bluuebunny/crossref_metadata_2025 huggingface dataset:
The management of a patient with chronic oedema: A case study
Authors: McGrath Alison
Published: May 2014

Chronic oedema is a complex long-term condition that can have profound effects on the patient. Therefore, it is vital that the district nurse has the knowledge and skills to manage an individual to ensure a therapeutic concordant relationship. This feature seeks to consider best-practice management of a patient with chronic oedema.
Gastrostomy site infections: Dealing with a common problem
Authors: Edwards-Jones Valerie , Leahy-Gilmartin Anne
Published: May 2014

The most popular method of providing appropriate nutrition for large numbers of patients with swallowing difficulties is enteral feeding. However this treatment is not without complications, one of which is localized gastrostomy site infection.

This is prevented initially by decolonisation of the oropharyngeal tract with antibiotic prophylaxis prior to insertion, and systemic antibiotics post insertion. Later complications include tracking infection, which is rare but can occur. Hypergranulation of the tissue can occur around the gastrostomy tube and this can become colonised or infected leading to further problems for the patient. A good gastrostomy site care pathway plan is required to maintain a healthy site and appropriate treatment required to minimize the infection risk.
A fresh way to treat venous leg ulcers with measured compression
Authors: Bianchi Janice , Mahoney Kirsty , Nugent Lisa , Keen Delia
Published: May 2014

The majority of lower leg ulceration has a venous component. Compression therapy is the “Gold Standard” to reverse venous hypertension and heal venous ulceration. Over recent years, new compression systems have evolved which means greater choice for patients. This describes venous disease and assessment and treatment choices. Case studies are also presented.
Venous leg ulcer management: single use negative pressure wound therapy
Authors: Dowsett Caroline , Grothier Lorraine , Henderson Valerie , Leak Kathy , Milne Jeanette , Davis Lynn , Bielby Alistair , Timmons John
Published: May 2014

A number of leg ulcer specialist/tissue viability specialists from across the UK were invited to evaluate PICO (Smith and Nephew, Hull) as a treatment for venous leg ulcers also in conjunction with a variety of compression bandages and garments. Patients across 5 sites had PICO applied in conjunction with compression therapy. This group of treating clinicians were then asked to give feedback on the outcome of the patients on whom they had used the new device. All feedback was recorded at a meeting and this was used to create a guideline for use.
Catheter-associated bladder pain: it's not always infection
Authors: Nazarko Linda
Published: May 2014

This article is a case study examining the diagnosis and management of bladder dysfunction and catheter-associated pain in an older woman with diabetes and a hypotonic bladder. The incidence of diabetes has reached epidemic proportions. Although people with diabetes frequently develop lower urinary tract symptoms and voiding difficulties, this is often an unrecognised problem. As the incidence of diabetes grows, the incidence of diabetes-related bladder dysfunction will also increase. It is important that community nurses are aware of how diabetes affects bladder function and how to enable people with diabetes to manage bladder dysfunction well.
Switching to an antimicrobial solution for skin cleansing before urinary catheterisation
Authors: Levers Helen
Published: May 2014

Catheter-associated urinary tract infections (CAUTIs) are a cause of considerable concern and any measures which can be taken to potentially reduce the rate of CAUTIs should be given careful consideration. In 2012, the Infection Prevention and Control team at Rotherham Foundation Trust switched from saline solution to an antimicrobial solution (Octenilin® cleaning solution sachets) for skin cleansing prior to urinary catheterisation to try to reduce CAUTIs. Initially, Octenilin cleaning solution sachets were intended for use solely for patients with a current or historical confirmed result of MRSA in the urine and/or other sites. However, use has been extended to other patients, including those with a history of E. coli or Klebsiella, Gram-negative organisms frequently identified as a source of UTIs. Early feedback from using Octenilin cleaning solution sachets in place of saline solution has indicated a high level of satisfaction from both patients and health-care professionals. Reports of catheterisation-associated trauma have reduced significantly and no CAUTIs have been identified to date.
World War I remembered with reference to district nurses
Authors: While Alison
Published: May 2014

World War I is remembered for the appalling loss of life, but it also heralded major social and political change which included wider opportunities for women and, later, universal suffrage. World War I also formed the context for the emergence of the 1919 Nurses' Registration Act. District nurses (Queen's Nurses) undertook a range of roles during the war, including roles overseas as members of the military nursing services. Like nurses, they had their work supplemented by Voluntary Aid Detachments. This article discusses the war from the perspective of the district nursing profession.
Redefining essential care in lymphoedema
Authors: Wigg Jane , Lee Natalie
Published: May 2014

The awareness, diagnosis and management of chronic oedema and lymphoedema is improving. The enduring treatment format for the condition has always been regarded as the ‘four cornerstones’ of care for maintenance therapy in the UK. However, with changes in technology, availability of additional treatments and increased research and studies, this baseline is changing. This article outlines some of the recent changes and advancement in diagnostic tools and new technologies used in diagnosing and managing lymphoedema and chronic oedema. Emerging therapies will be introduced, as will other aspects of care that may now be considered ‘essential care’ in the management of lymphoedema and chronic oedema.
Health promotion and the healthcare assistant
Authors: Hand Tanis
Published: May 2014

This article discusses the role that the healthcare assistant (HCA) can play in promoting health and explores some of the fundamental principles of health promotion. Although based in primary care, the information is transferable to all healthcare settings. HCAs are often the closest point of contact for patients and so their contribution to health promotion programmes has the potential to be invaluable. This article looks at the areas of health promotion HCAs can and should be involved in. It also explores the Stages of Change model (Prochaska and DiClemente, 1986) which can be referred to for guidance when helping patients to change their lifestyles for the better.
Body fluids part 1: infection control
Authors: Peate Ian
Published: May 2014

Body fluids are potentially infectious fluids putting patients, visitors and hospital staff at risk of infection. All staff have a duty to ensure that they protect themselves and others by instigating standard infection control precautions. Standard infection control precautions are centred on five key aspects: effective hand washing, personal protective equipment (includes protective clothing), safe handling and disposal of sharp instruments, safe disposal of waste (including linen) and decontamination of equipment.

Precautions are required for all body fluids and as such, they should be treated as infectious regardless of the patient's diagnosis. Safety measures are required to be taken whenever there is potential contact between healthcare workers and non-intact skin, mucous membranes, blood or other body fluids. Healthcare assistants and assistant practitioners must develop insight and understanding in order to perform standard infection control precautions effectively.

This series will look at different body fluids and starts with this article on infection control - a vital consideration when dealing with body fluids.
Dignity in nursing
Authors: Barber Chris
Published: May 2014

Well, here we are again at sunny Bournemouth for the annual fun and frolics known as Royal College of Nursing (RCN) Congress where I am writing this editorial at nearly 12 o’clock, Tuesday morning. And no, I am not sunbathing on the beach. I am actually looking at a more or less blank screen in front of me and wishing that it was a full screen of intelligent writing. Oh, well, can’t have it all, I suppose! But seriously, when I was asked to write this editorial a couple of weeks ago I was told that I had a blank canvas with which to work and that I could write more or less whatever I wanted, within reason. What should I write? Well, I do have a bit of a bee in my bonnet about spirituality in healthcare, informal carers (of whom there are around 6million in the UK and which saves the NHS and social service budgets around £57billion a year), and the proposed demise of the learning disability branch at pre-registration nurse training.
Tips for learning part 1: anatomy and physiology
Authors: Neville Lillian , Wild Jill
Published: May 2014

For many people working in healthcare, understanding how the body functions normally and how it is affected by disease can be difficult. Even more importantly, this leads to a lack of understanding about how care and treatment decisions are made for the patients they care for. This series of articles will provide tips on how to break the learning process down and make it more manageable and enjoyable.
Treating the patient or the labstick? Urinary infections in older people
Authors: Nazarko Linda
Published: May 2014

People who are admitted to hospital are at risk of developing infections. Infections such as Clostridium Difficile have caused the deaths of thousands of people (Healthcare Commission, 2007: Office of National Statistics, 2007). Infection control strategies including strict hand hygiene, using standard precautions and prudent antibiotic prescribing reduce the risks of patients developing infection and maintain health (Health Protection Agency, 2006; Nazarko, 2007). In the past antibiotics were often prescribed unnecessarily, as we become more aware of the dangers of imprudent prescribing practice is changing. This article aims to enable you to understand how urinary tract infection is diagnosed and treated.
Reaching your goals with training and development
Authors: Ramdas Sharon
Published: May 2014

It's funny how I seem to end up where I started. I was born at King's and have spent the last 8years working here! It all began with employment with The London Ambulance Service, working through the ranks from a data entry clerk to an ambulance driver for patient transport. It was a great job but I had an itch I couldn’t scratch and I thought I could satisfy this by working in the training department. After all, I thought I was kept busy by my managers inducting new colleagues to the job by showing them the ropes and introducing them to all the different types of equipment we used on a daily basis. I thought wrong! The jobs for trainers were few a far between and a bit of a closed shop, it was the sort of job once in, not many people left. Funding was also an issue....
Are you being ignored?
Authors: Vaughan Paul
Published: May 2014

Sounds like we are facing hard times for a while yet with the latest news on inflation figures, food shortages and fuel shortages! The fuel shortage sounds like Northern Rock all over again. The media cause a hype about it and then wonder why people go crazy taking their money out or in the case of fuel, panic buying. The more you tell people not to do it, they more they think someone knows something they don’t and therefore there must be a crisis. So they panic buy and we have a downward spiral of being told in stronger terms not to panic buy so we buy more and before you know it we are in a mess.
Paediatrics: caring for a child with a temperature
Authors: Roberts Sheila
Published: May 2014

Fever is one of the leading reasons for a child to be admitted to hospital (National Institute of Clinical Excellence, 2007). The causes of the fever are most commonly viral illnesses but will also include more serious bacterial infections ranging from otitis media (an ear infection) to meningitis and septicaemia. A child with a fever is often lethargic, fractious and pale with a raised pulse and respiratory rate. This article will look briefly at the physiology relating to a fever, the correct method for taking and recording a temperature and how to care for a child with a fever. While qualified staff remain accountable for assessing the needs of his or her patients, healthcare assistants may be asked to record a child's temperature and care for a feverish child.
Paediatrics: caring for family and friends
Authors: Grainger Angela
Published: May 2014

If a child becomes ill and has to enter the healthcare system, it is likely that they will have family and friends who are deeply concerned. As a healthcare assistant, you will have to deal with there people regularly and it is important that you know how to do this effectively. They will often be worried and upset and it is vital that you provide the appropriate advice and support. Your role is to reassure them and to help them feel as comfortable as possible given the circumstances because by doing so, you are helping them to help the child cope.
Marking criteria for summative coursework
Authors: Beretta Ruth
Published: May 2014

The marking grid is based on that of the University of Plymouth and is used for all the courses run at HE level in Cornwall College. The columns identify certificate, diploma and degree level; these equate to students achieving a certificate if they were studying at HE Level 1, a diploma if they were studying at HE Level 2 and a full degree if they were studying at HE Level 3. In Linda's instance, she was working at Level 2, which is the highest a foundation degree goes to.
Invest in education
Authors: Vaughan Paul
Published: May 2014

Not sure if you can tell from my accent that I am Irish. So, ‘top of the morning to you'! In fact we only say that for the tourists, so whatever you do, don't be tempted to say this to the next Irish person you meet!
Learning from success: the flexibility of distance learning
Authors: Jones Linda
Published: May 2014

The role of healthcare assistants (HCAs) and support workers has never been more important than in today's NHS.
Nutrition part 1: maintaining a healthy diet
Authors: Nazarko Linda
Published: May 2014

A healthy diet should be varied and include appropriate portions of food from all the food groups. This article considers the different food groups and the special dietary requirements of the elderly and those with diabetes.
In and out of hospital
Authors: Beech Denise , Hopkins Susan
Published: May 2014

I am 47 years old and I have spent far too much time in hospitals, especially in the last few years. I had bad asthma in my twenties but then went into a good phase. During this I married and had two children (now teenagers) and I have a fantastic husband. My asthma came back with a vengeance about 5 years ago and I found myself in and out of hospital and on very high doses of steroids. Things got so bad I ended up on a sub cut bricanyl infusion for a year. Unfortunately my steroids began to have an adverse effect, I developed diabetes and hypertension and as my asthma slowly improved my heart took over causing problems. This was finally diagnosed as dilated cardiomyopathy about 2 years ago. My unequal struggle to continue to work was finally ended by this and I am now retired on medical grounds. I was a university lecturer teaching mostly child branch nurses and it was a job I loved.
Community care
Authors: Owen Marnel
Published: May 2014

This year, the Queen's Nursing Institute has been celebrating 150years of district nursing since William Rathbone; a Liverpool Merchant and philanthropist employed Mary Robinson to nurse his wife at home during her final illness. At this time, I feel it is pertinent to look back not only on how the role of the district nurse has developed over the years but also that of the supporting team. And key to that team today is the role of the healthcare assistants (HCAs).
Hearing impairments: problems and assistive devices
Authors: Swann Julie
Published: May 2014

With an increase in the prevalence of hearing loss, it is likely that healthcare assistants and assistant practitioners will encounter patients who have impaired hearing during their daily work. This article discusses some ways to overcome problem areas that hearing impairment causes, and concentrates on alternative communication and assistive equipment.
Tuning in to tinnitus
Authors: Swann Julie
Published: May 2014

Tinnitus is becoming increasingly common. This article explains the symptoms of tinnitus, and factors that can contribute to it. The noise is not generated by an external source, and cannot be cured. Prolonged exposure to loud noise can cause tinnitus in young people, and the next generation can be helped by raising awareness of acoustic trauma. Prevention is a key issue. The article also highlights the range of available treatments, from self-management to specialist care.
All eyes on Charles and Joseph
Authors: Amoah Charles , Allimuthu Joseph
Published: May 2014

Moorfields Eye Hospital, situated in London, is home to some of the most advanced and pioneering eye research and treatment being carried out worldwide. The medical retina service encompasses chronic retinal conditions such as age-related macula degeneration (ARMD), diabetic retinopathy, ocular infection, ocular melanomas and genetic disorders. The unit is open Monday to Saturday, 8:30-5:30, and sees approximately 1200 patients a month.
Hoists and slings: the correct procedures for moving a patient
Authors: Alexander Pat
Published: May 2014

For many years now it has been recognized that the use of hoists can reduce nursing injuries when assisting patients to move. When used correctly, they can also provide a safe and dignified method of transfer for patients. As Justice Munby remarked:
Cervical spondylosis part 1: osteoarthritis of the cervical spine
Authors: Swann Julie
Published: May 2014

Degenerative changes are common within bones and joints, owing to excessive wear and tear, resulting in osteoarthritis. When these symptoms appear in the cervical region of the spinal vertebrae, this degenerative process is termed ‘cervical spondylosis’.

A multitude of problems can occur, ranging from mild localized pain and discomfort to a major dysfunction of the nervous system. This article explains cervical spondylosis and outlines the main forms of treatment.
Self-improvement
Authors: Dunbar Amanda
Published: May 2014

In our busy working lives, we strive to provide the best healthcare experience that we can. We are encouraged to ensure that this includes following protocols and guidelines along with Department of Health documents specific to our area of practice. The fact that you are reading this demonstrates that you are engaging with activities in order to keep up-to-date with evidence-based practice and expand your knowledge base. All very commendable.
Cancer care
Authors: Archer Veronica
Published: May 2014

I started work as a healthcare assistant over 7years ago in the busy out-patient department at The Christie in Withington, Manchester, where I work full time Monday to Friday. Patients attend this hospital for treatment for all types of cancer. Since starting work at The Christie I have gained my NVQ3, and most recently I have completed a 2-year foundation degree in health and social care. Since finishing the programme I am now an assistant practitioner.
Take time to listen
Authors: Vaughan Paul
Published: May 2014

Since my last column, I have been the best man at my friend’s wedding. You might disagree but from my perspective, the bridesmaids have it easy. They turn up and look gorgeous but not quite as gorgeous as the bride. However, the best man is expected to make the traditional best man speech and let me assure you, that adds a certain amount of pressure to the whole wedding day. Well it did for me anyhow. Everyone expects the best man to be as witty as some famous comedian and with expectations running high, it’s a wonder I was able to speak at all! However, I did manage to deliver the speech and there was one rather funny moment during the speech when I was actually being nice about the groom that a miscommunication occurred and gave for a rather hearty laugh. I was using some adjectives to describe the groom to his new wife, tender, witty and assiduous (meaning passionate and caring). However, the brides grandmother though I said tender, witty and ‘hideous’! Perhaps that was a Freudian slip on her part, but funny none the less.
Accountability for HCAs and assistant practitioners
Authors: Mulryan Chris
Published: May 2014

While much is written about accountability, very little of this is directed towards assisting healthcare assistants (HCAs) and assistant practitioners (APs) to understand the framework of accountability that they operate within. Many registered professionals are also confused about the degree of accountability that HCAs and APs hold, often wrongly assuming that being currently unregistered makes HCAs and APs unaccountable. This article intends to outline some of the key issues that surround accountability so that APs and HCAs can use this to guide decision making and demonstrate accountability in their practice.
Campaigning for change
Authors: Vaughan Paul
Published: May 2014

March has been a busy month. I have been out on the conference trail. It has given me a tiny insight into the gruelling campaign schedule Barack Obama must have gone through during the American presidential campaign. However, I am sure he would agree, the opportunity to meet people and hear their story is what makes it all worthwhile.
Beyond borrowing books: make the most out of libraries
Authors: Peate Ian , Pickering Pauline
Published: May 2014

Using the library and the multitude of services that libraries offer can help your personal and professional development. Getting to know about the resources available to you will enable you to get the most out of the whole library. This article explains how healthcare assistants (HCAs) and associate practitioners (APs) can exploit the services on offer and develop their current knowledge base. When HCAs and APs become more confident and competent in using libaries, resources and new ways of learning can be accessed.
Health workers on the frontline
Authors: Jones Peter
Published: May 2014

Arsene Masseo (pictured) is a nurse assistant and Chef du Poste at the Ndomete health centre in the Central African Republic (CAR). Arsene lives just 50 yards from the health centre, and his working day starts at sunrise. Living so close, Arsene is rarely off the clock:
Understanding dementia: diagnosis and development
Authors: Nazarko Linda
Published: May 2014

Dementia is a term used to describe the symptoms of a range of progressive, terminal, organic brain diseases. It can lead to neuropsychiatric symptoms and behaviours that are considered challenging. This article explains the different types of diseases that can lead to dementia symptoms and how these diseases are diagnosed. It aims to enable support workers to understand the reasons dementia develops, its stages and how it is diagnosed.
The support workers' guide to burnout in the workplace
Authors: Wilcockson Matthew
Published: May 2014

Although widely used in lay language, burnout is also a medical diagnosis and a psychological syndrome. Despite this, it is rarely used as a diagnosis or formulation by health professionals, with depression and anxiety disorders more commonly used to explain symptoms of the condition. Certain professional groups are known to have a greater risk of developing burnout, including front-line health workers. This article explains the key features of the condition, outlines a number of risk factors, and offers some practical suggestions for avoiding, managing and developing resistance to burnout.
Medication, polypharmacy and compliance in older people
Authors: Perry Margaret
Published: May 2014

The role of healthcare assistants (HCAs) has developed in recent years and now often includes helping patients with medication. This is particularly true for support workers working in the community. HCAs can play an important part in preventing and detecting problems related to medication, because of the close and often regular contact they have with patients. This article looks at problems encountered when patients are taking several medications (polypharmacy), what problems can potentially occur, how problems can be avoided and the role of HCAs in relation to this.
Skill mix–HCAs and their role in quality healthcare
Authors: Mclntosh Bryan , Smith Stephen
Published: May 2014

The NHS must increase productivity by 6% every year if it is to make projected efficiency savings of £21 billion by 2014. At the same time, it is expected to maintain or improve the quality of care. We know staff costs make up 60% of the NHS budget, so it is likely that both the number and composition of the 1.7 million-strong workforces will need to change in order to meet these targets. We argue that while substituting registered nurses with healthcare assistants (HCAs) is desirable in terms of financial benefits, there is not enough research evidence to identify the impact of changes or maximisation in skill mix upon efficiency (represented by the number of NHS cases treated) and the quality of care experienced by service users.
Carers legislation and the role of the HCA, AP and nurse
Authors: Barber Chris
Published: May 2014

There is a perception, held by many caregivers, that they have few if any legal rights as caregivers. This article sets out to present and discuss 3 pieces of legislation, the 1995, 2000 and 2004 Carers Acts. It looks at the various carer's strategies that derive from these Acts, along with the role of the healthcare assistant/assistant practitioner and nurse in promoting caregivers’ rights.
Can't pay? Won't pay!
Authors: Bradley
Published: May 2014

Our survey question asking if HCAs/APs would be prepared to pay for registration struck a raw nerve with one reader. Let us know your opinion ( bjhca@markallengroup.com ). The BBC Health News story below had 30 000 visits.
BPS2: nursing care of patients wearing anti-embolic stockings
Authors: Lloyd Jones Menna
Published: May 2014

The House of Commons Health Committee (2005 ) reported that an estimated 25000 patients a year die in the UK from preventable hospital-acquired venous thromboembolism (VTE). Meetoo (2010 ) explains that VTE includes deep vein thrombosis (DVT) and pulmonary embolism (PE). It is estimated that, in the developed world, 1 in 1000 adults are affected annually, and the financial overhead of this condition amounts to £640 million ( Meetoo, 2010 ).

Recognising the incidence of unnecessary death and morbidity, the National Institute for Health and Care Excellence (NICE) (2007) has developed guidelines that make recommendations on assessing and reducing the risk of VTE in patients in hospital. The use of anti-embolic (AE) stockings was one preventative measure recommended. However, it is important to understand that there are contraindications to wearing AE stockings and there are also care needs required by patients wearing AE stockings ( Cock, 2006 ).

The aim of this article is to briefly review the content of the guideline for best practice, The Nursing Care of Patients Wearing Anti-Embolic Stockings (published by the All Wales Tissue Viability Nurses Forum (AWTVNF), 2009 ) and also to highlight its relevance in clinical practice.
So you want to be an AP? How you could get there
Authors: Mullen Chris , Banks Sophie
Published: May 2014

This article is based on a workshop held by the two authors at the annual HCA conference in November 2013. It builds on previously published articles about how someone wanting to become an assistant practitioner (AP) could take steps towards that goal. The article includes the personal story of how one of the speakers became an AP and she openly describes how it changed not only her ‘job title’, but how the learning and development programme impacted on her personally and how it changed her attitude to the importance of continuous learning and developing.

An outline of the different ‘routes’ to becoming an AP as it stands today will be provided, with a cautionary note that access to the various options does vary from region to region and from trust to trust and that the ‘routes’ to becoming an AP are still changing and developing.
‘The first thing we do, let's kill all the lawyers’
Authors: Henry Shakespeare
Published: May 2014

Sir Thomas Moore, in his famous work Utopia, suggested that the fewer laws a society has, the better off it is. And anyone who has had recourse to the law in recent times would no doubt agree that it has become so tangled and complex it seems to positively obscure the justice it is meant to serve.
Duty of care needs to be at centre of new mental health legislation
Authors: Easterbrook Joanne
Published: May 2014

Anticipating the Government's mental health strategy, this article considers the current initiatives and the potential changes to the legal duties and liabilities for providers within a community setting.
Untangling the intricacies of the world wide web: Site design part 2
Authors: Harvey Trevor P
Published: May 2014

This article, the second part of our practical guide to website design, draws on two case studies to discuss design, style and access issues.
Quality ber alles? The German approach to clinical regulation
Authors: Pugner Klaus
Published: May 2014

This article compares the British and German health care systems — examining where the concept of governance fits in the latter and whether there are any lessons to be learnt from the German approach.
What impact will the new quality agenda have on trust executives?
Authors: Sewell Nigel
Published: May 2014

Several months have now elapsed since the publication of ‘The New NHS’ White Paper and while the supporting consultation papers are still being absorbed or awaited, it is now possible to take a more reasoned view of the ‘new’ NHS.
Cousin Bob and the downside of US-style doctoring-as-a-business
Authors: Roth Andrew
Published: May 2014

You may not have noticed it but the political scene is out of sync with the calendar. The political year ends with July and only begins again with the Trade Union Conference (TUC) and political party conferences in September. In the meantime, those lucky enough to go abroad can take their medicines anally in France, taste the largely-empty hospitals of Brussels or go even further abroad.
Engaging the public in primary care issues
Authors: Smith Rod
Published: May 2014

This article questions how best to manage public involvement in primary care purchasing. The author assesses the various management tools available in the light of the substantial cultural change required.
Disabled access -- law facilitates new approach
Authors: Peace Su , Mc Gough Stewart
Published: May 2014

All NHS buildings must comply with Phase three of the Disability Discrimination Act 1995 by 2004. This article outlines what every estates manager needs to know.
An end to medical paternalism?
Authors: Stone Malcolm
Published: May 2014

The role of medicine in modern society is expanding and evolving at a rapid pace. Based on the attenuation and application of knowledge, it has been profoundly influenced by the impact of advances in information technology. The continued and massive changes to primary care in this country being one obvious example of this. The sustained growth of the internet has catalysed the development of NHSnet — a secure intranet linking GP's surgeries to secondary care. And the technology's attendant philosophy of empowered consumerism has facilitated the A introduction of J intelligent triage 1 systems like NHS I Direct and the new approach to personal health sym-bolised by Walk In centres.
Understanding emotions the key to preventing feelings of alienation
Authors: Kirk Phil
Published: May 2014

Major change in organisations can often create feelings of fear and isolation, but learning emotional management techniques can help managers and their staff.
Ignored and invisible: tales of disappearance at the interface
Authors: Henwood Melanie
Published: May 2014

An examination of the pivotal role carers need to play if collaboration is to be meaningful.
Wiltshire prove mutual recognition and respect can conquer divide
Authors: Macalister-Smith Ed
Published: May 2014

Perhaps nowhere have health and social services integrated more successfully than in Wiltshire. This article briefly outlines some of their innovative projects and the lessons learned.
Is new legislation the way to make actions speak louder than words?
Authors: Glendining Caroline
Published: May 2014

This critique of the Government's recent consultative document ‘Partnership in Action’ assesses what effect the proposed legislation is likely to have.
Survey of 36 trusts establishes the level of service user involvement
Authors: Shelton Graham
Published: May 2014

Reporting on a survey designed to establish user involvement in mental health services, this article seeks to stimulate new initiatives and fresh dialogue about the issues.
The unending search for reality and reform
Authors: Roth Andrew
Published: May 2014

Things are seldom what they seem, as I have repeatedly had to relearn. The other day I was ‘phoned by my daughter, a Somerset clinical psychologist. She was coming to town with my grandson. Could I find her the Bill on reforming the NHS, whose title she had got off the internet? Of course, what else is the point of having a father who has spent 40 years in the Palace of Westminster? When she arrived I handed her the Health (House of Lords) Bill, which HMSO had mis-titled and mis-priced on the internet.
NICE: Wise men on a mountain or an alliance for change?
Authors: Bosanquet Nick
Published: May 2014

The NICE (National Institute for Clinical Excellence) is being sent out from Whitehall with a sunrise brief of increasing take up of cost effective innovation. This is quite reassuring on the Executive web site, but may well turn out to be horribly difficult in practice.
Let's let managers use markets properly and end staff shortages
Authors: Maynard Alan
Published: May 2014

Why are the markets for doctors and nurses so different? The NHS wails about a ‘shortage’ of nurses and its entrepreneurial managers recruit nurses from Finland, the Philippines and many other countries where there is an ‘oversupply’ of such valuable skills.
Leaders need understanding
Authors: Goodwin Neil
Published: May 2014

Calls to establish a ‘management academy’ or staff college for the NHS, coupled with reports of the Secretary of State wishing to be more in touch with chief executive appointments, reflects an underlying belief that developing better leadership is the way forward. But what is leadership and do we really understand it?
Rationing debate - doctrines and dogmas
Authors: Royce Robert G
Published: May 2014

The rationing debate polarises opinion and prejudice. This is the first of three articles assessing the issues and arguing that the setting of priorities within the NHS is an unavoidably political process.
Napoleon's asdvice to PCGs...
Authors: Maynard Alan
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.
Union's constitution is in weakening state
Authors: Hazell Robert , Jervis Paul
Published: May 2014

This paper explores how the interplay between the ‘devolution’ and ‘health policy’ agendas may evolve over the next few years, and identifies potential pressure points.
Start of the clinical disputes reformation
Authors: Urwin Jenny
Published: May 2014

In the face of a rapidly growing ‘compensation culture’, last month's reforms are expected to make clinical negligence disputes less adversarial and more cost effective. But since new bodies like the Civil Disputes Forum will only succeed if both parties co-operate, will anything really change?
Time we invested in changing practitioner behaviour
Authors: Maynard Alan
Published: May 2014

The economist emphasises that resources are scarce and that difficult choices have to be made about how to allocate competing resources amongst alternative activities.
Exchanging flows
Authors: Benson Tim
Published: May 2014

This paper identifies ground floor ways in which electronic communication could improve clinical and administrative workflows. Arguing that the main challenge is not technological, but one of appropriate management.
Access all areas
Authors: Booth Andrew
Published: May 2014

A key architect involved in the creation of the lauded National electronic Library for Health, the author outlines the thinking behind the project and the pivotal role it will play in the Government's modernisation drive.
Reality Bytes
Authors: Hoeksma Jonathan
Published: May 2014

The NHS is poised on the brink of an explosion in clinical information and can little afford to make the costly errors that litter its past. This article examines the latest guidance and asks whether it will catalyse effective managerial procurements.
Tories opt for ‘feelgood’ factor with Dr Fox's bedside manner
Authors: Roth Andrew
Published: May 2014

It showed the pulling power of the middle-aged diva that the media and the public followed Ann Widdecombe off the Health stage to her ‘higher’ Home Office role, mulling over her final triumph over her former boss, one-time Home Secretary Michael Howard. Virtually nobody noted the more interesting double contrast between Ann and her successor as Tory Health spokesman, Dr Liam Fox.
Bridging the R & D divide
Authors: Caan Woody , Cooke Mary
Published: May 2014

The Executive's latest R & D initiative, the Service Delivery and Organisation programme, has major implications for improving the knowledge base for managers. This article identifies the main issues and why managers should play a key role in its development.
Improving practice through peer review
Authors: Jenkins Emrys , Grey Robert
Published: May 2014

This paper considers the impact of a peer review mechanism on paramedic ambulance staff working in a West Wales NHS Trust.
Clinical audit systems and lifelong learning
Authors: Wilson Jo
Published: May 2014

Clinical audit is a crucial tool for ensuring improvements in the quality of patient care. One of the key components of clinical governance is for all clinicians to participate in clinical audit systems. Clinical audit will provide a comprehensive framework for quality improvement and the monitoring of clinical care using effective information and clinical record systems.
NHS website symbolises ‘nice little earner’ culture
Authors: Harvey Trevor
Published: May 2014

This month, I advance my thesis by taking the pretty way. The world of government funding works in a mysterious fashion. Sitting in an inauspicious regional office of the Passport Agency last week, cursing the broken lavatory flush, the exhausted hand cleanser dispenser and the equally drained coffee machine, as demonic infants ran amok in what looks all too like an unreconstructed social security office from a former age, it crossed my mind that here was a nice little earner for the British Government.
Potential pitfalls when procuring IT under PFI
Authors: Newsam Tony
Published: May 2014

In this article Tony Newsam, Deputy Director of Contracts at the government's Central Computer and Telecommunications Agency (CCTA), looks at some of the key issues which arise when contracting for IT services under the PFI.
How to build value-for-money into a PFI deal
Authors: Fletcher Jim
Published: May 2014

While both the public and private sectors proclaim each PFI transaction signed as a value-for-money deal, in practice what they are really saying is that the offer compared favourably with the Public Sector Comparator (PSC) and has met the affordability criteria. But is it really possible to evaluate value-for-money? And, if so, how?
E-privacy R.I.P.
Authors: Harvey Trevor
Published: May 2014

‘Public ignorance of the issues has worked wonders for the Government.’
When the centre is the weakest link, it's time to leave the stage
Authors: Halpern Stephen
Published: May 2014

So, from top of the mops to top of the slops. After squandering resources on manageri-ally-demeaning gimmicks to improve the cleanliness of hospitals, the Government has risen to new heights of absurdity in promoting a ‘£40 million overhaul of hospital food’.
Facing up to health and safety - or not?
Authors: Aston Graham
Published: May 2014

Like taxes and bad television game-shows, the importance of managers‘ health and safety responsibilities never ends.

This article provides an overview and reminder of the legal duties of health care professionals at all levels to keep up to date with this issue.
Primary care managers: ‘mixed model’ development
Authors: Williams Steffi , Emmerson Melody , Thomas Paul
Published: May 2014

Following up their paper in the April issue of the British Journal of Health Care Management, the authors have reviewed some outcomes of the ‘mixed model’ approach to developing primary care managers in the NHS in Wales.

Their findings, and the future implications for funding of management development, are considered here.
Everything is different and the same
Authors: Maynard Alan
Published: May 2014

‘Providers are powerful ... many reforms in health care are not evidence-based and reflect political preferences’
HImP: learning from PCGs’ early experience
Authors: Hunter David , Marks Linda , Sykes Wendy
Published: May 2014

This article covers the mid-point findings of a research programme into the impact of Health Improvement Programmes (HImPs) in a sample of six Primary Care Groups. It considers HImPs’ value and likely strategies for further development.
‘Care managers are, by nature, Type A people. Discuss.’
Authors: Harvey Trevor
Published: May 2014

Trevor Harvey on information overload.
Did Total Purchasing help the advent of PCGs?
Authors: Abbott Stephen , Killoran Amanda
Published: May 2014

We consider how Total Purchasing helped prepare primary care organisations for the change to Primary Care Groups. PCGs’ focus in developing a public health role and addressing health inequalities is thrown into relief by the limited enthusiasm found for increased accountability, partnership-working and adopting a population-based strategy for health.
Identification card trends in the NHS
Authors: Campbell Sylvia
Published: May 2014

The potential impact of ‘smart card’ technology for improved security is discussed in this article, which also looks at how the technology can benefit managers in other areas.
Asylum seekers: needy, not guilty
Authors: Bell Andy
Published: May 2014

Recent media coverage of and politicians’ attitudes towards refugees in the UK has (among other failures) neglected to address practical issues, such as the healthcare requirements they will have.

Andy Bell of The King's Fund considers how we can plan ahead in preparation to meet their needs.
Change or die: the need to retrain managers
Authors: Maynard Alan
Published: May 2014

‘Senior managers appear to be unskilled and reluctant to hire people who can count’.
The ‘Reform’ club: topics hot and reheated
Authors: Halpern Stephen
Published: May 2014

It is a truth universally acknowledged that the self-importance of the title of a health care policy pamphlet is in inverse proportion to the value of the actual content. So the relatively modest sounding Pressures in UK healthcare: challenges for the NHS from the Institute of Fiscal Studies (IFS) at least delivers what it promises.
External auditors: bean counters / bean growers?
Authors: Pfleger Martin
Published: May 2014

The importance and impact of the work of external auditors in the NHS today is considered in this article from the Deputy Auditor General of the National Audit Office.

Ways to improve management strategies through external audit are considered, and pointers for the future addressed.
Professional development of senior managers
Authors: Howell Valerie , Secker Jenny
Published: May 2014

The value of supervision for clinical staff is well recognised. Less attention has been paid to the professional development of senior mental health managers. This article makes recommendations for the development of a strategy to ensure managers are supported in addressing the complex issues they face
Involving the public: it's not just for Christmas
Authors: Bell Andy
Published: May 2014

If Chancellor Gordon Brown was playing Santa Claus with the Budget bonus for the NHS, the time has come to look after the puppy of reform that accompanied the new bicycle of extra funding.

Andy Bell of The King's Fund looks at the public consultation exercise, and considers what its results could actually mean.
Educating and involving the public: on whose terms?
Authors: Renshaw Carole
Published: May 2014

The need for education and involvement of the public in the realities of health care provision is a common mantra for policy-makers. Is it just a placebo? Is it a red herring? Is it actually possible? The ‘Provocations’ series continues.
The effects of the current spending frenzy
Authors: Maynard Alan
Published: May 2014

‘Current spending policy may work against the Government's equity targets and disadvantage the poor’
Key partners for the elderly: primary health & social care
Authors: Rummery Kirstein
Published: May 2014

As speculation about the imminent NHS reform plan alludes to closer formalised integration of health and social services, this article examines how prior reforms have affected primary care. The new challenges of collaborating with social services professionals are considered, and ways to optimise such partnerships suggested.
Implementing PCGs: the implications for the NHS
Authors: Goodwin Neil
Published: May 2014

As the reforms in primary care continue apace, this article looks at possible explanations for the varying quality of leadership and thus of service delivery in the context of the NHS in England. The viability of the drive to improve leadership in the public sector is considered.
The confidence trick in reforming the NHS
Authors: Bell Andy
Published: May 2014

As the countdown to publication of the plan on NHS reform continues, Andy Bell of The King's Fund looks at public confidence in the NHS. How can it be regained? Can it be regained?
Joining the real world: security in health care
Authors: van der Bijl Nick
Published: May 2014

The ‘Provocations’ series presents an account of the ways in which security failures undermine the provision of health care as well as the environment. The need to leave behind present lackadaisical attitudes is discussed, along with ways forward to improvement.
The media, the NHS, the ‘spin’ and the truth
Authors: Bell Andy
Published: May 2014

From the unique perspective of a not-for-profit health orgasnisation's media team , Andy Bell of The King's Fund looks at how the voracious attitude of the media for health stories can be fed without managers getting their hands bitten. Could the media be used for managers’ ends? Can the media be ‘helped’ to report more responsibly?
Electronic procurement: cutting costs, not care
Authors: Hoeksma Jon
Published: May 2014

The need for health care managers to learn how on-line purchasing could save time, money and effort is examined in this article. Rather than the current waves in the on-line consumer market, the internet revolution for health care is only just beginning.
The National Leadership Centre and The NHS Plan
Authors: Goodwin Neil
Published: May 2014

The NHS Plan (Department of Health, 2000) is a blueprint for transforming the culture of the NHS. If successful, it will result in an innovative, patient-focused and 21st century health service. However, with little exception, the plan is rooted in a strong, centrally-controlled and quantitatively-orientated approach.