NHS target driven culture is failing patients
The new tick box, target driven culture of the NHS is neglecting the quality of patient care, warns a senior doctor in this week's BMJ....... Craig Gannon, a consultant in palliative medicine, describes the fragmented care of an elderly woman at his hospital whose death from kidney failure (super-imposed on a malignancy) could have been avoided. ...... "The hospital care was spread across three s...NHS stop-smoking services are insufficient to deliver national smoking targets
NHS Stop-Smoking Services are insufficient to deliver national smoking targets, and Government smoking targets are themselves insufficient for the poorest communities, says a study published online by the BMJ today....... The study examined the effectiveness of NHS smoking cessation services in Northumberland and Tyne and Wear. These areas have populations dominated by manual workers and contain...New NHS payment system 'is no panacea'
The new NHS payment system has already run into problems and requires careful monitoring, say researchers at Dr Foster in this week's BMJ....... In April 2004 the NHS introduced its new "payment by results" system starting with foundation hospitals, whereby providers are paid for each individual case rather than through block contracts. ...... This new system uses healthcare resource groups (HRGs...Telemedicine revolution is 'disappearing' from the NHS
Despite high expectations, telemedicine and telehealthcare systems, which enable...doctors to interact with patients many miles away via video, digital imaging and electronic data transmission, have had only limited impact on the National Health Service, according to a study sponsored by the ESRC....... The expected revolution in medicine, overcoming problems of access to specialist care and spee...NHS Trusts meeting government target on stroke units 'in name only'
A large proportion of eligible NHS hospital trusts seem to be meeting the UK government target for setting up stroke units, but in name only, suggests a national audit, published in ....... And only just over one in three stroke patients admitted to hospital actually spends any time on a specialist stroke unit, the audit shows....... The findings are based on returns on inpatient stroke care to...NHS patients 'not fully engaged' with their own healthcare
NHS patients lag behind other western countries in actively involving patients and communities in healthcare, says an editorial in this week's BMJ....... According to a new study from the Commonwealth Fund of New York, British patients receive less information about medicines, preventative advice or help with managing chronic disease at home. They also have poorer access to their records than ot...Some hospitals face financial upheaval under new NHS payment system
Some hospitals will face sizeable changes to their incomes under a new NHS payment system, say researchers at Dr Foster in this week's BMJ....... The "payment by results" system is essentially a way of paying health care providers a fixed price for each individual case treated. Under the new system, providers are paid for the actual activity that they undertake, instead of being commissioned thro...The dangers of NHS reorganisation
The NHS should resist the temptation to reorganise and merge primary care trusts in the belief that it would bring benefit to patients, argue researchers in this week's BMJ....... Just over two years ago, 303 primary care trusts were created in England, each with responsibility for providing primary health care, improving health, and commissioning secondary care services for a population of aroun...Why is Ian Kennedy's healthcare commission damaging NHS care?
(below is the full text of an open letter from THE LANCET to Ian Kennedy, Chair of the newly established UK healthcare commission)....... On July 21, 2004, the UK's Healthcare Commission--a new independent inspectorate chaired by the lawyer and ethicist, Ian Kennedy--published its annual performance ratings of National Health Service (NHS) Trusts in England. Although the commission concluded tha...NHS trusts putting safety of pregnant doctors at risk
Some NHS trusts are exploiting pregnant junior doctors at the expense of health and safety, according to a disturbing article in this week's BMJ Careers....... It reveals how some pregnant doctors are expected to work excessive hours and are often exposed to violent or aggressive patients. It also uncovers major discrepancies in the way trusts apply guidelines to protect the rights of pregnant wo...NHS reforms have left no time to train surgeons
More and more reforms have resulted in less and less time to train the next generation of surgeons in the United Kingdom, warn doctors in this week's BMJ....... Reforms introduced in 1993 by Sir Kenneth Calman together with The European Working Time Directive have reduced training from 30,000 hours to an estimated 8,000 hours, and the Chief Medical Officer is proposing to reduce this even further...NHS set for 'airline style' transformation
UK health care may soon be transformed by the introduction of new providers, just as low-cost airlines Ryanair and Easyjet have radically changed European air travel in recent years, suggests an article in this week's ......Several new private providers have recently been awarded contracts to provide healthcare services for the NHS. Most of the work will be in general surgery and in areas with t...Healthcare watchdog calls for government rethink on public role in NHS decision-making
Independent healthcare charity the King's Fund has called on the Government to rethink its policy on public involvement in health care strategy, in a paper in this week's BMJ....... Dr Dominique Florin, GP and health service researcher, and Professor Jennifer Dixon, Director of Health Policy, say that although the Government aims to increase public involvement in health care policy making, there...New report reveals long standing problems in NHS research strategy
Health services research is still not making its full contribution to improvements in patient care, according to a new report from The Health Foundation and the Nuffield Trust, summarised in this week's BMJ....... Health services research accounts for 2-3% of the 4530m spent on health research in the UK each year, but it is unclear how much of the information generated is translated and used to i...NHS makes bad use of hospital beds
The NHS uses up to three and a half times the number of hospital bed days for conditions such as stroke and hip fracture as health organisations in the United States, according to researchers in this week's BMJ.... ...They compared the NHS with two health organisations (Kaiser Permanente in California and the Medicare Programme in California and the United States) using data on admission rates, l...Foundation trusts threaten core NHS principles
The creation of foundation trusts by the UK government endanger one of the founding principles of the NHS - to provide equal care for equal need, argue doctors in this week's BMJ....... The new Health and Social Care Bill abolishes government control of NHS trusts by turning them into foundation trusts - competing independent corporations with powers to generate income....... These powers threate...What trials do the NHS spend their money on?
The NHS Trusts Clinical Trials Register, launched by Current Controlled Trials Ltd in September 2003 ( ), makes information about randomised controlled trials wholly funded by the NHS in England freely available to health professionals, patients and researchers worldwide. ... ...Randomised controlled trials are considered the gold standard of research providing evidence on which future treatment...Should living liver donation be available in the NHS?
Living liver donation should be available on the NHS, although it should not be adopted without full public debate and agreement because of the risks to donors, argue researchers in this week's BMJ.... ...Living liver donation could benefit patients who are likely to die or deteriorate before a cadaveric donor becomes available. It involves a minimum graft to donor weight ratio of 1% and the dono...Few lessons are learnt from NHS inquiries
When things go wrong in the NHS the official reaction is to set up an inquiry. Yet a study in this week's BMJ finds that many inquiry reports highlight similar sorts of failures, suggesting that lessons are not always learnt....... Researchers at the University of Manchester analysed 59 inquiry reports from 1974 to 2002 to explore their use and impact in the NHS....... They found that the number...Radical solutions needed to tackle NHS nursing shortage
Current government initiatives to tackle the problems of recruiting and retaining nurses may not resolve the crisis fast enough, and more radical solutions may need to be considered, say researchers in this week's BMJ.... ...Problems in recruiting and retaining nurses are hampering the "modernisation" of the NHS. The underlying causes of these problems include pay, the changing nature of jobs, ho...What is the best way to fund the NHS?
The NHS in the United Kingdom is struggling to meet the needs of patients as costs continue to rise. A debate article in this week's BMJ asks: Does the current system of funding need to change?... ...David Green and Benedict Irvine believe that the case for social insurance deserves a more serious hearing than the British government has so far given it. ......For example, social insurance schemes...Trust mergers have negative effect on NHS services
The merger of NHS trusts has a negative effect on the delivery of NHS services, causes delays to service improvements and fails to deliver promised cash savings or improve staff recruitment and retention, says a study in this week's BMJ....... Researchers based at the London School of Hygiene & Tropical Medicine studied the process of merger in nine trusts in the capital, which took place between...Explosion in numbers of advice calls to hospital since introduction of NHS Direct
... ... ... ... ... ... ... ... Since the introduction of NHS Direct, incoming calls to one accident and emergency medicine (A&E) department have fallen by over 70 per cent, reports a study in Emergency Medicine Journal. But by the same token, the number of calls for medical advice received by the hospital switchboard soared by over 300.... . . . . .. . . . In the fifth of seven BMJ articles on the modernising of the NHS, Healthcare Consultant Mark Murray, looks at delays in access to care and argues that improving access involves determining the demand and applying resources to match it or reduce it.. . . . He suggests a number of principles towards managing demand and gaining capacity - such as clearing system backlogs, redu.... ... The care of mentally ill prisoners in prison healthcare centres falls well below that provided for mentally ill patients in the NHS, finds research in this week's BMJ. Most prison inpatients are mentally ill and the Prison Service has aimed to provide the same standard of health care as the NHS since 1991.. Reed and Lyne from HM Inspectorate of Prisons, conducted a semi-structured survey...