scholarly journals The Faculty of Medical Leadership and Management

2012 ◽  
Vol 94 (2) ◽  
pp. 51-52
Author(s):  
Peter Lees ◽  
Bill Thomas
Keyword(s):  
Quality Of Care ◽  
Leadership And Management ◽  
Current State ◽  
The Uk ◽  
Medical Leadership

In the current state of healthcare in the UK there is an urgent need for medical leadership and an increasing requirement for clinicians to become involved in management. The government's proposed reform of the NHS only reinforces the imperative for medical leadership to engage in setting standards, commissioning services, taking ownership of the agenda and thus seeking to restore professionalism. Success will drive up the quality of care for patients.

scholarly journals Widespread gaps in the quality of care for primary biliary cholangitis in UK

2021 ◽  
pp. flgastro-2020-101713
Author(s):  
Mathuri Sivakumar ◽  
Akash Gandhi ◽  
Eathar Shakweh ◽  
Yu Meng Li ◽  
Niloufar Safinia ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Medical Records ◽  
Clinical Symptoms ◽  
Primary Biliary Cholangitis ◽  
Cholestatic Liver Disease ◽  
Patient Demographics ◽  
Risk Patients ◽  
Wide Scale ◽  
The Uk

ObjectivePrimary biliary cholangitis (PBC) is a progressive, autoimmune, cholestatic liver disease affecting approximately 15 000 individuals in the UK. Updated guidelines for the management of PBC were published by The European Association for the Study of the Liver (EASL) in 2017. We report on the first national, pilot audit that assesses the quality of care and adherence to guidelines.DesignData were collected from 11 National Health Service hospitals in England, Wales and Scotland between 2017 and 2020. Data on patient demographics, ursodeoxycholic acid (UDCA) dosing and key guideline recommendations were captured from medical records. Results from each hospital were evaluated for target achievement and underwent χ2 analysis for variation in performance between trusts.Results790 patients’ medical records were reviewed. The data demonstrated that the majority of hospitals did not meet all of the recommended EASL standards. Standards with the lowest likelihood of being met were identified as optimal UDCA dosing, assessment of bone density and assessment of clinical symptoms (pruritus and fatigue). Significant variations in meeting these three standards were observed across UK, in addition to assessment of biochemical response to UDCA (all p<0.0001) and assessment of transplant eligibility in high-risk patients (p=0.0297).ConclusionOur findings identify a broad-based deficiency in ‘real-world’ PBC care, suggesting the need for an intervention to improve guideline adherence, ultimately improving patient outcomes. We developed the PBC Review tool and recommend its incorporation into clinical practice. As the first audit of its kind, it will be used to inform a future wide-scale reaudit.

scholarly journals The value of psychiatrists in leadership and management

2016 ◽  
Vol 22 (4) ◽  
pp. 263-268 ◽  
Author(s):  
Jennifer Perry ◽  
Fiona L. Mason
Keyword(s):  
Social Care ◽  
Self Awareness ◽  
Management Styles ◽  
Leadership And Management ◽  
Health And Social Care ◽  
The Uk ◽  
Medical Leadership ◽  
The Impact ◽  
Organisational Level

SummaryThe health and social care landscape in the UK is changing, and there is now, more than ever, a real need for doctors to embrace leadership and management. Evidence shows that medical leadership is associated with better outcomes for patients. Psychiatrists are particularly well suited to such roles, given the interpersonal skills and self-awareness that they develop in their training. In this article, we examine the role of the psychiatrist in leading at a patient, team and organisational level and the impact this has. We also discuss different leadership and management styles.

scholarly journals Pediatric Pharmacy Services: Current Models and Justification for Expansion

2019 ◽  
Vol 24 (5) ◽  
pp. 438-444
Author(s):  
Stephen Webster ◽  
Christine Kane ◽  
Carly Brown ◽  
Heather Warhurst ◽  
Sandy Sedgley ◽  
...  
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Clinical Pharmacy ◽  
Pediatric Patients ◽  
Pharmacy Service ◽  
Financial Impact ◽  
Pharmacy Services ◽  
Clinical Pharmacy Services ◽  
Current State

Despite recommendations from numerous health care bodies, some hospitals that care for children have struggled to establish or expand pediatric pharmacy services. The current state of dedicated pediatric operational and clinical pharmacy services was characterized by results from a survey of hospitals that provide care to pediatric patients. The discussion of quality of care, safety, and financial impact is meant to provide concepts for justification of pediatric pharmacy service expansion.

scholarly journals Effectiveness of UK provider financial incentives on quality of care: a systematic review

2017 ◽  
Vol 67 (664) ◽  
pp. e800-e815 ◽  
Author(s):  
Rishi Mandavia ◽  
Nishchay Mehta ◽  
Anne Schilder ◽  
Elias Mossialos
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Quality Of Care ◽  
Quality Of Health Care ◽  
Financial Incentives ◽  
Healthcare Quality ◽  
Standards Of Care ◽  
Positive Effects ◽  
The Uk

BackgroundProvider financial incentives are being increasingly adopted to help improve standards of care while promoting efficiency.AimTo review the UK evidence on whether provider financial incentives are an effective way of improving the quality of health care.Design and settingSystematic review of UK evidence, undertaken in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations.MethodMEDLINE and Embase databases were searched in August 2016. Original articles that assessed the relationship between UK provider financial incentives and a quantitative measure of quality of health care were included. Studies showing improvement for all measures of quality of care were defined as ‘positive’, those that were ‘intermediate’ showed improvement in some measures, and those classified as ‘negative’ showed a worsening of measures. Studies showing no effect were documented as such. Quality was assessed using the Downs and Black quality checklist.ResultsOf the 232 published articles identified by the systematic search, 28 were included. Of these, nine reported positive effects of incentives on quality of care, 16 reported intermediate effects, two reported no effect, and one reported a negative effect. Quality assessment scores for included articles ranged from 15 to 19, out of a maximum of 22 points.ConclusionThe effects of UK provider financial incentives on healthcare quality are unclear. Owing to this uncertainty and their significant costs, use of them may be counterproductive to their goal of improving healthcare quality and efficiency. UK policymakers should be cautious when implementing these incentives — if used, they should be subject to careful long-term monitoring and evaluation. Further research is needed to assess whether provider financial incentives represent a cost-effective intervention to improve the quality of care delivered in the UK.

The need for a National Service Framework for leg ulcers

2010 ◽  
Vol 25 (1_suppl) ◽  
pp. 68-72 ◽  
Author(s):  
R A Bulbulia ◽  
K R Poskitt
Keyword(s):  
Quality Of Care ◽  
Standards Of Care ◽  
Ulcer Recurrence ◽  
Leg Ulcers ◽  
National Service ◽  
National Service Framework ◽  
Assessment And Treatment ◽  
The Uk ◽  
Service Framework

Leg ulcers are common and costly to treat, and the quality of care provided to patients with this condition varies widely across the UK. The introduction of specialized community-based leg ulcer clinics in Gloucestershire has been associated with increased ulcer healing rates and decreased rates of ulcer recurrence, but this model of care has not been widely replicated. One way of ending this ‘postcode lottery’ is to produce a National Service Framework for leg ulcers, with the aim of delivering high-quality evidence-based care via such clinics under the supervision of local consultant vascular surgeons. Existing National Service Frameworks cover a range of common conditions that are, like leg ulceration, associated with significant morbidity, disability and resource use. These documents aim to raise quality and decrease regional variations in health care across the National Health Service, and leg ulceration fulfils all the necessary criteria for inclusion in a National Service Framework. Centrally defined standards of care for patients with leg ulceration, and the reorganization and restructuring of local services to allow the accurate assessment and treatment of such patients are required. Without a National Service Framework to drive up the quality of care across the country, the treatment of patients with leg ulcers will remain suboptimal for the majority of those who suffer from this common and debilitating condition.

Scotland

2019 ◽  
pp. 245-250
Author(s):  
Seamus V McNulty ◽  
Graham A Jackson
Keyword(s):  
Quality Of Care ◽  
Hospital Care ◽  
Dementia Care ◽  
General Hospitals ◽  
The Third ◽  
The United Kingdom ◽  
Novel Approaches ◽  
The Uk

Scotland is a small nation which has a devolved legislature, while still remaining part of the United Kingdom (UK). As the health service has become increasingly divergent from that of the remainder of the UK, more innovative approaches to dementia care have been allowed to develop. The Scottish Dementia Strategy, now in its third iteration, is unique in that it adopts a human rights-based method of dementia care, an approach that has subsequently been followed by other European countries. The Strategy is in continual evolution, with the third Strategy focusing more on care at the end stages of dementia, especially for those in nursing homes or long-term hospital care. Other novel approaches, such as the Dementia Champions programme, have shown benefits in the quality of care for patients with dementia in acute general hospitals, although less so for those in social care settings. Scotland was also a pioneer in enacting incapacity legislation, although this is now under review as shortcomings in the current procedures are becoming unmasked.

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