bluuebunny/crossref_metadata_2025 huggingface dataset:
Cancer report obscured by clouds of indifference
Authors: Halpern Stephen
Published: May 2014

The most serious priority in for health services in the UK is to tackle the appalling standard of cancer services. It is worth recalling that at least 10,000 people die from the disease every year due to inadequate standards of treatment compared to similar countries in Western Europe.
Where the heart is, the policy isn't
Authors: Bell Andy
Published: May 2014

In the midst of the important debate around the second reading of the Health and Social Care Bill early last month, the British Medical Association published a report on the effects of housing on people's health.
Dr John Reid, the hard-nosed battling shuttlecock ‘enforcer’
Authors: Roth Andrew
Published: May 2014

By his ‘in-your-face’ initial refusal to speak to consultants about the contracts they had rejected, the new Health Secretary, Dr John Reid, made clear he was 100% Tony Blair's ‘hard man’, dispatched to ram through the Prime Minister's NHS ‘reforms’.
Forum - ‘Health Contracts’ for the NHS?
Authors: Cowper Andy
Published: May 2014

This is the first of a new series, taking topical issues and submitting them to debate by e-mails among interested parties and commentators.

The Government's recent proposal of ‘health contracts’ between GPs and patients is our first subject in the series. ( http://news.bbc.co.uk/1/hi/health/2958148.stm )
The impact of motivation on health care services
Authors: Labiris Georgios , Petounis Andreas , Kitsos Georgios , Aspiotis Militades , Psillas Kostas
Published: May 2014

This article presents research into staff motivation on the quality of services.
Stigma is alive and well behind the ‘Berlin Wall'
Authors: Bell Andy
Published: May 2014

The star ratings for mental health trusts were published last month, to immense media and public interest. Alright, so I'm lying. In fact what happened was, predictably enough, that the star ratings came out and all the media interest was on which acute hospital trusts got no stars and which ones (that previously had three stars and a passport to the sunshine of foundation status) had been demoted to a lower league.
The weight
Authors: Harvey Trevor
Published: May 2014

Should my lifestyle choices affect my access to health care? This question has arisen again and again in recent years as resources for health services have been stretched, rationed and remain projected to be unable to meet the limitless demands and expectations of the population.
The obstacles to learning from experience
Authors: Maynard Alan
Published: May 2014

Alan Maynard looks at why opportunities for meaningful learning in the NHS are so often missed.
Old habits die hard
Authors: Harvey Trevor
Published: May 2014

Working in the health service can cause brain damage. Seriously. Not the kind of thing you can detect on a scan, but something more subtle, invasive and long-lasting. A kind of pathological change that reproduces itself with every generation and which is indigenous in hospitals and community care the length and breadth of the kingdom.
The foundations of Rome
Authors: Ainsworth Steve
Published: May 2014

I'm not easily shocked; but I was brought up with a start on realising that I was born in the same year as the Prime Minster. It seems impossible: I'm still young, cool and hip whilst Prime Ministers are by definition elderly gentlemen old enough to be my father, if not my grandfather.
The autistic NHS
Authors: Cowper Andy
Published: May 2014

Sometimes you've got to step back, take a deep breath and have a look at the big picture. I'm not just talking about leaving work early to go to an art gallery, although it's certainly to be recommended. This is slightly different.
Opening our eyes to choice, risk and accountability
Authors: Cowper Andy , Keep Jane , Sang Bob
Published: May 2014

As choice remains one of the key health care buzz-words of the moment, this article proposes that its two accompanying dimensions - of risk and accountability - are equally important.
PCTS - the real advocates for change
Authors: Sawbridge Yvonne
Published: May 2014

Yvonne Sawbridge, nursing lead of of the NHS Alliance, argues that PCTs have a crucial role in redefining the nursing role.
Clearing the path: the regulatory landscape ahead
Authors: Moyes Bill
Published: May 2014

The future path of NHS regulation became clearer in November with the publication by Monitor of the proposed regime for regulating NHS Foundation Trusts. Bill Moyes, Chairman of Monitor, presents the proposals and how they fit into wider NHS reform.
Health by misadventure
Authors: Harvey Trevor
Published: May 2014

We often hear a certain type of politician declaiming that Britain is a nanny state. This is a term redolent of privilege, paternalism and public schools: the collective elderly right-wing political class who cannot shake off their mixed feelings about the controlling women who helped to form their schoolboy attitude to the concept of ‘care’.
What's going on in the NHS crematorium?
Authors: Maynard Alan
Published: May 2014

With all the pundits predicting a May 2005 election, NHS fever is increasing. The Prime Minister has invested a lot of political capital - as well as taxpayers’ money - in ‘odernising’ the NHS.
National clinical indicators: more questions than answers?
Authors: Narayn-Lee Mary , Aylett Virginia , Donaldson Katrina
Published: May 2014

Publication of national clinical performance indicators is intended to improve the quality of clinical care. Presenting such information in the form of a league table is misleading. Experience in Leeds demonstrates the difficulties in taking the published data at face value. The use of statistical process control charts to show comparative performance should be explored further.
Where is the winter crisis?
Authors: Bell Andy
Published: May 2014

Tempting fate as this may be, one stalwart of winter news reporting has been notably absent from the national media this year. There have been no patients photographed on trolleys. No claims of avoidable deaths caused by casualty closures. Not even sight of any media-friendly surgeons berating the NHS's ability to cope with demand.
Harnessing the moon
Authors: Harmond Kate
Published: May 2014

As the NHS discusses the re-definition of targets, this article offers a timely re-appraisal of issues around culture and values of health care.
Measuring up
Authors: Cowper Andy
Published: May 2014

There's a fantastic saying, which George Borowski taught me recently, which goes like this:‘easure it seven times: cut it once’. His father had been a tailor, and taught him the aphorism (George, fans of music trivia might like to know, is the ‘Guitar George’ name-checked in the lyrics to Dire Straits’ hit Sultans Of Swing). What a good thing it would be if policymakers and managers alike could take this one to heart.
The next step to NHS reform: the NHS Foundation
Authors: Tremblay Michael
Published: May 2014

The ‘Provocations’ series resumes with a modest proposal to relocate many roles to a new charitable ‘NHS Foundation’.
Privates on parade: how the reluctant concordat opened up the future
Authors: Timmins Nicholas
Published: May 2014

It's over. But as we bid it farewell, it may be that April 2004 will go down as the date when the relationship between the National Health Service and the UK private sector finally changed for good.
We're big … but what else is new?
Authors: Harvey Trevor
Published: May 2014

The NHS is the world's third biggest employer, having gained 230,000 more employees since Labour came to power in 1997. Last year alone, a record 59,000 people were recruited.
Towards an NHS market?
Authors: Maynard Alan
Published: May 2014

The party line amongst Ministers in the English Department of Stealth is that after spending their youth protesting with placards and decrying the Thatcher reforms of 1990, they have now been converted to the ‘truth’ of the market mechanism. This conversion manifests itself most clearly in the creation of Foundation Hospitals and the incremental development of the national tariff, or payment by results.
The American dream
Authors: Cowper Andy
Published: May 2014

You'd almost think God was a Catholic, so perfectly timed was the announcement on Ascension Day that health policy guru Simon Stevens was leaving 10 Downing Street to become President of the UK branch of the US HMO UnitedHealth Group. Please submit your own line about rising into heaven here.
Fun and political games as the NHS election takes shape
Authors: Timmins Nicholas
Published: May 2014

It's over. But before it says farewell to sunny Birmingham, it will be remembered for the start of the longest election campaign ever to hit the National Health Service, with gun being fired some 12 months - and possibly even more - before the electorate will finally be asked to decide.
Why we must weep doubly for Michael Howard
Authors: Roth Andrew
Published: May 2014

If you wet your handkerchief weeping for what the UK Independence Party did to Michael Howard's hopes for the next general election on 10 June last, you must get out a bucket to contain the tears for what Howard has done to his Tories on the NHS.
Theory and practice
Authors: Harvey Trevor
Published: May 2014

In last month's BJHCM, the editor (Cowper 2004), made a detailed analysis of John Reid's response to a question about ‘Payment by Results’ on the issue of even funding throughout the service - what is officially called ‘Reforming NHS Financial Flows’.
How to survive The NHS Plan
Authors: Bosanquet Nick
Published: May 2014

For the NHS, the three-year public spending budget is not adequate for getting real value in the future. The future viability of the system depends on getting consistent incentives and feasible funding.
Fit to practice?
Authors: Harvey Trevor
Published: May 2014

I wonder if, like me, you can remember the day when you discovered your faith in Father Christmas was ill-founded. In my own case, the revelation came from my cousin. I can recall the moment in Technicolor detail.
Medical self-regulation: professional or amateur?
Authors: Cowper Andy
Published: May 2014

Happy New Year to you all. Well, here we go again. And one of 2005’s key issues will be the regulation of the medical profession.
Will 2005 be a happy new year for the health service?
Authors: Timmins Nicholas
Published: May 2014

It's over. But before we wish it Happy New Year, it's worth contemplating what 2005 may hold. It already looks like a year that, by any standards, is set to be one of the most challenging for the National Health Service.
‘Take your partner by the hand ...'
Authors: Harmond Kate
Published: May 2014

The health business is strong on rhetoric about partnership working, if somewhat weaker on implementation.
Desperate times and measures
Authors: Harvey Trevor
Published: May 2014

From time to time, the word ‘desperate’ best describes the way the NHS operates. The inevitable distortion to the economy of the health services in the Philippines, occasioned by the mass recruitment of nurses from those islands, and the bizarre spectacle of qualified doctors there retraining as nurses to earn more in Europe than they can make as medics back home, has been the topic of much complaint, but this has fallen on deaf ears in Britain.
Astrophysics and theology
Authors: Cowper Andy
Published: May 2014

Taking the credit always feels pretty sweet, and sometimes all the more so when it's not really yours to take. However, honour compels me to point out that the observation at the centre of this piece is borrowed from the consultant and magnificentlystyled ‘futurologist’ Chris Dabbs.
Taking the market pace of the new marketplace in the NHS
Authors: Timmins Nicholas
Published: May 2014

March 2005 will be remembered as the month when the harsh realities were spelt out of what a patient-led NHS is likely to mean for staff and services over the coming years.
Healthcare Needs Assessment in prison
Authors: Thornton-Jones Helen , Hampshaw Susan , England Peter
Published: May 2014

There is high-level commitment in the UK to addressing the historical weaknesses in the delivery of prison health care, and for prisons to work with their NHS colleagues in order “to give prisoners access to the same quality and range of healthcare services as the general public receives from the National Health Service” (National Health Service Executive 1999).
Delivering The NHS Cancer Plan: community pharmacists will be vital
Authors: Blanco-Criado Concepcion
Published: May 2014

Pharmacists' key role throughout the NHS is increasingly acknowledged, both in primary and secondary care (Colin-Thomé 2002). However, one of their most crucial areas of activity lies in the delivery of cancer care—an activity that will become increasingly important given the aims of The NHS Cancer Plan (Table 1) (Department of Health 2000[a]).
Food, inglorious food
Authors: Bell Andy
Published: May 2014

The current furore over school food has become the latest installment of the current debate on public health in the UK. From a minority sport of interest only to enthusiasts, public health has become a media obsession to such an extent that television shows such as celebrity chef and latterly social entrepreneur Jamie Oliver's Jamie's School Dinners can drive policy debate and create sufficient pressure to make sure change happens in practice.
Living Doll, dying of smoking and the need for action
Authors: Cowper Andy
Published: May 2014

This issue is being produced a week or so before the general election takes place. The result of that plebicite looks unlikely to be either a surprise or a change of government, barring radical and unforeseeable last-minute events.
Hiding a tree in a forest: information set free
Authors: Cowper Andy
Published: May 2014

If you wanted to hide a tree, you'd put it in a forest. If you wanted to hide some information about the NHS, you'd put it on the Department of Health's legendarily un-navigable website.
A thoroughly modern sense and sensibility
Authors: Hardacre Jeanne , Keep Jane
Published: May 2014

Sir Nigel Crisp's Chief Executive's report to the NHS (DH 2005) reaffirmed that the NHS is improving: waiting times are down; more services are available; staff are working differently; there is more money in the service than ever before.
More from Confed conference, and around the campus
Authors: Cowper Andy , Bell Andy
Published: May 2014

One of the pleasant surprises of the 2005 NHS Confederation Conference was an outspoken speech from the Confed's chief executive Dame Gill Morgan.
Big Brother is watching you
Authors: Cowper Andy
Published: May 2014

No, it's not going to be a laboured metaphor about the lame reality TV show that is our modern equivalent of a public flogging. The world doesn't need one more of those. Instead, I want to tell you about a recent discovery of mine: I met the real BIG brother of NHS policymaking. BIG brother lives in the secret basement underneath the Department of Health's Whitehall HQ. And his real name is Norman Puddifoot.
The French do health better than we do
Authors: Roth Andrew
Published: May 2014

Ionly seem to come in contact with French medicine once in three-score years. The last time before this year was in the French Hospital in Beirut, Lebanon and Syria having been French protectorates between the two world wars.
The grave danger of terrorism in the NHS
Authors: Maynard Alan
Published: May 2014

Is it time to apply to the Protection of Terrorism legislation to the English Secretary of State for Health? She seems determined to undermine vital regulatory mechanisms in the NHS which were created to protect the patient and the taxpayer. Her behaviour is inflicting avoidable morbidity and mortality on the population, while at the same time increasing their tax bills.
Persisting care inequalities in mental health
Authors: Bell Andy
Published: May 2014

Last month, a major report from the Disability Rights Commission confirmed that both people with mental health conditions and those with learning difficulties do not get the care for their physical health that they need (DRC 2006).
The commissioner is king; the DH must get slim
Authors: Cowper Andy
Published: May 2014

MD: It's right at the centre, and there's an unparalleled opportunity for primary care to lead the NHS and undertake a wide number of roles that it hasn't previously — things that traditionally have been secondary care roles.
Regulation revolution, re-connecting Connecting For Health and remarkaby good wages
Authors: Timmins Nicholas
Published: May 2014

November was the one in which the Department of Health again struggled with the thorny question of how to regulate the new NHS; in which it became clear that the NHS's IT programme is subject to something of a rethink; and when pay and money — as ever these days — refused to move far from the top of the agenda.
Mental health foundation trusts: how to proceed
Authors: Confue Phil , Bell Andy
Published: May 2014

The Sainsbury Centre for Mental Health and Tribal recently held a seminar considering the impact that foundation trust status might have on the development of better mental health services.
Don't panic, Captain Mainwaring! Don't panic!
Authors: Maynard Alan
Published: May 2014

Government is a bit like Dad's Army. The enemy are always at the gate, and the bold defenders of England's green and pleasant land are always scatterly disorganised if well-meaning. Government, like Captain Mainwaring panics - often unnecessarily.
Practice-based commissioning
Authors: Lusignan Simon de , Shaw Adrienne , Wells Sally , Rowlands Gill
Published: May 2014

Personal Medical Services (PMS) is a locally-agreed quality-orientated contract for general practice, which allows services to be developed to meet local needs. Practices in the scheme agree targets for service delivery over and above a minimum standard with its local health service managers (Department of Health, 2001).
Which planet can be trusted with the NHS?
Authors: Roth Andrew
Published: May 2014

We have all heard about men being from Mars and women from Venus. But which different planets are inhabited by the Tories criticising Labour's management of the NHS and Blairite Labour Ministers like Health Secretary Patricia Hewitt claiming all is rosy in the NHS? I pity those who tried to make it out after watching the knockdown- drag-out debate of June 7 on their Parliamentary channel.
Taming the Wild West
Authors: Timmins Nicholas
Published: May 2014

July 2006 was the month of the mighty wobble. The one when some rules were laid down to control the Wild West. And the one where it became clear that caution is creeping in at Richmond House as it — or more precisely its politicians — try to work out what the world will be like, and what will be permitted, under Gordon Brown.
Warning: health service research can damage your health
Authors: Kernick David
Published: May 2014

The history of health service research has been characterised by an overwhelming volume of literature that has little impact on those who actually get on and do the work.
Learning from Castle (or how not much changes in 30 years)
Authors: Maynard Alan
Published: May 2014

“The level of resources which will be available over the next few years means that difficult choices will have to be made ... When resources are limited it is clear that growth in any particular service can only be afforded if counterbalancing economies are made elsewhere” (Department of Health and Social Security, ‘Priorities for Health and Personal Social Services in England’, HMSO, 1976)
The right diagnosis of NHS reviews?
Authors: Appleby John
Published: May 2014

Reviews, it seems, are all the rage at the moment. First (plain old) Professor Sir Ara Darzi's Review of London's NHS, then the (upgraded) Professor the Lord Darzi's ongoing Review of the whole of the NHS and, not forgetting Sir Derek Wanless's King's Fund Review of progress since his 2002 and 2004 Reviews.
New vaccine to protect against HPV cancers
Authors: Cowper Andy , Pasteur Sanofi , Stubbins Richard , Kitchin Nick
Published: May 2014

Nick Kitchin: The main 4 HPV strains can lead to cervical, vulval and vaginal cancer and associated precursor pre-cancerous lesions.
Behind the headlines: Alzheimer's ruling
Authors: Dillon Andrew
Published: May 2014

This summer brought an official conclusion to the media storm surrounding one of the most publicised pieces of guidance NICE: the technology appraisal on the effectiveness of drugs (donepezil, galantamine, rivastigmine and memantine) to treat Alzheimer's disease.
Regulation - it's getting better all the time
Authors: Needle Gary
Published: May 2014

Regulation doesn't tend to set many people's pulses racing. However, its importance in healthcare has certainly come under the spotlight of late. We are not surprised. After all, the issues that we deal with are the same as those that regularly occupy the front pages of the newspapers. These issues touch the lives of every family.
Miss information
Authors: Bamford Terry
Published: May 2014

While I was trying to find out figures on the total amount taken from PCTs' budgets for public health (after the acknowledged topslicing of £844 million at national level) to achieve this financial year's forthcoming ‘financial balance’ that I again reflected on the unadulterated self-interest of the Government's proposals that will increase the charge for Freedom Of Information requests.
The reorganisation will not be televised
Authors: Bell Andy
Published: May 2014

Managing the NHS is a difficult business. We know this from the reaction in this and other journals to Gerry Robinson's BBC2 / OU television series attempting to ‘turn around’ Rotherham Hospitals NHS Foundation Trust.
Is it time for competing regulators in healthcare?
Authors: Maynard Alan
Published: May 2014

In February, the London Health Observatory (2007) identified 34 procedures where saving could be made if explicit criteria were applied uniformly across London. The authors estimated that between £28 million and £93 million could have been saved in 2004-5 if common access criteria were used across the capital.
Health secretary's verdict: We have stopped the rot
Authors: Cowper Andy
Published: May 2014

The NHS faced a uniquely difficult last financial year. It brought a deficit of £500 million into last year and a rate of spending growth and cost pressures that would have seen this heading towards £1 billion. NHS managers have done an outstanding job in bringing the service back into balance.
NHS independence: can things only get better?
Authors: Dickinson Helen , Glasby Jon , Peck Edward , Ham Chris
Published: May 2014

In the 2001 general election campaign, PM Tony Blair was publicly confronted by Sharron Storer, the partner of a cancer patient about conditions in the NHS. This incident was quite damaging for New Labour, coming as it did just hours after their manifesto launch.
Engaging clinicians while balancing the books
Authors: Cowper Andy
Published: May 2014

It has to be regaining the relationship with the clinical community. As you will notice, that's not a million miles from what I saw as the biggest issue last year ...
How PCTs will need to manage care in the UK
Authors: Bosanquet Nick
Published: May 2014

PCTs were hitherto provider-driven to an amazing degree, acting as mother hen to their own providers, and spending little time assessing whether the cheque-writing machines to their local acute trusts were delivering value.
Windmill signals the change in weather
Authors: Appleby John
Published: May 2014

It may come as a bit of a shock to ye of great faith, but economics and economic techniques have their limits. Armed with some spreadsheets, a few mathematicallyexpressed theoretical suppositions, an assumption or two (especially, ‘everything else being equal’), a truckload of numbers and, crucially, a research question narrowed down to just this side of policy relevance visibility, the economist can then confidently generate an answer.
Supporting nutrition in and out of hospital
Authors: Cowper Andy
Published: May 2014

The relationship between nutrition and health is a theme that pervades a huge amount of social and economic discourse. As our awareness grows of the healthcare problems around rising obesity, it would be easy for the flip side of that coin — problems of undernutrition and malnutrition — to be given less weight.
A fixed price offer of cost-effective care
Authors: Johnston Andy
Published: May 2014

Cost-effectiveness and commissioning are at or near the top of most managers’ lists: a position that, regrettably, has not always been occupied by mental heath. Yet the new offering from The Huntercombe Group to the NHS, of a comprehensive treatment package within a fixed price, from pre-admission to post discharge, draws together the two key themes for management.
Is the NHS ready for direct payments?
Authors: Bell Andy
Published: May 2014

Amid the heat of debate about the demise of district general hospitals this summer (if not of the summer itself), a less well-publicised paper called for something equally radical: direct payments within the NHS.
The future isn't what it used to be
Authors: Cowper Andy
Published: May 2014

Happy new year and good wishes for 2008 – I hope you had a good break. 2008 launched with a relaunch – Gordon Brown's first substantive speech on health policy at Kings Hospital. While there has been a certainty vacuum since the departure of Tony Blair, it is surely welcome that Brown did not rush to set out his distinctive stall. He is evidently both cautious and thoughtful, and the wait made his focus in the speech more interesting.
Policy recycling in practice
Authors: Appleby John
Published: May 2014

The NHS, as David Cameron and Andrew Lansley inform us in a foreword to their recently published healthcare strategy, is the Conservatives’ number one priority. Which is nice. So what, potentially, is on the horizon for the NHS if there's a change of government?
Quality of management in radiography services
Authors: Okaro Augustine , Eze Charles
Published: May 2014

Total quality management is a management style based on a system of continuous improvement, employing participative management centered on the needs of the customer (Jurow and Barnard, 1993). Walklin (1992) sees total quality management as a senior management-led, company-wide initiative to improve effectiveness and build quality with the service delivered. It is the integration of all functions and processes within an organisation to achieve continuous improvement of the quality of goods and services (Feigenbaum, 1996; Ross and Perry, 2004). It is the unwavering strategic commitment to enhancing the quality of organisations through continuous improvement by all members of that organisation (Axline, 1992).
Tiny pearls among oyster shells
Authors: Roth Andrew
Published: May 2014

My witty colleague, Guardian Parliamentry sketchwriter Simon Hoggart, seems to be doing well with his books of horrendous excerpts from those ubiquitous Christmas letters, those year-end missives which usually tell us more than we want to know about people we either don't know or about whom we don't really care.
Reducing MRSA – the knowns and unknowns
Authors: Cowper Andy
Published: May 2014

Concern over healthcare-acquired infections (HAIs) has escaped the management community and firmly entered public consciousness. HAIs' cost to the NHS and to public confidence has been significant, typified in the appalling events at Maidstone and Tunbridge Wells NHS Trust (Cowper 2007), where 90 deaths were attributed to failed and inept management of C. difficile.
Andy McKeon
Authors: McKeon Andy
Published: May 2014

I have been really lucky to work with top managers and politicians whose views have commanded the whole of the NHS. I have had no single mentor, but they have all left a keen impression on me, from Ken Clarke's openness, to Alan Langland#x0027;s perceptiveness and Alan Milburn#x0027;s restless drive. They all seemed to me to share common characteristics, which I like to think have rubbed off on me.
Interpreting the new language of leadership
Authors: Leech Darren
Published: May 2014

NHS leaders could be forgiven for better equipping themselves and their organisations for life in a more competitive world. Throughout England, the reality of competition between healthcare providers is increasingly evident.
Full of eastern promise
Authors: Timmins Nick
Published: May 2014

March 2008 was the month when ‘free choice’ finally arrived’just as some of Britain's biggest private hospital chains said that doing NHS work had ceased to be ‘core’ to their strategy.
New approaches to physician power
Authors: Harmond Kate
Published: May 2014

The ambitious proposal to engage physicians in healthcare management has been debated in the UK for many years, culminating in the appointment of Lord Ara Darzi as Parliamentary Under Secretary of State for Health. It is a significant vote of political confidence in (selected) members of the medical professions to have a practising surgeon leading radical policy developments and challenging strong vested interests, such as the traditional patterns of care delivery in London-based teaching hospitals.
A critique of NHS culture as applied to psychiatry
Authors: Shankar Rohit
Published: May 2014

The evolution of Homo sapiens from bacteria over 3000 million years was based on the development of a number of diverse and complex skills. One of the greatest competencies that humans have improved over time has been the ability to plan, organise, communicate, work in cohesion and review results. This has, over the ages, been reflected on and practised to derive maximum benefit, whatever the endeavour.
Transfering myocardial infarction patients
Authors: Banerjee Ashis , Mbamalu David , Hinchley Geoff , Kennon Simon
Published: May 2014

Primary percutaneous coronary intervention (PCI) has been shown to provide significant benefits over thrombolysis in the management of ST elevation myocardial infarction (STEMI), as evidenced by reduced 30day mortality, reduced re-infarction rate, reduced stroke incidence and reduced length of stay (Andersen et al, 2003; Keeley et al, 2003; Stenestrand et al, 2006). Following angiographic visualisation, the underlying anatomical lesion is treated definitively with stent deployment.
Care pathways: legal sword or legal shield?
Authors: Griffith Richard
Published: May 2014

Care pathways are a tool to manage the delivery of healthcare by setting out standards for evidence-based best practice in patient care and recording deviations from planned care in the form of variances. They are used in a number of areas to ensure the quality of care delivered to patients is consistent and efficient, and address one of the key challenges facing healthcare managers today; making the best use of limited resources, while providing high quality, timely, evidence-based care.
Battle lines drawn for the NHS
Authors: Timmins Nick
Published: May 2014

April 2008 was the month when the first tit bits of what might emerge from Lord Darzi's ‘next steps’ review began to appear; when the service saw the battle against MRSA falter; and when the (admittedly remote possibility) reform of the NHS that would also lead to significant reform of the private sector appeared to be slipping away.
Time is money: a polyclinic polemic
Authors: Bell Andy
Published: May 2014

As the debate over polyclinics and GP hours rumbles on, the NHS Confederation (2008) has produced its own contribution examining the potential merits and risks of the scheme. Within the document, it refers to a concept it has developed that might provide a lens through which the current impasse might be viewed differently.
Health 2.0
Authors: Hill Rosalind
Published: May 2014

When I first began my journalism training, the buzz word at the time was ‘web 2.0’. So much so in fact, that my online tutor went so far as to say that in the future no one would buy newspapers or magazines. A worrying thought for all those whose careers hang in the balance of the printed word.
The Darzi reforms: just words?
Authors: Maynard Alan
Published: May 2014

The publication of how the outcome of the Darzi's Next Stage Review will affect each of the strategic health authorities (SHAs) was interesting, but worrying. This resource-intensive exercise involved hundreds of clinicians and had a focus on clinical effectiveness.
Clinical Negligence, Fourth Edition
Authors: Tingle John
Published: May 2014

Clinical Negligence provides everything you need to know about clinical negligence in one easily accessible volume. To produce it has been no mean feat; there are 56 chapters–25 legal and 31medical–written by leading experts in the field.
Gordon Hextall
Authors: Hextall Gordon
Published: May 2014

I believe that information and IT has the capacity to make a transformational shift in the way that healthcare is delivered and improve the health of the nation.
The new year squeeze
Authors: Timmins Nick
Published: May 2014

December 2008 was the one that provided the ground rules for 2009, and indeed for 2010, which are plainly going to be crucial years for the National Health Service.
Adrian Pancott
Authors: Pancott Adrian
Published: May 2014

I worked for three years in the British Red Cross for an outstanding CEO—Sir Nick Young—who has presided over a formidable period of growth for the charity.
The US, the NHS and NICE
Authors: Rawlins Michael
Published: May 2014

As someone who has practiced medicine in the NHS for 40 years, I was irritated beyond measure by the scurrilous claims about the NHS made by some US politicians and their allies this summer.
Another word for efficiency
Authors: Appleby John
Published: May 2014

The Germans (leistungsfähigkeit), Spanish (eficacia), French (efficacité) and Italians (efficienza) have their own words for ‘fficiency’ but, according to the OECD, all could improve the way they use their healthcare resources in order to enhance the health of their populations. The same message goes for all OECD countries—including the UK.
MSAs, personal budgets and direct payments
Authors: Dixon Anna
Published: May 2014

The concept of medical savings accounts (MSAs), while apparently at odds with the underlying principles of the NHS (i.e. free at the point of need), has some parallels with the ideas behind personal budgets and direct payments. Both of these are used already in social care and are being piloted in the NHS in England (the latter subject to regulations in the current Health Bill). MSAs and personal budgets are premised on the idea that the consumer or patient knows best. Patients will have greater control over the care they receive and in the case of direct payments, will act as purchasers of care (DH, 2008).
How do we improve the quality of patient care?
Authors: Hill Rosalind
Published: May 2014

The past 12 years of the Labour Government have seen enormous changes to the NHS, including the creation of the National Institute for Health and Clinical Excellence (NICE) 10 years ago. However, uptake has always been a key agenda for industry when discussing with NICE and the NHS. How can the NHS increase uptake? How can NICE improve the quality of care in the NHS? And where could NICE and industry improve in their approaches?
These strange times
Authors: Timmins Nick
Published: May 2014

February 2009 was a slightly weird one. A month that saw the NHS beaten up for a bunch of things not entirely in its control. One that saw a significant landmark reached–or almost reached–with next to no fanfare. And one where a bunch of difficult problems refused to go away.
Making price = value
Authors: Appleby John
Published: May 2014

Confused by the almost infinite mobile phone plan permutations and combinations of free texts, free minutes, pay as you go, ‘family and friends’, free internet access (weekends only), business rate...?
Oral health-related quality of life
Authors: Richards Wayne , Harris Catherine , Gear Tony
Published: May 2014

General dental practice is ideally positioned to improve the oral health of communities. This has been recognised by the Department of Health (DH) in England, and therefore Improving Oral Health with the New Dental Contract has been distributed to all NHS general dental practitioners (DH, 2006). It is acknowledged that inequality in oral health and access to dental services are two major challenges for NHS dentistry in the UK (DH, 2000). Preventive approaches are key to improving oral health so that subgroups traditionally experiencing high levels of oral disease are treated appropriately (Department of Health and the British Association for the Study of Community Dentistry, 2007).
Advocating mental health care
Authors: Bell Andy
Published: May 2014

This month sees two major changes to the way the Mental Health Act is managed in England that could bring about significant improvements for those subject to it.
Budget basement
Authors: Timmins Nick
Published: May 2014

Budgets come and budgets go. But Budget 2009 will linger long in the memory. It is the one where the full cost to public services of the current economic and financial crises became plain; or at least plainer.
Market management
Authors: Appleby John
Published: May 2014

After nearly two decades of one form or another of internal market–though a constant has been the separation of those with the money and no services (purchasers), and those with services but no money (providers) with a requirement to swap one for the other–there is an embarrassing lack of evidence that this economic arrangement has produced any significant benefits.
The best laid plans...
Authors: Appleby John
Published: May 2014

The Department of Health published its annual Departmental Report in the middle of last month and geekily, I started reading it from the back, beginning with the 95-page annexes which set out in nerdy detail the Department of Health's resource budgets and, among other fascinating financial figures, a table that takes a whole page to explain why the NHS budget for this last year, this year and next, is different to that promised in the 2007 spending review.
Training excellence in the independent sector
Authors: Baker Mark , Bowker Erika , McLean Sheila , Monkman David
Published: May 2014

Train to Gain is a national skills service to support employers of all sizes and in all sectors, to improve services and the skills of their employees as a way of improving overall performance and enhancing customer care. Train to Gain is a joint investment-employers and the Government working together to boost business by improving the skills of individual staff members.
Intimate examinations and trained chaperones
Authors: Griffith Richard
Published: May 2014

It is the very nature of healthcare provision that it is often necessary to touch patients in order to examine them and provide treatment. This can frequently involve intimate touching. To ensure that patients are protected, the law makes specific provisions that must be followed for intimate touching to be lawful. This article outlines the legal requirements that must be followed when carrying out intimate examinations, and argues that healthcare managers must ensure that a chaperone policy is in place to ensure these requirements are complied with.
Worst case scenario catchphrase
Authors: Appleby John
Published: May 2014

Prospects for future funding for the NHS look anything but rosy. Quite how bleak the outlook will be was the subject of analysis by the King's Fund and researchers from the Institute for Fiscal Studies.
The case for dual MBBS/MBA degrees
Authors: Bhogal Pervinder , Bhogal Maninder
Published: May 2014

Good management is essential for an efficient NHS that is able to provide world class health care. In the United States, clinicians have engaged in the pursuit of management education and many top universities now offer a dual MD/MBA degree. This article looks at the rise of the dual degree, the factors that influence the physician's decision to enter onto the course, and what the British undergraduate medical system could learn from these courses.
Payment by Results and delayed discharges
Authors: Manzano-Santaella Ana
Published: May 2014

Delayed discharges caused by social services could potentially pose a financial risk for hospitals. In 2003, the English Government introduced a controversial policy based on fines for social services departments unable to discharge patients from hospital within set timescales. This article analyses the implicit relationship between Payment by Results (PbR) and the Delayed Discharges Act (DDA), and highlights some of its most relevant features.
Protecting vulnerable adults from abuse
Authors: Griffith Richard
Published: May 2014

Abuse of vulnerable adults is a growing yet under-reported problem. Episodes of abuse are often considered to be rare incidents of physical or sexual abuse that are widely reported in the media. However, the House of Commons Health Select Committee point out that the most common incidents of abuse relate to poor practice, neglect, and poor management. Although the great majority of abuse occurs in the person's own home, some 27% of abuse occurs in care homes and hospitals. In an attempt to prevent those who would abuse the vulnerable from entering the workforce, the Government is to introduce a revised Vetting and Barring Scheme for staff and volunteers under the Safeguarding Vulnerable Groups Act 2006, which will also apply to the NHS. This article discusses the extent and forms of abuse against the vulnerable, and the implications of the new Vetting and Barring Scheme for healthcare managers.
How to maintain 18 weeks
Authors: Jones Rod
Published: May 2014

The previous article discussed the capacity margin associated with delivering 18 weeks and the need for flexible deployment of resources (Jones, 2009a).
Insuring future mental health
Authors: Williams Simon
Published: May 2014

The NHS has a surplus of nearly £2 billion, and any sensible frontline staff must be asking themselves, ‘Should I? Could I? Will I get what I need to do my job properly? Should I have asked for more?’
Get it off your chest: men and mental health
Authors: Kemple Mariam
Published: May 2014

A new report from Mind (2009) has warned that the mental health needs of men are not being met. With the recession putting even more men at risk, the charity has called for more to be done to give men the right support, at the right time.
COPD: inspiring better health
Authors: Phillips Fiona , Holton Kevin , Hill Sue
Published: May 2014

Chronic obstructive pulmonary disease (COPD) has been identified as a priority in England, following recommendations in the Chief Medical Officer's 2005 annual report (Department of Health (DH), 2005). The Government are due to publish a consultation on the National Strategy for COPD this summer. This article outlines how the Strategy will address current inequalities within COPD care, and how health professionals can prepare for its publication.
A guide to Dr Foster analyses
Authors: Taylor Roger
Published: May 2014

The publication of the Dr Foster Hospital Guide at the end of November sparked a debate about safety in hospitals. The national regulator, the Care Quality Commission (CQC), announced they were looking into problems at Basildon-the hospital which scored worst in Dr Foster's survey of hospital safety. But it failed to adequately explain why its own rating of the hospital gave it a clean bill of health. The opposition called for reform of the regulator. Andy Burnham, the Secretary of State for Health, answered questions in the House.
Cyclic factors behind NHS deficits and surpluses
Authors: Jones Rod
Published: May 2014

The economic cycle and its consequences to NHS funding are by now widely appreciated and the wider issue of cycles in demand may be worthy of some consideration. Almost all natural phenomena follow long-term cycles, from crop yields (Cantelaube and Terres, 2004) to global warming (Holbrook, 2009). This suggests that health care may also be subject to the same forces. Indeed, climate change is anticipated to have future negative and positive impacts on specific aspects of emergency medicine (Hess et al, 2009).
Is it real? Unpicking the spending review
Authors: Appleby John
Published: May 2014

First some very precise numbers and then a joke.

So, the pledge has been fulfilled by the narrowest whisker of a cigarette paper: a real annual average increase of one tenth of 1% each year. To be brutally and forensically accurate, the increase actually less than 0.1%: 0.084% to be precise—just over eight hundredths of 1%.
Giving it one million percent
Authors: Appleby John
Published: May 2014

The latest results from the frontier of, er, production possibility frontier research, suggests that most primary care trusts (PCTs) are not the useless and ineffective organisations that some like to imply, but are incredibly efficient at turning their inputs (money) into outcomes (reduced mortality). Indeed, 11 PCTs are rated as 100% efficient at this task.
Preferred provider woes
Authors: Timmins Nick
Published: May 2014

March 2010 was the month in which the staff survey produced results that should frighten anyone. And one in which the battle over Andy Burnham's ‘preferred provider‘ policy advanced to a score draw that in practice probably favours the unions over the independent sector.
Recruitment: breaking the chain effect
Authors: Rodgers Mark
Published: May 2014

All organisations crave talent and this is no different in the NHS. The need for talented individuals to deliver and manage complex services with complex demands means only the best will do. This article suggests that some NHS organisations, perhaps for historic reasons, become stuck in a rut of recruitment, and that any given recruitment decision is only as robust and effectiveas the recruiting manager or panel. This means that a chain effect of recruitment from one manager to another develops, whereby the talent and innovation coming into an organisation reaches a ceiling over time. This could be seriously affecting the current performance of the relevant NHSorganisations and unless something changes, will continue to have an adverse impact on future NHS performance. It is therefore suggested that it is a requirement of strategic importance to break this recruitment chain effect, and increase the level of talent throughout a given organisation where performance is suffering due to this effect. Two possible solutions are discussed with this in mind, firstly employing external recruitment specialists; the main downside here being cost. Secondly, the idea of an independent organisation being involved in local high level NHS board member recruitment, which could facilitate breaking the recruitment chain from the top down. The new coalition government has recently published intentions to create an organisation that could potentially facilitate this.
League tables: not football
Authors: Appleby John
Published: May 2014

An interesting study of the extent of variations in drug use across selected countries was published by the Department of Health on the day Andrew Lansley announced his special cancer fund. On the latter by the way, the fund is now £50 million, not the £200 million originally announced.
Why is health care so special?
Authors: Appleby John
Published: May 2014

On 20 October 2010, George Osborne will set out the horror show that will be the Coalition government's public spending plans for the next four years. Filling the deficit hole is a must do—though many wonder whether it must be done so quickly.
Improving spinal theatre efficiency: imaging training
Authors: Stenning Matthew , Hilton Andrew , Green Sue
Published: May 2014

Efficiency within a theatre team is paramount in completing the required caseload. In order to improve efficiency in our orthopaedic spinal theatre, we trained members of the theatre team to use an image intensifier, which eliminated the need for a radiographer to be present in the theatre. In practice, the main results of this change are an improvement in output and less demands on the radiographers. In addition, staff trained on the image intensifier have found the process rewarding, both professionally and personally.