MedWorm: National Health Service (NHS)

Plan to Take British Health Records Into Virtual Reality Encounters Bureaucratic Reality, Shuts Down

ICMCC: The International Council on Medical and Care Compunetics — Sun, 05 Feb 2012 15:43:22 +0100

Source: Peter Suderman, Reason Content: “It’s hard to imagine a better environment in which to test a government-run health information technology system than Britain’s National Health Service. The system is fully socialized, with a single government payer, universal enrollment, and doctors employed directly by the state. There are roughly 60 million beneficiaries, which is big [...] (Source: ICMCC: The International Council on Medical and Care Compunetics)

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[Editorial] Genomic medicine and the NHS: it is possible

LANCET — Sat, 04 Feb 2012 05:00:00 +0100

An independent advisory group has urged the UK Government to integrate genomic medicine into the National Health Service (NHS). The Human Genomics Strategy Group (HGSG), established in 2010 after a House of Lords inquiry into genomic medicine, set out their recommendations in a report published on Jan 25. First, the group proposed that the government outline a policy for expansion of genomic technology in the NHS; HGSG emphasised that commissioning of cost-effectiveness studies will be a necessary step. (Source: LANCET)

[Comment] How the Health and Social Care Bill 2011 would end entitlement to comprehensive health care in England

LANCET — Sat, 04 Feb 2012 05:00:00 +0100

The National Health Service (NHS) in England has been a leading international model of tax-financed, universal health care. Legal analysis shows that the Health and Social Care Bill currently making its way through the UK Parliament would abolish that model and pave the way for the introduction of a US-style health system by eroding entitlement to equality of health-care provision. The Bill severs the duty of the Secretary of State for Health to secure comprehensive health care throughout England and introduces competitive markets and structures consistent with greater inequality of provision, mixed funding, and widespread provision by private health corporations. (Source: LANCET)

[World Report] Cuts in Portugal's NHS could compromise care

LANCET — Sat, 04 Feb 2012 05:00:00 +0100

Portugal's debt crisis is forcing hospital closures and hasty reform of the National Health Service, causing some observers to raise concerns about patient care. Gonçalo Figueiredo Augusto reports. (Source: LANCET)

The need for standardised outcome reporting in colorectal surgery

Gut — Fri, 03 Feb 2012 05:00:00 +0100

We were interested to read the paper by Morris et al demonstrating significant variation in 30-day postoperative mortality following major colorectal cancer surgery in National Health Service hospitals in England.1 While we agree that understanding the underlying causes of this variation will be invaluable to inform best practice, we think that it is necessary to choose a definition of postoperative mortality that provides information relevant to patients as well as clinicians. In cardiothoracic surgery, this issue has been debated for some years, resulting in a measure of ‘operative mortality’ which encompasses any death occurring (a) within 30 days after surgery, in or out of hospital, and (b) any death occurring after 30 days during the same hospitalisation subsequ...

In United Kingdom, Clinical Pathology Laboratories Must Transform to Help Primary Care Physicians Achieve Improved Patient Outcomes

Dark Daily — Thu, 02 Feb 2012 11:00:32 +0100

Frontiers in Laboratory Medicine (FiLM) attracted another record crowd of clinical laboratory managers and pathologists DATELINE—BIRMINGHAM, ENGLAND: Healthcare in the United Kingdom is undergoing a host of reforms. Consequently, medical laboratories in this country are scrambling to evolve in ways that allow them to serve the new line-up of primary care trusts and hospital trusts, [...] (Source: Dark Daily)

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Evidence‐Based Practice, Talking Therapies and the New Taylorism

Psychotherapy and Politics International — Wed, 01 Feb 2012 05:00:00 +0100

ABSTRACTThis paper explores the development of evidence‐based practice (EBP) in the field of talking therapies, and particular its realisation in the Improving Access to Psychological Therapies (IAPT) programme in the National Health Service in England. A critique of EBP is offered, starting with an examination of its epistemological and methodological foundations. The critique is then developed to examine the way EBP is being used to support the implementation of a new form of management ideology, Digital Taylorism, which is based on the codification and routinisation of what was previously considered to be subjective knowledge and practice. The service offered by IAPT, and supported by guidance from the National Institute of Health and Clinical Excellence, is presented as a prime examp...

Recruitment of Sites for Assignment of National Health Service Corps Loan Repayors (FY 2012)

Federal Register updates via the Rural Assistance Center — Fri, 27 Jan 2012 16:23:56 +0100

The Health Resources and Services Administration (HRSA) announces that the proposed list of the Health Professional Shortage Areas (HPSAs) and entities that would receive priority in applying for the assignment of National Health Service Corps (NHSC) Loan Repayors (Corps personnel, Corps members) during the period November 1, 2011, through September 30, 2012 is posted on the NHSC Web site. (Source: Federal Register updates via the Rural Assistance Center)

Socio-economic variation in CT scanning in Northern England, 1990-2002.

BMC Health Services Research — Fri, 27 Jan 2012 05:00:00 +0100

This study aimed to assess socio-economic variation among young people having CT scans in Northern England between 1990 and 2002 inclusive. Methods: Electronic data were obtained from Radiology Information Systems of all nine National Health Service hospital Trusts in the region. CT scan data, including sex, date of scan, age at scan, number and type of scans were assessed in relation to quintiles of Townsend deprivation scores, obtained from linkage of postcodes with census data, using chi2 tests and Spearman rank correlations. Results: During the study period, 39,676 scans were recorded on 21,089 patients, with 38,007 scans and 19,485 patients (11344 male and 8132 female) linkable to Townsend scores. The overall distributions of both scans and patients by quintile of Townsend deprivation...

Access to the next wave of biologic therapies (Abatacept and Tocilizumab) for the treatment of rheumatoid arthritis in England and Wales

Clinical Rheumatology — Tue, 24 Jan 2012 07:54:07 +0100

Abstract Patients in England and Wales with rheumatoid arthritis (RA) receive treatment from the National Health Service (NHS) with therapies approved by the European Medicines Agency (EMA), under guidance from the National Institute for Health and Clinical Excellence (NICE). This document overviews the current NICE guidelines for the treatment of RA and identifies scenarios when such guidance may not represent the optimum management strategy for individual patients. Specifically, we consider the use of tocilizumab or abatacept as the most appropriate treatments for some patients. In such scenarios, it may be possible for the clinician to secure access to the required therapy through an application procedure known as an ‘individual funding request’, the process of whic...

British can learn from VA on telehealth: report

ICMCC: The International Council on Medical and Care Compunetics — Fri, 20 Jan 2012 10:57:19 +0100

Source: Joseph Conn, ModernHealthcare Content: A report by a London-based, physician-led think tank concludes that the British National Health Service would do well to emulate the telehealth services developed by the Veterans Health Administration, the healthcare operation of the U.S. Veterans Affairs Department. The not-for-profit reporting group 2020Health.org, in its 22-page report, “Telehealth—What can the NHS [...] (Source: ICMCC: The International Council on Medical and Care Compunetics)

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Advances in pain management

Postgraduate Medical Journal — Wed, 18 Jan 2012 05:00:00 +0100

Acute and chronic pain has a major impact on the individual, the family, the National Health Service and society. Acute pain is common following surgical procedures and often only partially controlled. Chronic pain currently affects around 7–8 million people in the UK, and in the USA, estimates suggest that more than 75 million people live with chronic pain.1 It is likely that the number of people with chronic pain will continue to grow as a result of increasing longevity, rising prevalence of co-morbidities such as diabetes mellitus and obesity, and improving survival rates for cancer and trauma patients. Rather than solely being a normal adaptive response following tissue injury, we now understand pain as an evolving plastic phenomenon that can be influenced by a variety of physiol...

Sertraline and mirtazapine do not reduce severity of depression in people with dementia

Evidence-Based Mental Health — Tue, 17 Jan 2012 05:00:00 +0100

QuestionQuestion Are the two most commonly prescribed drugs for depression in dementia (sertraline and mirtazapine) efficacious and safe compared with placebo? Patients 326 adults with probable or possible Alzheimer's disease (National Institute of Neurological and Communicative Diseases and Stroke – Alzheimer's Disease and Related Disorders Association criteria) and depression which lasted for ≥4 weeks and was assessed as potentially needing antidepressants by the referring psychiatrist. Participants also had to score ≥8 on the Cornell scale for depression in dementia (CSDD). The inclusion criteria were selected to reflect clinical practice. Individuals were excluded if they were clinically critical (eg, suicide risk), had contraindications to study drugs, were already on anti...

Review: supportive interventions may improve short-term psychological distress in informal caregivers of patients at the end of life

Evidence-Based Mental Health — Tue, 17 Jan 2012 05:00:00 +0100

QuestionQuestion What are the effects of supportive interventions on the psychological and physical health of informal caregivers of terminally ill patients? Outcomes Psychological and physical health outcomes. MethodsDesign Systematic review and meta-analysis. Data sources The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, PsycINFO; CINAHL; and Dissertation Abstracts were searched to May 2010, and the National Health Service Research Register to November 2008. Reference lists of included trials and relevant reviews and the peer-reviewed journals are Palliative Medicine, Journal of Pain and Symptom Management and the British Journal of Psychiatry (from January 2005 to May 2010) were hand searched and experts in the field were contacted to identify other potentially relev...

NHS: How to secure tablets for healthcare

mobihealthnews — Mon, 16 Jan 2012 17:20:55 +0100

The UK’s National Health Service (NHS) Connecting for Health division recently published a guidance document for how healthcare providers in that country should and shouldn’t be using tablet devices. The document is chock-full of warnings about tablet use in healthcare settings, but it also includes some helpful hints for how CIOs should secure the devices. The [...] (Source: mobihealthnews)

An innovative joint approach to HIV and lymphoma care

Sexually Transmitted Infections — Sun, 15 Jan 2012 05:00:00 +0100

The prognosis of patients with HIV and lymphoma has improved in the highly active anti-retroviral therapy era. The British HIV Association's clinical standards1 state that the care of patients with diagnosed or suspected lymphoma should be transferred to a HIV centre provider of specialised HIV oncology services. A novel clinic was therefore set up at the Barts and the London National Health Service Trust in September 2007. Patients were seen jointly by a HIV and a haemato-oncology consultant in a fortnightly clinic in the HIV department. This aimed to improve patient outcomes and satisfaction by facilitating communication between the specialties, decreasing outpatient attendances and ensuring access to the specialist HIV multidisciplinary team. Potential problems included insufficient tim...

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[Viewpoint] What are the lessons from the USA for clinical commissioning groups in the English National Health Service?

LANCET — Sat, 14 Jan 2012 05:00:00 +0100

The UK coalition Government's plans to make groups of general practices responsible for commissioning health services have attracted much attention. Investigation of the experiences of other countries in which doctors control budgets could help the UK to understand how these plans might work. We visited the USA in March 2011 to learn how medical groups manage the budgets that they negotiate with health insurers and how they work with hospitals to control costs and improve outcomes. Our report describes what we learnt and identifies several lessons for the National Health Service (NHS), as the government's plans to establish clinical commissioning groups are taken forward. (Source: LANCET)

In the United Kingdom, Pathology and Medical Laboratory Testing Face Tough Challenges as the NHS Implements Reforms and Budget Cuts

Dark Daily — Wed, 11 Jan 2012 11:00:24 +0100

Innovative pathology laboratory organizations in the UK and Europe will come together at the Frontiers in Laboratory Medicine (FiLM) conference on January 31-February 1, 2012 For decades, the pathology and medical laboratory service in the United Kingdom has been the envy of many developed nations. But times change and the National Health Service (NHS) finds [...] (Source: Dark Daily)

HRSA's Wakefield on CHCs, ACOs and Strengthening the Health Workforce

News stories via the Rural Assistance Center — Wed, 11 Jan 2012 06:00:00 +0100

MedScape Today News interviews Mary Wakefield, administrator of the Health Resources and Services Administration (HRSA), on the Affordable Care Act and how it will impact Community Health Centers (CHCs), as well as discussing the National Health Service Corps and Teaching Health Centers. (Source: News stories via the Rural Assistance Center)

Homeopathic medicines for children

Archives of Disease in Childhood — Wed, 11 Jan 2012 05:00:00 +0100

This article describes the homeopathic tradition and considers the safety, manufacture, effectiveness and regulation of homeopathic medicines. These medicines are commonly purchased without prescription for children, so an understanding of the basis of therapy is important to ensure appropriate and safe usage. The role of integrated medicine in the National Health Service is also reviewed with identification of research priorities. (Source: Archives of Disease in Childhood)

Self-reported practices, attitudes and levels of training of practitioners in the English NHS Stop Smoking Services.

Addictive Behaviors — Wed, 11 Jan 2012 05:00:00 +0100

Authors: McDermott MS, West R, Brose LS, McEwen A Abstract The primary aim of the current study is to investigate the self-reported practices, attitudes and levels of training of stop smoking practitioners (SSPs) working at the English National Health Service's (NHS) Stop Smoking Services (SSSs). A secondary aim was to investigate differences between 'Specialist' and 'Community' SSPs. An online survey was conducted with 484 SSPs. Most (94%) SSPs offered one-to-one appointments to smokers, only 43% always used the abrupt quit model and 30% reported ever recommending particular medication to clients. SSPs reported an average of 3.7days training when starting work and 26% reported never observing an experienced practitioner before seeing clients of their own. Over half (56%) never rec...

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Pre‐prescribing: a safe way to learn at work?

The Clinical Teacher — Mon, 09 Jan 2012 11:25:21 +0100

This study took place in the National Health Service (NHS) Fife where, in common with all health boards in the UK, medical students are not permitted to prescribe. University of Edinburgh final‐year medical student volunteers took part in the study.Innovation: Medical, pharmacy and nursing staff collaborated to design and implement a controlled process (pre‐prescribing) that allows medical students to write instructions on in‐patient drug charts, and requires a doctor’s countersignature before drugs are dispensed. Key features of the pre‐prescribing protocol include fluorescent stickers for drug charts, bookmark aide‐memoires to guide countersigning and ward‐based information sheets. Twelve final‐year medical students wrote 586 pre‐prescriptions, and no adverse events ...

British Statement on Defective Implants Offers Limited Help

NYT Health — Sat, 07 Jan 2012 07:40:48 +0100

The government said there was still not enough evidence to recommend routine removal, but allowed free replacement for some women who received the implants under the National Health Service. (Source: NYT Health)

[Correspondence] The NHS IT project: more than just a bad dream

LANCET — Sat, 07 Jan 2012 05:00:00 +0100

There is much in The Lancet's Editorial (Aug 13, p 542) on England's National Programme for Information Technology (NPfIT) in the National Health Service (NHS) that it is difficult to argue with. Our assessment of the implementation of NHS electronic health records revealed the problems faced by hospitals in implementing NPfIT systems which, more often than not, failed to benefit clinicians or patients. (Source: LANCET)

Differences in length of stay for hip replacement between public hospitals, specialised treatment centres and private providers: selection or efficiency?

Health Economics — Fri, 06 Jan 2012 19:50:01 +0100

ABSTRACTWe investigate differences in patients' length of stay between National Health Service (NHS) public hospitals, specialised public treatment centres and private treatment centres that provide elective (non‐emergency) hip replacement to publicly funded patients. We find that the specialised public treatment centres and private treatment centres have, on average, respectively 18% and 40% shorter length of stay compared with NHS public hospitals, even after controlling for differences in age, gender, number and type of diagnoses, deprivation and regional variation. Therefore, we interpret such differences as because of efficiency as opposed to selection of less complex patients. Quantile regression suggests that the proportional differences between different provider types are larger...

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Scottish government invests £2bn in hospital infrastructure projects

Hospital Management — Fri, 06 Jan 2012 00:00:00 +0100

The Scottish government will invest £2bn in hospital infrastructure projects to deliver better facilities for the National Health Service. (Source: Hospital Management)

Transcranial stimulation in depression [Reappraisal]

The British Journal of Psychiatry — Tue, 03 Jan 2012 05:00:00 +0100

Transcranial direct current stimulation is coming of age with the large treatment study published in this issue. We review transcranial stimulation methods, their efficacy and the likely impact on National Health Service (NHS) practice. Their use in individuals who do not respond to or cannot tolerate medication should now be explored in large controlled naturalistic studies in the NHS. (Source: The British Journal of Psychiatry)

Distribution of litigation claims across a generalised psychiatric patient journey [Original papers]

Psychiatric Bulletin — Tue, 03 Jan 2012 05:00:00 +0100

Aims and method We analysed all 1213 negligence claims made against contributing psychiatric services since the inception of the National Health Service Litigation Authority (NHSLA) in 1995 and until 1 June 2009. More than half (55%) were settled, at a cost of £47.2 million, 26% were closed without penalty and 19% were still in progress at the time of review. Five individual claims exceeded £1 million. Results By allocating 43 NHSLA-assigned causes for a claim to the 11 stages of a generalised patient journey, we noted that assessment of patient risks was the single largest cause of claims (32%) and the single largest cost of settlements (£16.2 million, 34%). Clinical implications At the individual level it is difficult to see patterns of errors, whereas increased volumes...

An innovative service but will it work in practice?: Commentary on... Fair Horizons [Special articles]

Psychiatric Bulletin — Tue, 03 Jan 2012 05:00:00 +0100

This commentary discusses the proposed service, Fair Horizons, a new development designed to ensure comprehensive mental healthcare coverage. Although the aims of the new service are laudable and derive from recent seminal papers on changes in the National Health Service, the proposed initiatives are so far untested and there is uncertainty about how far costs will be reduced under this new system. Success is more likely to result if clinicians are committed to the new service and work harder. (Source: Psychiatric Bulletin)

Peer bullying in a pre-registration student nursing population. - Cooper B, Curzio J.

SafetyLit: All (Unduplicated) — Sun, 01 Jan 2012 12:07:07 +0100

Peer bullying is a major problem in schools and workplaces including the National Health Service. Although there are a few published studies exploring the incidence of peer bullying among university students, none is specific to pre-registration nursing st... (Source: SafetyLit: All (Unduplicated))

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Tracking shame and humiliation in Accident and Emergency. - Sanders K, Pattison S, Hurwitz B.

SafetyLit: All (Unduplicated) — Sun, 01 Jan 2012 12:07:07 +0100

In this paper, we reflect upon shame and humiliation as threats to personal and professional integrity and moral agency within contemporary health care. A personal narrative, written by a nurse about a particular shift in a British National Health Service ... (Source: SafetyLit: All (Unduplicated))

[Comment] Cancer care after the National Health Service reforms

The Lancet Oncology — Sun, 01 Jan 2012 05:00:00 +0100

The Lancet Oncology's Commission makes a valuable contribution to the debate about the future of cancer care. The challenges of treatment for such a complex disease are many, and in the UK the present round of National Health Service (NHS) reforms offer real scope for fresh emphases to drive forward the quality and success of cancer care. (Source: The Lancet Oncology)

[Correspondence] What price cure?

The Lancet Oncology — Sun, 01 Jan 2012 05:00:00 +0100

Because the UK's National Health Service (NHS) needs to make savings of £20 billion by 2013–14, The Lancet Oncology Commission on the affordability of cancer care is highly relevant. To make the appropriate decisions, clear priorities need to be set. However, these priorities are not explicitly identified by this Commission. (Source: The Lancet Oncology)

The rise of the regulatory state in health care: a comparative analysis of the Netherlands, England and Italy.

Health Economics, Policy, and Law — Sun, 01 Jan 2012 05:00:00 +0100

Authors: Helderman JK, Bevan G, France G Abstract In a relatively short time, regulation has become a significant and distinct feature of how modern states wish to govern and steer their economy and society. Whereas the former 'dirigiste' state used to be closely related to public ownership (e.g. hospitals), planning (volume and capacity planning) and centralised administration (e.g. fixed prices and budgets), the new regulatory state relies mainly on the instrument of regulation to achieve its objectives. In this paper, we wish to relate the rise of the 'regulatory state' to the path-dependent trajectories and institutional legacies of discrete European health-care systems. For this purpose, we compared the Dutch corporatist social health insurance system, the strongly centralised...

The history of paediatric surgery in the United Kingdom and the influence of the national health service on its development

Journal of Pediatric Surgery — Sun, 01 Jan 2012 05:00:00 +0100

Abstract: Details of the modern history of paediatric surgery in the United Kingdom with particular emphasis on the 3 main training centres in England in the 1960s to 1970s are discussed. The genesis of the National Health Service and of the British Association of Paediatric Surgeons and their influence on the establishment and siting of regional centres, education and training, and centralization of rare conditions is highlighted. (Source: Journal of Pediatric Surgery)

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Recruiting and retaining postpartum women from areas of social disadvantage in a weight‐loss trial – an assessment of strategies employed in the WeighWell feasibility study

Maternal and Child Nutrition — Sun, 01 Jan 2012 05:00:00 +0100

AbstractLittle is known about the response of post‐partum women from deprived backgrounds to weight management interventions, however behavioural intervention trials in disadvantaged communities are often characterised by recruitment difficulties. Recruitment and retention is key to the robust conduct of an effective trial, and exploratory work is essential prior to a definitive randomised controlled trial. This paper describes strategies used to recruit to the WeighWell feasibility study, which aimed to recruit 60 overweight or obese post‐partum women living in areas of deprivation to a trial of a weight‐loss intervention. Recruitment strategies included the following: (1) distribution of posters and ‘business cards’; (2) newspaper advertisements; (3) visits to community groups;...

NICE technology appraisals: working with multiple levels of uncertainty and the potential for bias

Medicine, Health Care and Philosophy — Sat, 24 Dec 2011 16:44:36 +0100

Abstract One of the key roles of the English National Institute for Health and Clinical Excellence (NICE) is technology appraisal. This essentially involves evaluating the cost effectiveness of pharmaceutical products and other technologies for use within the National Health Service. Based on a content analysis of key documents which shed light on the nature of appraisals, this paper draws attention to the multiple layers of uncertainty and complexity which are latent within the appraisal process, and the often socially constructed mechanisms for tackling these. Epistemic assumptions, bounded rationality and more explicitly relational forms of managing knowledge are applied to this end. These findings are discussed in the context of the literature highlighting the inherent...

“It’s just a clash of cultures”: emotional talk within medical students’ narratives of professionalism dilemmas

Advances in Health Sciences Education — Tue, 20 Dec 2011 16:48:17 +0100

Abstract Recent investigations into the UK National Health Service revealed doctors’ failures to act with compassion and professionalism towards patients. The British media asked questions about what happens to students during their learning that influences such behaviour as doctors. We listened to 200 medical students’ narratives of professionalism dilemmas during workplace learning (n = 833) to understand the range of dilemmas experienced and emotional reactions to them. 32 group and 22 individual interviews were held across three medical schools (England, Wales, Australia). Data were analysed thematically (Framework Analysis), for negative emotional content (Linguistic Inquiry and Word Count) and a narrative analysis of one exemplar narrative was also cond...

Patient Satisfaction with Postoperative Follow‐up by a Hand Therapist

Musculoskeletal Care — Tue, 20 Dec 2011 05:00:00 +0100

[Comment] No evidence that patient choice in the NHS saves lives

LANCET — Fri, 16 Dec 2011 12:02:44 +0100

The Health and Social Care Bill 2011 has been framed to abolish direct parliamentary control and public accountability for the National Health Service (NHS) in England. In the face of enormous public opposition to the Bill, the UK Government stood down the legislative process between April and June, 2011. Prime Minister David Cameron used the temporary pause to advance the case for the Bill and argued “Put simply: competition is one way we can make things work better for patients. This isn't ideological theory. (Source: LANCET)

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[Correspondence] In defence of our research on competition in England's National Health Service

LANCET — Fri, 16 Dec 2011 12:02:44 +0100

In their Comment (published online Oct 10), Allyson Pollock and colleagues misrepresent our research. Although such work might run counter to Pollock and colleagues' prior beliefs, this is not grounds to dismiss it. Nowhere in their review have Pollock and colleagues given evidence that the reforms we studied have harmed patients' outcomes. Instead, they dismiss the research as “flawed” and criticise the data in our analysis in an effort to undermine our findings, which they view as supporting the current UK Government's policies. (Source: LANCET)

[Correspondence] In defence of our research on competition in England's National Health Service – Authors' reply

LANCET — Fri, 16 Dec 2011 12:02:44 +0100

In their response to our Comment, Nicholas Bloom and colleagues make four main points. The first is the claim that we misrepresented their research. They follow this by saying that “nowhere in the review have Pollock and colleagues given evidence that the reforms we studied have harmed patients' outcomes”, but omit to acknowledge that this was not the purpose of our Comment. They then claim that our criticism was politically motivated, and that what they assume are our prior beliefs (without knowing what these are) led to a lack of objectivity. (Source: LANCET)

Guidance Released for National Health Service Corps Critical Access Hospital Pilot Program

News stories via the Rural Assistance Center — Fri, 16 Dec 2011 06:00:00 +0100

The Health Resources and Services Administration has released its 2012 guidance for the National Health Service Corps (NHSC) Loan Repayment Program (LRP), which includes a pilot program that expands eligibility to Critical Access Hospitals (CAHs) and eligible clinicians working in CAHs: primary care physicians; psychiatrists; nurse practitioners; certified nurse midwives; and physician assistants. (Source: News stories via the Rural Assistance Center)

Effectively Training the Hospice and Palliative Medicine Physician Workforce for Improved End-of-Life Health Care in the United States.

The American Journal of Hospice and Palliative Care — Thu, 15 Dec 2011 05:00:00 +0100

Authors: Bui T Abstract The widening gap between the demand for palliative care services and the supply of trained palliative care professionals has resulted in considerable end-of-life distress for patients. Without formal training in palliative medicine and end-of-life symptom management, physicians in the United States are less equipped to competently address seriously ill and dying patients' medical, emotional, and spiritual needs. Recent attempts within graduate medical education training deliberately seek to prepare a critical mass of physicians as the new hospice and palliative medicine workforce in the United States. In addition, healthcare reform proposals may re-define the National Health Service Corps (NHSC) post-graduate training over the next five years and the Hospice...

From child health surveillance to child health promotion, and onwards: a tale of babies and bathwater

Archives of Disease in Childhood — Tue, 13 Dec 2011 05:00:00 +0100

Child health surveillance (CHS) has evolved greatly over the past 30 years from a proactive screening process by health professionals to a more passive approach of child health promotion (CHP), which places the main responsibility for detection of developmental problems on carers. The impetus for this change came from the Hall Report (1989), which reported a lack of evidence for CHS. Although research on developmental screening is sparse, some data show that use of structured methods for identifying deviations from normal increases the pick-up rate of abnormalities, compared with informal or parent-initiated methods. The majority of countries recommend a universal ‘CHS’ type of programme, in contrast to the UK and some other European countries. Alternatives to universal CHS inc...

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Mr Angry won't cure a poorly NHS

Telegraph Health — Mon, 12 Dec 2011 07:30:26 +0100

Poison-pen postings online are no way to ensure a better National Health Service, says Max Pemberton. (Source: Telegraph Health)

How to Lie With Numbers: Alcohol and Health Care Edition

Forbes.com Healthcare News — Sat, 10 Dec 2011 13:16:50 +0100

If we were to be polite we would say that it's very easy to mislead people by quoting numbers at them. If we were to be impolite then we'd have to say that it's very easy to lie with numbers. Which is what seems to be happening here over the National Health Service numbers for the health effects of alcohol. (Source: Forbes.com Healthcare News)

National health service corps ranks are swelling

Modern Medicine — Sat, 10 Dec 2011 05:00:00 +0100

The number of clinicians participating in the federal program designed to provide healthcare to underserved communities around the nation is at a record high. (Source: Modern Medicine)

The Service Pledge for Breast Cancer – Improving services through patient involvement

Radiography — Fri, 09 Dec 2011 05:00:00 +0100

Abstract: A guiding principle for today’s National Health Service is for services to reflect the needs and choices of patients and carers. There is evidence that meaningful patient involvement and engagement of people in their own care supports relationships with NHS professionals, and improves the quality and experience of healthcare. This paper reviews the Service Pledge for Breast Cancer, developed by the charity Breakthrough Breast Cancer as a tried and tested route to delivering effective patient involvement and examines some implications for radiotherapy services.The Service Pledge, which has benefitted an estimated 19,000 patients across the UK, is a tool that enables healthcare professionals and patients to work in partnership to improve local breast cancer services. Based on the...

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UK Department of Health renews focus on improving patient results

Hospital Management — Thu, 08 Dec 2011 00:00:00 +0100

The Department of Health in the UK has launched the updated National Health Service (NHS) Outcomes Framework 2012/13 which is set to deliver a true verdict on how the NHS is performing. (Source: Hospital Management)

Patients assessing students' assignments; Making the patient experience real

Nurse Education Today — Wed, 07 Dec 2011 05:00:00 +0100

Summary: The care of patients with inflammatory bowel disease (IBD) frequently falls short of the highest standards. This is noted in several publications, including national standards, despite nursing students being taught the importance of listening to and understanding patients. Teaching staff at the University of Glasgow primarily responsible for teaching third year undergraduate nursing students undertook a radical rethink of the planning, delivery and assessment of lectures on IBD. The subject had previously been delivered in a modified lecture format. Although the topic could be included in the end-of-year exams, there was little evidence to show whether this traditional teaching method had any effect on students' clinical practice. In a novel approach to learning and assessment, st...

UK Leader Wants Health Service to Help Industry

Drugs.com - Pharma News — Tue, 06 Dec 2011 14:04:45 +0100

From Associated Press (December 5, 2011) LONDON -- Britain's publicly-funded National Health Service should share all patient data anonymously with private health care companies to boost innovation in a key U.K. industry, Prime Minister David... (Source: Drugs.com - Pharma News)

The Relative Geographic Immobility Of New Registered Nurses Calls For New Strategies To Augment That Workforce [Nursing Trends]

Health Affairs — Mon, 05 Dec 2011 05:00:00 +0100

Little is known about registered nurses’ geographic mobility after they earn their first professional degree and become licensed to practice. Through a cross-sectional mailed survey of newly licensed registered nurses in fifteen states, we found that 52.5 percent work within forty miles of where they attended high school. Our complementary analysis of Census Bureau data shows that next to teaching, nursing is one of the least mobile professions for women, for reasons that remain unclear. To ensure that underserved areas have an adequate workforce of registered nurses, policy makers should expand the number of educational programs in these areas; fund programs that provide incentives to young people from these areas to attend nursing programs; consider supporting extension progra...

Cooperation or competition? Proposed changes in healthcare provision in England [Editorials]

Psychiatric Bulletin — Wed, 30 Nov 2011 05:00:00 +0100

The Health and Social Care Bill currently going through the UK Parliament seeks to further increase cooperation in the English National Health Service (NHS). The proposals are controversial in significant part because the benefits of competition in healthcare are uncertain. Will patients benefit from innovation and choice brought about by new providers of care or will the vulnerable be faced by geographically variable, fragmented and non-integrated services? Will there be financial savings to reinvest in patient care or will there be increased administration driven by the transaction costs of market driven care? This editorial advocates a cautious targeted approach for the implementation of competition in those areas where current NHS provision is poor rather than whole scale potentially d...

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Diversity and choice in mental healthcare: Commentary on... Cooperation or competition? [Editorials]

Psychiatric Bulletin — Wed, 30 Nov 2011 05:00:00 +0100

Independent sector psychiatrists believe that they work hard for the benefit of vulnerable people. Differences between them and National Health Service colleagues are not clear cut in terms of motivation or quality of care. However, unfair generalisations are made about the diverse ‘private sector’, with selective comparison such as with the worst of US healthcare. Although there are many examples of excellence in the UK state, commercial and charity sectors, global economic changes are bringing risk of care failures from which no area can be immune. We should all be working together to protect our patients from the mistakes of others. (Source: Psychiatric Bulletin)

Secondary mental healthcare in prisons in England and Wales: results of a postal questionnaire [Original papers]

Psychiatric Bulletin — Wed, 30 Nov 2011 05:00:00 +0100

Aims and method Prison mental health inreach teams (PMHITs) were introduced in response to policy from 2003. This provision comes under the responsibility of the National Health Service. Service development and structure was not defined in policy. A total of 97 prisons of an estimated 100 known to have a PMHIT were targeted by postal questionnaire and responses covered 62 prisons. Team structures were captured in the data with specific regard to the number of available professional sessions. Results Findings determine there is generally no correlation between input and prison capacity, although there was some evidence of correlation in the high secure (category A) estate and that the female estate was generally better served. Clinical implications It is evident from this study that PMHITs ...

Agency Information Collection Activities: Proposed Collection: Comment Request - National Health Service Corps (NHSC) Site Survey

Federal Register updates via the Rural Assistance Center — Tue, 29 Nov 2011 15:13:42 +0100

Comments are being requested by the Health Resources and Services Administration on the NHSC Site Survey that renames and revises the previously known NHSC Uniform Data System (UDS) Report. (Source: Federal Register updates via the Rural Assistance Center)

An epidemiological survey on the incidence of non-fatal injury and influencing factors among children under 5 years old in China. - Hu GQ, Zhu SL, Wang QQ, Chen TM, Tan AC, He Q, Liu X, Xu L.

SafetyLit: All (Unduplicated) — Sat, 26 Nov 2011 00:42:13 +0100

OBJECTIVE: To determine the incidence of non-fatal injuries and related influencing factors among children under 5 years old in China. METHODS: Data involving 10 819 children under 5 years old was from the Fourth National Health Service Survey of China. In... (Source: SafetyLit: All (Unduplicated))

A Retrospective Review of the Impact of Influenza A(H1N1)v Swine ‘flu Variant on a District General Hospital: Category: Lesson in Microbiology & Infection Control

Journal of Infection — Fri, 25 Nov 2011 11:05:46 +0100

On 11th June 2009 the World Health Organisation declared a pandemic of Influenza A(H1N1)v, a unique strain of Influenza A, containing genetic components from swine, avian and human sources. Concerns were expressed that this virus would stretch the National Health Service to breaking point and cause significant fatalities. (Source: Journal of Infection)

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The impact of culture and religion on truth telling at the end of life

Nephrology Dialysis Transplantation — Fri, 25 Nov 2011 05:00:00 +0100

Truth telling, a cardinal rule in Western medicine, is not a globally shared moral stance. Honest disclosure of terminal prognosis and diagnosis are regarded as imperative in preparing for the end of life. Yet in many cultures, truth concealment is common practice. In collectivist Asian and Muslim cultures, illness is a shared family affair. Consequently, decision making is family centred and beneficence and non-malfeasance play a dominant role in their ethical model, in contrast to patient autonomy in Western cultures. The ‘four principles’ are prevalent throughout Eastern and Western cultures, however, the weight with which they are considered and their understanding differ. The belief that a grave diagnosis or prognosis will extinguish hope in patients leads families to prot...

The Fallacy of Choice in the Common Law and NHS Policy

Health Care Analysis — Tue, 22 Nov 2011 17:58:58 +0100

This article examines whether beneath the rhetoric any form of real choice is endorsed either in law or in NHS policy. I explore the case law on ‘consent’, look at choice within the NHS and highlight the dilemmas that a mismatch of language and practice poses for clinicians. Given the variance in interpretation and lack of consistency for the individual patient I argue for a semantic change that obviates the use of ‘choice’, focussing instead on the options for treatment that are available and accessible, with due acknowledgement of individual patient preferences, without raising unfettered and false expectations. Content Type Journal ArticleCategory Original ArticlePages 1-25DOI 10.1007/s10728-011-0198-4Authors Ingrid Whiteman, Bioethics and Medical Jurisprudence, CSEP/...

UK’s NHS smartphone app passes 1M downloads

mobihealthnews — Mon, 21 Nov 2011 18:17:14 +0100

The UK’s NHS (National Health Service) announced this week that its NHS Direct app for iOS and Android smartphones has been downloaded more than 1 million times since its release in May. The app is free to download from the app stores. The app’s features include a health and symptom checker, general symptom relief, and specialist [...] (Source: mobihealthnews)

[Editorial] Politics and patient care

LANCET — Sat, 19 Nov 2011 05:00:00 +0100

Some patients in hospitals run by the UK's National Health Service (NHS) do not receive adequate pain relief, are not helped to go to the toilet, and are not given enough to eat or drink. These were the stark headlines of a report published last week by the Patients Association, which presented first-hand accounts of the treatment of 16 mostly elderly patients in NHS hospitals. The report, sourced from stories phoned in to the Patients Association's helpline, provided no statistics for the overall quality of care available throughout the NHS, or for how often incidents such as those presented occur. (Source: LANCET)

[Correspondence] Leadership and public health

LANCET — Sat, 19 Nov 2011 05:00:00 +0100

The Lancet's recognition of threats to the public's health from current UK Government policy and the National Health Service reorganisation is welcome, but its criticism of leadership in the Faculty of Public Health by use of selective quotes from a private Yahoo group of trainees is unfair, unwarranted, and unhelpful. (Source: LANCET)

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Risk Adjusted Comparisons of Bloodstream Infection Rates in Neonatal Intensive Care Units

Clinical Microbiology and Infection — Fri, 18 Nov 2011 05:08:52 +0100

AbstractComparisons of bloodstream infection (BSI) rates between neonatal intensive care units (NICU) should take into account differences in babies’ vulnerability and invasive procedures which can introduce infection. Our aim was to investigate which risk factors recorded in routine records should be adjusted for when comparing NICUs.This was a retrospective cohort study using routine records for two London NICUs. We analysed rates of BSI using Poisson regression models.The level of neonatal care used by the National Health Service (NHS) was the strongest predictor for BSI incidence. The rate ratio for BSI, adjusted for birth weight, inborn/outborn status and postnatal age was 3.15 (95% confidence interval (CI) 2.01, 4.94) for intensive care and 6.58 (95% CI 4.18, 10.36) for high depend...

Student doctors taking responsibility

The Clinical Teacher — Thu, 17 Nov 2011 14:31:45 +0100

Discussion: The article presents a number of practical issues in relation to assigning responsibility to student doctors. Respondents indicate that successful assistantships will only be possible if the UK National Health Service trusts review their attitude to balancing short‐ and long‐term risks: assistantships need to be long enough to create genuine responsibility opportunities, and will require investment in supervision beyond the current capacity. (Source: The Clinical Teacher)

An educational conference in a general hospital

The Clinical Teacher — Thu, 17 Nov 2011 14:31:32 +0100

SummaryBackground: Western Sussex Hospitals National Health Service (NHS) Trust comprises the District General Hospitals of Worthing and Chichester. Both hospitals have successful postgraduate medical education centres, providing training for junior doctors and continuing professional development for senior doctors. Until now, there have been limited multi‐professional teaching and learning activities available.Context: The two hospitals have recently merged. The education executive felt that workplace learning had become undervalued since the implementation of Modernising Medical Careers in the UK. The executive wanted to provide a multi‐professional conference on Workplace Learning, both to support the merger and to promote the value of workplace and multi‐professional learni...

The challenges of quality improvement reports and the urgent need for more of them

Thorax — Thu, 17 Nov 2011 05:00:00 +0100

This report captured widespread interest with the oft-quoted estimate that medical errors annually cause 44 000–98 000 deaths in US hospitals alone. This period also coincided with publication of ‘An organisation with a memory’,2 which described the scale and nature of serious failures in the UK National Health Service. A widely accepted definition describes quality as the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge.3 4 This definition further characterised quality in terms of six dimensions: safety, effectiveness, patient centeredness, timeliness, efficiency and equitability. Numerous studies document major shortcomings in each of these dimensions...

Risk‐adjusted comparisons of bloodstream infection rates in neonatal intensive‐care units

Clinical Microbiology and Infection — Thu, 17 Nov 2011 05:00:00 +0100

Clin Microbiol InfectAbstractComparisons of bloodstream infection (BSI) rates between neonatal intensive‐care units (NICUs) should take into account differences in babies’ vulnerability and invasive procedures that can introduce infection. Our aim was to investigate which risk factors recorded in routine records should be adjusted for when NICUs are compared. This was a retrospective cohort study using routine records for two London NICUs. We analysed rates of BSI with Poisson regression models. The level of neonatal care used by the National Health Service was the strongest predictor of BSI incidence. The rate ratios for BSI, adjusted for birthweight, inborn/outborn status, and postnatal age, were 3.15 (95% CI 2.01–4.94) for intensive care and 6.58 (95% CI 4.18–10.36) for high...

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Pharmacists' collaboration with primary care did not improve outcomes in heart failure patients, study finds

Drug Topics - Top News — Tue, 15 Nov 2011 05:00:00 +0100

Consultation with non-specialist pharmacists did not improve rates of hospitalization or death for patients with left ventricular systolic dysfunction (heart failure), according to the results of a large-scale, long-term prospective randomized trial conducted by the National Health Service and reported at the American Heart Association's Scientific Sessions 2011 in Orlando, Fla. (Source: Drug Topics - Top News)

The challenge of the information culture for the paediatrician

Archives of Disease in Childhood — Fri, 11 Nov 2011 05:00:00 +0100

Summary ‘Liberating the NHS’ and the new outcomes framework place information at the heart of the management of the National Health Service (NHS) and develop further the quality framework defined by Lord Darzi. In support of children, paediatricians have a responsibility to understand the informatics agenda and to ensure that data collection is as accurate as possible. There are particular difficulties in supplying a comprehensive health record for children and providing them with the benefits of access to their health records. It is essential that paediatricians work to ensure that these problems are overcome and that children do not miss out because of legal, practical and ethical issues which can be overcome, but often are permitted to stand in the way of real improvements. ...

Circle clinches UK hospital management deal

Reuters: Health — Thu, 10 Nov 2011 11:58:22 +0100

LONDON (Reuters) - Circle Holdings, a British health workers' co-operative backed by investment funds, is set to be the first private company to run a general hospital for Britain's state-funded National Health Service. (Source: Reuters: Health)

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UK health firm Circle clinches hospital deal

Reuters: Health — Thu, 10 Nov 2011 10:29:52 +0100

LONDON (Reuters) - British health workers' co-operative Circle Holdings will become the first private firm to manage a state-funded National Health Service (NHS) general hospital after signing a contract to run Hinchingbrooke hospital in Huntingdon, England. (Source: Reuters: Health)

Knowledge, attitude and practice of women in Campinas, Sao Paulo, Brazil with respect to physical exercise in pregnancy: a descriptive study

Reproductive Health — Thu, 03 Nov 2011 04:00:00 +0100

The objective of this study was to evaluate the knowledge, attitude and practice of pregnant women with respect to appropriate physical exercise during pregnancy, and also to investigate why some women do not exercise during pregnancy. Methods: A descriptive study was conducted in which 161 women of 18 to 45 years of age were interviewed in the third trimester of pregnancy. These women were receiving prenatal care at National Health Service (SUS) primary healthcare units and had no pathologies for which physical exercise would constitute a risk. The women were selected at an ultrasonography clinic accredited to the SUS in Campinas, Sao Paulo. A previously elaborated knowledge, attitude and practice (KAP) questionnaire was used to collect data, which were then stored in an Epinfo database. ...

Ensuring Delivery of the Highest Quality of Care for Dying Patients

Journal of Pain and Symptom Management — Thu, 03 Nov 2011 04:00:00 +0100

This is the second edition of what was a well-received book on delivering high-quality and evidence-based guidance to clinicians who care for dying patients in hospitals, nursing homes, and the community. Eleven chapters promote an integrated framework directly derived from the Liverpool Care Pathway (LCP) for the Dying Patient. This unique perspective was developed between the Royal Liverpool and Broadgreen University Hospital National Health Service Trust and the Marie Curie Palliative Care Institute to adapt the hospice model and philosophy of care for dying patients to fit hospitals and other care settings. Since its initial development in the 1990s, the LCP has emerged as a multidisciplinary proactive management plan that helps document and facilitate improved communication, symptom c...

Dabigatran Recommended After 'Plausible' Cost-EstimatesDabigatran Recommended After 'Plausible' Cost-Estimates

Medscape Today Headlines — Tue, 01 Nov 2011 18:25:00 +0100

NICE has concluded that the "most plausible" incremental cost-effectiveness ratios for all patients eligible for dabigatran are within the range considered cost-effective for use in the UK National Health Service. Heartwire (Source: Medscape Today Headlines)

NICE gives dabigatran thumbs-up after getting "plausible" cost estimates

theHeart.org — Tue, 01 Nov 2011 16:45:28 +0100

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The effect of aspirin and low-molecular-weight heparin on venous thromboembolism after hip replacement: A non-randomised comparison from information in the National Joint Registry.

The Journal of Bone and Joint Surgery. British volume — Tue, 01 Nov 2011 04:00:00 +0100

Authors: Jameson SS, Charman SC, Gregg PJ, Reed MR, van der Meulen JH Abstract We compared thromboembolic events, major haemorrhage and death after total hip replacement in patients receiving either aspirin or low-molecular-weight heparin (LMWH). We analysed data from the National Joint Registry for England and Wales linked to an administrative database of hospital admissions in the English National Health Service. A total of 108 584 patients operated on between April 2003 and September 2008 were included and followed up for 90 days. Multivariable risk modelling and propensity score matching were used to estimate odds ratios (OR) adjusted for baseline risk factors. An OR < 1 indicates that rates are lower with LMWH than with aspirin. In all, 21.1% of patients were prescribed ...

Digging Deeper: Nurse Excess or Shortage? The Effect on a New Nurse

Journal of Professional Nursing — Tue, 01 Nov 2011 04:00:00 +0100

The past decade has experienced great success in publicizing and decreasing the nursing shortage. Articles describing the shortage continue with impressive but disparate projections of its dimension. New degree programs have been created and established programs expanded as increasing numbers of students answer the call, and there are signs that the publicity has succeeded. Recent graduates have experienced difficulties finding employment or postgraduate training positions, which prompt a more detailed look at the numbers. Previously published research projects the nurse shortage for the year 2025 to lie somewhere between 500,000 and 1,000,000 nurses. If it is presumed that these numbers refer to RNs only, then the net of dropout, retirement, and graduation rates suggests that this project...

Digging deeper: nurse excess or shortage? The effect on a new nurse.

Journal of Professional Nursing — Tue, 01 Nov 2011 04:00:00 +0100

Authors: Sephel A Abstract The past decade has experienced great success in publicizing and decreasing the nursing shortage. Articles describing the shortage continue with impressive but disparate projections of its dimension. New degree programs have been created and established programs expanded as increasing numbers of students answer the call, and there are signs that the publicity has succeeded. Recent graduates have experienced difficulties finding employment or postgraduate training positions, which prompt a more detailed look at the numbers. Previously published research projects the nurse shortage for the year 2025 to lie somewhere between 500,000 and 1,000,000 nurses. If it is presumed that these numbers refer to RNs only, then the net of dropout, retirement, and graduati...

Evaluation and measurement for improvement in service-level quality improvement initiatives

Health Services Management — Mon, 31 Oct 2011 04:00:00 +0100

The National Health Service (NHS) in England, as with other health services worldwide, currently faces the need to reduce costs and to improve the quality of patient care. Evidence gathered through effective and appropriate measurement and evaluation, is essential to achieving this. Through interviews with service improvement managers and analysis of comments in a seminar of NHS staff involved in health service improvement, we found a lack of understanding regarding the definition and methodology of both measurement and evaluation, which decreases the likelihood that NHS staff will be competent to commission or provide these skills. In addition, we highlight the importance of managers assessing their organizations' ‘readiness’ to undergo change before embarking on a quality imp...

Well-structured teams and the buffering of hospital employees from stress

Health Services Management — Mon, 31 Oct 2011 04:00:00 +0100

This study examined how membership of well-structured teams was associated with lower levels of strain, when testing a work stressors-to-strains relationship model across the three levels of team structure, namely well-structured, poorly structured (do not fulfill all the criteria of well-structured teams) and no team. The work stressors tested, were quantitative overload and hostile environment, whereas strains were measured through job satisfaction and intention to leave job. This investigation was carried out on a random sample of 65,142 respondents in acute/specialist National Health Service hospitals across the UK. Using multivariate analysis of variance, statistically significant differences between means across the three groups of team structure, with mostly moderate effect sizes, w...

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'From glorious to infamous': the life span of (addiction) specialists in psychiatry [Editorials]

Psychiatric Bulletin — Mon, 31 Oct 2011 04:00:00 +0100

In this editorial we look at the implications of organisational changes to the National Health Service and financial constraints on addiction psychiatrists, and how creativity and adaptability could be the key to fostering survival and sustainability of subspecialties in danger of extinction. (Source: Psychiatric Bulletin)

Health care professionals’ understanding and day-to-day practice of patient empowerment in diabetes; time to pause for thought?

Diabetes Research and Clinical Practice — Mon, 31 Oct 2011 04:00:00 +0100

Abstract: This exploratory study examines what Health Care Professionals (HCPs) working with diabetes patients, understand by the term ‘empowerment’, their attitudes towards it and whether they believe they practise in ways consistent with empowerment principles. A small sample of diabetes HCPs (N=13), from National Health Service (NHS) hospital, walk-in and General Practitioner (GP) clinics in South-East England, was interviewed. In-depth semi-structured interviews established attitudes towards and use of empowerment in day-to-day practice. Interviews were recorded, transcribed verbatim and analysed thematically. There was no clear specific understanding of what empowerment is and what it involves, although there was broad reporting of factors around education and informed choices. Di...

[Correspondence] Royal Colleges must act over Health and Social Care Bill

LANCET — Sat, 29 Oct 2011 04:00:00 +0100

Despite intense lobbying during its passage through the UK's House of Commons, the Health and Social Care Bill now passes to the House of Lords and will enter into the Committee Stage on Oct 11. We are extremely concerned that, should this legislation be passed, we will be taking yet another step down the road towards a fully private insurance system. The National Health Service (NHS) will be fragmented and its assets will be stripped by private providers looking to run services with profits at the heart of business, not patients. (Source: LANCET)

Reforms in the British National Health Service: what are the implications?

ANZ Journal of Surgery — Thu, 27 Oct 2011 11:38:27 +0100

(Source: ANZ Journal of Surgery)

An ethicist's journey as a patient: are we sliding down the slippery slope to sloppy healthcare?

Quality and Safety in Health Care — Tue, 25 Oct 2011 04:00:00 +0100

People who are sick are often the most vulnerable in society. They frequently rely on caring and competent healthcare professionals and should and do have expectations of a safe and caring environment. In a recent unexpected adventure through the healthcare system, the organisation, professionalism, caring and compassion associated with healthcare provision were in very short supply. A lack of basic dignity and humanity were among the most concerning deficits. Any form of dehumanisation of the national health service that leads to unsafe, undignified and degrading treatment not only infringes patients' and clients' human rights but should not be acceptable or excused as a by-product of economic pressures. (Source: Quality and Safety in Health Care)

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National Health Service Corps participation hits new heights

American Medical News - GOVERNMENT — Fri, 21 Oct 2011 12:59:41 +0100

More than 10,000 doctors, nurses and physician assistants are working in underserved areas, but demand and interest still outstrip funding. (Source: American Medical News - GOVERNMENT)

Men with breast cancer 'isolated'

BBC News | Health | UK Edition — Wed, 19 Oct 2011 23:31:21 +0100

Men with breast cancer in Scotland are left feeling 'isolated' by the National Health Service, the Medical Research Council finds. (Source: BBC News | Health | UK Edition)

RACGP identifies critical success factors for Australia�s PCEHR

Royal Australian College of General Practitioners (RACGP) Media Releases — Wed, 19 Oct 2011 08:00:00 +0100

The Royal Australian College of General Practitioners (RACGP) is encouraged by the progress made towards providing access to personally controlled electronic health records (PCEHR) for people in Australia, especially with the release of the Department of Health and Ageing's PCEHR System: Legislation Issues Paper for comment. However, there are four areas that are of particular concern to the RACGP, and the College would seek to further contribute to the refinement of the PCEHR program. The recent termination of England's existing National Health Service (NHS) Connecting for Health program has further highlighted the College's concerns. (Source: Royal Australian College of General Practitioners (RACGP) Media Releases)

Report: Scotland should look to telehealth for better patient care

ICMCC: The International Council on Medical and Care Compunetics — Sun, 16 Oct 2011 13:54:08 +0100

Source: Jeff Byers, CMIO Content: “The National Health Service (NHS) for Scotland should do more to consider telehealth when introducing or redesigning services, according to a report published by Audit Scotland, an organization that assists the Auditor General and the Accounts Commission in making sure organizations that spend public money in Scotland use it properly. “It [...] (Source: ICMCC: The International Council on Medical and Care Compunetics)

Infecting Hospital Staff With Contagious Awareness

Health News from Medical News Today — Sat, 15 Oct 2011 07:00:00 +0100

Infections picked up in hospital affect almost a third of patients in intensive care, and kill 44% of those people. Given that some infectious agents can linger for weeks or months it is increasingly important that staff awareness of the problem is improved and that training in infection prevention across the National Health Service and in private healthcare is expanded, according to researchers at the University of Northampton. Microbes such as methicillin-resistant Staphylococcus aureus (MRSA), Clostridium difficile (C... (Source: Health News from Medical News Today)

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[Editorial] Ethics and organ transplantation

LANCET — Sat, 15 Oct 2011 04:00:00 +0100

Around the world, countries are trying to encourage more people to donate their organs after death to help those desperately in need of transplants. Wales, for example, is poised to become the first country in the UK to introduce an opt-out system, where consent after death is assumed unless families object. Such systems already exist in Spain and Belgium. Meanwhile, a new report by the UK Nuffield Council on Bioethics suggests that the National Health Service tests the idea of paying for the funerals of organ donors as an incentive for donation. (Source: LANCET)

Yervoy (ipilimumab) Turned Down By UK Watchdog

Health News from Medical News Today — Sat, 15 Oct 2011 03:00:00 +0100

The National Institute for Clinical Excellence (NICE) has recommended in a draft guidance against Bristol-Myers Squibb's Yervoy (ipilimumab) for the treatment of advanced malignant melanoma in patients who have already been treated with chemotherapy. NICE decides whether a drug, medical device or treatment should be covered by the National Health Service (NHS), the country's universal health care service... (Source: Health News from Medical News Today)

UK Cost Agency Rejects Skin Cancer Drug Yervoy (ipilimumab)UK Cost Agency Rejects Skin Cancer Drug Yervoy (ipilimumab)

Medscape Medical News Headlines — Fri, 14 Oct 2011 23:22:49 +0100

Bristol-Myers Squibb's Yervoy -- the first drug to help patients with advanced melanoma live longer -- is not cost effective for use in the taxpayer-funded National Health Service (NHS), Britain's health costs watchdog has announced. Reuters Health Information (Source: Medscape Medical News Headlines)

Infecting hospital staff with contagious awareness

ScienceDaily Headlines — Fri, 14 Oct 2011 16:25:25 +0100

Infections picked up in hospital affect almost a third of patients in intensive care, and kill 44% of those people. Given that some infectious agents can linger for weeks or months it is increasingly important that staff awareness of the problem is improved and that training in infection prevention across the UK's National Health Service and in private healthcare is expanded, according to researchers. (Source: ScienceDaily Headlines)

In Bad Economy, More Docs and Nurses Trade Debt for Service

News stories via the Rural Assistance Center — Fri, 14 Oct 2011 06:00:00 +0100

MSNBC article tells of family nurse practitioner Sarah Baker, of Bismarck, N.D., who cares for everyone from newborns to the very elderly at the Northland Community Health Center in McClusky, N.D. She's able to stay in part because of the National Health Service Corps, a federal program that has tripled its members in three years. (Source: News stories via the Rural Assistance Center)

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UK cost agency rejects skin cancer drug Yervoy (ipilimumab)

Modern Medicine — Fri, 14 Oct 2011 04:00:00 +0100

LONDON (Reuters) - Bristol-Myers Squibb's Yervoy -- the first drug to help patients with advanced melanoma live longer -- is not cost effective for use in the taxpayer-funded National Health Service (NHS), Britain's health costs watchdog has announced. (Source: Modern Medicine)

UK House of Lords Rejects Bid to Block Health BillUK House of Lords Rejects Bid to Block Health Bill

Medscape Medical News Headlines — Fri, 14 Oct 2011 00:03:01 +0100

The government has defeated attempts to derail its plans to reform the National Health Service in England after the House of Lords voted down amendments that would have killed or delayed its legislation. Reuters Health Information (Source: Medscape Medical News Headlines)

HHS Announces Record Number of National Health Service Corps Members

News stories via the Rural Assistance Center — Thu, 13 Oct 2011 06:00:00 +0100

U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius today announced that the number of participants in the National Health Service Corps has nearly tripled with more than 10,000 National Corps members doctors, nurses and other health care providers caring for Americans in communities nationwide. (Source: News stories via the Rural Assistance Center)

Labour pledges to fight on over NHS reform

FT.com - Drugs and Healthcare — Wed, 12 Oct 2011 18:22:05 +0100

Labour could deploy filibustering tactics in an effort to derail the government's contentious reforms of the National Health Service (Source: FT.com - Drugs and Healthcare)

UK government claims that patient choice improves health care is based on flawed research, experts say

ScienceDaily Headlines — Mon, 10 Oct 2011 05:05:01 +0100

Research which claims to show that the introduction of patient choice in the United Kingdom's National Health Service (NHS) reduced deaths from heart attacks is flawed and misleading, according to a new report. (Source: ScienceDaily Headlines)

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Vascular Injury in the United Kingdom

Perspectives in Vascular Surgery and Endovascular Therapy — Mon, 10 Oct 2011 04:00:00 +0100

This article discusses developing trauma network issues, particularly the organization and evolution of vascular trauma services in the United Kingdom. (Source: Perspectives in Vascular Surgery and Endovascular Therapy)

Sentamu warning on health reforms

BBC News | Health | UK Edition — Sat, 08 Oct 2011 09:58:44 +0100

The Archbishop of York warns of the dangers of introducing a more commercial culture into the National Health Service. (Source: BBC News | Health | UK Edition)

Multi-professional clinical medication reviews in care homes for the elderly: study protocol for a randomised controlled trial with cost effectiveness analysis

NeLM - Care of Older People — Fri, 07 Oct 2011 04:00:00 +0100

Source: Trials Area: Evidence > Medicines Management > References Background: Evidence demonstrates that measures are needed to optimise therapy and improve administration of medicines in care homes for older people. The aim of this study is to determine the clinical and cost effectiveness of a novel model of multi-professional medication review. Methods: A cluster randomised controlled trial design, involving 30 care homes in East Anglia. In line with current practice in medication reviews, recruitment and consent will be sought from general practitioners and care homes, rather than individual residents. Care homes will be segmented according to size and resident mix and allocated to the intervention arm (15 homes) or control arm (15 homes) sequentially using min...

A comparison of mortality predictive data systems in high risk patients

International Journal of Surgery — Thu, 06 Oct 2011 22:52:31 +0100

Background: Measurement of performance within the National Health Service (NHS) has increased in importance over the past twenty years. Trusts and regulatory bodies like the Care Quality Commission (CQC) increasingly rely on Hospital Episode Statistics (HES) data and Dr Foster algorithms. These latter methodologies rely heavily upon population and whole hospital analyses, and a small number of variables. However such data is now being increasingly used to measure surgeon specific performance without validation studies. The POSSUM system has been extensively validated in general surgery and is considered the methodology of choice by the specialist societies and the colleges. (Source: International Journal of Surgery)

Perception and practice of junior surgeons regarding smoking cessation in the surgical patients

International Journal of Surgery — Thu, 06 Oct 2011 22:52:31 +0100

Aims: Smoking is a well known risk factor in development of various medical and surgical conditions, costing the National Health Service approximately 1.5 billion pounds a year. Doctors’ advice has been considered vital in promoting smoking cessation. The aim of this study was to assess junior surgical trainees’ perception and practice in promoting smoking cessation. (Source: International Journal of Surgery)

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Theatre delays and their financial implications on the national health service

International Journal of Surgery — Thu, 06 Oct 2011 22:52:31 +0100

Aim: To identify the amount and causes of available theatre time lost and financial implications to the NHS. Method: Data was collected prospectively between October and December 2010 to estimate number of hours lost in delays and evaluate their causes. The information was collated by the same person in order to reduce ascertainment bias. In addition all members of the staff were blinded to the study. (Source: International Journal of Surgery)

Laundering May Not Kill Hospital-Acquired Bacteria

Health News from Medical News Today — Wed, 05 Oct 2011 07:00:00 +0100

Residential washing machines may not always use hot enough water to eliminate dangerous bacteria like methicillin-resistant Staphylococcus aureus (MRSA) and Acinetobacter, a Gram-negative bacteria, from hospital uniforms, according to a study published in the November issue of Infection Control and Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America. The study, conducted by researchers from University College in London, was prompted by changes in Britain's National Health Service that led many hospitals in the UK to end in-house laundry services... (Source: Health News from Medical News Today)

The National Health Service Act 1946

BMJ Online First — Wed, 05 Oct 2011 04:00:00 +0100

Some good things come in small packages: and this compact document changed the world. Its proposals opened up the possibility of modern medicine, sweeping away economic barriers to healthcare that... (Source: BMJ Online First)

Multi-professional clinical medication reviews in care homes for the elderly: study protocol for a randomised controlled trial with cost effectiveness analysis

Trials — Wed, 05 Oct 2011 04:00:00 +0100

This study will establish the effectiveness of a new model of multi-professional clinical medication reviews in care homes, using novel approaches to recruitment and consent. It is the first study to undertake an examination of direct patient outcomes, together with an economic analysis.Trial RegistrationCurrent Controlled Trials ISRCTN90761620. (Source: Trials)

Commissioning health care in England: an evolving story.

Annals of Internal Medicine — Tue, 04 Oct 2011 04:00:00 +0100

This article outlines the current organization of the National Health Service, the rationale for change, and government proposals. PMID: 21969345 [PubMed - in process] (Source: Annals of Internal Medicine)

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Lean thinking: Can it improve the outcome of fracture neck of femur patients in a district general hospital?

Injury — Mon, 03 Oct 2011 16:03:48 +0100

We present our experience in the management of hip fracture patients after the application of a value-stream approach, the Lean framework, in our trust. This system uses available resources in an efficient manner whilst eliminating waste. A statistically significant reduction of 5% and 9.3% was noted in the 30-day and overall mortality, respectively, after implementing ‘Lean thinking’. Further improvements were also noted in door-to-theatre time, use of trauma beds and early discharge from hospitals. To our knowledge, this is the largest study in the literature where the Lean framework has been successfully employed for the management of a very challenging health-care issue faced by the National Health Service. Future prospective studies are, however, needed to reconfirm these results ...

British EHR fiasco shows U.S. may be on the right track

ICMCC: The International Council on Medical and Care Compunetics — Mon, 03 Oct 2011 08:47:50 +0100

Source: Ken Terry, FierceHealthIT Content: “Is it possible that the Obama Administration is doing something right in its ambitious health IT program? The U.K. National Health Service’s failed, decade-long effort to implement a nationwide electronic health record system suggests that, in many ways, the U.S. government is taking a wiser approach to encouraging widespread EHR [...] (Source: ICMCC: The International Council on Medical and Care Compunetics)

Audit of mandibular trauma waiting times: Royal London Hospital UK: January 2011–May 2011

International Journal of Oral and Maxillofacial Surgery — Sat, 01 Oct 2011 04:00:00 +0100

Introduction: Brought about by concerns of the maxillofacial team about waiting times for open reduction and internal fixation of mandibular fractures. Aims: Produce data that may support the establishment of separate trauma lists in order to reduce hospital stay, financial constraints on National Health Service and increase patient satisfaction. (Source: International Journal of Oral and Maxillofacial Surgery)

Lupus Drug Suffers U.K. Setback

WSJ.com: Health — Fri, 30 Sep 2011 10:15:11 +0100

Lupus drug Benlysta, from GlaxoSmithKline and Human Genome Sciences, doesn't represent value for money, Britain's health-care watchdog said, and shouldn't be made available on the publicly funded National Health Service. (Source: WSJ.com: Health)

The final frontier: The UK's new coalition government turns the English National Health Service over to the global health care market

Health Sociology Review — Fri, 30 Sep 2011 04:00:00 +0100

Health Sociology Review 20(3): 294-305 Abstract The authors describe the incremental approach to the marketisation of the English National Health Service (NHS) since the introduction of an `internal market' in 1990 until the 2010 White Paper, `Equity and Excellence: Liberating the NHS', and the subsequent Health and Social Care Bill published in January 2011. The introduction of a competitive market for a universal, tax-financed health system requires fundamental changes in regulation in order that market bureaucracy can be substituted for direct management. The components of reform are insufficiently captured by the framework of hierarchies and networks in new public management theories of decentralisation. (Source: Health Sociology Review)

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Are NHS foundation trusts able and willing to exercise autonomy? 'You can take a horse to water...'

Journal of Health Services Research and Policy — Fri, 30 Sep 2011 04:00:00 +0100

This article examines the implementation of FTs in the NHS and focuses on the nature and exercise of autonomy by FTs. It argues that the ability of FTs to exercise autonomy is in place, but the (relatively limited) extent of implementation may be explained by trusts' lack of willingness to exercise such autonomy. Such unwillingness may be because of continued centralization, unclear policy and financial regimes, fear of negative impacts on relations with other local organizations, and awareness of greater risk to the FT, among others. Addressing the tension between FTs' ability and willingness to exercise autonomy will largely explain the extent to which the government's provider side reforms will be implemented. (Source: Journal of Health Services Research and Policy)

Lessons From Britain’s Health Information Technology Fiasco

ICMCC: The International Council on Medical and Care Compunetics — Wed, 28 Sep 2011 14:36:02 +0100

Source: Steve Lohr, The New York Times Content: “Government press releases tend to be bland, earnest blather. But not one posted on the British Department of Health’s Web site last Thursday. Its headline: “Dismantling the NHS National Programme for IT.” To translate the acronyms a bit, the NHS is Britain’s state-run National Health Service and the [...] (Source: ICMCC: The International Council on Medical and Care Compunetics)

UK's NHS Rejects Late-Stage Prostate Cancer Drug

About.com Prostate Cancer — Wed, 28 Sep 2011 04:00:00 +0100

The United Kingdom's National Health Service (NHS) recently announced that they will not cover the late-stage prostate cancer drug, cabazitaxel, which is marketed under the brand name Jevtana. The National Institute for Health and Clinical Excellence (NICE) released a statement saying that they had evaluated the drug and determined that the high cost of the drug could not be justified by the relatively short increase in life expectancy. The group also said that they were concerned by some potential side effects of the drug. (Source: About.com Prostate Cancer)

Britain Revamps its EHR Program

ICMCC: The International Council on Medical and Care Compunetics — Tue, 27 Sep 2011 07:42:05 +0100

Source: Joseph Goedert, HDM Breaking News Content: “Britain’s National Health Service is significantly scaling back its National Programme for IT, a decade-old initiative to implement electronic health records across the nation of about 60 million. Changes in the program come after spending about $10 billion on the $18.6 billion initiative. The program has been harshly criticized [...] (Source: ICMCC: The International Council on Medical and Care Compunetics)

Editorial Comment

The Journal of Urology — Mon, 26 Sep 2011 04:00:00 +0100

This interesting and timely study helps us understand the modern incidence of the exstrophy-epispadias-cloacal exstrophy spectrum in an organized and structured way. As a former trainee in the National Health Service, I can attest to the accuracy of these well maintained health care records. These findings mirror what we have seen at our exstrophy unit. While high risk obstetrician-gynecologists are doing a better job of making the diagnosis prenatally even among the classic exstrophy group, many of these cases seen prenatally at smaller centers are still being missed, delaying referral and prenatal parent education about this major birth defect. The breakdown of the incidence of these various entities also basically mirrors that seen at our unit. (Source: The Journal of Urology)

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Innovations in Continuing Professional Development — Countering the Dunning–Kruger Effect

Clinical Oncology — Mon, 26 Sep 2011 04:00:00 +0100

Continuing professional development (CPD) is the process by which doctors keep their knowledge and skills up to date throughout their working lives. The importance of CPD was first outlined in a number of National Health Service (NHS) documents in 1998–2000 and CPD remains one of the key elements of the General Medical Council revalidation process due to be implemented in 2012, albeit with a difference — there is a shift of emphasis from the purely ‘time spent’ model to a more ‘reflective’ model whereby doctors are required to evaluate what they have learned from their CPD activity and how it may affect and improve their performance. (Source: Clinical Oncology)

Benefits of insulin analogs may be overrated

MedWire News - Diabetes — Mon, 26 Sep 2011 00:00:00 +0100

The benefits of using insulin analogs rather than human insulin are not necessarily sufficient to outweigh their increased cost to the National Health Service, say UK researchers. (Source: MedWire News - Diabetes)

Occurrence and impact of delayed cerebral ischemia after coiling and after clipping in the International Subarachnoid Aneurysm Trial (ISAT)

Journal of Neurology — Sat, 24 Sep 2011 05:45:07 +0100

Abstract Delayed cerebral ischemia (DCI) is an important cause of poor outcome after aneurysmal subarachnoid hemorrhage (SAH). We studied differences in incidence and impact of DCI as defined clinically after coiling and after clipping in the International Subarachnoid Aneurysm Trial. We calculated odds ratios (OR) for DCI for clipping versus coiling with logistic regression analysis. With coiled patients without DCI as the reference group, we calculated ORs for poor outcome at 2 months and 1 year for coiled patients with DCI and for clipped patients without, and with DCI. With these ORs, we calculated relative excess risk due to Interaction (RERI). Clipping increased the risk of DCI compared to coiling in the 2,143 patients OR 1.24, 95% confidence interval (95% ...

NHS: If only the Government listened to the geeks

Telegraph Health — Fri, 23 Sep 2011 19:49:56 +0100

Whizzy IT systems are expensive - in the National Health Service or at home, says Vicki Woods. (Source: Telegraph Health)

Family-based behavioural treatment of childhood obesity in a UK national health service setting: randomized controlled trial

International Journal of Obesity — Tue, 20 Sep 2011 04:00:00 +0100

Authors: H Croker, R M Viner, D Nicholls, D Haroun, P Chadwick, C Edwards, J C K Wells & J Wardle (Source: International Journal of Obesity)

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The use of Cochrane Reviews in NICE clinical guidelines.

Cochrane Database of Systematic Reviews — Fri, 16 Sep 2011 09:32:03 +0100

Authors: Alderson P, Tan T Abstract The National Institute for Health and Clinical Excellence (NICE) produces clinical guidelines for the National Health Service (NHS) in England and Wales. These guidelines are developed by groups that combine people with expertise in conducting systematic reviews and health economic analyses, with those with expertise in the clinical area (from healthcare professionals and patients). During guideline development, the group poses about 20 to 25 clinical questions, which are then addressed by systematic reviews. As described in the NICE Guidelines Manual, groups routinely search for existing relevant systematic reviews. The NHS funds NICE and makes substantial contributions to The Cochrane Collaboration, so there is a common interest in making the b...

From Surgery To Nutritional Supplements, Access To Necessary Treatment Being Denied To NHS Patients In UK

Health News from Medical News Today — Thu, 15 Sep 2011 15:00:00 +0100

Doctors in the UK are reporting that many of their patients are now being denied access to a range of treatments on the NHS, examples include : infertility treatment, hernia operations, vasectomies and nutritional supplements. A survey by www.pulsetoday.co.uk, a leading UK based website and magazine for healthcare professionals, surveyed some 300 GPs and the results demonstrate that rationing of treatments has become widespread within the National Health Service in the UK... (Source: Health News from Medical News Today)

Patient safety and healthcare-associated infection.

British Journal of Nursing — Tue, 13 Sep 2011 04:00:00 +0100

This article has taken a 'conceptual culture of safety model' that has been previously described in the literature and applied it to the organization of infection control. It is clear that while there are many areas of good practice, in relation to infection prevention and control, there is still much to do if the NHS is to invoke the type of paradigm shift that will result in a mature sustainable safety culture. PMID: 22067582 [PubMed - in process] (Source: British Journal of Nursing)

Maternal Anemia in Rural Jordan: Room for Improvement

Clinical and Developmental Immunology — Mon, 12 Sep 2011 16:38:54 +0100

The objectives of this cross-sectional study were to estimate the prevalence and determine factors associated with anemia among pregnant women in rural Jordan. A cohort of 700 pregnant women from a National Health Service hospital and ten health centers completed a questionnaire. Of the total, 243 (34.7%) had anemia. The prevalence was the highest for women in their 3rd trimester (42.5%) compared to those in 2nd trimester (32.7%) and 1st trimester (18.9%). Gestational age, body mass index, history of previous surgery, and multivitamin intake during pregnancy were significantly associated with anemia. Women in the 2nd and 3rd trimesters had higher odds of anemia (OR=2.2 and 3.3, resp.). Underweight women had higher odds of anemia (OR=2.9). History of previous surgery and mul...

Gavin James Brown

BMJ Online First — Fri, 09 Sep 2011 04:00:00 +0100

was born in Newcastle upon Tyne, where his father was a pre-National Health Service general practitioner working in a mining community with a heavy clinical workload. Gavin... (Source: BMJ Online First)

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Bitter contemplation before the road to specialist sport and exercise medicine recognition... and the challenges ahead?

British Journal of Sports Medicine — Wed, 07 Sep 2011 04:00:00 +0100

It was May 1991 and I was sitting in ‘The Good Samaritan’, a pub behind The London Hospital in Whitechapel. I was staring into my pint of ‘Bitter’ with a sense of a brooding contemplation. With me were the three other members of my study group, British doctors Mark Batt, Ian McCurdie and Phil Bell. We had just completed the graduation ceremony for our Diploma of Sports Medicine. The elation and euphoria of having successfully completed a formative year of study was giving way to more serious thoughts of the future. For each of us, the unsettling question kept raising its head. ‘What's next?’ In 1991, there was no clear pathway in the UK for sports medicine specialist recognition and certainly no pathway that included recognition within the National Healt...

The politics of NHS reconfiguration

BMJ Online First — Tue, 06 Sep 2011 23:00:00 +0100

For all its clinical dynamism, the National Health Service suffers from a sclerotic inability to change. Were Aneurin Bevan, architect of the NHS, to take a tour of today’s service, he would marvel... (Source: BMJ Online First)

UK's NICE rejects three drugs for bowel cancer

Modern Medicine — Sun, 04 Sep 2011 23:00:00 +0100

LONDON (Reuters) - Britain's health costs watchdog has rejected three drugs for advanced bowel cancer saying the medicines' benefits are not clear enough to justify providing them on the country's state-funded National Health Service (NHS). (Source: Modern Medicine)

There IT goes again

BMJ Online First — Thu, 01 Sep 2011 23:00:00 +0100

For nearly two decades, the National Health Service has had a public reputation for incompetence with information technology. A recent report by the House of Commons Public Accounts Committee into... (Source: BMJ Online First)

Britain's life expectancy can be raised with a bit of Japanese-style nannying | Stephen Dunn

Guardian Unlimited Science — Thu, 01 Sep 2011 14:19:39 +0100

Compared with Japan, we are in the midst of a public health crisis. It will take more than a nudge to get us out of itJapan has the highest life expectancy in the world. Girls born in Japan today can expect to live to 86. And boys will live to 80. In the UK if you are a female you expect to live until you are 82 and men are only expected to live until they are 78. So how can we catch up?New research in the Lancet suggests Japan's success is down to three key factors. First, Japan has a universal healthcare system and it has invested in public health. Second, the Japanese are health- and hygiene-conscious. They have a good balanced diet and generally take responsibility for their health.Third, and most importantly, Japan has not been afraid to be a bit of a nanny. Japan has sought to tackle...

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Cognitive Analytic Therapy for Borderline Personality Disorder: Therapist Competence and Therapeutic Effectiveness in Routine Practice

Clinical Psychology — Thu, 01 Sep 2011 04:00:00 +0100

This study sought to examine the competency of cognitive analytic therapy (CAT) delivered under routine care conditions and to identify the effectiveness of CAT for patients with borderline personality disorder (BPD). Ten cognitive analytic therapists in six National Health Service Trust sites treated 19 patients with BPD using the standard CAT BPD contract of 24 sessions plus four follow‐ups. The methodology was small N repeated measures deign, with patients interviewed at the third follow‐up session using the Change Interview. Results indicate a high treatment and follow‐up compliance rate (89.47%). Significant reductions in psychological distress, risk and dissociation over the time course of the CAT occurred, with a significant increase in personality integration. Most sessions (...

Occupational psychiatry in the armed forces: should depressed soldiers carry guns? [Articles]

Advances in Psychiatric Treatment — Tue, 30 Aug 2011 23:00:00 +0100

This article outlines the structure and function of the DMHS and its approach to risk management. (Source: Advances in Psychiatric Treatment)

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BMJ Online First — Tue, 30 Aug 2011 23:00:00 +0100

Whistleblowing in the medical world has a “tortured history,” especially in the UK’s National Health Service (JRSM 2011;104:278-82, doi:10.1258/jrsm.2011.110034). The term itself is English and... (Source: BMJ Online First)

A public health culture in the ED

The American Journal of Emergency Medicine — Mon, 29 Aug 2011 14:30:30 +0100

Diarrhea and vomiting are common modes of presentation to an emergency department (ED). National Health Service guidelines recommend a stool culture be sent for patients who are systemically unwell or immunocompromised, have a recent history of travel or suspected giardiasis, have blood or pus in the stool, or had recent antibiotic usage or hospital admission. It is recommended that a stool sample be considered where there is a suspected public health hazard, such as diarrhea in food handlers, health care workers, elderly residents in care homes, or suspected outbreaks . (Source: The American Journal of Emergency Medicine)

[Correspondence] UK Royal Colleges and health service reform

LANCET — Fri, 26 Aug 2011 23:00:00 +0100

In a press release, the UK's Royal College of Paediatrics and Child Health (RCPCH) welcomed the report by the National Health Service (NHS) Future Forum, which it considers “passes the test for children”. But does it actually pass the test for anyone? (Source: LANCET)

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Agency Information Collection Activities: Proposed Collection: Comment Request

Federal Register updates via the Rural Assistance Center — Fri, 26 Aug 2011 18:49:00 +0100

The Health Resources and Services Administration, Bureau of Clinician Recruitment and Service is requesting comments for the National Health Service Corps Site Survey. The NHSC Site Survey provides information that is utilized for monitoring and evaluating program operations and effectiveness, in addition to accurately reporting the scope of supported activities. (Source: Federal Register updates via the Rural Assistance Center)

Federal Jobs Program Targets Rural Physician Recruitment

News stories via the Rural Assistance Center — Wed, 24 Aug 2011 20:02:14 +0100

HealthLeaders Media reports that critical access hospitals across the country are expected to benefit from an expanded loan repayment program aimed at boosting physician recruitment. The expanded eligibility for the National Health Service Corps is part of President Obama's recently announced jobs initiative for rural America. (Source: News stories via the Rural Assistance Center)

Labial Reduction Surgery Pursued By Women For Cosmetic Reasons

Health News from Medical News Today — Wed, 24 Aug 2011 11:00:00 +0100

Women with normal sized labia minora still seek labial reduction surgery for cosmetic reasons finds new research published today (24 August) in BJOG: An International Journal of Obstetrics and Gynaecology. Female cosmetic genital surgery is increasingly popular and the number of labial reduction procedures in the National Health Service has increased five fold in the past 10 years. This is the first study looking specifically at the labial dimensions of women seeking cosmetic surgery... (Source: Health News from Medical News Today)