bluuebunny/crossref_metadata_2025 huggingface dataset:
Doing it by the book: statutory dispute procedure
Authors: Edwards Gareth , Day Clive
Published: May 2014

New laws from 1 October 2004 affect dispute resolution procedures. Read all about it.
Health and efficiency
Authors: Bell Andy
Published: May 2014

Of all the values society expects the NHS to uphold, efficiency has enjoyed one of the lowest profiles in the last year or so. With choice, accessibility and even equity in the ascendant, the requirement that it provide good value for money has been largely ignored in public debate.
Soaring costs, failing credibility?
Authors: Harvey Trevor
Published: May 2014

With spiralling costs and consumer dissatisfaction mounting, the NHS seems unable to get its act together. The raw data is startling. When the present Government took over in 1997, the annual cost of the NHS was £45.6 billion.
When will managers ever manage clinicians?
Authors: Maynard Alan
Published: May 2014

For thirty years, an American clinical researcher has been emphasising the problem of small area medical practice variations. John Wennberg is now in his 70s and continues to explore further a phenomenon in which American physicians are shown to offer very different volumes of care to patients.
Mixed economy for NHS provision is here to stay
Authors: Timmins Nicholas
Published: May 2014

It's over. But before we ask what it wants for Christmas, this was a month in which a number of the strands that make up the new NHS began to come together.
Has Dr John Reid turned semi-Trotskyist?
Authors: Roth Andrew
Published: May 2014

Although I had attended his wedding to my Hungarian cousin over a quarter of a century ago, I was half-content that Dr Peter Whelan, the urologist at St James Hospital, Leeds, did not turn up at my third marriage the other day.
French lessons, and why money doesn't talk: it swears
Authors: Cowper Andy
Published: May 2014

Deficits: don't ya just love 'em? This being the point in the financial year that it is, they will not have been far from your mind, what with the Department of Health strenuously denying there is going to be any bale-out cash and targets to be met.
No plaudits for Pyrrhic victories
Authors: Roth Andrew
Published: May 2014

Because Tony Blair studied law like his father, he is weak on history. He will not have read about King Pyrrhus of Epirus, 318-272 BC, who gave his name to counter-productive Pyrrhic victories. In contemporary politics, this means that you can win the vote without winning the argument or solving the problem.
The Ides of March for the ‘new NHS’?
Authors: Timmins Nicholas
Published: May 2014

It's over. But before we let it go let's examine its entrails to get a glimpse of the future. It has been a big month for managers, with almost every bit of the “new NHS” in play.
What follows targets?
Authors: Cowper Andy
Published: May 2014

The re-definition of performance targets has been signalled in recent policy announcements by the Health Secretary and the NHS Chief Executive.
Managing poor performance in primary care
Authors: Baeza Juan I
Published: May 2014

The management of poor performance within the National Health Service has become an increasingly important issue in recent years, both politically and professionally.

However, historically it has proved difficult to manage this area within primary care.

The implementation of clinical governance provides a framework within which primary care organisations can potentially tackle this issue more effectively.
Institutional racism and NHS mental health care
Authors: Bell Andy
Published: May 2014

Last month, the independent inquiry into the death of David Bennett found the NHS, or at least the mental health service part of it, to be institutionally racist. The publication of the inquiry led to a fierce debate in the media about whether or not this was the case; whether the Government accepted the allegation or not; and what it was planning to do about it.
The lost word
Authors: Ainsworth Steve
Published: May 2014

Birds incubate their eggs by sitting on them, hence the word incubate - from the Latin verb in-cubare to lie upon. But since the warmth in incubators comes from beneath not above, their name ought really to a derivation of sub-cubare. A pity succubator sounds so rude.
Fund, fund, fund
Authors: Timmins Nicholas
Published: May 2014

It's over. But before it goes, it is worth wondering what historians will make of the current debate about the funding of the NHS.
Lining the doctors’ pockets
Authors: Harvey Trevor
Published: May 2014

The original concept was flawed. The central socially reconstructive project of the Labour government which immediately followed the Second World War was the founding of the NHS, and the fledgling organisation seemed very vulnerable, even to its boisterous creator, Nye Bevan.
Why ignore the obvious?
Authors: Maynard Alan
Published: May 2014

The last thing the NHS wants is further shifting of the deck chairs on the Titanic with further madcap non-evidence based reforms. However, the other last thing the service and its patients want is a loss of focus on the need to manage clinical activity.
The balancing act
Authors: Cowper Andy
Published: May 2014

It's a miracle. No, really, it is. The past three months have seen a series of deeply concerned acute trusts (in the south of England in particular) issuing official and unofficial warnings that they were going to be overspent in a big way as a result of ‘target practice’. Yet Sir John Bourn, Head of the National Audit Office was able to report to Parliament that the Department of Health successfully met its target of ensuring that financial balance was achieved in aggregate across the 607 individual NHS organisations. The NHS as a whole reported an underspend of £96 million within the context of health care commissioned of £46.7 billion.
The US Medicare programme in political flux
Authors: Marmor Ted
Published: May 2014

For more than twelve months, Medicare, the costly but popular public programme of hospital and physician health insurance for America's disabled and citizens over 65 years of age, has been constantly in the news in the USA.
Of choice and consequences
Authors: Bell Andy
Published: May 2014

Choice, is appears, is now the Big Idea in health policy. In almost every document produced by the Department of Health over the past year, it has been a constant presence. It has been the subject of Labour's Big Conversation and the Tories’ Patient's Passports scheme. Even the recent public health consultation paper was named ‘Choosing Health?’ as if to emphasise that this really is the signature issue for all health policy thinking.
The NHS Spring clean-up and the departure of Simon Stevens
Authors: Timmins Nicholas
Published: May 2014

It's over. But before we kiss it goodbye, it's worth considering that if April is the cruellest month of year, May can bring in the spring. And there is an undoubted sense of spring inside the Department of Health at the moment: a mood that contrasts sharply with the sense of anxiety that was discernible at the end of last year.
NHS mergers compared with the private sector
Authors: Furniss Lee
Published: May 2014

How do mergers in the NHS compare with best practice in the private sector?
Reporting the truth
Authors: Bell Andy
Published: May 2014

Every once in a while, a report turns up that tells us nothing new but relates it in a new way: one that that finally galvanises governments and public services into action in an area they have previously neglected.
Regulation, confusion, and career moves for Sir Nigel Crisp
Authors: Timmins Nicholas
Published: May 2014

This time the column looks forward. And here's a thought. If the Government follows its reforms to the NHS through to their local conclusion, Sir Nigel Crisp will hold a unique distinction. He will be the first and last person to be, at the same time, both permanent secretary at the Department of Health and chief executive of the NHS.
Mitigating risks associated with major IT projects
Authors: Cook Anna
Published: May 2014

Public and private sector companies are now well versed in the risks associated with complex IT projects. Some highprofile government projects, such as the computer system for the Child Support Agency, have become notorious for delay and spiralling costs.
The high cost of pensions
Authors: Ainsworth Steve
Published: May 2014

It was the 81-year-old Victorian Prime Minister Lord Palmerston who famously said ‘Die my dear Doctor? That's the last thing I shall do’. Today, more and more folk share Palmerston's sunny outlook, and they do so with some confidence Compared to our recent ancestors, 21st-century man is almost immortal.
Wish it could be Christmas every day? Become a GP.
Authors: Maynard Alan
Published: May 2014

The 2004 contract for general practitioners was a triumph of BMA trade unionism. It seems taxpayers shelled out an additional £2 billion a year and that some GPs now do less work. Perhaps these lucky GPs need more leisure time to spend their inflated salaries, estimated by some audit figures to be £100,000 per annum?
The windmill
Authors: Cowper Andy
Published: May 2014

No, it's not the name of a pub. Ok then, yes it is, but it's also something a bit more useful to us than that as the ingenue 2006 makes its nervous debut. The windmill is a metaphor.
The high-wire act of financial balance in the NHS circus
Authors: Timmins Nicholas
Published: May 2014

December 2005 was the one when the big fat chicken known as NHS accounting came home to roost.
Crisis in the credit card NHS
Authors: Roth Andrew
Published: May 2014

Although you may not have read about it in the skimpy coverage national newspapers accord to serious Parliamentary debates, but more and more MPs are complaining that the deepening crisis in the NHS (now facing an aggregate deficit of £1 billion) is a result of inadequate financial brains on the top boards of hospital trusts.
The New World? NHS Alliance 2005 annual conference (2)
Authors: Cowper Andy
Published: May 2014

Day Two began with Professor Dame Carol Black of the Royal College of Physicians, Professor Aidan Halligan, Director of Clinical Governance for the NHS and Professor Sir Ian Kennedy, chair of the Healthcare Commission launching the debate on regulation.
Why public health matters
Authors: Cowper Andy
Published: May 2014

In ‘Stuck Inside Of Mobile With The Memphis Blues Again’, Bob Dylan wrote about “Waiting to find out what price / You have to pay to get out of / Going through all these things twice”. Then again, Bob also wrote “Wiggle, wiggle, wiggle like a bowl of soup”: it's hard to know which to believe.
Choice, voice and the parlous state of public health
Authors: Cowper Andy
Published: May 2014

DH: Choice is a complete nonsense in health care. Paradoxically, choice has been foisted on people — they were not given the choice! Personalisation is the more important issue, not choice. Choice is wasteful of scarce resources and it is not wanted, despite what ministers insist adnauseam.
Hate something, change something, make health care better
Authors: Thornton Stephen
Published: May 2014

I was at a conference recently when a speaker referred to an advert for Honda cars which has been much acclaimed by advertising gurus. It talks about public dissatisfaction with dirty, noisy, diesel engines and uses the mantra of “hate something, change something, make something better”.
Reflections from Romania on NHS leadership
Authors: Born Chris
Published: May 2014

A recent visit to Romania to speak on health service leadership and management gave me the opportunity to reflect on the high standards of behaviour in the NHS and the support we give to service, clinical and leadership development.
The Powers That Be have lost the plot
Authors: Maynard Alan
Published: May 2014

We are promised hospital closures and the rationalisation of maternity and accident and emergency facilities across England, and particularly in the London area and the North East.
To err is human; to forgive divine
Authors: Maynard Alan
Published: May 2014

Hospitals are dangerous places, where patients are damaged and killed every day due to simple errors. The failure of operatives to wash their hands leads to avoidable infections such as MRSA and C. Diff, which can kill and are very costly to remedy for those who survive.
PCT commissioning: an innovative approach
Authors: Beenstock Jane , Cleary Paul , Green Barbara , Johnstone Fiona , Jones Sue , Lavan Eugene
Published: May 2014

In this article, we describe how we have understood the new commissioning agenda for primary care trusts and the approach that has been taken across three PCTs.
Engaging clinicians in NHS innovation
Authors: Crump Bernard
Published: May 2014

The November issue of this publication featured an interview with Dr Michael Dixon of the NHS Alliance (Cowper 2006). In the interview, the value that the NHS Institute for Innovation and Improvement is adding was questioned, as was the extent to which the organisation is engaging with clinicians.
The European Working Time Directive 2009
Authors: Ahmed-Little Yasmin , Bluck Matthew
Published: May 2014

European Working Time Directive (EWTD) has become a term that provokes a variety of reactions within the medical profession.
NHS deficits: a triumph of fragmented management
Authors: Maynard Alan
Published: May 2014

The NHS deficit in England was small in comparison to overall expenditure but created a political circus that has led to the Secretary of State putting her job on the line by promising financial balance at the end of March 2007. She has promised a report on the causes of the deficits before the year's end.
The new financial balance
Authors: Cowper Andy
Published: May 2014

If Fortune favours the brave, then a lot of NHS managers must be wondering how the Lady Goddess feels about the suicidallyinclined. The recent White Paper, imaginatively titled ‘Our Health, Our Care, Our Say’ (DH 2006), will not provide them with much enlightenment.
Booming voices for patients in ‘Our Care, Our Health, Our Say’
Authors: Timmins Nicholas
Published: May 2014

Although it was January, already you can feel the searing heat of the sun. To patient choice, the Government is to add patient voice.
The wrong cure for Hewitt's billion-pound headache
Authors: roth Andrew
Published: May 2014

A normal person, afflicted with a blinding headache, would probably reach for a paracetamol, a wet cloth and retreat to a quiet dark room. Not Health Secretary Patricia
From rhetoric to reality: PPI in general dental practice
Authors: Richards Wayne , Evans Linda
Published: May 2014

In December 2003, a Strategic Framework for the NHS in Wales was published for implementing the principles from the Review of Health and Social Care in Wales advised by Derek Wanless (Welsh Assembly Government 2003). This report is routinely referred to as the Wanless Report.
Changing how we act out the annual NHS pantomime
Authors: Hardacre Jeanne , Keep Jane
Published: May 2014

It's pantomime season again, boys and girls! (Oh yes it is!) And the pantomime's format is pretty predictable: we can even guess some of the plot, even if we can't anticipate all the surprises stored up for us backstage. Let's remind ourselves of the story so far for 2006 …
Making NICE work of rationing: it's the productivity, stupid!
Authors: Maynard Alan
Published: May 2014

After seven years of plenty, the NHS is heading for the biblical difficulties of seven years of famine. According to HM Treasury's Comprehensive Spending Review, things look bleak for the NHS.
Gravity talks
Authors: Cowper Andy
Published: May 2014

You'll probably remember the Newton's Pendulum. These were popular executive toys in the 1980s - a decade that taste forgot. They sat on executive desks and in executive homes, a load of balls suspended by nylon thread from a thin frame. Yes, it does sound rather like a bit of Department of Health policy of recent vintage, doesn't it?
Practice-based commissioning and practice engagement
Authors: Hynes Donal
Published: May 2014

The concept of demand management has changed radically over the past few years. Initially seen as a series of measures to restrict patient access to scarce resources, it is now focussed on ensuring that patient's needs are matched with an appropriate and available range of provision.
O Lord (or Allah), out of this policy mess, grant us order!
Authors: Maynard Alan
Published: May 2014

There is a policy shambles in the NHS and Whitehall Village, as a result of the reform frenzy of recent years. Where shall we start in describing this dismal balls-up? For make no mistake, that is precisely what it is - leaving us up a certain creek.
If I were going there, I wouldn't start from here
Authors: Cowper Andy
Published: May 2014

Great. We just got rid of one middle-aged white knight of the realm, and then they send in another one.
Can Patricia Hewitt's career survive Tony Blair's?
Authors: Roth Andrew
Published: May 2014

Has the meltdown of the reputation of Patricia Hewitt outstripped that of Tony Blair? We should know that by Parliament's recess, beginning at the end of July.
Bolstering clinical research in the NHS
Authors: Greener Mark
Published: May 2014

British clinical research and development has long punched above its weight. Indeed, it's a world champion. British laboratories developed around half the major medicines sold in the UK, including propranolol, cimetidine and sildenafil.
Life's a puzzle … or is it a problem?
Authors: Ainsworth Steve
Published: May 2014

Most folk have a manager, subordinate or colleague whom they dislike, or in extreme cases loathe to such an extent it makes them quite literally feel ill to be in their presence.
A tale of true overspends, connecting for health audited, and commission
Authors: Timmins Nicholas
Published: May 2014

June 2006 was the one in which the overspend — or a version of it — finally came home to roost. One that saw the National Audit Office, a year later than promised, come to no very particular conclusion about the NHS's mighty £6.2bn, or £12.4bn, or £20bn IT programme. And one that saw another brick put in the wall of the Government's new style NHS with the invitation to the private sector — chiefly to health insurers — to tender for a call-off contract for primary care trust commissioning.
Monitoring progress
Authors: Cowper Andy
Published: May 2014

I haven't studied the figures yet, but the Government has to deal with two things with these figures: the financial position of individual organisations, and also with health spending in terms of the national economy
Planning a treatment centre's outpatient services
Authors: Bowers John , Lyons Bob , Mould Gillian , Symonds Tom
Published: May 2014

When the Nottingham health community began planning a new treatment centre, they welcomed the opportunity to redesign outpatient services into a new setting. However, the lack of detailed information of exactly what resources outpatients required posed an initial problem.
The cost of deficits to mental health services
Authors: Bell Andy
Published: May 2014

The impact of the NHS's current financial situation on mental health services has been the topic of some debate in recent weeks. Some have claimed the pressure is biting hard and causing wholesale losses of services. Others, most notably the DH, report that mental health trusts are better off than average and in good shape.
Unlike ours, French health hacks seldom bite
Authors: Roth Andrew
Published: May 2014

During my August holiday in France, I was struck by the absence of complaints about failures in the French health service by their health correspondents. Admittedly, this was partly because I just missed the end-July doctors’ strike for better pay.
Looking to the IHM's future
Authors: Cowper Andy
Published: May 2014

That depends on who you talk to! It certainly isn't the place it was in the 1960s and 70s, when it was the only place to get support, education and training.
How much spending is enough?
Authors: Bell Andy
Published: May 2014

In the midst of the August ‘silly season’, a short report by the King's Fund (2006) created a small storm by showing variations in programme budget spending across England. The report was the first of its kind to use the recently available data showing how much PCTs devote to each of the broad ‘disease areas’ the NHS treats.
Public health: evolution, devolution or dud?
Authors: Griffiths Sian , Griffiths Sian , Hunter David J
Published: May 2014

Back in 1999, with New Labour still in its first flush of enthusiasm and impatient to make its mark on public policy, we published a collection of essays on the state of public health in the UK.
Electing for health
Authors: Cowper Andy
Published: May 2014

So we have learned something unsurprising about PM Gordon Brown — that he is not a gambler. There will not be a general election this year, nor probably next. Despite the comprehensive spending review being brought forward, and the NHS due to get 3% a year for the next three years, the polling of key marginals evidently looked too tight.
The utility of culture in healthcare reform
Authors: Halligan Aidan
Published: May 2014

What everyone knows but nobody says is that the greatest barriers to systematically imposing the quality of medicine are not financial, structural or technical, but practice, custom and tradition — cultural.
Time for PCTs to embrace democracy
Authors: Bell Andy
Published: May 2014

Primary care trusts could be forgiven for feeling under attack from policymakers over the past month. Health minister Ben Bradshaw stated that PCTs “don't have any democratic accountability ... If people in their local area don't like what their PCT is doing it is quite difficult for them to make their voices heard” (quoted in HSJ, 13.9.07).
The indefensible
Authors: Cowper Andy
Published: May 2014

I've been writing about NHS management for some years, and probably more importantly, learning and reading about it. It has been an interesting, occasionally shocking and almost always worthwhile voyage of discovery. The intention with which I started has remained unchanged — to help in the promotion of improving health services.
The future is already here if we want it ...
Authors: Halligan Aidan
Published: May 2014

In 1859, typhoid fever and cholera were killing thousands of Londoners each year. Yet the idea that Government should intervene was still seen by many as an unacceptable infringement of freedom. “We prefer to take our chance with cholera and the rest”, declared The Times, “rather than be bullied into health” (Robert Lacey, Great Tales of English History, 2006: 175).
Ann James
Authors: James Ann
Published: May 2014

So far my career has taken me through roles in hospitals, mental health services, regional health authority and community trusts as well as PCTs.
Three cheers for CBT funding
Authors: Bell Andy
Published: May 2014

While most of the country was debating the politics of inheritance tax the day after last month's Comprehensive Spending Review, Health Secretary Alan Johnson announced an historic decision to invest in a national effort to make psychological therapies available on the NHS across the country.
Summing up
Authors: Cowper Andy
Published: May 2014

Whether it's your budget surplus or the ever-decreasing number of shopping days left till Christmas, it's a summing-up time of year. What counts, both literally and metaphorically, is what matters.
Awash with cash; still not cleaning up
Authors: Timmins Nick
Published: May 2014

Novemeber 2007 was c. diff, if not v. diff. And one can only hope that, in a decade's time, anyone trawling through the archive of this journal will find that little joke incomprehensible because the service will have got on top of hospitalacquired infections.
Put polyclinics in supermarkets
Authors: Roth Andrew
Published: May 2014

Even without being offered a life peerage for my pains, I am happy to propose a plan that will ease the stand-off between the Government and Britain's GPs.
Building healthcare strategy, cradle to grave
Authors: Darzi Lord , Oborn Eivor , Howitt Peter
Published: May 2014

Developing regional strategy is lacking in modern healthcare systems (Porter and Teisberg 2006).
The ongoing fight with healthcare infection
Authors: Siddall Rhonda
Published: May 2014

The Health Act 2006 and the Code of Practice for the Prevention and Control of healthcare-associated infections (HAIs) enshrine the commitment of the NHS to improve its performance on HAIs.
The out-chirping of Hazel Blears
Authors: Roth Andrew
Published: May 2014

It is rare that you enjoy coming back from a Christmas fortnight in France to travel through the thick pile of British newspapers your newsagent has been saving for you. But this time it was a double delight to find that tiny, chirpy Hazel Blears had joined a Salford picket line protesting a threatened closure of the maternity ward of the local Hope hospital.
Is the NHS providing value for money?
Authors: Smith Peter C
Published: May 2014

The financial condition of the English National Health Service has recently received an extraordinary amount of attention from the media and politicians. Extra money has poured into the NHS since 2000, yet the NHS as a whole is struggling to contain expenditure within its overall budget.
Shifting eligibility criteria for social care
Authors: Bell Andy
Published: May 2014

That adult social services are being forced to raise their thresholds for home care is hardly shock news, nor indeed is it new. Every year of the last decade and more has seen evidence that social services departments are working more intensively with fewer people with higher levels of need than ever before.
No hope for Hewitt
Authors: Roth Andrew
Published: May 2014

No matter how talented a chameleon, Patricia Hewitt has, according to a recent poll for doctors.net.uk website reported in The Times (Hawkes 2007), united twothirds of Britain's doctors against her and persuaded almost half of them to retire prematurely or move their work to another country.
That'll be £6,496 please, Mr Jones
Authors: Appleby John
Published: May 2014

You may not have spotted a new policy initiative trailed by the prime minister's Strategy Unit in March. Apparently, the new policy seems to be based on the notion that the NHS works something like this Man in surgery: “I'd like a new hip please, doctor.”
Hewitt's hairy moment as she does a U-turn
Authors: Roth Andrew
Published: May 2014

However risible, the Government's U-turn on interviews for aspiring young doctors was very graceful.
The 15 letters that spell a swear word
Authors: Cowper Andy
Published: May 2014

Reconfiguration is a 15-letter word. This has not prevented the NHS from treating it very much like a four-letter word.
Patients must not pay the PPRS price
Authors: Barker Richard
Published: May 2014

NHS managers are actively seeking to get the best value for money in all aspects of their work. With financial pressures and budgetary constraints a matter of public debate, the need is paramount. Medicines are not above this scrutiny — nor should they be.
Cost and value: The new pharmaceutical frontier
Authors: Bosanquet Nick
Published: May 2014

The well-trodden path of relationship between pharma companies and the NHS is now coming under new seismic stress. The doubling of expenditure on drugs over the last five years brings about stronger pressures on value for money. In 1987, the NHS spent £2 billion on drugs. It now spends £11 billion. There are specific challenges from a new range of high-cost drugs which need to be targeted.
The sum total is better management
Authors: Maynard Alan
Published: May 2014

The effects of workforce increases and the reform of pay contracts for GPs and consultants, and of Agenda For Change (A4C) on NHS finances has been nicely described in a recent report of the Select Committee on Health (2007).
The NHS Blair years
Authors: Cowper Andy
Published: May 2014

Beware a leader in search of a legacy? Watching Tony Blair's performance at the recent Kings Fund event, that thought sprang to mind despite a highly effective performance by our own dear Great Communicator.
Blair legacy: good policy but unfit commissioning
Authors: Cowper Andy
Published: May 2014

Yes — but with the introduction of better financial incentives. The Government has gone some way in this direction, but less far than it wanted with competition and choice. Impatience with the rate of progress led to some problematic things, like the rather heavy-handed imposition of ISTC contracts on PCTs.
Don't forget, we're in it for the long-term
Authors: Sang Bob
Published: May 2014

Last issue (Sang 2007), I looked at changing aspects of public and patient involvement in the NHS over the last decade.
Service-line reporting is key to productivity
Authors: Moyes Bill
Published: May 2014

“I had no idea an extra 10 minutes in theatre cost so much”: not the words of a new management accountant, but a senior clinician working in an NHS foundation trust.
Peter Homa
Authors: Homa Peter
Published: May 2014

I was fortunate to be appointed as a Chief Executive of a large teaching hospital at the age of 32. I was very daunted by the seemingly myriad of challenges and questions that presented themselves for me to solve on a daily basis. At an early stage of this job, I had to make a Director appointment in the Trust.
End game nears for Mental Health Act
Authors: Bell Andy
Published: May 2014

While the NHS faces a summer of industrial action over pay, the Mental Health Bill continues its own troubled progress in Parliament.
The question of NHS independence
Authors: Cowper Andy
Published: May 2014

Independence, like virginity, is an absolute. Either you are, or you're not. The NHS, while it remains mainly tax-funded and universal, is not.
Your money or your statistical life?
Authors: Appleby John
Published: May 2014

NICE (the National Institue for Health and Clinical Excellence) could be forgiven for feeling increasingly a bit put upon. Although the evidence doesn't support an increase in appeals against its decisions, since 1999 around a third of its appraisals have been challenged (with under half of those challen ges upheld).
Hats off to the NHS break-even success
Authors: Timmins Nick
Published: May 2014

May 2007 was a month, almost, to revel in. Now this column, like all journalism, normally deals with problems. They are the stuff of dayto-day life.
An open letter to Gordon Brown
Authors: Roth Andrew
Published: May 2014

Since you say you are in a ‘listening mood’, I am making my first-ever proposal of a person for the job certain to be vacated by Patricia Hewitt. I am encouraged by your promise that you plan to include ‘all talents’ in your long-awaited first Cabinet.
Power to the people? The true costs of choice
Authors: Cable Vincent
Published: May 2014

Frustration with public services often relates to the lack of personal attention and service: the treatment of individuals as an undifferentiated mass of people who should be grateful for what the state provides. Queuing and rationing quickly induce this kind of relationship.
Repression or repair? Managing complaints
Authors: Kent Alexandra
Published: May 2014

Sweden's model of the caring society is often trumpeted as being as close as one can get to an ideal world. With characteristic self-deprecation, the British are inclined to compare themselves unfavourably with their Scandinavian neighbours.
No words from the Healthcare Commission
Authors: Cowper Andy
Published: May 2014

Back in March, the Healthcare Commission were invited to participate in our new slot for ‘The Regulators’, giving them an opportunity to speak directly to the NHS management community (or those bits of it wise enough to read BJHCM) about a subject of their choosing.
Public involvement - an inconvenient truth
Authors: Sang Bob
Published: May 2014

In the autumn of 2006, I observed thousands of people rally in Worthing on the south coast in defence of their local hospital and, more specifically, its Accident and Emergency department.
‘Multimorbidity’ must be managed
Authors: Bell Andy
Published: May 2014

The prospect of strike action by nurses and the anger of junior doctors put the NHS in the headlines yet again last month. This of course is hardly a rarity, and will amount to quite a headache for managers.
NHS management costs low? Not so
Authors: Maynard Alan
Published: May 2014

The conventional wisdom is that tax financed health care systems such as the NHS have low managerial costs, while systems based on private insurance, such as the USA, are very expensive to manage
Better clinical engagement
Authors: Cowper Andy
Published: May 2014

Welcome Mr Brown and Mr Johnson. Our ‘health advice’ feature (p. 239) offers a good steer on the key issues from industry leaders and experts. Maximise newness in the job while you can, and good luck. You will need it.
Time for NICEr public engagement?
Authors: Dillon Andrew
Published: May 2014

Making decisions about resource allocation in the NHS is likely to cause debate at the best of times, even when the issues being decided are internal to a single organisation and the dialogue confined to the staff concerned.
No magic bullet for commissioning
Authors: Bell Andy
Published: May 2014

If anyone had a magic bullet for the kind of healthcare commissioning we all know we want but by and large do not have, they might very soon become incredibly wealthy.
Why the NHS must think about sustainability
Authors: Davis Alan Maryon
Published: May 2014

Until now, most of what's been written about climate change has tended to focus on its potentially catastrophic environmental and economic impacts. Less has been written about the potential public health disaster, which is every bit as real.
It's the incentives that matter, stupid!
Authors: Maynard Alan
Published: May 2014

What makes the world go round? Incentives, of course! The behaviour of everyone — including doctor gods, nursing angels and manipulating managers — is a product of the incentives they face. Sadly, this is as obvious as it is continually ignored when dealing with perverse behaviours in healthcare markets.
King Complex and Slack Tongue models
Authors: Appleby John
Published: May 2014

If you thought that the King Complex and Slack Tongue title above referred to an alternative stand-up comedy duo or perhaps a couple of Orleans-based bluesmen then you have obviously never played the simulation game Theme Hospital; a place where an MRSA outbreak is represented by visibly growing green blobs and doctors treat problems like Bloaty Head using a machine with a big spike attachment.
Pilots prior to polyclinics, please
Authors: Roth Andrew
Published: May 2014

I knew there was someone or something missing when Alan Johnson was named Secretary of State for Health. An amiable and emollient man from a modest working-class background and the former moderate head of the postal workers’ union, he was ideally suited to smoothing the ruffled feathers of the unhappy unions and professional bands who make up the 1.3 million NHS employees.
The Emperor's new NHS business clothes
Authors: Bamji Andrew
Published: May 2014

Current dogma has it that care must be shifted from hospitals ‘into the community’. As a result of this ill-considered idea, born of politicians who won't listen to doctors, we have ended up with consultants and GPs (or their respective managers) fighting again. When I leave my hospital I do not cross a barbed-wire fence with a notice saying ‘You are now entering the community’.
The Mental Health Act: could be worse
Authors: Bell Andy
Published: May 2014

Following eight years of heated debate, we finally have a new Mental Health Act. Its implications for health services are far-reaching.
Dr Patrick Geoghan OBE
Authors: Geoghan Patrick
Published: May 2014

Bringing together two organisations through merger was a huge challenge — particularly when you have been the chief executive for one of the two. It's a bit like relationship therapy: you need to help both parties work through their feelings and come to a mutual understanding about the way forward for the relationship. The skill lies in taking the best of both, and you reach the tipping point when you have managed to create something new that people can get excited about really want to ‘buy into’.
Commissioners - pee or get off the pot!
Authors: Maynard Alan
Published: May 2014

Just what do we want commissioners to do? The answer is that we want them to be discriminating purchasers but generally they are passive bank clerks paying out taxpayers’ money.
I screen, you screen, we all screen …
Authors: Appleby John
Published: May 2014

I screen, you screen, we all screen for abdominal aortic aneurysm (AAA): ultrasound screening for men aged over 65 some time soon. Should we?
NICE, social value judgments and you
Authors: Rawlins Michael , Gillis Tonya
Published: May 2014

No matter how good the evidence, scientific advisory committees have to make judgments. NICE's advisory bodies are no exception.
A mentally healthier new year
Authors: Bell Andy
Published: May 2014

Last year, the NHS lost an estimated £1.3 billion because of mental ill health among the people who work for it. Such was the finding of a report we published at the Sainsbury Centre at the end of 2007 following a study of the impact of untreated, often unidentified, mental distress in Britain's workplaces.
Bad times just around the corner
Authors: Timmins Nick
Published: May 2014

September 2008 was the month in which it became clear, in Noel Coward’s timeless and cheering phrase, that there are bad times just around the corner.
Disability discrimination law 1: defining disability
Authors: Griffith Richard
Published: May 2014

Around 20% of people of working age are considered, by the Government and Disability Rights Commission, to be disabled as they have a disability or long-term health condition that has an impact on their daily lives. They are protected by the Disability Discrimination Act (DDA) 1995, which addresses the discrimination that many face. Healthcare managers have a significant role in supporting disabled employees and users of health services. As part of that support, it is essential that they are aware of how the law defines a disability and what constitutes discrimination.
A case of the emperor's new clothes?
Authors: Jones Rod
Published: May 2014

The Department of Health (DH) recently published a response to the consultation over the future of payment by results, including developments in the national tariff and the process of setting the tariff (DH, 2008).
Table manners at the healthcare feast
Authors: Maynard Alan
Published: May 2014

As those feasting from the £105 billion available on the NHS table begin to realise that one faction's gain is another group's loss, the cacophony about healthcare rationing grows. All the feasters are developing an Oliver Twist syndrome of wanting ‘more’. But with limited budgets, opportunity cost rules: treating you denies me of care.
Japan's long-term care insurance
Authors: Ikegami Naoki
Published: May 2014

When the NHS was established, ‘health care’ was made available to all and free at the point of delivery, but ‘social care’ remained with the local authorities and continued to be provided after a means-test (i.e. only for the poor). With the aging of society, the dividing line between health and social care has become blurred. Older people need a complex combination of both services.
The NHS PROMs: a historic moment
Authors: Appleby John
Published: May 2014

As Nick Timmins pointed out in last month's BJHCM, health economists have been clapping their hands with glee over the prospect of the NHS routinely recording patient reported outcome measures (PROMs) for some selected interventions from April 2009. This will be a first, not just for the NHS, but for any national health system in the world.
Odds on for Lansley's gamble?
Authors: Roth Andrew
Published: May 2014

I am glad I bet on Andrew Lansley as the frontbencher best able to help David Cameron to de-nastify the Conservatives on health. His pro- NHS approach, like that of most Tory voters, contrasts with the pro- BUPA line of his radical rightwing predecessor, Dr Liam Fox.
Gill Morgan
Authors: Morgan Gill
Published: May 2014

Gill Morgan, current Chief Executive of the NHS Confederation, reflects on the challenges the NHS faces and her forthcoming role
A new era for carers of disabled children?
Authors: Foster Rosey
Published: May 2014

Rosey Foster, chair of Contact a Family, considers whether 2008 might be the year when families with disabled children get the support they need
Marketing madness
Authors: Hill Rosalind
Published: May 2014

Allow me to introduce myself: I am the new editor of the British Journal of Healthcare Management, having taken over this role from the renowned Andy Cowper, who sat in the editor's chair for 8 years-a tough act to follow.
Laparoscopic adjustable gastric banding
Authors: Rhodes Michael
Published: May 2014

There is a morbid obesity epidemic in the UK. In 2001, the National Institute for Health and Clinical Excellence (NICE) estimated there were 1.2 million morbidly obese people in the country, and this is rising year on year.
Jennifer Dixon
Authors: Dixon Jennifer
Published: May 2014

When I left medicine in 1989, it took me a long time to accept that, after all the training, exams, drama and hard graft during my 20's as a junior hospital doctor, and the advice of many, clinical medicine was not for me.
The P4P bug: proceed with caution
Authors: Maynard Alan
Published: May 2014

Healthcare systems worldwide are being infected by the pay for performance (P4P) bug. As with the consumption of tobacco, this condition should carry a health warning.
See? Oh! Too (much)
Authors: Appleby John
Published: May 2014

The cost of the NHS can not just be measured in pounds spent but, as the Department of Health has recently reported, it can also be computed interms of its carbon footprint; that is, how much carbon dioxide (CO2) its activities produce. In one sense the NHS contribution to England's total carbon footprint is small–around 3%. But that doesn't minimise its responsibility–particularly given the health consequences of climate change.
Caroline Shaw
Authors: Shaw Caroline
Published: May 2014

The people from whom I learned the most are Dr Helen Bevan OBE, Director of Service Transformation at the NHS Institute for Innovation and Improvement, and Dr Peter Homa, Chief Executive of Nottingham University Hospitals NHS Trust.
Everything the same, but whats different?
Authors: van Terheyden Nick
Published: May 2014

Medicine and disease are remarkably similar from one country to the next; what changes is the individual access together with some variance in disease prevalence. These issues can mostly be explained by geography and local environmental factors.
Paying for quality and best practice
Authors: Appleby John
Published: May 2014

Page 55, paragraph 40 of Lord Darzi's Next Stage Review puts forward an interesting, and at first sight, appealing suggestion for varying the payment by results tariff to reflect best practice.
Tomorrow's world: telecare
Authors: Sadler Steve
Published: May 2014

Since it was first aired in 1965, the BBC's iconic programme Tomorrow's World informed, instructed and entertained viewers with a glimpse of how we would live in decades to come.
Past, present and future superlatives
Authors: Hill Rosalind
Published: May 2014

Last month I attended my first NHS Confederation conference, the most important date in the healthcare calendar, with a degree of trepidation.
Stephen Davies
Authors: Davies Stephen
Published: May 2014

The Service Delivery and Organisation (SDO) programme exists to commission research that is relevant to managers in the NHS. It aims to create new partnerships between managers and researchers and to promote the cause of evidence-informed management practice. In my view, this is essential if managers are to manage the complexities of modern healthcare and are to be valued as peers by clinical colleagues.
About time: hopes and aspirations
Authors: Bell Andy
Published: May 2014

Research has consistently shown that most people who have periods of mental ill-health would like to work. We also know that anyone with a mental health problem can work if they have the belief in themselves and effective, ongoing support.
Managing markets, monitoring changes
Authors: Maynard Alan
Published: May 2014

Since Thatcher's NHS reforms, which created the purchaser–provider split and an internal market, there has been a need for constant regulation. In the 1990s there was advocacy of mechanisms similar to those created to regulate public utilities. But OFFSICK, a regulator agency for market transactions in the NHS, was not created.
Duty of confidence: sharing information
Authors: Griffith Richard
Published: May 2014

eciding when personal information about a patient can be disclosed is often a function that healthcare managers are required to undertake. It requires them to consider whether the general duty to maintain patient confidences has been tipped in favour of disclosure. Making the correct decision is crucial and the burden on the manager to get it right is a double-edged sword. An inappropriate disclosure might result in an allegation of a breach of confidentiality; an inappropriate failure to disclose may result in the patient not receiving the care and treatment they require or worse, be subject to continued distress or abuse. For example, a case highlighting how confusion over the extent of the duty of confidentiality to a patient can result in crucial information not being disclosed was reported by the Safeguarding Children Board in Birmingham. They found that a 15-year-old girl killed herself some three weeks after telling a nurse that she had been raped. The nurse agreed to keep the conversation confidential and did not refer the allegation on to her manager, police or social services (Doherty, 2007).
Resolving the care crisis: technology in action
Authors: Fröderberg Urban , Harvey Trevor
Published: May 2014

It is well known that an ageing population, ever-changing health and social care models, staff shortages, and the ongoing drive to streamline expenditure, are adding pressure to an already stretched healthcare system.
NHS Information Centre
Authors: Straughan Tim
Published: May 2014

An independent special health authority, The NHS Information Centre (The NHS IC) is England's central, authoritative source of health and social care information.
One small step, one giant leap
Authors: Hill Rosalind
Published: May 2014

As I write this month's editorial (Monday 1 September), thousands of 12- and 13-year-old girls across Scotland will begin receiving vaccinations against cervical cancer, with pupils across England, Wales and Northern Ireland receiving their jabs in the coming weeks.
Bills, bills, bills: problems for NICE
Authors: Timmins Nick
Published: May 2014

August 2008 was a nasty month for NICE, save that finally, almost a decade on from the creation of the National Institute for Health and Clinical Excellence, some of the fundamental issues that lie behind the decisions it has to take may be beginning to be addressed.
HCAIs: challenging the assumptions
Authors: Cole Mark
Published: May 2014

Healthcare-associated infections (HCAIs) are a modern day and worldwide healthcare reality that affect hundreds of millions of people (World Health Organization (WHO), 2005). They can complicate the delivery of patient care, cause death and disability, promote resistance to antibiotics, and add further costs to those already incurred (Pittet and Donaldson, 2005).
Lord Darzi's review and what it means for NICE
Authors: Leng Gillian
Published: May 2014

Along with everyone throughout the NHS, we were very interested in the outcome of Lord Darzi's review earlier this summer, and in particular, what his findings would mean for NICE.
Personal healthcare management
Authors: van Terheyden Nick
Published: May 2014

In a recent physician advisory discussion forum that I participated in, one of my colleagues made an interesting comment about the clinical data that resides in electronic medical record systems. This data was, in is opinion, the property of the physician.
Fit or fat
Authors: Hill Rosalind
Published: May 2014

Memories of Christmas 2008 mostly centre on food and a vast amount of overconsumption.