Public to be given more power in plans to localise NHS
The Government proposes to put patients at the heart of the National Health Service (NHS) in a radical restructure of the current service, as discussed in ‘Equity and Excellence: Liberating the NHS’ (Cm. 7881).
The public will have greater choice and control over how healthcare services are coordinated through a blend of Conservative and Liberal Democrat ideas to improve patient experience and outcomes.
Hospitals are well-maintained by privately funded hospital contracts
The design, construction and management of privately funded National Health Service (NHS) hospitals is satisfactory or better, according to the National Audit Office.
Private Finance Initiative (PFI) hospital contracts, awarded and managed by local Trusts, ensure the upkeep of services including cleaning and catering and require buildings to be maintained in a specified condition. Currently there are 76 operational PFI contracts in England supported by the Department of Health.
Secure checks on foreign doctors must be made
'The Use of Overseas Doctors in Providing Out-of-Hours Services’ (HC 441) reports that foreign General Practitioners (GP) offering out-of-hours services must be completely vetted to improve standards.
The Health Committee urges that language and medical skills must be improved by European Economic Area (EEA) doctors due to poor English and general practice capability.
Lord Darzi proposes NHS overhaul
2008 marks the 60th anniversary of the creation of the National Health Service (NHS). In July 2007, Secretary of State for Health Alan Johnson announced that Professor Ara Darzi (now Lord Darzi of Denham) had been asked to carry out a wide-ranging review of the NHS.
'High Quality Care for All: NHS Next Stage Review Final Report by Lord Darzi' (Cm. 7432) sets out the Government's 10-year plan for the future of the NHS. It incorporates the views and visions of 2,000 clinicians and other health and social care professionals from every NHS region in England and has been developed in discussion with patients, carers, and the general public.
Dental services 'deteriorating'
In April 2006 the Department of Health (the Department) reformed the General Dental Service. Primary Care Trusts (PCTs) were given the power to commission dental services, the patient charging system was simplified, and under the terms of a new dental contract dentists were remunerated according to the number of Units of Dental Activity (UDA) completed. The Department issued a number of criteria for success.
This Report, 'Dental Services' (HC 289-I), assesses how far the Department's criteria have been met.
Modernising Medical Careers (MMC) programme investigated
The Modernising Medical Careers (MMC) programme of work was established in 2003 to address difficulties in poor training and indifferent career prospects and a new Foundation programme was introduced in 2005, the Specialty Training system was reformed, and the SHO grade scrapped in 2007.
As a result of inadequate preparation during the implementation of the reforms, in 2007 the MMC programme was plunged into crisis.
Health of the working population reviewed
Around 175 million working days were lost to illness in 2006. Some 7% of the working-age population is workless and receiving benefits because of long-term health conditions or disabilities. This represents a significant cost to the economy - in cost of benefits, healthcare, forgone taxes, lost production, sickness absence, informal care - estimated at between £103 and £129 billion.
This Review from Dame Carol Black (the National Director for Health and Work), 'Working for a Healthier Tomorrow', establishes the first baseline for the health of the working population. Its vision for health and work in Britain is based on three principal objectives: prevention of illness and promotion of health and well-being; early intervention for those who develop a health condition; and an improvement in the health of those out of work.
GP salaries up by average of 58% as working hours
fall
Each year general medical practices provide some 290
million consultations. The new contract which was implemented in April 2004
(increased spending began in April 2003) changed the basis for commissioning
primary care services. Instead of contracting with individual General
Practitioners (GPs), Primary Care Trusts (PCTs) commission services from some
8,325 GP practices with around 33,000 GPs.
'NHS
Pay Modernisation: New Contracts for General Practice Services in England' (HC
307) examines the negotiation and implementation of the new contract and
how well it is working in practice.
Prescription costs examined
This Report,
'Department
of Health: Prescribing costs in primary care' (HC 173), from the Committee
of Public Accounts, examines the cost of prescriptions in primary care.
Care for vulnerable babies examined
This National Audit Office (NAO) Report
‘Caring
for Vulnerable Babies’ (HC 101) examines the reorganisation of neonatal
services in England.
Government should withdraw all NHS funded homeopathy urges inquiry
'Evidence Check 2: Homeopathy’ (HC 45) examines the Government's policies on the provision of homeopathy through the National Health Service (NHS) and the licensing of homeopathic products by the Medicines and Healthcare products Regulatory Agency (MHRA). This was prompted after a Government response in September 2009 indicated that scientific evidence was not used to formulate the licensing regime operated by the MHRA.
This inquiry is an examination of the evidence behind government policies on homeopathy, not an inquiry into homeopathy. The task was to determine whether scientific evidence supports government policies.
Air travel health issues examined
In this Report,
‘Air
Travel & Health: An Update’ (HL 7), the House of Lords Select Committee
on Science and Technology sets out the current situation and still finds issues
that remain of concern, particularly the risk to air travellers of venous
thromboembolism (VTE).
Mental Health Crisis services reviewed
This National Audit Office (NAO) Report,
'Helping
People Through Mental Health Crisis' (HC 5), examines the role of Crisis
Resolution and Home Treatment services (CRHT) in helping people through mental
health crisis.
Improving health services in England and Wales
This report,
'State
of Healthcare 2007: Improvements and Challenges in Services in England and
Wales’ (HC 97), is the fourth annual State of Healthcare Report from the
Healthcare Commission.
Abortion 24 week limit examined
‘Scientific
Developments Relating to the Abortion Act 1967’ (HC 1045-I) discusses key
scientific and technological issues relating to the law on abortion.
Report evaluates the Department for International Development's HIV and AIDS Strategy
Progress has been made on providing HIV/AIDS treatment in developing countries but the 2010 target of universal access to treatment will not be met. 'Progress on the Implementation of the DFID's HIV/AIDS Strategy’ (HC 49-1) reports that the disease remains a significant development and public health challenge in many developing countries.
Report reveals poor value for money in dementia services
The Department of Health has developed an ambitious and comprehensive strategy for dementia, 'Living Well with Dementia: A National Dementia Strategy (February 2009)'. Yet, despite the Department stating that dementia is now a national priority, it has not been given the levers or urgency normally expected for such a priority and there is a risk that value for money will remain poor unless these weaknesses are addressed urgently.
Dementia was not included in the Department's tier 1 Vital Signs indicators for the NHS through which it monitors performance. Other levers such as joined-up commissioning and comprehensive performance information are not yet fully developed. Achieving transformation in the proposed five years will be very challenging.
Report examines the failings of the Mid Staffordshire NHS Foundation Trust
Concerns about mortality and the standard of care provided at the Mid Staffordshire NHS Foundation Trust resulted in an investigation by the Healthcare Commission which published a highly critical report in March 2009, followed by two reviews commissioned by the Department of Health.
These investigations gave rise to widespread public concern and a loss of confidence in the Trust, its services and management. ‘Independent Inquiry into Care Provided by Mid Staffordshire NHS Foundation Trust: January 2005 - March 2009’ (HC 375-I & 375-II) was set up primarily to give those most affected by poor care an opportunity to tell their stories and to ensure that the lessons learned were fully taken into account in the rebuilding of confidence in the Trust.
Specialist allergy centres needed
Allergy in the United Kingdom has now reached epidemic
proportions.
This Report
‘Allergy’
(HL 166-I) examines the provision of allergy treatment in the UK.
Clinical governance in primary care
Following serious concerns about
clinical and organisational failures in the NHS during the 1990s (such as Alder
Hey, the Bristol Royal Infirmary and Shipman), the Government identified the
need for a more systematic approach to improving quality and safety in
healthcare.
This Report
‘Clinical
Governance in Primary Care’ (HC 302) examines the introduction of the
clinical governance framework in the NHS.
Mental health ‘deprivation of liberty’
safeguards introduced
The main purpose of the
Mental
Health Act 2007 is to amend the Mental Health Act 1983. It also introduces
"deprivation of liberty safeguards" through amending the
Mental
Capacity Act 2005 and extends the rights of victims by amending the
Domestic
Violence, Crime and Victims Act 2004.
NHS spending on prescription drugs examined
The National Health Service spends £8 billion a year on
prescription drugs in primary care in England. This has grown 60% in real terms
over the last decade and the trend continues to be upward.
Digital hearing aid waiting times examined
One in seven people in England suffer from hearing loss of
some kind, and the advent of digital hearing aids has proved of great benefit
to many patients.
This publication from the House of Commons Health
Committee,
‘Audiology
services’ (HC 392)’ examines the Modernising Hearing Aid Services
(MHAS) programme to improve audiology services introduced in 2000.
Disability discrimination laws "should protect
mental health"
This Report
‘Improving
the Mental Health of the Population: Can the European Union help?’ (HLP 73-
I) from the House of Lords European Union Committee brings together
evidence on the impact of mental health problems from a wide range of
individuals and organisations.
NHS IT “behind schedule”
The National Programme for IT in the NHS was set up to
utilise information technology to help provide high quality services to
patients, using centrally managed procurement to provide impetus to the uptake
of IT and to secure economies of scale.
Expenditure on the Programme is
expected to be £12.4bn over ten years to 2013-14.
NHS consultant contract reviewed
This National Audit Office (NAO) Report
‘Pay
modernisation: a new contract for NHS consultants in England’ (HC 335)
examines the contract for NHS consultants agreed in 2003 and widely implemented
by April 2004.
The contract was needed to increase the size and
commitment of the consultant workforce if it was to deliver the NHS reform
agenda and comply with the requirements of the European Working Time Directive
to reduce consultants’ hours.
New out of hours care ‘shambolic’
Approximately nine million patients receive urgent primary
out-of-hours care in England.
In April 2004, the Department of Health
gave GPs the chance to opt out of providing this service and transfer
responsibility to the Primary Care Trust.
Mental Health Bill human rights examined
This Report from the Joint Committee on Human Rights
'Legislative
Scrutiny: Mental Health Bill' (HC 288/HL 40) examines the provisions of
the
'Mental
Health Bill' (HLB 1) in relation to human rights compatibility issues and
considers significant omissions from the Bill which could have enhanced the
protection and promotion of human rights.
Health professionals should "revalidate" fitness to
practice
This White Paper
'Trust,
Assurance and Safety: The Regulation of Health Professionals in the 21st
Century' (Cm. 7013) sets out a programme of reform to the UK's system for
the regulation of health professionals.
NHS, armed forces and prison officers’ pay
reviewed
These Reports review the salaries of the armed forces,
senior civil servants, prison offers and health professionals, including
doctors, dentists and nurses.
Recommendations set out in these Reports
are applicable from 1 April 2007.
Primary Care Trusts “improving quality and
safety”
Primary Care Trusts (PCTs) are responsible at the local NHS
level for the statutory “duty of care”, largely through implementing clinical
governance.
“Clinical governance” involves improving the overall
standard of clinical care, reducing variations in access to services, and
ensuring that local decision-making is based on the most up to date
effectiveness principles.
New single fund for health research proposed
The Cooksey Review proposes a structure for funding health research, with the objective of obtaining maximum benefit and eliminating duplication of effort.
The Review found that the UK is at risk of failing to reap the full economic, health and social benefits of public investment in health research, with two key gaps in the translation of health research:
- Translating ideas from basic and clinical research into the development of new products and approaches to treatment of disease and illness
- Implementing those new products and approaches into clinical practice.
NHS plans investment and reform
The Department of Health releases its Autumn Performance Report 2006. The Report looks at progress made in the Department’s commitments to delivering better public services, examining public service agreements and analysing targets.
Primary Care Trusts “improving quality and
safety”
Primary Care Trusts (PCTs) are responsible at the local NHS
level for the statutory “duty of care”, largely through implementing clinical
governance.
“Clinical governance” involves improving the overall
standard of clinical care, reducing variations in access to services, and
ensuring that local decision-making is based on the most up to date
effectiveness principles.
Hybrid embryo research ban examined
This Report
‘Government
Proposals for the Regulation of Hybrid and Chimera Embryos’ (HC 272-I) is
a response by the House of Commons Science and Technology Select Committee to
the publication of Government proposals to prohibit the creation of
human-animal chimera or hybrid embryos for research for the time being,
published as
‘Review
of the Human Fertilisation and Embryology Act’, (Cm. 6989).
NHS "lack of planning" over use of temporary
nurses
Properly managed, the use of temporary nurses can play an
important role in helping hospitals achieve flexibility. However their high use
can have a detrimental impact on patient care and satisfaction.
In 2001,
the Department of Health anticipated that a growth in the National Health
Service (NHS) workforce would lead to a decline in the use of temporary staff
but, in spite of this intention, temporary nurses still account for the same
percentage of the nursing budget (around 9%).
Human Tissue and Embryos Draft Bill: key
concerns
This Report
‘Human
Tissue and Embryos (Draft) Bill’ (HL 169-I / HC 630-I) from the Joint
Committee on the Human Tissue and Embryos (Draft) Bill scrutinises proposals
set out within the Government’s
'Human
Tissue and Embryos (Draft) Bill (Cm. 7087)'.
After scrutinising the
Draft Bill, the Committee challenge a number of aspects of the Government’s
approach.
NICE: slow publication of guidance criticised
This Report,
'National
Institute for Health and Clinical Excellence’ (HC 27), looks at the role of
National Institute for Health and Clinical Excellence (NICE), how the
organisation works, changes made since its establishment and the new challenges
it faces.
NHS Electronic Patient Records reviewed
One of the main aims of the 10-year National Programme for
Information Technology in England is implementing Electronic Patient Records
(EPR). The NHS Care Records Service creates two separate EPR systems: a
national Summary Care Record, containing basic information, and local Detailed
Care Records, containing more comprehensive clinical information.
This
Report
‘The
Electronic Patient Record’ (HC 422-I) examines the implementation of the
scheme.