1. NHS research ethics approval: Open to interpretation?

    10 Mar 2015
    Comments

    Research is key to providing evidence for best practice in healthcare. The current system of approvals and permissions for conducting research in the NHS presents a number of practical challenges, most noticeably navigating the complexities of the system and overcoming the inconsistencies that can be encountered.

    Few would argue with the need for some sort of ethical review of research in the NHS – protection of patients under NHS care is paramount. There is a clear duty of care that exists, particularly when research involves potentially vulnerable populations like children.

    ...

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  2. The way the NHS manages A&E problems is not fit for purpose

    6 Mar 2015
    Comments

    In researching the recent problems in accident and emergency performance, I was struck by the way the NHS is managing the situation: there appears to be a large amount of activity across the system – conference calls, emails, phones calls – to check progress and request detailed information. Is this adding value or causing problems? And why is this type of activity thought to be an important part of the response? 

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  3. ‘Devo Manc’: Small steps, great leaps

    5 Mar 2015
    Comments

    The bold proposals to transfer responsibility for Greater Manchester’s health and social care needs to accountable bodies in the region were the talk of our annual Health Policy Summit.

    This reflected two very contrasting themes that were evident at the Summit. At one end of the spectrum, there was a focus on micro-level improvements that have the potential to add up to major change. At the other end, were discussions of big structural changes needed within the NHS.

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  4. Fact or fiction? Demand for GP appointments is driving the ‘crisis’ in general practice

    3 Mar 2015
    Comments

    Headlines and stories about the ‘crisis’ in general practice have become commonplace over the last year or so. A demoralised and squeezed workforce is struggling to meet the needs of increasing numbers of patients demanding immediate appointments. Or so the narrative goes.

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  5. A patient perspective on self-care

    (Guest blogger)
    25 Feb 2015
    Comments

    When I was 13 years old, I experienced the first symptoms of what almost 20 years later would be diagnosed as Parkinson’s disease. Getting Parkinson’s in your teens is pretty unusual, if not rare. Nevertheless, I am happy that I wasn’t diagnosed with an “old person’s disease” in my teens. I am convinced that if I had known when I was 16 that the problems I experienced with movement, gait and balance were due to Parkinson’s, I would not have gone to university, got my driver’s licence or dared to start a family with the man I met at university.

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  6. The NHS is in an era of opportunity; let’s not lose sight

    24 Feb 2015
    Comments

    Would you go out on a hazardous journey, with barely enough food to survive on, and with no map or compass? It could be argued that this is precisely what has been asked of the NHS since funding stopped keeping pace with our country’s rising health and social care needs and the Health and Social Care Act undermined the strategic leadership of the NHS. 

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  7. Fact or Fiction? The NHS has too many managers

    19 Feb 2015
    Comments

    It’s election season, and NHS managers and 'bureaucracy' are once again in the firing line. The Coalition boast of putting “more money on to the front line and less into management”; Labour and its supportive press accuse them of the opposite. So who's right? 

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  8. MPs will always be part of the rationing equation

    (Guest blogger)
    18 Feb 2015
    Comments

    Most people can accept that, in any cash-limited system, there will be some things that cannot be funded. However, translating this relatively simple, if abstract, concept into a practical and defensible process is challenging.

    Rationing is probably not a very helpful term to describe the difficult decisions health services face about potentially denying people care that their doctors think they need. In the UK when we think of rationing we tend to think of the World Wars.

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  9. Rationing: An unhelpful term for the broader issue of prioritisation

    (Guest blogger)
    18 Feb 2015
    Comments

    Clinical commissioning places general practitioners at the heart of local health planning. As clinicians, we want to ensure that we provide every service our patients want, and that every health intervention comes with the necessary aftercare and support. There are, however, two important additional factors.

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  10. Fact or Fiction? Targets improve quality in the NHS

    13 Feb 2015
    Comments

    Views on targets are highly polarised, and recently there has been much anguish and headlines that the NHS is "dying" and "third world". But are targets good or bad for the NHS? Ian Blunt looks at the facts. 

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  11. Mortality rates: getting the right measure

    13 Feb 2015
    Comments

    The Secretary of State has recently announced an annual review of the case notes of 2,000 people who have died in hospital every year. Chris Sherlaw-Johnson examines the problems with this approach. 

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  12. Managing doctors, doctors managing: Troubled relations at the heart of the NHS

    (Guest blogger)
    6 Feb 2015
    Comments

    Two years ago today, Robert Francis QC published his report into the failures of care at Mid Staffordshire NHS Trust. The report found that one of the contributing factors was a focus on finances at the expense of patient care within the trust.

     

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  13. Fact or Fiction? The Welsh NHS performs poorly compared to the English NHS

    5 Feb 2015
    Comments

    Claims about the Welsh NHS fly back and forth between politicians in Westminster and Cardiff Bay: Labour politicians can barely appear on national media without being questioned about their record running the NHS in Wales and Welsh NHS staff and patients find themselves at the centre of a fierce debate almost every week at Prime Minister’s Questions.

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  14. The health of our children, the health of the NHS

    30 Jan 2015
    Comments

    While there has been much focus on the challenges faced by the NHS of an ageing population, there has been less discussion at the other end of the spectrum. Children are the adults, and parents, of tomorrow – they represent the future. Their health in childhood is critical to their physical and mental wellbeing later in life. Protecting their health could translate into a healthier, sustainable NHS.

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  15. The challenge of change in the NHS in Wales

    30 Jan 2015
    Comments

    It can’t have escaped many people’s notice that English politicians continue to throw a spotlight on the performance of the Welsh NHS. With Wales the only UK administration controlled by Labour, the Conservative party has consistently sought to highlight the state of the Welsh NHS, perhaps in response to Labour’s comparative political advantage on the NHS in the forthcoming UK election.

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  16. Fact or Fiction? Social care cuts are to blame for the 'crisis' in hospital emergency departments

    29 Jan 2015
    Comments

    Rising demand for urgent and emergency care is not a new challenge. But in recent months, there’s been a scramble to find explanations for the overheating hospital sector. Nigel Edwards examines what we do know. 

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  17. Level up: new responsibilities for CCGs

    23 Jan 2015
    Comments

    Clinical Commissioning Groups (CCGs) – now approaching their second birthday – are having to grow up fast. They have cut their teeth on community and acute services, and now have the option to take up further responsibilities.

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  18. The tail of the long waiters

    16 Jan 2015
    Comments

    In August, Jeremy Hunt announced a ‘managed breach’ of two shorter-term (18 week) treatment waiting time targets: the expectation that 90% of inpatient and 95% of outpatient treatments started within 18 weeks of referral. But did it pay off? 

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  19. The Cancer Drugs Fund: An important stopgap

    (Guest blogger)
    14 Jan 2015
    Comments

     At a time when the CDF is under the public spotlight, it’s useful to remind ourselves about the problems that the Fund was set up to address, and recognise that while it is by no means the finished article, it has gone some way to plugging a gap. 

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  20. We are in a hole with the Cancer Drugs Fund – why do we keep on digging?

    (Guest blogger)
    14 Jan 2015
    Comments

    The news that the Fund was to be extended into 2016 brought equal amounts of delight and concern. The proponents of the Fund, who had hailed its introduction, were delighted, however, it raised huge concerns for those that could see its obvious flaws.

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