Clinical commissioning group funding of oculoplastic services: is there a postcode lottery?

2021 ◽  
Vol 27 (11) ◽  
pp. 303-308
Author(s):  
Samantha Hunt ◽  
Rebecca Ford
Keyword(s):  
Visual Function ◽  
Healthcare Services ◽  
Practical Implementation ◽  
Freedom Of Information ◽  
Patient Access ◽  
Information Request ◽  
Funding Policies ◽  
Access Policies

Background/Aims Clinical commissioning groups have been responsible for commissioning healthcare services since 2013, allocating resources according to local needs. This has given rise to concerns about a ‘postcode lottery’. This study examined the variability of clinical commissioning group-imposed funding restrictions and access policies for oculoplastic procedures in England. Methods A freedom of information request was sent to all 206 clinical commissioning groups in February 2018 seeking information about their funding policies for common oculoplastic procedures. When signposted to online policies, these were reviewed. Results Significant funding variation exists across all procedures examined. Access criteria usually depends on visual function sequelae. Some clinical commissioning groups have adopted shared policies. Although many policies are publicly available online, the authors frequently found them unclear and thus suspect that practical implementation may be challenging. Conclusions Access policies vary significantly across England. Practical interpretation is difficult, leading to a postcode lottery. This has implications for patient access, and clinician workload.

scholarly journals Institutional thoughtlessness and the needs of older probation clients

2020 ◽  
Vol 67 (2) ◽  
pp. 118-136
Author(s):  
Nichola Cadet
Keyword(s):  
Older People ◽  
Qualitative Interviews ◽  
Freedom Of Information ◽  
Self Awareness ◽  
Policy And Practice ◽  
Daily Experiences ◽  
Information Request ◽  
Older Prisoners ◽  
Probation Service ◽  
First Time

This article explores the increase in the number of older people on probation caseloads. ‘Older’ clients are defined as those aged 50 and over, in line with the use of this definition by Her Majesty’s Prison and Probation Service. Drawing upon a Freedom of Information request submitted to the Ministry of Justice, the data show increases in the age of probation clients across community orders, suspended sentences, and supervision on licence. One in five residents in Approved Premises are over 50. Despite the increase, there is a dearth of research relating to the needs of older people on probation and how well probation services and staff are equipped to meet their needs. Consequently, this article utilises research relating to older prisoners, drawing inferences to probation experiences. This prompts the question of whether probation is ‘institutionally thoughtless’, a term coined relating to the daily experiences of older prisoners. This article depicts findings from qualitative interviews with older prisoners in prison for the first time. The findings highlight ambivalence towards completing accredited programmes, which may be applicable to probation settings. This article concludes that action to tackle discrimination requires a commitment to justice, self-awareness, and knowledge via policy and practice.

Baseline trials reveal more uncertainties

2019 ◽  
Vol 21 (4) ◽  
pp. 14-16
Author(s):  
Sue Cowley
Keyword(s):  
Freedom Of Information ◽  
Baseline Trial ◽  
Information Request

A Freedom of Information request to find out more about the baseline trial is raising questions about the test's validity, reliability and implications for workload. When will the DfE admit it is in trouble?

Litigation trends and costs in otorhinolaryngology

2015 ◽  
Vol 129 (10) ◽  
pp. 941-944 ◽  
Author(s):  
C W Metcalfe ◽  
S J Muzaffar ◽  
C J Coulson
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Freedom Of Information ◽  
Policy Changes ◽  
Delay In Diagnosis ◽  
Information Request ◽  
Inappropriate Treatment ◽  
Recent Policy ◽  
Delay In Treatment

AbstractBackground:Litigation in surgery is increasing and liabilities are becoming unsustainable. This study aimed to analyse trends in claims, and identify areas for potential risk reduction, improved patient safety and a reduction in the number, and cost, of future claims.Methods:Ten years of retrospective data on claims in otorhinolaryngology (2003–2013) were obtained from the National Health Service Litigation Authority via a Freedom of Information request. Data were re-entered into a spreadsheet and coded for analysis.Results:A total of 1031 claims were identified; of these, 604 were successful and 427 were unsuccessful. Successful claims cost a total of £41 000 000 (mean, £68 000). The most common areas for successful claims were: failure or delay in diagnosis (137 cases), intra-operative problems (116 cases), failure or delay in treatment (66 cases), failure to warn – informed consent issue (54 cases), and inappropriate treatment (47 cases).Conclusion:Over half of the claims in ENT relate to the five most common areas of liability. Recent policy changes by the National Health Service Litigation Authority, over the level of information divulged, limits our learning from claims.

scholarly journals HIV patient access to healthcare services in post-austerity era in Greece

2021 ◽  
Keyword(s):  
Healthcare Services ◽  
Access To Healthcare ◽  
Patient Access

Abstract The authors have requested that this preprint be withdrawn due to erroneous posting.

Networkcentric Healthcare and the Entry Point into the Network

2011 ◽  
pp. 87-94
Author(s):  
Dag von Lubitz ◽  
Nilmini Wickramasinghe
Keyword(s):  
Healthcare Costs ◽  
Healthcare Delivery ◽  
Armed Forces ◽  
Healthcare Services ◽  
Limited Range ◽  
Insurance Companies ◽  
Practical Implementation ◽  
Healthcare Operations ◽  
Healthcare Information ◽  
Minimal Impact

The concept of e-health gains rapid and widespread international acceptance as the most practical means of reducing burgeoning healthcare costs, improving healthcare delivery, and reducing medical errors. However, due to profit-maximizing forces controlling healthcare, the majority of e-based systems are characterized by non-existent or marginal compatibility leading to platformcentricity that is, a large number of individual information platforms incapable of integrated, collaborative functions. While such systems provide excellent service within limited range healthcare operations (such as hospital groups, insurance companies, or local healthcare delivery services), chaos exists at the level of nationwide or international activities. As a result, despite intense efforts, introduction of e-health doctrine has minimal impact on reduction of healthcare costs. Based on their previous work, the authors present the doctrine of network-centric healthcare operations that assures unimpeded flow and dissemination of fully compatible, high quality, and operation-relevant healthcare information and knowledge within the Worldwide Healthcare Information Grid (WHIG). In similarity to network- centric concepts developed and used by the armed forces of several nations, practical implementation of WHIG, consisting of interconnected entry portals, nodes, and telecommunication infrastructure, will result in enhanced administrative efficiency, better resource allocation, higher responsiveness to healthcare crises, and—most importantly—improved delivery of healthcare services worldwide.

Network-Centric Healthcare and the Entry Point into the Network

2011 ◽  
pp. 647-652
Author(s):  
Dag von Lubitz ◽  
Nilmini Wickramasinghe
Keyword(s):  
Healthcare Costs ◽  
Healthcare Delivery ◽  
Armed Forces ◽  
Healthcare Services ◽  
Limited Range ◽  
Insurance Companies ◽  
Practical Implementation ◽  
Healthcare Operations ◽  
Healthcare Information ◽  
Minimal Impact

The concept of e-health gains rapid and widespread international acceptance as the most practical means of reducing burgeoning healthcare costs, improving healthcare delivery, and reducing medical errors. However, due to profit-maximizing forces controlling healthcare, the majority of e-based systems are characterized by non-existent or marginal compatibility leading to platform-centricity that is, a large number of individual information platforms incapable of integrated, collaborative functions. While such systems provide excellent service within limited range healthcare operations (such as hospital groups, insurance companies, or local healthcare delivery services), chaos exists at the level of nationwide or international activities. As a result, despite intense efforts, introduction of e-health doctrine has minimal impact on reduction of healthcare costs. Based on their previous work, the authors present the doctrine of network- centric healthcare operations that assures unimpeded flow and dissemination of fully compatible, high quality, and operation-relevant healthcare information and knowledge within the Worldwide Healthcare Information Grid (WHIG). In similarity to network-centric concepts developed and used by the armed forces of several nations, practical implementation of WHIG, consisting of interconnected entry portals, nodes, and telecommunication infrastructure, will result in enhanced administrative efficiency, better resource allocation, higher responsiveness to healthcare crises, and—most importantly—improved delivery of healthcare services worldwide.

Charging of overseas visitors within England and achieving Universal Health Coverage: A cross sectional analysis of a freedom of information request of NHS trusts in England

2019 ◽  
Author(s):  
Joanna Dobbin ◽  
Adrienne Milner ◽  
Alexander Dobbin ◽  
Jessica Potter
Keyword(s):  
Health Care ◽  
Linear Regression ◽  
Reproductive Age ◽  
Freedom Of Information ◽  
Health Coverage ◽  
Cross Sectional ◽  
Information Request ◽  
Cost Of Health Care ◽  
The Cost ◽  
Universal Health

Abstract Background Not everybody living in or visiting the UK is eligible for free NHS care. Individuals from outside the European Economic Area who have not paid the immigration surcharge are chargeable for NHS care at 150% of cost. In 2017, new regulations introduced upfront charging for non-urgent care. Following this, reports of individuals being denied treatment – in particular British people from the Windrush generation appeared. This research provides the first large scale dataset examining the demographics of those charged. Methods A freedom of information request was sent to 135 acute non-specialist NHS trusts in England to create a database of non-EEA overseas visitors charges from 2016/17 and 2017/18. This cross sectional survey was analysed using multiple linear regression to explore the relationship between sex, age, nationality, ethnicity, urgency and the cost of health care. Results Of 135 acute non-specialist trusts in England 64 replied, providing a data set of 13,484 patients. Women were found to be invoiced higher amounts than men (p=0.002). Patients were more likely to be women (63% vs. 37% men), and within this group, almost half of patients were of reproductive age, with 47.9% (3165) aged 16 to 40 years old. Multiple linear regression by age group showed that age is significantly related to the cost of health care with patients over 65 paying more than those aged 16-40, and 41-64 (p=0.011), and children under 16 paying less (p<0.001). The urgency of treatment was significantly related to cost, with the most urgent (immediantly necessary) treatment costing the most (p<0.001). Conclusions The demographics of those charged as overseas visitors alligns with the pattern of estimated costs of care for NHS care overall, where women of reproductive age and older patients require a higher amount of medical care. This research reflects current concerns of migrants being left behind in the strive towards universal health coverage which should be based upon quality, equality, and financial protection for patients. A key limitation was the low response rate.. The limitation of missing data has meant that questions surrounding possible charging discrimination of ethnic grounds cannot be answered.

scholarly journals Mental health service discrimination against older people

2013 ◽  
Vol 37 (3) ◽  
pp. 98-103 ◽  
Author(s):  
David Anderson ◽  
Peter Connelly ◽  
Richard Meier ◽  
Cherie McCracken
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Older People ◽  
Freedom Of Information ◽  
Ageing Population ◽  
Information Request ◽  
Specialist Services ◽  
The Face ◽  
Equality Of Access

Aims and methodTo provide a picture of availability and equality of access to mental health services for older people prior to the Equality Act. In 2010, a questionnaire was sent to health commissioners in England, Scotland and Wales under a Freedom of Information request.ResultsOverall, 132 (76%) replied. Of 11 services, 7 were either unavailable or did not provide equality of access to older people in more than a third of commissioning areas. When provided by specialist older people's mental health, services were more often considered to ensure equality.Clinical implicationsIncreasing need resulting from an ageing population is unlikely to be met in the face of current inequality. Inequality on the basis of age is the result of government policy and not the existence of specialist services for older people. Single age-inclusive services may create indirect age discrimination. Availability alone is insufficient to demonstrate equality of access. Monitoring the effects of legislation must take this into account.

scholarly journals Current use of procedure specific consent forms for laparoscopic cholecystectomy

2018 ◽  
Vol 100 (6) ◽  
pp. 446-449 ◽  
Author(s):  
MJ Courtney ◽  
TJ Royle
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
National Health Service ◽  
Bile Duct ◽  
Informed Consent Process ◽  
Freedom Of Information ◽  
General Anaesthetic ◽  
Consent Forms ◽  
Information Request ◽  
Current Usage

Introduction Procedure specific consent forms (PSCFs) have been shown to improve consenting practice for a standardised list of complications. The aim of this study was to assess the current usage and quality of PSCFs in the National Health Service (NHS) for cholecystectomy, specifically comparing the listed complications with those mentioned on the NHS website. Methods A freedom of information request was sent to all NHS trusts asking whether they perform laparoscopic cholecystectomy and whether they have a PSCF for this. A copy of the PSCF was also requested. Complications stated on these forms were compared with those on the NHS Choices website. Results Overall, 162 (88%) of the 185 trusts responded, with 121 of these performing cholecystectomies. Among these, 20 (17%) currently use PSCFs; all provided a copy. Five (25%) of the PSCFs contained all eight risks mentioned on the NHS website. The number of risks listed varied from 4 to 18 per form. Only bile duct injury was listed on every PSCF. The least frequently mentioned complication (45% of forms) was the risk from general anaesthetic. Conclusions This study suggests that too few trusts are using PSCFs and that those PSCFs that are in use contain too little detail on the risks of cholecystectomy. The listed risks and incidences on each PSCF were highly variable. More trusts should begin to use PSCFs during the informed consent process and each PSCF should include a nationally standardised list of potential complications to act as a prompt for discussion (and documentation) of risk.

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