A Dutchman in London: reflections of a hospital chief executive from the Netherlands in the NHS

BMJ Leader ◽  
2021 ◽  
pp. leader-2021-000509
Author(s):  
Marcel Levi

BackgroundThe NHS is a fascinating health care system and is enjoying a lot of support from all layers of British society. However, it is clear that the system has excellent features but also areas that can be improved.Story of selfA number of years as a chief executive in one of London’s largest hospital has brought me a wealth of impressions, experiences, and understanding about working in the NHS. Contrasting those to my previous experience as chief executive in Amsterdam (The Netherlands) provides an interesting insight.ObservationsVery strong features of the NHS are the high level of health care professionals, the focus on quality and safety, and involvement of patients and the public. However, the NHS can significantly improve by addressing the lack of clinical professionals in the lead, curtailing ever increasing bureaucracy, and reducing its peculiar preference for outsourcing even the most crucial activities to private parties. The frequent inability to swiftly and successfully complete goal-directed negotiations as well as the large but from a clinical point of view irrelevant private sector are areas of sustained bewilderment. Lastly, the drive for innovation and transformation as well as the level of biomedical research in the NHS and supported by the British universities is fascinating and outstanding.

2012 ◽  
Vol 27 (3) ◽  
pp. 273-280 ◽  
Author(s):  
Pauline SC Kouwenhoven ◽  
Natasja JH Raijmakers ◽  
Johannes JM van Delden ◽  
Judith AC Rietjens ◽  
Maartje HN Schermer ◽  
...  

1993 ◽  
Vol 17 (9) ◽  
pp. 531-533 ◽  
Author(s):  
Denise M. Riordan ◽  
Philip Barron ◽  
Melanie F. Bowden

Electroconvulsive therapy is widely seen by the public as a barbaric and outmoded form of treatment. Even within groups of health care professionals, ECT does not have a ‘good press’. Most research into the area of patient attitudes to ECT has been retrospective and often considerably so, and is therefore unlikely to illustrate patients' feelings about a course of treatment at the time it took place (Freeman & Kendell, 1980; Kerr et al, 1982). The only prospective study is that by Malcolm (1989). This showed a low level of understanding of treatment and a high level of anxiety both before treatment and afterwards, but, despite this, a high level of compliance with ECT therapy.Our aim was to re-examine these findings in order to find a way of improving the experience of ECT.


2020 ◽  
Vol 4 (1) ◽  
pp. 13-27 ◽  
Author(s):  
Lynn Rochester ◽  
Claudia Mazzà ◽  
Arne Mueller ◽  
Brian Caulfield ◽  
Marie McCarthy ◽  
...  

Health care has had to adapt rapidly to COVID-19, and this in turn has highlighted a pressing need for tools to facilitate remote visits and monitoring. Digital health technology, including body-worn devices, offers a solution using digital outcomes to measure and monitor disease status and provide outcomes meaningful to both patients and health care professionals. Remote monitoring of physical mobility is a prime example, because mobility is among the most advanced modalities that can be assessed digitally and remotely. Loss of mobility is also an important feature of many health conditions, providing a read-out of health as well as a target for intervention. Real-world, continuous digital measures of mobility (digital mobility outcomes or DMOs) provide an opportunity for novel insights into health care conditions complementing existing mobility measures. Accepted and approved DMOs are not yet widely available. The need for large collaborative efforts to tackle the critical steps to adoption is widely recognised. Mobilise-D is an example. It is a multidisciplinary consortium of 34 institutions from academia and industry funded through the European Innovative Medicines Initiative 2 Joint Undertaking. Members of Mobilise-D are collaborating to address the critical steps for DMOs to be adopted in clinical trials and ultimately health care. To achieve this, the consortium has developed a roadmap to inform the development, validation and approval of DMOs in Parkinson’s disease, multiple sclerosis, chronic obstructive pulmonary disease and recovery from proximal femoral fracture. Here we aim to describe the proposed approach and provide a high-level view of the ongoing and planned work of the Mobilise-D consortium. Ultimately, Mobilise-D aims to stimulate widespread adoption of DMOs through the provision of device agnostic software, standards and robust validation in order to bring digital outcomes from concept to use in clinical trials and health care.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
A Callegaro ◽  
L Chinenye Ilogu ◽  
O Lugovska ◽  
S Mazzilli ◽  
A Prugnola ◽  
...  

Abstract Background Immunisation programs are still facing substantial challenges in achieving target coverage rates. This has been attributed to the growing negative individual vaccination attitudes and behaviours. Most of the current studies assessing vaccination knowledge, attitude and beliefs targets adults. However, young people represent future parents and health care professionals. The objective of this study was to investigate vaccination knowledge attitudes and behaviours among university medical and non-medical students in Europe. Methods We performed a cross-sectional online survey between April and July 2018. The study participants were students attending different faculties at the University of Antwerp, Belgium and the University of Pisa, Italy. We described sample characteristics. The effect of risk factors was tested with univariate and multivariate logistic regressions. Results A total of 2079 participants completed the survey including 873 medical students and 1206 from other faculties. The average of vaccination knowledge, attitudes, and confidence was respectively 5.51 (SD: 1.41), 4.66 (SD: 0.14) and 5.28 (SD: 0.57) on the 6-points scale. Our respondents demonstrated a high level of awareness with respect to their vaccination history. In total, 67.7% (n = 1407) reported to have received at least one vaccine in the previous five years; only 6.0% (n = 35) did not receive any vaccine in the previous 10 years. According to logistic regression analysis Italian students had significantly higher knowledge, attitude and confidence scores than Belgium respondents. Students of medicine scored significantly higher compared to non-medical students. Conclusions In order to reduce the gaps in vaccinations knowledge between non-medical and medical students we should plan educational interventions. In this way the number of future sceptical parents could be decreased. Further studies are required to explain the differences between countries. Key messages Young adults are the parents and the health care professionals of the future, for this reason their vaccination knowledge attitudes and behaviours should be carefully monitored. European non-medical students have lower vaccinations knowledge, attitudes and confidence compared with medical student. In order to fill these gaps, we should plan educational interventions.


2020 ◽  
Author(s):  
Martine W J Huygens ◽  
Helene R Voogdt-Pruis ◽  
Myrah Wouters ◽  
Maaike M Meurs ◽  
Britt van Lettow ◽  
...  

BACKGROUND Telemonitoring could offer solutions to the mounting challenges for health care and could improve patient self-management. Studies have addressed the benefits and challenges of telemonitoring for certain patient groups. OBJECTIVE This paper will examine the nationwide uptake of telemonitoring in chronic care in the Netherlands from 2014 to 2019 by means of an annual representative survey among patients and health care professionals. METHODS Between 2014 and 2019, approximately 2900 patients with chronic diseases, 700 nurses, and 500 general practitioners (GPs) and medical specialists received a questionnaire. About 30 questions addressed topics about the use of eHealth and experiences with it, including data about telemonitoring. RESULTS Between 2014 and 2019, the use of telemonitoring remained stable for all groups except medical specialists. In medical specialist departments, the use of telemonitoring increased from 11.2% (18/161) in 2014 to 19.6% (36/184) in 2019 (<i>χ</i><sup>2</sup><sub>4</sub>=12.3; <i>P</i>=.02). In 2019, telemonitoring was used by 5.8% (28/485) of people with chronic disease. This was 18.2% (41/225) in GP organizations and 40.4% (44/109), 38.0% (78/205), and 8.9% (29/325) in the organizations of nurses working in primary, secondary, and elderly care, respectively. Up to 10% of the targeted patient group such as diabetics were regarded by health care professionals as suitable for using telemonitoring. The main benefits mentioned by the patients were “comfort” (421/1043, 40.4%) and “living at home for longer/more comfortably” (334/1047, 31.9%). Health care professionals added “improvement of self-management” (63/176, 35.8% to 57/71, 80.3%), “better understanding of the patient’s condition” (47/176, 26.7% to 42/71, 59.2%), “reduction of workload” (53/134, 39.6% of nurses in elderly care), “better tailoring of care plan to the patient’s situation” (95/225, 42.2% of GPs), and “saves time for patients/caregivers” (61/176, 34.7% of medical specialists). Disadvantages mentioned by professionals were that “it takes time to monitor data” (13/130, 10% to 108/225, 48.0%), “it takes time to follow up alerts” (15/130, 11.5% to 117/225, 52.0%), and “it is difficult to estimate which patients can work with telemonitoring” (22/113, 19.5% to 94/225, 41.8%). CONCLUSIONS The uptake of telemonitoring in Dutch chronic care remained stable during 2014-2019 but increased among medical specialists. According to both patients and professionals, telemonitoring improves the quality of life and quality of care. Skills for suitably including eligible patients and for allocating the tasks of data monitoring and follow-up care within the team would help to further increase the use of telemonitoring.


2019 ◽  
Author(s):  
Anat Gesser-Edelsburg ◽  
Nour Abed Elhadi Shahbari ◽  
Ricky Cohen ◽  
Adva Mir Halavi ◽  
Rana Hijazi ◽  
...  

BACKGROUND In the new media age, the public searches for information both online and offline. Many studies have examined how the public reads and understands this information but very few investigate how people assess the quality of journalistic articles as opposed to information generated by health professionals. OBJECTIVE The aim of this study was to examine how public health care workers (HCWs) and the general public seek, read, and understand health information and to investigate the criteria by which they assess the quality of journalistic articles. METHODS A Web-based nonprobability sampling questionnaire survey was distributed to Israeli HCWs and members of the public via 3 social media outlets: Facebook, WhatsApp, and Instagram. A total of 979 respondents participated in the online survey via the Qualtrics XM platform. RESULTS The findings indicate that HCWs find academic articles more reliable than do members of the general public (44.4% and 28.4%, respectively, P<.001). Within each group, we found disparities between the places where people search for information and the sources they consider reliable. HCWs consider academic articles to be the most reliable, yet these are not their main information sources. In addition, HCWs often use social networks to search for information (18.2%, P<.001), despite considering them very unreliable (only 2.2% found them reliable, P<.001). The same paradoxes were found among the general public, where 37.5% (P<.001) seek information via social networks yet only 8.4% (P<.001) find them reliable. Out of 6 quality criteria, 4 were important both to HCWs and to the general public. CONCLUSIONS In the new media age where information is accessible to all, the quality of articles about health is of critical importance. It is important that the criteria examined in this research become the norm in health writing for all stakeholders who write about health, whether they are professional journalists or citizen journalists writing in the new media.


1989 ◽  
Vol 5 (1) ◽  
pp. 103-109 ◽  
Author(s):  
J. Cohen

This article examines the meaning of appropriate technology in the World Health Organization's comprehensive definition of primary care. The author concludes that broad-ranging aspects of health maintenance, such as public health, personal lifestyles, and scientific research, as well as traditional diagnostic and therapeutic practices, need to be subjected to clear and careful scrutiny. It is vital that the results of these technology assessment studies be disseminated as widely as possible to both health care professionals and the public.


2019 ◽  
Vol 31 (5) ◽  
pp. 460-467
Author(s):  
Anita Ham

Introduction: Within a Dutch nursing home, the prevailing workforce culture was challenged by new personnel, which caused institutional change, which in turn, affected workforce integration. The purpose of this study was to examine social processes affecting workforce integration of first-generation immigrant health care professionals in aging citizens in a Dutch health institution in the Netherlands. Method: A purposive sample of 10 immigrants and 10 established nurses was recruited. Ethnography was used to guide this study. 105 hours of participant observation, 8 semistructured interviews with 4 immigrants and 4 established nurses, and 2 focus-group discussions with 8 immigrants and 6 established nurses. Results: The study identified various processes that affect culturally congruent care in the nursing home, like the imposing professional norms, the use of “weapons of the weak,” mutual suspicions of indifference, and collective images of “us” versus “them.” Both groups conceived the “others” as the source of their discomfort, however, both had pain of not mattering. Discussion: When recruiting international educated nurses “all nursing staff” face difficulties when going through the precarious process of mutual integration in daily care practices. We recommend that nurse leaders facilitate positive intergroup interactions that promotes reciprocity for all groups of nurses for better health care outcomes for all.


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