plans are discussed from the GPs perspective, drawing on the experience of GP tutors in Sheffield.
The NHS Plan.
Authors: Halpern Stephen
Published: May 2014

After having committed itself to raising NHS spending by one-third within five years, the Government lays out, in the NHS Plan how these extra resources will be used. Basically the answer is more and better doctors, more and better nurses and more and better facilities.
Is Mr Blair stealing Mr Milburn's clothes or donning them in endorsement?
Authors: Roth Andrew
Published: May 2014

For insiders, one of the crucial political side-issues of the Prime Minister's historic statement to Parliament on 27th July on The NHS Plan, was whether he would be seen to be stealing the clothes of Health Secretary Alan Milburn outright, or donning them to demonstrate his full endorsement. This emerged from the recently-leaked memo, which showed how insecure the Prime Minister is, and how he wants to be associated with crowd-pleasing initiatives.
The Competition Act 1998: the possible risks
Authors: Northway Nicola
Published: May 2014

This succinct overview of the possible risks for health care managers from the 1998 Competition Act is particularly timely given the proposals for ‘NHSplus’ occupational health services to be sold in The NHS Plan (see Policy Developments, pages 303-4).
Book Review
Authors: Harvey Trevor
Published: May 2014

The Red Book is the Bible for general practice finance within the NHS, and this highly-useful disk, licenced by the Department of Health, will be a boon to those whose daily work employs the paper version. A short review can hardly do justice to the numerous functions on offer here.
Productivity costs: principles and practice in economic evaluation
Authors: Barton Garry
Published: May 2014

The inclusion of productivity costs within economic evaluation has the potential to change recommendations about the cost-effectiveness of health care interventions.
Turning back the clock
Authors: Maynard Alan
Published: May 2014

‘Health care reform is social experimentation without controls to protect the patient.’
What size is best for orthopaedic trauma services?
Authors: Bowers John , Mould Gillian
Published: May 2014

The re-organisation of acute trusts in April 1999, left many trusts with duplication of services on different sites. In some instances, the duplication is desirable owing to the geographical spread of the population. In other instances, benefits could be gained by merging the specialties on one site. Loss of a specialty at a hospital is never popular with the general public and politicians: particularly in the case of orthopaedics, where the disappearance of the department would have serious implications for the provision of A&E services at the hospital. A less radical approach to concentration of specialties might consider the alternation of emergency admissions between sites.
The price and value of care services
Authors: Bell Andy
Published: May 2014

As the NHS prepares for a winter of close media scrutiny, the outlook for those services that keep vulnerable people out of hospital during cold weather is, to say the least, unclear. This week, the Government's new system of long-term care funding comes into place, providing users with a narrowly-defined range of free nursing care while requiring them to take means tests for personal care services. At the same time, reports from social care services predict a series of possible crises in the coming years.
Pissing out of the NHS tent: Milburn playing Johnson
Authors: Roth Andrew
Published: May 2014

Alan Milburn irresistibly reminded me of US President Johnson as he testified before the Health Select Committee. Johnson was a complex personality. Although a Texan, he was a non-racist, having come to love his little Mexican-American pupils when an impoverished teacher. Yet he was mainly responsible for involving the USA in the Vietnam War, which cost 60,000 American and over 2 million Vietnamese lives. As a politician, he was corrupt: I know because I shared his Washington lawyer. However, he was brilliant as a fixer: one who could push through legislation in a way never achieved by his overrated glamour-boy predecessor Jack Kennedy.
For better or worse? How the job is evolving
Authors: Wall Andrew , Baddeley Simon
Published: May 2014

This article looks at the careers, aspirations and motivations of four health service managers to consider how the role, and the people suited for it, have adapted and evolved.
Pneumococcal infection: savings with vaccination
Authors: Madden Vicki
Published: May 2014

As the discontent of our winter takes hold, this article considers cost-effective approaches to treating pneumococcal infection. Does vaccination hold the key?
A word to the wise about the whys and wherefores
Authors: Maynard Alan
Published: May 2014

Comrade Milburn is demanding to know what has happened to the generous injection of funds made available to the NHS. Our Beloved Leader (OBL) comrade Blur is suggesting that Milly's failure to ensure increases in NHS activity and nice reductions in waiting times for patients may have deleterious effects on the Secretary of State's job tenure. The chattering class are muttering about the problematic performance of both Milly and the Chief Executive of the NHS,‘Golden Wonder’ Crisp.
Animal tests, ethics, mortality and mortuaries
Authors: Cowper Andy
Published: May 2014

The news that Huntingdon Life Sciences has been relieved of a significant bank debt and also found long-term financial backing is a surprising outcome to the history of protest which has dogged the research laboratory and its staff. It is not ironic: this much-debased word actually refers to saying one thing while meaning the opposite. It is, however, welcome that the protestors’ tactics (which have included threats to kill and firebombing cars) have not won the day.
Patients: participants, proxies, power …
Authors: Bell Andy
Published: May 2014

There was a time when life seemed so simple. At least, there was such a time for the Labour Party's health policy. They would save the NHS; they would end the ‘two-tier’-ism of GP fundholding; and they would get those wretched waiting lists down. They did not pretend that these tasks would be easy in themselves, but at least the diagnosis of the problem was simple enough and the targets for change were clear for all to see.
LETTERS TO THE EDITOR
Authors: Harding Ann
Published: May 2014

University Hospital Birmingham NHS Trust is by no means unique. Like many large public sector organisations, we are facing a future built on changes in the way we provide services and the way we work.
Desmond Swayne: the elevation of a ‘cad'
Authors: Roth Andrew
Published: May 2014

A certain jokiness was in the air when 44-year-old Tory MP Desmond Swayne was promoted to become an assistant spokesman on health at the beginning of the year. This was because of the new Conservative policy of promoting to the front bench their sharpest-toothed backbench Rottweilers regardless of their expertise. It is good to see them making a stand against discrimination. The elevation of little John Bercow, a high-performing mini-Rottweiller with a prodigious memory, to underpin Ann Widdecombe had set a prize example.
Managing temporary staff in the NHS
Authors: Morgan Sîan
Published: May 2014

This article considers the potential for ‘Nurse Banks’ to make a real difference to staffing in the health service.
Making decisions for which there is no evidence
Authors: Charny Mark
Published: May 2014

Our series of articles looking at the use of evidence in health care concludes with a consideration of what can be done when there is no randomised control trial (RCT) evidence upon which to base decision-making.
Making counting count: the NHS’ ethnic monitoring
Authors: Neuberger Julia
Published: May 2014

This article considers how the health service can improve ethnic monitoring and contribute to some non-directed self-modernisation.
The laws of evidence-based health care
Authors: Kernick David
Published: May 2014

The Provocations series continues with a modest proposal that there are five laws of evidence-based health care.
Social justice and NHS jobs
Authors: Bell Andy
Published: May 2014

The NHS, as we all know, is a wonderful thing. It helps people to stay healthy, it supports people when they're sick, and it does this without regard to their ability to pay. As a means of pooling our resources to provide health care on the basis of need alone, it is probably second to none. Yet it is not without room for improvement sometimes.
Winter referrals: emergency admission patterns
Authors: Loudon Michael , Ward Helen
Published: May 2014

Every winter, hospital managers hope that patient admission rates are not exceptional. When admission rates rise, some managers ask GPs to request fewer admissions to ease the secondary care load.

Is this feasible? Are admissions by GPs avoidable and / or unnecessary? For an ill patient, is nursing home admission an alternative to hospital?

This study assesses such issues on the basis of one locality's experience, and offers opinions and provisional lessons from the findings.
Contract cleaning
Authors: Cowper Andy
Published: May 2014

‘What's it all about, Alan?’ That pretty much summarises the response to The Secretary of State's announcement that he was asking the NHS Confederation to take operational charge of the negotiations with the General Practitioners’ Committee of the BMA, which aim to result in the new GP contract.
The new NHS: will complementary therapies fit in?
Authors: Peters David , Gillam Steve
Published: May 2014

The integration of complementary therapies into the mainstream is a sign of the times. What can it tell us about the future of a more patient-centred NHS?
The lessons of striking doctors
Authors: Marmor Teodore R
Published: May 2014

For two days (January 8th-10th 2001), 1,300 New Brunswick doctors were on strike, bitterly complaining about the government's pay offer; their working conditions; and the inadequate supply of physicians in the province. Hardly a crippling strike, the New Brunswick episode is nevertheless significant, it shows how angry and frustrated doctors can get, despite average incomes of $150,000 per year, when their status erodes, their paymasters appear stingy, and the media treat them less as independent and worthy professionals than grumpy claimants on the public purse who too often fail to police their own ranks.
Information for health: you say you want a revolution?
Authors: Harvey Trevor
Published: May 2014

Fall-out from the Kennedy Report, disclosing the Bristol Royal Infirmary's lamentable record of patient survival after paediatric heart surgery and its underlying causes, has prompted suggestions that we are on the brink of a care revolution. It is even suggested that we will in future refer to pre-and post-Bristol, so profound will be the change in the relationship patients will have with the service.
Privatising the NHS, again?
Authors: Maynard Alan
Published: May 2014

In the United States, the Chrysler Motor Company laments that it spends more money on health insurance for its workers than it does on steel to make its cars. in Britain, Foxy (Liam Fox is the Conservative health spokesperson) declares that the only solution to the NHS's failures is competition between providers and increased private insurance. This is a solution tried, tested and seen to fail in the USA, where premium inflation is over 20 per cent as managed care and competition fail due to powerful provider monopolies, is being advocated as a remedy for the UK.
Health managers’ slow road from perdition
Authors: Halpern Stephen
Published: May 2014

The preface of ‘Managing for Excellence in the NHS’ has a photograph of NHS Chief Executive Nigel Crisp. It appears to have been taken on a thirty-year old box camera whose lens has not been cleaned since it was purchased. The photograph lacks perspective, is badly framed, out of focus and fails to engender any sense of the contemporary.
A lucid interval? Whatever next!
Authors: Baker Mark R
Published: May 2014

It is hard to believe, but there are hints that Ministers are beginning to understand the consequences of their recent folly. Whatever intangible, illusory and elusive benefits there might be from delegating resources and responsibility to scarcely-formed and staggeringly ill-prepared Primary Care Trusts, the negative consequences of such action are starting to register with our Lords and masters.
All change? Please!
Authors: Bell Andy
Published: May 2014

Last month, the Institute for Public Policy and Research (IPPR) published a weighty tome on the future of social care. Among its recommendations was that local government could take responsibility for commissioning both health and social services, with the NHS becoming the main provider (but not purchaser) on the health side (Kendall and Harker 2002).
Advances in the cataract salient
Authors: Roth Andrew
Published: May 2014

It would take a snapshot from a satellite to know whether and by how much the NHS is advancing all along its many fronts. But from my worm's eye view ‘ from a worm with an improved left eye ’ the increasing inflow of money is producing advances in specific salients.
NICE: still advancing the excellence curve
Authors: Cowper Andy
Published: May 2014

Professor Sir Michael Rawlins, Chairman of the National Institute for Clinical Excellence and Professor, Wolfson Unit of Clinical Pharmacology, University of Newcastle, answers questions on the Institute's development, progress, successes and challenges.
Employment law: the changes and the lessons
Authors: Cronin James
Published: May 2014

This article reviews various recent changes in employment law and their implications for management of staff.
From Beckham to Byers, foot and mouth overshadow true radicalism
Authors: Cowper Andy
Published: May 2014

‘New Labour's spin machine went into action and, having promised less than we thought we could do, we started hyping more than we were actually delivering.’
Family-friendly measures in the Employment Bill 2001
Authors: Davies Lynn
Published: May 2014

This article considers what impact the new ‘family-friendly’ Employment Act of 2001 will have on the management of staff.
A comedy of errors?
Authors: Harvey Trevor
Published: May 2014

At the end of June, following publication of a study of NHS errors of every conceivable type, occurring in 28 Trusts over six months, we witnessed the inevitable comedy of errors between the two Liams. The CMO, Dr. Liam Donaldson, was apologetic and declared the data unreliable. His opposite number, Liam Fox, demanded public transparency and all but implied a cover-up. Much shroud-waving later, the rationale of this research exercise remains lost on me.
No news is good news?
Authors: Bell Andy
Published: May 2014

After a short respite (I hope you enjoyed it), the NHS is back on the front pages of the tabloids. The National Patient Safety Agency's first report brought with it a flurry of publicity about not only the figures it contained but the ‘spin’the Government supposedly tried to put on them. Both the Daily Mail and, in London, the Evening Standard carried front page headlines claiming a ‘Great Hospital Blunders Cover-Up’ and warning of the one million errors that the report suggested were happening in the NHS each year. Others followed suit, with stories across the board focusing on both the one-in-10 rate of adverse incidents in NHS hospitals and the way the report was handled by ministers.
CHD: the new frontier for primary care (and NHS) achievement?
Authors: Bosanquet Nick
Published: May 2014

Almost two years on from the launch of the National Service Framework for coronary heart disease, this article considers the opportunities for real improvements in treatment and equity through primary care.
The changing public-private mix in health care
Authors: Hunter David , Robinson Ray
Published: May 2014

As the debate with regard to the use of public-private partnerships (P-PPs) in the NHS reform programme continues, this article examines the findings of some recent research among active and committed participants in the partnership process.
Shallow and soggy and uneven
Authors: Halpern Stephen
Published: May 2014

The gap between policy and its implementation is heading for a serious crisis. Hardly a week passes without a major signal emerging that the NHS remains without proper central managerial direction.
Implementing NICE guidance: smoking cessation support
Authors: Spinks Julian
Published: May 2014

This article presents an approach to implementing the National Institute for Clinical Excellence's guidance on how to support smoking cessation.
The father to the man and woman
Authors: Bell Andy
Published: May 2014

The BBC is dumbing down; the police are getting younger; and morale in the NHS is not what it used to be. Such mythical truisms are axiomatic. That teenagers aren't as healthy (or well-behaved, or well-educated) as they once were is another. But, thanks to the good work of the BMA, this old chestnut was actually given some substance – and a hefty supply of newspaper column inches – last month.
The price is right ... right?
Authors: Cowper Andy
Published: May 2014

One of the more interesting news stories towards the end of 2003 was the issuing of a civil prosecution on behalf of the NHS by the Directorate of Counter-Fraud and Security Management Services. Several generic drug manufacturers (Norton Healthcare, Norton Pharmaceuticals, Regent-GM, Kent Pharmaceuticals, Generics UK, Ranbaxy UK and DDSA Pharmaceuticals) have been accused of forming a price-fixing cartel for widely-used non-patent drugs, which is estimated to have cost the NHS £30 million over the past few years.
More social than market, and a missed target in NHS PLC
Authors: Timmins Nicholas
Published: May 2014

It's over. But before we wave it off to the seaside, it remained remarkable for being one of the few months, certainly in recent time when there seemed to be more support for the NHS in public commentaries than attacks upon it.
Directing the workforce towards 2008
Authors: Cowper Andy
Published: May 2014

We interview Andrew Foster, Director of Workforce for the Department of Health.
Is governance now inhibiting research?
Authors: Holmes Susan
Published: May 2014

Has the burden of current research governance regulation spiralled out of control?
Policy zombies and the NHS
Authors: Maynard Alan
Published: May 2014

The Canadian economist Bob Evans has argued that zombies plague health care systems. Health care zombies are daft ideas that are continuously recycled by groups that stand to gain from their adoption. However much you knock down these ideas with evidence, like zombies, they bounce back up again and haunt the health care systems of the world.
Local authority fines: penny wise, pound foolish
Authors: Millard Peter H
Published: May 2014

This article uses a modelling approach to consider the risky unintended consequences of fining local authorities for failing to provide intermediate care, made law under the 2003 Community Care (Delayed Discharges) Act.
Improving A&E waiting times for acute stroke
Authors: Keir JA , Oates AJ , Paskins J , Wright A
Published: May 2014

This paper looks at improving care and trolley waiting times for acute stroke patients in Accident and Emergency departments.
More than White Papering over the cracks
Authors: Bell Andy
Published: May 2014

After months of expectation, the public health white paper, Choosing Health, was published in November and prompted widespread debate and discussion. The debate, for the most part, focused on just a few aspects of the paper – on its proposals for limited bans on smoking and its approach to the food industry.
Nurses: vampires or angels?
Authors: Harvey Trevor
Published: May 2014

Recently, I happened to be watching what must surely be the best ever British hospital drama, ‘Holby City’, from the comfort of a friend's sofa. My friend, who now runs her own thriving complementary therapy practice, left nursing last year. She has a disparaging view of the profession. Having worked for many years in hospitals and industry, she found it all very frustrating and rather depressing. It is not, she believes, the place for a free spirit.
PCT / primary care referrals: current and future trends
Authors: Rowlands Gill , Lewis Graham , Keene David , Ashworth Mark , Majeed Azeem
Published: May 2014

A survey of London PCTs to assess current activities and future plans for the primary-secondary care interface found that PCTs were developing many innovative approaches. This article discuss the implications of the findings for doctors and managers.
The re-discovery of public health (again)
Authors: Bell Andy
Published: May 2014

For decades, public health advocates have complained bitterly about being consigned to the margins of the NHS and of health policy. While the NHS, and the population it served, amassed billions of extra pounds, efforts to promote good health existed on paltry sums of money with little political or public support.
Three Martinis and a sticking plaster
Authors: Kepple Stephen R
Published: May 2014

This unsolicited short story was submitted at the same time as Professor Ted Marmor's article (previous pages) was received.

It throws an interesting perspective on Marmor's observations and as such, appears here as the first piece of fiction we have (consciously) published.

Its author works in health care publishing in the USA.
Re-disorganisation from within: all change again?
Authors: Maynard Alan
Published: May 2014

With the NHS slowly improving its performance, radical reform of the NHS before the 2005 election seems unlikely. However, after the general election, it may be time yet again to shift the deckchairs on the Titanic. Is it possible to do this in a way that improves NHS performance?
Teaching Limeys to suck eggs
Authors: Maynard Alan
Published: May 2014

Give policy-makers a budget and some targets that will generate political dividends, and they will flail about like drowning sailors clutching at any old policy that drifts into their consciousness. Often, such folk have nice expense accounts and wander around the globe indulging in posh dinners and policy tourism, adopting health care programmes of dubious utility.
Will Blair help corrupt the NHS?
Authors: Roth Andrew
Published: May 2014

I am worried about the Prime Minster's letting down the barriers between the government and private industry by making it quicker and easier for former Ministers and senior civil servants to switch over to lucrative jobs in big business. I worry particularly about the additional opportunities for the use of inside knowledge to enable some businesses to secure a leg-up in securing an unfair portion of the many billions the NHS spends on protecting the health of 95% of Britain's population.
Mens sana and the sign of ‘The Times'
Authors: Bell Andy
Published: May 2014

Last month, a study was published showing that one doctor in five in Britain could be diagnosed with a mental health problem (McManus et al,2004). The study, understandably, caused quite a lot of concern.
Should the poor get stuffed?
Authors: Maynard Alan
Published: May 2014

As endless research reports have shown and endless Government policy initiatives have reiterated, the poor do not get a good deal in the NHS. Yet the rationale of Government intervention in health care markets is to improve the lot of the poor. So what's going wrong?
The NHS as the back wheel of a penny farthing
Authors: Roth Andrew
Published: May 2014

The best way I can describe the continuing battle over the radical ‘reforms' which the PM wishes to leave us as his legacy is to depict the NHS as the smaller rear wheel of the penny-farthing bicycle of Blairite reform
Changing primary care: commission impossible?
Authors: Bell Andy
Published: May 2014

It may not have featured in the front pages of the national press very often (Outside In, November 2005) but the current row over the future of primary care trusts has without doubt sparked off a lot of debate within the NHS and the policy thinkers who gather around it.
Breaking down, or slowing down? Reform meets reality.
Authors: Timmins Nicholas
Published: May 2014

It's far from over. January 2005 will be remembered as the month when policy designed on high hit the road and the result was the smell of burning rubber. Local reality proved hard to reconcile with theoretical constructs, and the brakes had to be applied.
Audiology and psychiatry battle over Blair's head
Authors: Roth Andrew
Published: May 2014

Tony Blair should be warned. The next time he visits a hospital for a check-up on his back, there may be a battle between its audiology and psychiatric departments to examine his head. Audiology may want to find out how a ‘listening’ Prime Minister can seem to hear only a quarter of the electorate's loud grumbles. Psychiatrists should be curious about what enables him to downplay blows aimed at him while re-interpreting others as endorsements.
Managing violence in general practice
Authors: Cornell John
Published: May 2014

Violence is a global public health problem. The World Report on Violence and Health published in 2002 claims that each year over 1.6 million people loose their lives to violence and many more are injured and suffer from a range of health problems. Violence is a leading cause of death for people aged 15-44 years. Recommendations were made urging action to tackle violence at local, national and international levels
The 23-hour ward: an efficient alternative to day case surgery
Authors: Kok K , Hayhurst C , Wilson PS
Published: May 2014

Emergency admissions reduce available inpatient bed spaces, impacting on elective operating lists and reducing surgical efficiency. Emphasis has been placed on day case surgery to improve throughput and reduce waiting lists in recent times.
Cameron's Chinese hosepipe conversion of the Tories
Authors: Roth Andrew
Published: May 2014

My diabetic consultant was genuinely shocked. Previously told that he would be replaced by two diabetes specialists on his retirement, he had just been told, as his retirement nears, that he will not be replaced. Previously he had laboured long and hard on the Royal Free's full portion of the 2.1 million Britons who know they have diabetes, trying to prevent their going blind and to extend their lives.
The benefits of ‘buffer management’ in health care
Authors: Mur-Veeman I , Govers M
Published: May 2014

Practical experience with health care ‘supply chains’, as systems of linked care provisions delivering sequential care to patients with multiple care demands, often indicates that patient logistics are poorly managed.
Wanless III - Engagement 0? The public's health.
Authors: Bell Andy
Published: May 2014

Late last month, Derek Wanless announced his return to the health policy field with a fiveyears- later review of progress towards his landmark recommendations of 2002. The review, he said, would look at where the extra money has been spent on the NHS and which of his three ‘engagement’ scenarios is emerging.
Incontinents excel over pregnants
Authors: Roth Andrew
Published: May 2014

A friendly neighbour jokes: “I went from continent to continent until I became incontinent!” It was his jokey way of letting understanding people know that he was one of the more than a million people in Britain who cannot control their anal or urinary sphincters, often as a result of strokes.
When was the last plague in Britain? 1906, not 1666
Authors: Ainsworth Steve
Published: May 2014

Worried about Avian flu spreading here from Turkey? It wouldn't be the first time that a dangerous disease arrived in Europe from that part of the world.
Regulating health and social care: a meeting of minds?
Authors: Denise Dame
Published: May 2014

In the course of a working life, there are some meetings that constructively move an agenda forward, and other discussions from which one is quite content to be excluded. The description in this magazine's policy column, ‘Regulation, confusion and career moves for Sir Nigel Crisp’ (Timmins 2005), of meetings in ‘smokefilled rooms’ about the future of health regulation sounds very much like an example of the latter!
Trust, instability and uncertainty
Authors: Bell Andy
Published: May 2014

It is now more than six years since the Prime Minister used a Sunday morning television interview to pledge to increase NHS funding to the European average by 2008. In a move which was said to have been a surprise even to his most senior Cabinet colleagues, the PM was responding to a barrage of media criticism of the NHS as it struggled to manage emergency winter admissions. The onslaught peaked when Lord Winston infamously compared the NHS unfavourably with health care in Poland.
The big disconnection between ministers and the NHS
Authors: Roth Andrew
Published: May 2014

At first I could scarcely believe the tale told to my daughter. The somewhat disingenuous finance director of a PCT in the southwest told it to her as the local spokesman of Amicus, the second-biggest union in the NHS.
Breaking down the walls
Authors: Dean John D , Dixon Michael , Irani Minoo
Published: May 2014

The current changes and continuing debate about future primary care services, primary care trusts (PCTs) and acute hospitals and Foundation Trusts in England need to take into account the growing number of practitioners and services providing specialist care in non-hospital settings.
How to avoid being confused by evidence and facts
Authors: Maynard Alan
Published: May 2014

Government is constantly setting out new policies, and the challenge - as ever - is whether they have an evidence base or whether they are just random, jolly wheezes informed by prejudice and designed to keep happy the foot soldiers of the Government in power.