bluuebunny/crossref_metadata_2025 huggingface dataset:
A sure start for new workers
Authors: Evans Christine , Hood Adele , Jolly Sara
Published: May 2014

A range of induction programmes are available for support workers throughout the NHS but these may not be accessed until days or even weeks following recruitment. Traditionally, in many organizations support workers start their first day in post with no prior training or introduction. This can leave them feeling vulnerable and demoralised. An innovative approach to the delivery of an accredited induction programme for newly recruited support workers has recently been launched in Aneurin Bevan Health Board, Wales. This article outlines the induction programme and the perceived benefits.
Spurred on by job satisfaction
Authors: Hand Tanis
Published: May 2014

On St David's Day, I made welsh cakes and took them into work. Nothing strange there, I thought, wearing my daffodil proudly, as you do! I was amazed and quietly delighted with the surprise and gratitude shown by my colleagues-for simply doing something that I do regularly at home. But the feeling of warmth lasted for days, and it reminded me of the feeling I used to get when a patient or their family thanked me for simply “doing me job”.
Broken English
Authors: Green Barrie
Published: May 2014

The tragic case of David Gray, whose death was found to have been caused at least in part by the inability of GP, Dr Daniel Ubani, to speak English to a sufficient standard, demonstrates both the appalling state of NHS out-of-hours services and the woefully inadequate way in which attempts to reform the working conditions of GPs has resulted in almost third world levels of service (Triggle and Wilson, 2010).
Gaining confidence in caring for a child on traction
Authors: Roberts Sheila
Published: May 2014

Children of all ages may at some time need to be on traction for a variety of reasons. This article will discuss the care required by children and young people while on traction. It will also explore some of the more common types of traction seen in paediatric settings and the reasons why children or young people may need traction. While many of the principles of care will be the same, this article will not be looking at complex orthopaedic conditions seen in specialist centres.
Disorders of the thyroid function
Authors: Mulryan Chris
Published: May 2014

Patients with disorders of thyroid function are commonly encountered in clinical practice; however the conditions that they present with are not always well understood by health professionals. In this article the anatomy and physiology of the thyroid gland will be described along with the actions of thyroid hormones. Following this the main disorders of thyroid function will be explained as will the management options that are available to patients with these conditions.
HCA study day: long-term bowel management
Authors: Roberts Anna , Roberts Buddug , James Gwennan
Published: May 2014

Teams of healthcare assistants (HCAs) supply most of the day-to-day care needs of spinal cord injury patients within their own homes, including establishing and maintaining a long-term bowel management regime. There can also be similar care needs for continuing healthcare patients (e.g. motor neurone, multiple sclerosis, stroke patients) when HCAs will work as part of a district nursing team providing bowel management care. A training need was identified for staff to secure competencies in Digital Rectal Examination (DRE) and Manual Evacuation of Faeces (MEF) as well as basic bowel and peri-anal assessment. One area which was highlighted as an urgent training need was the recognition and identification of the life-threatening emergency condition of autonomic dysreflexia, which only affects spinal cord injury patients.
Prevent depression and anxiety from affecting your home life
Authors: Carr Caroline
Published: May 2014

This is the third in a short series on depression, anxiety and how to prevent them affecting you and your life outside work. The previous articles looked at the impact of depression and anxiety on relationships, as well as how to help patients who are experiencing either condition.
The economy: challenges for new government
Authors: Hughes Rhidian
Published: May 2014

The UK is said to be limping out of deep recession. The downturn is believed to be the product of, among other factors, the global collapse of credit, a downturn in the housing market and rising unemployment (O' Grady, 2010). The recovery has been slow, but fears that the UK could dip back into recession are beginning to be allayed. The management of the economic downturn featured strongly in the run up to what was a very competitive general election campaign from all the major parties. While each political party had their own strategy for securing the recovery, all recognized that the financial pressures on health and social care services will stay with us for the foreseeable future.
What if...? Reflective practice
Authors: Grainger Angela
Published: May 2014

In the second in our series on reflective practice, we consider how healthcare assistants (HCAs) and assistant practitioners (APs) can respond appropriately when a complaint is made about the care they give.
Supporting support workers
Authors: Muddiman Barbara
Published: May 2014

If someone had told me 10 years ago that at the age of 40 I would start studying, which would lead to me being employed as a learning and development instructor/ assessor, and that I would be delivering training to staff across various disciplines in the NHS, I would have laughed. Yet here I am, doing just that and more besides.
Infected eczema in older people: identification, treatment and management
Authors: Nazarko Linda
Published: May 2014

Age-related changes lead to an increase in skin problems, and around 70% of older people have a treatable skin condition (Jordan, 2002). Ageing and poor physical health can make it difficult for older people to care for their skin, and eczema can develop. This can become infected and cause discomfort and health problems. This article, which is based on a case history, explains how ageing affects the skin, how eczema can develop and how it can be treated.
Assistance dogs and independent living for disabled people
Authors: Moir Jenny
Published: May 2014

Having a life-changing, and very often, life-limiting disability brings all kinds of challenges, including loss of independence and confidence, and in many cases, reduces social interaction with people to a level where depression, isolation and loneliness become constant companions. But help is at hand from a small charity based in West Sussex called Canine Partners, that train assistance dogs to transform the lives of people with disabilities across the UK.
The role of APs and the Allied Health Professions-a Scottish perspective
Authors: Dunlop Gloria
Published: May 2014

This article will review the development of the assistant practitioner's (AP' s) role for the Allied Health Professions in Scotland since the outcome of an audit conducted in 2004. The study tracks progress made in developing the role through the review of published literature from journal articles and from government health department reports.
Caring for the person with chronic obstructive pulmonary disease, part 2
Authors: Peate Ian
Published: May 2014

This is the second and last part of an article that aims to provide an understanding of a common respiratory condition: chronic obstructive pulmonary disease (COPD). Although the condition can affect people of any age, this article will focus on older people. Respiratory disease can have a negative impact on a person's health and wellbeing. It may also impinge on an individual's body image and their ability to perform day-to-day activities. The role of the healthcare assistant (HCA) and associated practitioner (AP) is outlined, and care considerations are explored.
Access to health records-a review, part 1
Authors: Peate Ian
Published: May 2014

This article is the first in a two-part series discussing health records. People have a statutory right to see their health records, whether they are hand written or those held on a computer. There are, however, some limitations to this right. There are a number of records that health professionals use in order to provide safe and effective care. This article provides the healthcare assistant and assistant practitioner with an understanding of the key issues associated with requests that may be made to access an adult person's records or health information in England. This article considers the adult within a NHS setting.
Pain-induced stress in wound care, part 2: assessment and management
Authors: Solowiej Kazia , Dominic Upton
Published: May 2014

Pain and stress can be detrimental to wound healing. This article, which is the second and last in a series, discusses how healthcare assistants should focus on the assessment and management of pain in order to promote faster healing of wounds, particularly those that are chronic in nature.
The right start: induction for support workers
Authors: Gough Anne , Briggs Elaine , Godbold Karen
Published: May 2014

To enable a person to start a career in an acute hospital trust as a clinical support worker (CSW), it is essential that he or she receives the right start. CSWs fulfil an important role in health today, and have a key role in the patient experience. This article describes how the development of an induction programme for CSWs and the standardisation of induction processes at Maidstone and Tunbridge Wells NHS Trust. It states how this prepares the CSWs for their role, starting them on a path that offers professional development and career progression.
The written word
Authors: Hand Tanis
Published: May 2014

How long is it since you actually put pen to paper and wrote a letter? Do any of you remember the lessons we had in school about how a letter should be set out, and whether you should end a formal one with ‘Yours sincerely’ or ‘Yours faithfully’? I still do not know which is correct, and I guess I am far less likely to need to than when I was at school.
A practical approach to issues of challenging behaviour
Authors: Nazarko Linda
Published: May 2014

In the past, when people with dementia developed challenging behaviours and staff sought advice from senior nursing and medical staff, the response was often to prescribe a class of drugs known as neuroleptics or anti-psychotic drugs. We now know that these drugs are overprescribed and have the potential to harm people and worsen dementia ( Banerjee, 2009 ; Shah et al, 2011 ). This article aims to provide readers with information to enable them to feel more confident about caring for people who display behaviours that are considered challenging. Achieving a level of confidence in dealing with such behaviour is important in light of the findings of Edvardsson and colleagues (2008) , that residents had higher levels of behavioural problems when surrounded by stressed staff. Staff who understand why people with dementia display such behaviours can work to reduce problems and provide care that is tailored to the needs of the person with dementia.
Management and leadership for support workers
Authors: David Stonehouse
Published: May 2014

In this article, the two important roles of manager and leader within the workplace will be examined. The differences between the two terms will be discussed, and it will be demonstrated that everyone, no matter their official job role, can be a leader. Support staff play a vital role in supporting and assisting managers and leaders in the smooth running of the care setting for the benefit of all patients/clients, families/carers and staff in the delivery of high quality care.
‘Can I tell you something in confidence?’ — Law and ethics
Authors: Yeomans Paul
Published: May 2014

Issues of confidentiality and data protection may seem daunting to healthcare assistants and assistant practitioners. It can be useful to consider the case law behind the development of confidentiality protection, as well as particular practice situations in which issues may arise.
Breastfeeding: implementing the Baby Friendly Initiative
Authors: Ellis Angie , Surtees Ann
Published: May 2014

The United Nations Children's Fund (UNICEF) recognizes that practices in maternity units can influence breastfeeding outcomes positively and negatively. It is important that women receive accurate information from midwifery care assistants about the benefits of breastfeeding, so that they can make an informed choice, and be prepared for breastfeeding.
The balancing act: body fluids and protecting patient health
Authors: McMillen Rachel , Pitcher Ben
Published: May 2014

Fluid balance relates to the balance of fluid input and output in the body. If fluid volume fluctuates by even a small percentage, there can be adverse consequences for the individual. Careful and accurate monitoring of fluid balance is an important aspect of the nursing practices in which healthcare assistants are involved. This article provides an overview of the mechanisms of fluid intake and output in the body and the implications of dehydration and overhydration. The assessment of fluid balance and use of fluid balance charts is also discussed.
Raynaud’s phenomenon: what can be done for patients?
Authors: Mawdsley Anne
Published: May 2014

Raynaud’s phenomenon is a very common medical condition that describes an increased sensitivity of the blood vessels to cold or stress. It results in episodes of poor blood supply to the hands, feet and other extremities that can occur many times a day and cause significant pain and problems with hand function. In some cases it is very severe, especially if associated with another medical condition, such as a rheumatic disease like scleroderma. In these cases, blood supply can be so poor that skin breakdown (ulcers) or even gangrene of fingers can occur. Various medications and lifestyle changes can improve Raynaud’s.
Hypertrophic cardiomyopathy and inherited heart conditions
Authors: Oliver Jan
Published: May 2014

As well as diagnosing and supporting individuals with inherited cardiac conditions, it is important to identify family members that may be at risk. Hypertrophic cardiomyopathy is a complex and common cardiac genetic disorder that affects one out of every 500 people. Inherited cardiac condition clinics identify families at high risk of developing an inherited cardiac condition in order to reduce sudden cardiac deaths and detect early life threatening problems experienced by relatives. This article will explain inherited cardiac conditions, looking at hypertrophic cardiomyopathy in particular.
Urine testing through the use of dipstick analysis
Authors: Mulryan Chris
Published: May 2014

Assessment of a patient's urine using reagent dipsticks is a commonly performed health assessment undertaken by support workers. While the practical performance of the test is relatively straightforward, interpreting the results of urine analysis is more complicated. This article outlines the most common tests that are performed on urine using reagent dipsticks and discusses the significance of these tests.
Hidden caregivers: providing appropriate services
Authors: Barber Chris
Published: May 2014

Although most caregivers are, by the nature of care giving, hidden, some caregivers are perhaps more noticeable than others. This suggests that some caregivers are less noticeable, more hidden. This third article in this series on caregivers will focus on the ‘more hidden’ of the caregivers: male caregivers, young caregivers, BAME caregivers, LGBT caregivers, rural caregivers and caregivers who are elderly or have a disability themselves. Some suggestions will be offered that may help healthcare assistants (HCAs) and nurses to support these caregiver groups.
Osteoporosis: the fragile bone disease
Authors: Swann Julie I
Published: May 2014

Healthcare staff need to have an understanding of why osteoporosis occurs, and how to prevent it, is important; not only to enable healthcare staff to help their patients, but also to prevent this condition within their own health. This article explains what causes osteoporosis and ways healthcare staff can be proactive in its prevention.
HCAs: developing skills in reflective writing
Authors: Pearson Janice
Published: May 2014

With the emergence of the assistant practitioner (AP) role, many healthcare assistants (HCAs) now attend university in order to gain academic qualifications, such as a foundation degree in health and social care, to enhance their developing role. HCAs who may not have previously studied within a higher education environment may feel anxious at producing academic assignments, especially those that need to demonstrate evidence of reflection. Reflective writing differs from traditional academic writing and this article will explore briefly the concept of reflection, the nature of the HCA as an adult learner, characteristics of reflective writing and two frameworks that support workers can use to demonstrate reflection within their writing.
It is time to recognise our 6 million UK care-givers
Authors: Barber Chris
Published: May 2014

There are around 6 million ‘informal carers’ in the UK. This series of 5 articles sets out to explain what informal caring is and how healthcare assistants and nurses can work with and meet the needs of a variety of informal carers in a variety of clinical and healthcare settings and environments. This short series will commence with a brief definition of what informal caring is, placing this short definition within a demographic framework.
Taking ECGs: being skilled, competent and confident
Authors: Peate Ian , Wild Karen
Published: May 2014

The phrase ‘cardiac monitoring’ usually refers to either continuous or one-off electrocardiograph (ECG). There are many ways of monitoring cardiac function, for example, telemetry (this allows cardiac monitoring to be done at a distance) and haemodynamic monitoring (monitors the pressure and flow of blood within the circulatory system). This article provides the healthcare assistant (HCA) and assistant practitioner (AP) with a brief introduction to the ECG. An overview of the anatomy and electrophysiology of the heart is provided. Emphasis is placed on ensuring that the person is safe and comfortable before, during and after the procedure. The equipment needed to obtain an accurate 3-lead ECG is discussed, as well as providing a description of the appropriate positioning of the leads on the person's body.
Telehealth: the hospital in your home
Authors: Dewsburys Guy
Published: May 2014

The traditional hospital-based service is beginning to change and services are beginning to be delivered through other, more modern, electronic methods. This paper outlines the new generation of services called ‘telehealth’ and suggests that the home is now becoming an extension of the hospital/GP surgery for many people with long-term conditions who are using telehealth devices to support and manage their conditions. The paper also provides a brief overview of other electronic services that are becoming established within the health field.
Resistance to change: the human dimension
Authors: Stonehouse David
Published: May 2014

In this article, the author will examine how change can affect individuals, both staff and patients, and how resistance to change can be managed to enable organisations to be successful. Support workers are at the forefront of change. Where there are any changes within an organisation, or of service delivery, support workers will be directly affected by it. They are the ones who will be closely involved in the implementation of the change and also the frontline staff who are left to manage the new situation or working practice. More importantly, patients and clients will be directly affected by any changes that occur. It is therefore important for support workers to have an understanding of how change is implemented and to recognise why people are resistant to it.
Should I be an advocate? A good question for HCAs
Authors: Megson Denise Yuen
Published: May 2014

The paper will define advocacy and discuss the various types and settings where the various types may be used or in evidence. It intends to explore the importance of the knowledge and practice of advocacy for HCAs in current health and social care environments. A format by which HCAs could prepare for and be assessed on their knowledge and skills of advocacy is suggested, based on the National Minimum Training Standards and Code of Practice for HCAs released by Skills for Health and Skills for Care earlier this year.

The national minimum standards for training specified 10 areas for HCAs. Apart from the roles, it targets areas of effective communication, equality, diversity and inclusion, duty of care, safeguarding, person-centred care which are core elements for the practice of advocacy.
Spirituality and mental health: applications for HCAs
Authors: Barber Chris
Published: May 2014

Mental health, religion and spirituality have had a lengthy, if at times uneasy and rocky, relationship with each other. This article sets out to explore this relationship briefly, some of the effects that spirituality, faith and religion can have upon those who are experiencing mental health issues and some of the roles of the HCA and nurse in supporting service users to engage in their spirituality.
HCAs and patient observations: evaluation of OSCE approach
Authors: Hensler Edda
Published: May 2014

This article describes the use of a simulated assessment method to assess the competence of HCAs in taking routine patient observations. In the context of the expanding role of healthcare support workers and discussions about training requirements, it outlines the related national and local standards in this area.

The preparation and process of the Objective Structured Clinical Examination (OSCE) is then described, followed by an interpretation of the results. Perceived challenges in using this assessment tool are outlined, as well as opportunities for HCAs and their managers.
Early years support worker education: impact on practice
Authors: Beirne Pauline
Published: May 2014

This article describes the development of education and a capability framework for support workers working with children in a variety of early years settings across health and social care.

The education was developed through collaboration between education providers, Scottish Social Services Council (SSSC) and NHS Education for Scotland (NES), with the intention of creating a skilled and mobile workforce capable of working across organisational boundaries to support improved outcomes.

The education content, the learner experience and the external evaluation of the education are described. The learning from the delivery of the education and the future direction of support worker education in Scotland are also discussed
NICE e-learning tool to detect acute kidney injury
Authors: Mavahalli Pranam
Published: May 2014

Acute kidney injury (AKI) is a common and serious condition that can be easily prevented. Early detection of AKI is important in order to prevent potentially fatal complications from occurring, and healthcare assistants can play a vital role with this.

In order to improve awareness of AKI, the National Institute for Health and Care Excellence (NICE) has developed an e-learning tool together with the Centre for Pharmacy Postgraduate Education. This article discusses AKI, and how the e-learning tool can help healthcare assistants improve the care of patients with the condition.
Widdecombe is ready to rumble, but is she punching above her weight?
Authors: Shallcross Mike
Published: May 2014

Fresh from her celebrated oration at the Conservative Party conference, shadow Health Secretary Anne Widdecombe discusses Tory NHS policies, the Private Finance Initiative and her current campaign to start an ‘honest, open debate’ about health care rationing.
Beyond the primary care led NHS: reflecting on an island of stability?
Authors: Keep Jane , Smith Judith
Published: May 2014

This article suggests that times of NHS ‘policy hiatus’ or waiting for central guidance can provide valuable time for reflection and review. These ‘islands of stability’ should be sought out and valued by managers, rather than being resented as frustrations or unnecessary delays.
Seeking a second opinion on committal
Authors: Roth Andrew
Published: May 2014

Normally, the passage of a Bill, with all its convoluted language contrived by the specialist Parliamentary legal draftsmen, is one of the most excruciatingly boring things to observe. Nonetheless, some bills are more stimulating than others. For example, the new Mental Health Act. Although many would argue that any legislation foreshadowed by Health Secretary Frank Dobson is bound to be interesting, I must confess that interest on my part has been guaranteed more by strong personal feelings about the subject.
Establishing core competencies for mental health workers by listening
Authors: Sirotkin Melanie , Brooks Bernie
Published: May 2014

This article describes an evolving competency based model of mental health training which has the views of mental health service users and their carers at its core.
Commissions seek consistency
Authors: Stone Malcolm
Published: May 2014

At the start of last month Health Minister John Hutton launched the consultation paper, Fit for the Future?, and the process of unifying the regulation of residential and nursing homes began in earnest.
Citizen's juries: tackling the democratic deficit
Authors: Elizabeth Susan
Published: May 2014

Drawing on the findings of an independent evaluation of six citizen's juries, this article argues that they can prove a powerful vehicle for active citizenship if managed properly.
NAC survey reveals asthma is still a low NHS priority
Authors: Greener Mark
Published: May 2014

Approximately 3.4 million people suffer from asthma in the UK and it costs the NHS more than £466 million in prescriptions alone. So why is it still such a low priority? BJHCM investigates.
Dear Alan
Authors: Bosanquet Nick
Published: May 2014

You have made a start—in defining the problem. There is clear, in fact, massive evidence that the NHS is giving a poor service to many people with serious illness. The problem goes way beyond cancer and heart disease and covers most types of serious illness: but there is no quick or easy solution. You have a choice: you can either reshuffle the queues or take the strategic decisions which might make a real difference.
Exploiting the scope for enhanced screening
Authors: Forster Robert
Published: May 2014

Telemedicine has been recognised by the government as pivotal to the success of its modernisation programme. This article examines recent advances in telemicroscopy and how these could radically improve screening programmes.
Death by viewgraph -- the perils of presentations
Authors: Harvey Trevor
Published: May 2014

Inside Information Death by viewgraph -- the perils of presentations s a manager, you are necessarily an important learning resource for your colleagues. Their on-the-job education relies on your initiatives. Yet I wonder how you present them with t
Seven new standards set in mental health
Authors: McFadyen John Alexander
Published: May 2014

The new National Service Framework for Mental Health contains much to be applauded, but will the reaction to its challenging agenda be more than an exercise in ticking the right boxes?
Delivering on promises
Authors: Hill Rosalind
Published: May 2014

For those of you who may have been hibernating this winter, last month saw the inauguration of America's new President, Barack Obama. And following the fever pitch of this momentous occasion, it is time for the President to roll up his sleeves and deliver on the promises he made. Not least, perhaps, with healthcare reform, given the current financial climate.
The ‘quick fix’ generation - dispensing with old boundaries
Authors: Shallcross Mike
Published: May 2014

Over the last few months Viagra has dominated the headlines, bringing our ‘instant gratification’ culture sharply into focus. It has also forced the Health Secretary to grasp the rationing nettle for the first time. This feature examines the issues behind the headlines and tries to put this potent drug into perspective.
Research matrix reveals real typology of primary care groups
Authors: Meads Geoff
Published: May 2014

This article suggests a new matrix of inter-organisational relationships within Primary Care Groups based on research conducted by the Health Education Authority.
Let the people decide
Authors: Evans Paul
Published: May 2014

In 1997 the first NHS PFI deals were signed. Two years and over £2 billion later, the public are finally being granted access to the figures and the picture doesn't look good.
Pre-emptive strike needed at PCGs’ Achilles heel: prescribing budgets
Authors: Bosanquet Nick
Published: May 2014

PCGs are off to a good start. They will soon have active chief executives and the NHS has recognised the need for realistic pay. Nonetheless, the first problem is likely to be controlling the budget. Health Improvement Programmes could stress the need to reduce teenage smoking and accidental falls among the elderly, but there is a more serious crime than not taking action on these issues. Namely, to exceed your budget. PCGs face a difficult first year.
Hague's change of tack leaves Widdecombe flailing
Authors: Roth Andrew
Published: May 2014

Poor old Tories! Just as we got set for an entertaining, protracted slugging match between the two heavweights Ann Widdecombe and Frank Dobson, Ann's manager, William Hague, sigalled her to use her ‘left’ and ‘right’ alternately. She almost threw in the towel. Little wonder since the timing could hardly have been worse: a fortnight before the 6 May elections and on the very evening top Tories wer anniversary of Mrs Thatcher's power. As they were sitting dow £150 dinner to celebrate Tha the ultra-blue carpet was being elsewhere in town.
Research answer is to ask the right question
Authors: Higgins Alan , Harries Ursula
Published: May 2014

This article highlights examples of where the commissioner/research process relationship can go wrong and suggests that asking the right questions can help to keep the process on track.
Diva's swan song ends health ‘Punch and Judy’ show
Authors: Roth Andrew
Published: May 2014

Compared to the recent health ding-dongs we've been enjoying, it was hardly earth-shattering. Nonetheless, as an historic event it showed great promise. On May 19th the Tories' most dramatic diva, Ann Widdecombe, gave what is likely to be her last health curtain-call.
BOOK REVIEWS
Authors: Buckley Peter
Published: May 2014

This book is a must for all those working in smaller not-for-profit organisations looking to address how they manage their organisations. The authors are clear in their target audience right from the start: small, often under-resourced and under-skilled agencies while including small devolved units of larger government agencies. For good measure they include students in Human Services and related courses. A broad church indeed.
The HIPs keep on rolling
Authors: Maynard Alan
Published: May 2014

The current policy problem is not that the Government doesn't have any good ideas, but that it has too many and is intent on delivering them in a half-baked manner.
NICE work if you can get it... right
Authors: Maynard Alan
Published: May 2014

Chris Woodhead, who runs OFSTED in a vigorous and innovative fashion, is slowly creating an evidence base about the performance of schools. The few schools and local authorities which fail to meet OFSTED's standards are now having their functions put out to tender by competing private groups who offer to run public facilities by contract. Is this a model for the NHS?
Storytelling, humour and learning in medicine
Authors: Calman Kenneth
Published: May 2014

This article reviews the importance and uses of humour, narrative and learning methods in medicine.

It presents a strong personal view of the potential value and use of humour within the context of delivering health care, and the lessons that it can convey uniquely and valuably.
Hilary Clinton's crusade for better US health
Authors: Roth Andrew
Published: May 2014

We have been so transfixed by the cliff-hanger result for the top job in the USA that we have tended to ignore the implications of the contest for American, and British, health care financing.
Book Review
Authors: Sawyer Brenda
Published: May 2014

With the increased emphasis on learning, personal and professional development supervision has increased in importance and relevance to all who work in health care. It has been part of the culture of nursing and professions allied to medicine for many years, and, with the advent of appraisal and revalidation for doctors, is likely to become an integral part of their development.
Measure for measure, or how can we judge the NHS?
Authors: Bell Andy
Published: May 2014

Continuing our new series of ‘Provocations’, Andy Bell of The King's Fund considers the inherent problems of finding workable criteria by which NHS performance and improvement can be judged.
Modernisationing: same old faces taking the ‘p's
Authors: Halpern Stephen
Published: May 2014

Although recent initiatives earn the Government high marks for common sense, its complete lack of strategic vision is laid bare in the announcement over the Prime Minister's ‘famous five’ challenges to the NHS.
Whistleblowing in the workplace
Authors: Mackenzie Lord
Published: May 2014

The practicalities of whistleblowing at work are considered in this article by the advisor to the Home Secretary on policing matters.
Drug marketing: a public educated / manipulated?
Authors: Copp Paul , Cardy Peter
Published: May 2014

Forum is a new opportunity for debating the ethical and professional issues which inform the working lives of our readers. In the first of the series, we examine concern over techniques used for marketing of drugs (highlighted by recent media coverage). Paul Copp, Head of Communication of Schering Health Care (makers of beta interferon) and Peter Cardy, Chief Executive of the Multiple Sclerosis Society, put forward their views.
Planning and power: anticipating the ‘New NHS'
Authors: Webster Charles
Published: May 2014

Everybody is eagerly awaiting the new National Plan for the NHS. It is somewhat disconcerting that little direct information has been released about the government's intentions. Only the seasoned observer might guess what major policy shifts are now being contemplated.
Is e-security just too e-asy to circumvent?
Authors: Harvey Trevor
Published: May 2014

‘the necessary IT metamorphosis in British health service information transfer between ... agencies will not occur without I T-competent managers in place’
Book Review
Authors: Wall Andrew
Published: May 2014

The language of quality is getting rather dog-eared: all those assurances and all those apologies. Now, the Government are making the most of clinical mistakes in order to bring doctors to heel: perhaps not a very wise policy in the long term. Whatever the motives, the long-suffering public would like to have their faith in the NHS restored.
Money, money, money for the comrades
Authors: Maynard Alan
Published: May 2014

The adverse publicity associated with the non-existent influenza crisis last winter led to major policy changes, which will give significant dollops of money to the comrades in the pharmaceutical industry and general practice.
The health improvement role for primary care
Authors: Abbot Stephen , Gillam Steve
Published: May 2014

Primary Care Groups and Trusts (PCG/Ts) are required to improve the health of their populations. How are they going about this?

This survey of 72 PCGs found that most are embracing national priorities, assessing local health needs, and contributing to Health Improvement Programmes (HImPs).

Although their focus is still on health care rather than on health, most are establishing partnerships with other agencies with a role in improving health.
Slow-slow, quick-quick, slow net
Authors: Harvey Trevor
Published: May 2014

‘the weakest link on the network dictates the speed of upload’
Funding games: at what price?
Authors: Bell Andy
Published: May 2014

Sometimes, it seems that there is a competition out there for people to come up with the most complex and bewildering system possible for reinventing the NHS. in the last year or so, we have seen an outpouring of writings from a range of ‘experts’, all purporting to have found a better system of funding health care than the one we have already. If one thing unites those schemes, it is that they are all considerably more complicated than that which we have at present. All put more responsibility (or risk) on the individual; all involve mixed systems of health care funding; and all seem to think that consumer choice is more important than fairness.
The cost of mediating clinical negligence claims
Authors: Allen Tony
Published: May 2014

The growth of claims for clinical negligence has become an administrative and financial concern for managers.

This article examines the potential in alternative methods of dispute resolution through the use of mediation.
What is evidence in health care?
Authors: Charny Mark
Published: May 2014

This is the first in a three-part series of articles looking at the issues of using evidence properly in health care.

What is meant by the terminology of evidence, and when may its uses be limited?
Nurses and nursing: influencing policy
Authors: Hammond Kate
Published: May 2014

The publication of this very readable book is timely, as nurses and nursing are seen to be playing such a central role in national health policy through the modernisation of the NHS.
Why are bankers such *ankers?
Authors: Maynard Alan
Published: May 2014

‘How can you manage primary care when you cannot answer the four service questions?’
GP support, Government policy: old stock, new market
Authors: Gillam Steve
Published: May 2014

How did it come to this? Barely nine months ago, the most inclusive listening process anyone could remember culminated in the publication of The NHS Plan (DoH 200). This promised, among other things, major investments in staff and infrastructure: 2,000 more GPs; a billion pounds for premises; and much that might be expected to ease the burden of containment for GPs in the community.
The NHS: it's not like Tescos
Authors: Bell Andy
Published: May 2014

How many times have you heard the assertion that the NHS would be a lot better to its ‘consumers’ if it wasn't a big, nationalised monolith? The idea, it appears, is that by virtue (or perhaps vice) of being a big public sector organisation, the NHS is somehow intrinsically incapable of responding flexibly to the needs of the people who have to use it.
Putting the race cards in the rest of the pack
Authors: Halpern Stephen
Published: May 2014

Racism has long been a perplexing subject for the NHS. There are complex and sometimes paradoxical dynamics which characterise the whole issue of race and health in the UK.
Animal rights and wrongs: harsh reality in medicine
Authors: Jones Trevor
Published: May 2014

This month's Provocations feature looks at the need for animal experimentation to produce new and improved drugs.
Pay ‘em or flay ‘em?
Authors: Maynard Alan
Published: May 2014

‘if paying consultants and GPs more does not raise their productivity, should we flay ’em?’
Dear Mrs Blair, (Elephant Traps & Bull Points)
Authors: Maynard Alan
Published: May 2014

Our concerns about Tony are increasing. Since our glorious victory in June, Our Beloved Leader (OBL) has continued to ramble on about the merits of the private sector in getting the NHS out of the doldrums.
The new anti-Government front on the NHS
Authors: Roth Andrew
Published: May 2014

The imminent emergence of a new multiparty assault on the Government over both its PFI proposals and its plans for closer links with the private sector emerged unnoticed in the last days just before the Commons departed for its holidays.
The witchdoctor's toolkit
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.
Michael Howard has not halved the importance of the NHS
Authors: Roth Andrew
Published: May 2014

I would hate for anyone to think that new Leader Michael Howard, in trying to restore the Conservatives as a fighting machine, has cut the importance of the NHS in half by putting it (together with education) in the hands of virile and articulate Tim Yeo.
Can Milburn nose by Brown to succeed Blair?
Authors: Roth Andrew
Published: May 2014

Can former Health Secretary Alan Milburn become Tony Blair's successor as Prime Minister, as suggested by his friend Stephen Byers? Or is he mainly the Blairites’ rottweiler, retained to sink his teeth into Gordon Brown's calf, to stop him moving next door into Number 10?
Compensatory rest – theory and practice
Authors: Meryon Marc
Published: May 2014

How ‘compensatory rest’, introduced under the European Working Time directive,
A third-rate second draft mental health bill
Authors: Bell Andy
Published: May 2014

After more than two years of waiting, last month the Government published an unprecedented second draft Bill to amend the Mental Health Act. The new draft was published with claims that major changes had been made since the previous attempt, following the controversy the latter created when it was published in June 2002.
What chance of choice?
Authors: Harvey Trevor
Published: May 2014

Choice is the key word when it comes to health care nowadays, but just how realistic is the choice of health care provision being proffered by both the major political parties in the months foreshadowing the next election? I am profoundly sceptical that any of the alternatives on offer have any real substance. Behind the choice word, the patient is faced with a lottery.
Penny-wise but pound-foolish about payment by results?
Authors: Cowper Andy
Published: May 2014

October 2004 will come to be seen as the month when the penny really dropped about payment by results. For many managers in primary care, the revelation took place at the NHS Alliance's conference in Bournemouth. The recent announcement that GP practices who wish to do so will be able to hold indicative budgets from April 2005 meant that the topic was never far from the conversation.
Is the NHS in danger of being Americanised?
Authors: Roth Andrew
Published: May 2014

Are you fearful that the NHS is being ‘Americanised’? Does it disturb you that the idea of putting a matron in charge of fifty pensioners under ‘Evercare’ is being piloted by the NHS in collaboration with the United Health Group - the American corporation that pioneered this idea in the USA?
Better organisation for psychological therapies in the NHS
Authors: Paxton Roger
Published: May 2014

Psychological therapies are effective and valued by people who use mental health services, but are in short supply in the NHS. Long waiting times are common, and there is no agreed organisational model. Some current arrangements are ineffective, inefficient and unsafe.
Rationing - the final solution?
Authors: Kernick David
Published: May 2014

The ‘Provocations’ series returns for 2004 with a thesis on how future demand for health care could be managed.
The NICE problem of affordability
Authors: Maynard Alan
Published: May 2014

Michael Rawlins, who is Chairman of the National Institute for Clinical Excellence, argues that it is not the role of NICE to consider the issue of the affordability of their guidelines and other advice to the NHS. This is legally correct as NICE's role is to give “guidance”, much of which is mandatory and whose implementation by the NHS will be the subject of scrutiny by the Commission for Healthcare Audit and Inspection.
Why Letwin disguises health subsidies as ‘passports’
Authors: Roth Andrew
Published: May 2014

I must confess to a special tolerance for soft-spoken, gentlemanly Oliver Letwin, the Tories new ‘Shadow Chancellor’, although his academic parents came to Hampstead from Chicago with a very different, Friedmanite and Thatcherite outlook from my own former New Yorker's left-wing Democrat viewpoint.
Nurturing an underclass?
Authors: Harvey Trevor
Published: May 2014

Staffing the NHS has always relied on the exploitation of niche markets in the workforce. We have a history of plugging the labour gap with short-term solutions which, though they relieve the strain for a while, distort and undermine our longer-term aims for professional development within nursing.
Will John Reid carry out Gordon Brown's NHS scenario?
Authors: Roth Andrew
Published: May 2014

The Budget-time debate on the NHS in March gave no serious hint of the heavy confrontations looming over the subject in the coming general election. The Tories’ shadow Health and Education Secretary, Tim Yeo, again promised to match Labour's spending on health but surprisingly refused to spell out precisely how their much-touted ‘Health Passports’ will work.
The mark on staff: the impact of stigma associated with mental health on the recruitment, retention and status of professionals
Authors: Gale Elizabeth
Published: May 2014

Recruitment and retention within the mental health sector has provided a challenge to managers tasked with delivering effective mental health services and supporting the National Service Framework for Mental Health.

The mental health promotion charity ‘mentality’ was commissioned by the Department of Health to consider why these problems were exacerbated within the mental health system.
Changes and developments in employment law
Authors: Edwards Gareth
Published: May 2014

The latest changes in employment law are summarised.
Promoting more accessible cancer care services
Authors: Richards Stephen
Published: May 2014

Despite The NHS Cancer Plan, problems continue in access to cancer services, as this article reminds us.
The sad state of mental health in prisons
Authors: Bell Andy
Published: May 2014

Last month, figures released by the Prison Reform Trust and mental health charity Mind found that some 52,000 prisoners in the UK (some three-quarters of the prison population) were experiencing significant levels of mental ill health. They also reported that one in 10 prisoners had schizophrenia, and that one-fifth had attempted suicide during their sentence.
The billion-dollar gamble
Authors: Greener Mark
Published: May 2014

This article looks at the cost of developing pharmaceuticals to market, and considers the changes that may lie ahead.
Walk-in patients in the context of advanced access
Authors: Jiwa Moyez , Auckloo Anjumane , Stanley Jonathan , Gordon Michael
Published: May 2014

The NHS Plan (Department of Health 2000) sets out that ‘by 2004, all patients will be able to see a primary care professional within 24 hours or a GP within 48 hours’ (Department of Health 2000).
Has the Government gone bonkers?
Authors: Maynard Alan
Published: May 2014

After the initial frugality of the Blair régime, the Government decided to invest heavily in the NHS and the Prime Minister demanded that it “act smarter”. The ‘modernisation’ of the NHS is long overdue.
The NHS manager as The NHS manager as anti-harlot
Authors: Cowper Andy
Published: May 2014

I'm not much given to quoting from longdeparted leaders of the Conservative party who aren't called Churchill, but Stanley Baldwin's fine line from 1931 denouncing the press barons Lords Beaverbrook and Northcliffe for exercising “power without responsibility, the prerogative of the harlot throughout the ages” has been much on my mind of late.
Going up the NHS's down escalator
Authors: Roth Andrew
Published: May 2014

Sometimes, when regarding the perpetual revolution in the NHS, including the latest proposal of a semi-independent, BBC-type structure, I feel as though I am revolving on a giant ceiling fan above the sort of parallel up and down escalators you see in department stores. I cannot seem to judge whether things are going up or down.
Why real patient involvement means real market research
Authors: Williams Simon
Published: May 2014

The great experiment in what the public and patients expect from the NHS has historical whiffs of the abolition of Community Health Councils, with the current proposals to get rid of Patient and Public Involvement Forums.
What is the scope to reduce workload from home visits?
Authors: Jiwa Moyez , Hossain Rashed , Davis Chris , Gordon Michael , Tooth David
Published: May 2014

Home visiting is an established feature of primary care in the UK but is not offered routinely in many other countries (Marshall 1996).