scholarly journals Non-medical prescribing policy in the United Kingdom National Health Service: systematic review and narrative synthesis

2019 ◽  
Author(s):  
Emma Graham-Clarke ◽  
Alison Rushton ◽  
Timothy Noblet ◽  
John Marriott

AbstractNon-medical prescribing was introduced into the United Kingdom (UK) to improve patient care, through extending healthcare professionals’ roles. More recent government health service policy focuses on the increased demand and the need for efficiency. This systematic review aimed to describe any changes in government policy position and the role that non-medical prescribing plays in healthcare provision.The systematic review and narrative analysis included policy and consultation documents that describe independent non-medical prescribing. A pre-defined protocol was registered with PROSPERO (CRD42015019786). Professional body websites, other relevant websites and the following databases were searched to identify relevant papers: HMIC, Lexis Nexis, UK Government Web Archive, UKOP, UK Parliamentary Papers and Web of Science. Papers published between 2006 and February 2018 were included.Following exclusions, 45 papers were selected for review; 23 relating to policy or strategy and 22 to consultations. Of the former, 13/23 were published 2006-2010 and the remainder since 2013. Two main themes are identified: chronological aspects and healthcare provision. The impact of government change and associated major healthcare service reorganisation resulted in the publication gap for policy documents. The role of non-medical prescribing has evolved to support efficient service delivery, and cost reduction. For many professions, prescribing appears embedded into practice; however, pharmacy continues to produce policy documents, suggesting that prescribing is not yet perceived as normal practice.Prescribing appears to be more easily adopted into practice where it can form part of the overall care of the patient. Where new roles are required to be established, then prescribing takes longer to be universally adopted. While this research concerns policy and practice in the UK, this aspect of role adoption has wider potential implications.

2017 ◽  
Vol 48 (1) ◽  
pp. 81-105 ◽  
Author(s):  
Sandeep Reddy ◽  
Peter Jones ◽  
Harsha Shanthanna ◽  
Raechel Damarell ◽  
John Wakerman

This systematic review sought to identify whether health care reforms led to improvement in the emergency department (ED) length of stay (LOS) and elective surgery (ES) access in Australia, Canada, New Zealand, and the United Kingdom. The review was registered in the PROSPERO database (CRD42015016343), and nine databases were searched for peer-reviewed, English-language reports published between 1994 and 2014. We also searched relevant “grey” literature and websites. Included studies were checked for cited and citing papers. Primary studies corresponding to national and provincial ED and ES reforms in the four countries were considered. Only studies from Australia and the United Kingdom were eventually included, as no studies from the other two countries met the inclusion criteria. The reviewers involved in the study extracted the data independently using standardized forms. Studies were assessed for quality, and a narrative synthesis approach was taken to analyze the extracted data. The introduction of health care reforms in the form of time-based ED and ES targets led to improvement in ED LOS and ES access. However, the introduction of targets resulted in unintended consequences, such as increased pressure on clinicians and, in certain instances, manipulation of performance data.


2019 ◽  
Vol 21 (12) ◽  
pp. 2667-2675 ◽  
Author(s):  
Caroline Pearce ◽  
Emma Goettke ◽  
Nina Hallowell ◽  
Pauline McCormack ◽  
Frances Flinter ◽  
...  

2009 ◽  
Vol 27 (4) ◽  
pp. 374-383 ◽  
Author(s):  
Terry L. Tudor ◽  
William K. Townend ◽  
Christopher R. Cheeseman ◽  
Jen E. Edgar

This paper reviews the current generation and management of healthcare waste in the United Kingdom, with a focus on that produced from healthcare provision in the National Health Service. While the current capacities of large-scale off-site treatment systems are adequate, there are a number of logistical factors that must be considered in future. These include variations in arisings from each country and from various regions within each country, the age and location of treatment/disposal facilities, the quantities, types and sources of healthcare waste, and the impact of waste minimization and recycling strategies. Managing UK healthcare waste is a complex issue that requires the correct technologies and capacities to be available. With increasing quantities and costs there is urgent need for future planning, and healthcare waste issues need to be addressed from a UK-wide perspective. Holistic strategies need to incorporate both minimization and segregation, with treatment using a combination of incineration and alternatives treatment technologies. The need for more research and accurate data to provide an evidence-base for future decision-making is highlighted.


2018 ◽  
Vol 18 (2) ◽  
pp. 134-151
Author(s):  
Andrea Circolo ◽  
Ondrej Hamuľák

Abstract The paper focuses on the very topical issue of conclusion of the membership of the State, namely the United Kingdom, in European integration structures. The ques­tion of termination of membership in European Communities and European Union has not been tackled for a long time in the sources of European law. With the adop­tion of the Treaty of Lisbon (2009), the institute of 'unilateral' withdrawal was intro­duced. It´s worth to say that exit clause was intended as symbolic in its nature, in fact underlining the status of Member States as sovereign entities. That is why this institute is very general and the legal regulation of the exercise of withdrawal contains many gaps. One of them is a question of absolute or relative nature of exiting from integration structures. Today’s “exit clause” (Art. 50 of Treaty on European Union) regulates only the termination of membership in the European Union and is silent on the impact of such a step on membership in the European Atomic Energy Community. The presented paper offers an analysis of different variations of the interpretation and solution of the problem. It´s based on the independent solution thesis and therefore rejects an automa­tism approach. The paper and topic is important and original especially because in the multitude of scholarly writings devoted to Brexit questions, vast majority of them deals with institutional questions, the interpretation of Art. 50 of Treaty on European Union; the constitutional matters at national UK level; future relation between EU and UK and political bargaining behind such as all that. The question of impact on withdrawal on Euratom membership is somehow underrepresented. Present paper attempts to fill this gap and accelerate the scholarly debate on this matter globally, because all consequences of Brexit already have and will definitely give rise to more world-wide effects.


2021 ◽  
pp. 203228442199492
Author(s):  
Catherine Van de Heyning

The submission discusses the provisions in the EU–UK Trade and Cooperation Agreement on data protection as well as the consequences for the exchange of passenger name record data in the field of criminal and judicial cooperation. The author concludes that the impact of the Agreement will depend on the resolvement of the United Kingdom to uphold the standards of protection of personal data equivalent to the EU’s in order to reach an adequacy decision.


Author(s):  
Ming-Bo Liu ◽  
Géraldine Dufour ◽  
Zhuo-Er Sun ◽  
Julieta Galante ◽  
Chen-Qi Xing ◽  
...  

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