scholarly journals Maintaining High Professional Standards, morally, ethically and fairly: what doctors need to know right now

2020 ◽  
Vol 96 (1141) ◽  
pp. 711-717
Author(s):  
Ifat Ataullah ◽  
Alexandra Livesey
Keyword(s):  
National Health Service ◽  
Health Service ◽  
Performance Management ◽  
National Health ◽  
Best Practice ◽  
Traumatic Events ◽  
Professional Standards ◽  
Long Term Outcomes ◽  
Management Procedures

Facing an investigation into performance concerns can be one of the most traumatic events in a doctor’s career, and badly handled investigations can lead to severe distress. Yet there is no systematic way for National Health Service (NHS) Trusts to record the frequency of investigations, and extremely little data on the long-term outcomes of such action for the doctors. The document—Maintaining High Professional Standards in the Modern NHS (a framework for the initial investigation of concerns about doctors and dentists in the NHS)—should protect doctors from facing unfair or mismanaged performance management procedures, which include conduct, capability and health. Equally, it provides NHS Trusts with a framework that must be adhered to when managing performance concerns regarding doctors. Yet, very few doctors have even heard of it or know about the provisions it contains for their protection, and the implementation of the framework appears to be very variable across NHS Trusts. By empowering all doctors with the knowledge of what performance management procedures exist and how best practice should be implemented, we aim to ensure that they are informed participants in any investigation should it occur.

scholarly journals Scottish rehabilitation services: eight year follow-up

1993 ◽  
Vol 17 (6) ◽  
pp. 341-344
Author(s):  
Robin G. McCreadie ◽  
Douglas J. Williamson ◽  
Lesley J. Robertson
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Mentally Ill ◽  
Support Services ◽  
Psychiatric Rehabilitation ◽  
Rehabilitation Services ◽  
Local Authorities

A survey of Scottish psychiatric rehabilitation and support services, carried out in 1983 (McCreadie et al, 1985), found that although there were wide between-hospital differences, the National Health Service in Scotland was making considerable efforts to provide services for the long-term mentally ill. However, services provided by local authorities were seriously deficient.

The lost worlds of royal commissions in the NHS: The unaccountable in pursuit of the unanswerable?

2019 ◽  
Vol 37 (2) ◽  
pp. 199-217
Author(s):  
Martin Powell
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Royal Commission ◽  
Select Committee ◽  
House Of Lords ◽  
The Impact ◽  
British National Health ◽  
Advisory Bodies

There have been recent calls for a royal commission (RC) on the British National Health Service (NHS). This article focuses on the impact of RCs and similar advisory bodies, particularly on finance recommendations, of three inquiries with broad remits across the whole of the NHS from very different periods: Guillebaud (1956); Royal Commission on the National Health Service (1979); and House of Lords Select Committee on the Long-term Sustainability of the NHS (2017). These inquiries appear to have had rather limited impacts, especially on NHS funding. First, there appears to be some hesitancy in suggesting precise figures for NHS expenditure. Second, the reports are advisory, and governments can ignore their conclusions. Third, governments have ignored their conclusions. In the 1950s and the 1980s, contrary to the recommendations of the inquiries, NHS expenditure subsequently grew only slowly, and charges were increased. In short, asking an independent RC to provide answers on NHS expenditure is perhaps the unaccountable in pursuit of the unanswerable.

scholarly journals Quantifying the impact of delayed delivery of cardiac rehabilitation on patients’ health

2020 ◽  
Vol 27 (16) ◽  
pp. 1775-1781
Author(s):  
Sebastian Hinde ◽  
Alexander Harrison ◽  
Laura Bojke ◽  
Patrick Doherty
Keyword(s):  
National Health Service ◽  
Health Service ◽  
Life Expectancy ◽  
Cardiac Rehabilitation ◽  
National Health ◽  
Average Lifetime ◽  
National Guidelines ◽  
Patient Health ◽  
The Impact

Background Despite its role as an effective intervention to improve the long-term health of patients with cardiovascular disease and existence of national guidelines on timeliness, many health services still fail to offer cardiac rehabilitation in a timely manner after referral. The impact of this failure on patient health and the additional burden on healthcare providers in an English setting is quantified in this article. Methods Two logistic regressions are conducted, using the British Heart Foundation National Audit of Cardiac Rehabilitation dataset, to estimate the impact of delayed cardiac rehabilitation initiation on the level of uptake and completion. The results of these regressions are applied to a decision model to estimate the long-term implications of these factors on patient health and National Health Service expenditure. Results We demonstrate that the failure of 43.6% of patients in England to start cardiac rehabilitation within the recommended timeframe results in a 15.3% reduction in uptake, and 7.4% in completion. These combine to cause an average lifetime loss of 0.08 years of life expectancy per person. Scaled up to an annual cohort this implies 10,753 patients not taking up cardiac rehabilitation due to the delay, equating to a loss of 3936 years of life expectancy. We estimate that an additional £12.3 million of National Health Service funding could be invested to alleviate the current delay. Conclusions The current delay in many patients starting cardiac rehabilitation is causing quantifiable and avoidable harm to their long-term health; policy and research must now look at both supply and demand solutions in tackling this issue.

scholarly journals Tilting the balance: the first long-term medium secure unit in the NHS in England and Wales

2006 ◽  
Vol 30 (1) ◽  
pp. 25-28 ◽  
Author(s):  
Niamh Power ◽  
Dawn Harwood ◽  
Akintunde Akinkunmi
Keyword(s):  
Mental Health ◽  
Risk Assessment ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
The West ◽  
England And Wales ◽  
Future Developments ◽  
Secure Unit

Rollo May Ward, a long-term medium secure facility integrated within the West London Mental Health National Health Service (NHS) Trust, is the first dedicated long-term NHS medium secure unit to have opened in England. It caters for a group of men with complex clinical needs and risk assessment issues who had previously been inappropriately detained within high secure services owing to a lack of suitable, less secure placement facilities. We describe the background to the development of the long-term medium secure service, the referral and assessment processes, the structure of the ward and the therapeutic programmes available to patients. We also outline the characteristics of the first 21 patients to be admitted to the ward and offer advice for similar future developments.

scholarly journals Evaluating Quality Improvement at Scale: Design Considerations for Routine Reporting to Executive Board of a Healthcare Organisation in the UK National Health Service

2020 ◽  
Author(s):  
Kia-Chong Chua ◽  
Claire Henderson ◽  
Barbara Grey ◽  
Michael Holland ◽  
Nick Sevdalis
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Healthcare Organisation ◽  
Retrospective Evaluation ◽  
Executive Board ◽  
Project Outcomes ◽  
Uk National Health Service ◽  
The Uk

Abstract BackgroundQuality improvement (QI) in healthcare is a cultural transformation process that requires long-term commitment from the executive board, a critical theme in emerging accounts of QI success in the UK National Health Service (NHS). To help sustain long-term commitment from the executive board, an organisation-wide picture of QI applications and their impact needs to be made routinely visible.MethodWe developed a retrospective evaluation drawing inputs from the resident QI team of a healthcare organisation and academic colleagues in the field of implementation and improvement science, as well as peer-reviewed and grey literature on what constitutes success for QI in healthcare. Formative feedback on content relevance, acceptability, and feasibility issues were used to guide evaluation design. The evaluation was conducted as an online survey so that the data accrual process resembles routine reporting to help surface implementation challenges. A purposive sample of QI projects was identified to maximise contrast between projects that were or were not successful as determined by the resident QI team. To hone strategic focus in what should be reported, we also compared factors that might affect project outcomes. For understanding implementation issues, we reviewed data quality to surface challenges in the design and sustainability of routine reporting for the executive board.ResultsOut of 52 QI projects, 10 led to a change in routine practice (henceforth referred to as adoption). Details of project outcomes were limited. Project team outcomes, indicative of capacity building, were not systematically documented. Service user involvement, quality of measurement plan, fidelity and documentation of plan-do-study-act (PDSA) cycles had a major impact on adoption. The proximal impact of these process factors on adoption was consistently more apparent than the distal impact of input and contextual factors.ConclusionsDesigning a routine reporting framework is an iterative process involving continual dialogue with frontline staff and improvement specialists to navigate data accrual demands. A retrospective evaluation, as in this study, can yield empirical insights for dialogue about the routine visibility of QI applications and their organisation-wide impact, thereby honing the implementation science of QI in a healthcare organisation.

scholarly journals Are short term savings worth long term costs? Funding treatment for personality disorders

1993 ◽  
Vol 17 (9) ◽  
pp. 517-519 ◽  
Author(s):  
D. Menzies ◽  
B. M. Dolan ◽  
K. Norton
Keyword(s):  
National Health Service ◽  
Health Service ◽  
Personality Disorders ◽  
National Health ◽  
Quality Service ◽  
Short Term ◽  
New System

The new system of funding introduced by the National Health Service reforms has led to an increased awareness of financial concerns within the NHS. This was indeed one of the main aims of the reforms, with the expectation that a more efficient and better quality service would result. This may be a realistic aim, as long as clinicians' freedom to make appropriate secondary and tertiary referrals do not become totally dependent upon financial considerations. Yet it has become clear from findings within our own unit, Henderson Hospital, that, in at least 42% of cases, requests for ECR funding for treatment were refused on a purely financial basis (Dolan & Norton, 1992).

The long-term future of dentistry

2013 ◽  
Vol 4 (1) ◽  
pp. 4-7
Author(s):  
Earl Howe
Keyword(s):  
Oral Health ◽  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Coalition Government ◽  
Health Minister ◽  
Pilot Programme ◽  
The Future ◽  
Insight Into

Dentistry in the National Health Service (NHS) is undergoing some of the most significant changes in its history as the pilot programme continues to shape the dental contract of the future. Lord Howe, Health Minister, has been at the helm of the transformation since taking responsibility for oral health and dentistry policy when the coalition government formed in 2010. Now, two years into an extraordinary journey, he gives his insight into the progress and hopes for the long-term future of dentistry.

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