A think-tank report said that National Health Service maternity services were under considerable strain - midwife hours were falling, consultant cover was inadequate, and administrative burdens were rising. It proposed reforms based on choice and diversity of provision, which would allow the development of networks of smaller modern units which would be more convenient for mothers and better able to cater for births of different levels of risk.
Source: Nick Bosanquet, Jen Ferry, Christoph Lees and Jim Thornton, Maternity Services in the NHS, Reform (020 7799 6699)
Links: Report | Reform press release
Date: 2005-Dec
A report said that although new treatment centres were helping to reduce waiting times and improve access for patients, those run by the private sector were much more likely to have an adverse affect on their surrounding National Health Service trusts.
Source: Impact of Treatment Centres on the Local Health Economy in England, British Medical Association (020 7387 4499)
Links: Report | BMA press release
Date: 2005-Dec
The foundation trusts regulator said that the purchasing of healthcare should be separated from the provision of services, so that the necessary attention and resource could be focused on commissioning (defined as including strategic planning, contract management, demand management and claims management).
Source: Developing Effective Commissioning in the NHS, Monitor (020 7340 2400)
Links: Report | Monitor press release
Date: 2005-Dec
A report said that a radical rethink of sexual health services was urgently needed to tackle rapidly increasing rates of sexually transmitted infections.
Source: Sexual Health Services, NHS Confederation (020 7959 7272) and Terrence Higgins Trust
Links: Report | NHS Confederation press release | THT press release
Date: 2005-Dec
A survey found that almost 2 in 5 people (38 per cent) in England felt that there was not enough choice of health services outside hospitals; and around 3 in 5 (59 per cent) believed that increasing choice would have a positive impact on quality of healthcare.
Source: Public Opinion on Choice in Out of Hospital Care, MORI Social Research Institute (020 7347 3000)
Links: Report | MORI press release
Date: 2005-Dec
A report said that most terminally ill patients wanted to die in the comfort of their own home: but all too often their dying wish could not be granted.
Source: Improving End-of-life Care, NHS Confederation (020 7959 7272)
Links: Report | NHS Confederation press release
Date: 2005-Dec
The Scottish Executive published a programme of action for the National Health Service in Scotland. It aimed to reduce reliance on episodic, acute care in hospitals, and move towards a system which emphasized wider health and well-being - through preventive medicine, support for self-care, and greater targeting of resources on those at greatest risk.
Source: Delivering for Health, Scottish Executive, available from Blackwell's Bookshop (0131 622 8283)
Date: 2005-Nov
The government announced that it would allow National Health Service trusts with two performance rating 'stars' (not just those with three) to be considered for foundation trust status.
Source: House of Commons Hansard, Written Ministerial Statement 7 November 2005, columns 4-5WS, TSO (0870 600 5522)
Links: Hansard | Monitor press release | Guardian report
Date: 2005-Nov
A report set out a new approach for the delivery of local health and adult social care. It emphasized the importance of local partnership working, to make services more responsive and adaptable to local needs.
Source: The Future of Health and Adult Social Care: A partnership approach for well-being, Local Government Association (020 7664 3000) and eight other organizations
Links: Report | LGA press release
Date: 2005-Nov
The Northern Ireland Executive announced reforms to the structure of health and social services in Northern Ireland. A Strategic Health and Social Services Authority would replace the four existing Boards; and 18 Trusts to be reduced to five by April 2007.
Source: Press release 22 November 2005, Northern Ireland Executive (028 9052 0500)
Links: NIE press release
Date: 2005-Nov
A report said that people were supportive of government moves to increase patient choice: but they insisted that it could only be made a reality if they could call on advice from their family doctor, if they had more information, and if there were more capacity in the system.
Source: Rebecca Rosen, Natasha Curry and Dominique Florin, Public Views on Choices in Health and Health Care: A qualitative study, King s Fund (020 7307 2591)
Links: Report (pdf) | King's Fund press release
Date: 2005-Oct
The Royal College of Nursing sought a judicial review of the government's failure to carry out public consultation on proposals for changing the role of primary care trusts in England. The proposals stated that trusts' role in provision of services would be reduced to a minimum - a policy decided without prior consultation.
Source: Press release 31 October 2005, Royal College of Nursing (020 7409 3333)
Links: RCN press release | Guardian report
Date: 2005-Oct
A report said that arrangements for overseeing and scrutinizing healthcare bodies was working - despite challenges around resources, joint working, and service changes.
Source: Process, Progress and Making it Work: Health overview and scrutiny in England, 2005, Centre for Public Scrutiny (020 7296 6595)
Links: Report (pdf) | Summary (pdf)
Date: 2005-Oct
The government responded to a report by a committee of MPs on the use of new medical technologies in the National Health Service.
Source: Government Response to the Health Committee s Report on the Use of New Medical Technologies within the NHS, Cm 6656, Department of Health, TSO (0870 600 5522)
Links: Response (pdf) | MPs report
Date: 2005-Oct
A report said that the private finance initiative process in the National Health Service needed updating to make it more effective. The formal process for choosing a private sector contractor for an approved PFI scheme was too bureaucratic, too expensive, and could result in better designed hospital buildings than it was achieving.
Source: The Future of PFI, NHS Confederation (020 7959 7272)
Links: Report (pdf) | NHS Confederation press release
Date: 2005-Oct
The government set out further details of how the National Health Service would deliver a maximum wait for patients of 18 weeks, from referral by a family doctor to the start of treatment, by the end of 2008. For the first time, primary care trusts would be responsible for ensuring that all of the local health providers moved patients as quickly as possible through the different stages towards treatment - under a new 'guaranteed patient pathway'.
Source: Commissioning an 18 Week Patient Pathway: Proposed principles and definitions, Department of Health (08701 555455)
Links: Discussion paper (pdf) | DH press release
Date: 2005-Oct
An article said that the impact of devolution on the health systems of England, Scotland, Wales and Northern Ireland was almost impossible to gauge, due to a lack of information needed to make meaningful comparisons.
Source: Arturo Alvarez-Rosete, Gwyn Bevan, Nicholas Mays and Jennifer Dixon, 'Effect of diverging policy across the NHS', British Medical Journal, 22 October 2005
Links: Article | Kings Fund press release
Date: 2005-Oct
The Welsh Assembly government published a National Framework for Children, Young People and Maternity Services.
Source: National Service Framework for Children, Young People and Maternity Services in Wales, Welsh Assembly Government (029 2082 5111)
Links: Framework | WAG press release
Date: 2005-Sep
The government responded to a report by a committee of MPs on the influence of the pharmaceutical industry.
Source: Government Response to the Health Committee s Report on the Influence of the Pharmaceutical Industry, Cm 6655, Department of Health, TSO (0870 600 5522)
Links: Response (pdf) | MPs report | RPS press release (pdf) | Mind press release
Date: 2005-Sep
An article summarized the range of policies that had promoted health and social care partnerships since 1997. It examined the evidence that partnerships constituted either an effective method of service planning and delivery or a distinctive 'Third Way' mode of governance.
Source: Caroline Glendinning, Bernard Dowling and Martin Powell, 'Partnerships between health and social care under 'New Labour': smoke without fire? A review of policy and evidence', Evidence & Policy, Volume 1 Number 3
Links: Abstract
Date: 2005-Sep
A series of articles examined management issues in the National Health Service - including performance measurement, decentralizing health services, and the relationship between health and social care.
Source: Public Money and Management, Volume 25 Issue 4
Links: Table of contents
Date: 2005-Sep
The government published a forward plan setting out what the Department of Health would do in 2005-06 to lead and support the drive to achieve the government s objectives for health and social care, and to support Ministers in their accountability to the public and Parliament.
Source: Department of Health Forward Plan, Department of Health (08701 555455)
Links: Plan (pdf)
Date: 2005-Aug
A new book examined the organization of health services. It said that it was necessary to consider healthcare at three key levels: individual patients and their experiences; healthcare organizations such as health centres and hospitals; and regional and national institutions such as governments and health insurance bodies.
Source: Nick Black and Reinhold Gruen, Understanding Health Services, Open University Press (01280 823388)
Links: Summary
Date: 2005-Aug
The healthcare inspectorate said that the creation of foundation trusts had made hospitals more responsive to local communities, and accelerated investment in patient care: but their development had been hampered by uncertainty over future direction of foundation trust policy, significant changes in financial arrangements, and the need for greater clarity over public representation.
Source: The Healthcare Commission?s Review of NHS Foundation Trusts, Commission for Healthcare Audit and Inspection (020 7448 9200)
Links: Report (pdf) | CHAI press release | DH press release | Monitor press release | King's Fund press release | Guardian report
Date: 2005-Jul
A think-tank report said that the National Health Service could do more to improve the health of patients and reduce expensive hospital admissions by helping people to manage their own conditions more effectively in the community.
Source: Sara Corben and Rebecca Rosen, Self-management for Long-term Conditions: Patients? perspectives on the way ahead, King?s Fund (020 7307 2591)
Links: Report (pdf) | King's Fund press release
Date: 2005-Jul
A report outlined the background to the need for the National Service Framework for Children, Young People and Maternity Services; described the process of its development; and offered a commentary on the lessons learned.
Source: Report from the National Clinical Director for Children to the Secretary of State for Health: The development of the National Service Framework for Children, Young People and Maternity Services, Department of Health (08701 555455)
Links: Report (pdf)
Date: 2005-Jul
A report said that patients were willing to sacrifice faster access to treatment in favour of better hospital care.
Source: Peter Burge, Nancy Devlin, John Appleby, Charlene Rohr and Jonathan Grant, London Patient Choice Project Evaluation: A model of patients choices of hospital from stated and revealed preference choice data, RAND Corporation (mailto:order@rand.org)
Links: Report (pdf) | King's Fund press release
Date: 2005-Jul
The government responded to a report by a committee of MPs on continuing care. It agreed with the committee's call for greater flexibility for direct payment users whose care became the responsibility of the National Health Service through the continuing care system.
Source: Response to Health Select Committee Report on Continuing Care, Cm 6650, Department for Health, TSO (0870 600 5522)
Links: Response (pdf) | MPs report
Date: 2005-Jul
The Welsh Assembly government began consultation on a draft National Service Framework for Older People, setting out what older people could expect from health and social care services by setting national standards to drive up quality and reduce variations in service delivery.
Source: Draft National Service Framework for Older People in Wales, Welsh Assembly Government (029 2082 5111)
Links: Consultation document (pdf) | Summary (pdf) | WAG press release
Date: 2005-Jul
A report called for further developments in the government's policy on foundation trusts. There were too many central targets that conflicted with local governance, foundation status, and self-directing boards of governors.
Source: Foundation Trusts: Future Thinking, Challenges and Change, Foundation Trust Network (020 7074 3200)
Links: Report (pdf) | NHS Confederation press release
Date: 2005-Jul
An audit report said that solving the problem of delayed discharges from hospitals in Scotland needed action across all parts of the health and community care system.
Source: Moving On? An overview of delayed discharges in Scotland, Audit Scotland for Accounts Commission and Auditor General (0131 477 1234)
Links: Report (pdf) | Audit Scotland press release (pdf)
Date: 2005-Jun
Researchers summarized data on the views of National Health Service staff on how system reform changes affected them. Many staff were positive about the ideology of the changes: but in the short term the constant pace of change, the resulting increased pressures on workload, and the development of a ?tick box culture? - all of which took time away from patient care - created negativity and resistance to change.
Source: Douglas Dalziel, Jeanette Attan and Pamela Bremner, System Reform: Behaviours and Relationships - Final report, Department of Health (08701 555455)
Links: Report (pdf)
Date: 2005-Jun
A report said that National Health Service Boards found themselves preoccupied by routine matters and the demands of targets, which prevented them from focusing on strategic planning.
Source: Effective Boards in the NHS?, NHS Confederation (020 7959 7272)
Links: NHS Confederation press release
Date: 2005-Jun
Researchers found that independent nurse prescribing was viewed positively by patients, doctors and nurses themselves, with patients citing accessibility as a major advantage when obtaining their medicine from a nurse rather than a doctor.
Source: Sue Latter et al., An Evaluation of Extended Formulary Independent Nurse Prescribing, Department of Health (08701 555455)
Links: Summary (pdf) | DH press release
Date: 2005-Jun
The government published a report on the evidence base which informed the development of the National Service Framework for children, young people and maternity services. It also highlighted some evidence gaps and potential areas for future research.
Source: Evidence to Inform the National Service Framework for Children, Young People and Maternity Services, Department of Health (08701 555455)
Links: Report (pdf links)
Date: 2005-Jun
The government published a plan for reforming the role of the ambulance service. Ambulance staff would increasingly take the place once filled by out-of-hours family doctor services - treating people who dialed the emergency service in their homes, rather than moving them to hospital.
Source: Taking Healthcare to the Patient: Transforming NHS ambulance services, Department of Health, TSO (0870 600 5522)
Links: Report (pdf) | DH press release | Guardian report
Date: 2005-Jun
An article said that, although the attitudes of National Health Service managers to partnership working and 'customer focus' had become more positive after two years of policy implementation, they remained centred on the service process rather than the customers it served.
Source: Gillian Wright and Andrew Taylor, 'Strategic partnerships and relationship marketing in healthcare', Public Management Review, Volume 7 Number 2
Links: Abstract
Date: 2005-Jun
A research report examined the role and function of strategic health authorities, their contribution to and impact on their health communities, and their future development.
Source: Joan Higgins, Donna Bradshaw and Kieran Walshe, The Developing Role of Strategic Health Authorities, Centre for Public Policy and Management/Manchester Business School/University of Manchester (0161 275 2908)
Links: Summary (pdf)
Date: 2005-Jun
The Welsh Assembly government published (following consultation) a common framework of healthcare standards to support the National Health Service and partner organizations.
Source: Healthcare Standards for Wales, Welsh Assembly Government (029 2080 1033)
Links: Report (pdf)
Date: 2005-May
A report said that discrimination against older people by health services was preventing many of them from having a dignified death.
Source: Jane Seymour, Ros Witherspoon, Merryn Gott, Helen Ross and Sheila Payne with Tom Owen, End of Life Care: Promoting comfort, choice and well being for older people at the end of their lives, Policy Press with Help the Aged, available from Marston Book Services (01235 465500)
Links: Summary | Help the Aged press release
Date: 2005-May
The government announced plans to increase private sector activity in the National Health Service. It announced new contracts for private healthcare corporations worth more than 3 billion over five years. These were intended to secure about 2 million extra operations a year, helping the government to achieve its target of cutting the maximum wait for treatment to 18 weeks by 2008.
Source: Speech by Secretary of State for Health (Patricia Hewitt MP), 13 May 2005
Links: Text of speech | BMA press release | Guardian report
Date: 2005-May
An expert group produced a detailed set of recommendations on how the National Health Service in Scotland could be shaped over the coming decades. Key recommendations included: a systematic approach to caring for people (especially older people) with long-term conditions, with a view to managing their care at home or in the community and, where possible, without hospitalization; and action in deprived areas, through anticipatory care, to prevent future ill-health and reduce health inequality.
Source: Building a Health Service Fit for the Future ('Kerr Group report'), Scottish Executive, available from Blackwell's Bookshop (0131 622 8283)
Links: Report (pdf) | Summary (pdf) | SE press release | NHS Confed press release | Children Now report
Date: 2005-May
A report said that advances in the availability of health-related information (via sources such as websites and telephone help lines) had failed to alleviate pressure on family doctors' surgeries in Wales.
Source: Sarah Richards, In Sickness and in Health: Consumer access to health information, Welsh Consumer Council (029 2025 5454)
Links: Report (pdf) | WCC press release
Date: 2005-Apr
An article said that the National Health Service needed to overhaul its approach to adolescent health if it were to meet the health needs of young people. While the health of children and older people had improved considerably, young people had fallen through the gap in targeted services.
Source: Russell Viner and Maggie Barker, 'Young people's health: the need for action', British Medical Journal, 16 April 2005
Links: Extract | BMJ press release
Date: 2005-Apr
The Northern Ireland Executive began consultation on draft standards aimed at raising the quality of health and social services, and improving people's health and well-being.
Source: Best Practice, Best Care: The quality standards for health and social care, Department of Health, Social Services and Public Safety/Northern Ireland Executive (028 9052 0500)
Links: Summary | NIE press release
Date: 2005-Apr
A report by a committee of MPs said that the Department of Health appeared unable to prioritize the interests of patients and public health over the interests of the pharmaceutical industry. It recommended that sponsorship of the industry should pass to the Department of Trade and Industry.
Source: The Influence of the Pharmaceutical Industry, Fourth Report (Session 2004-05), HC 42, House of Commons Health Select Committee, TSO (0870 600 5522)
Links: Report | Consumers' Association press release | Mind press release | Alzheimer's Society press release | Guardian report
Date: 2005-Apr
A report by a committee of MPs said that the potential benefits of new medical technologies were not being realized. The government needed to address the preference of the National Health Service for short-term savings as opposed to long-term advantages for patients,
Source: The Use of New Medical Technologies within the NHS, Fifth Report (Session 2004-05), HC 398, House of Commons Health Select Committee, TSO (0870 600 5522)
Links: Report
Date: 2005-Apr
A report by a committee of MPs said that arrangements for funding long-term healthcare were "beset with complexity", and that a lack of clear government guidance had led to widespread geographical variations in service provision.
Source: NHS Continuing Care, Sixth Report (Session 2004-05), HC 399, House of Commons Health Select Committee, TSO (0870 600 5522)
Links: Report | Alzheimer's Society press release | Guardian report
Date: 2005-Apr
A national service framework was published for people suffering long-term conditions. It was designed to transform the way health and social care services supported people with long-term neurological conditions.
Source: The National Service Framework for Long-term Conditions, Department of Health (08701 555455)
Links: Framework (pdf) | DH press release | LMCA press release
Date: 2005-Mar
A government report set out how commitments in the National Health Service improvement plan (published in July 2004) would be implemented. There would be more choice in acute care, with primary care trusts offering patients a choice of four or five local NHS providers, together with all NHS foundation trusts and nationally procured independent sector treatment centres. Hospitals would be allowed to advertise for patients.
Source: Creating a Patient-led NHS: Delivering the NHS improvement plan, Department of Health (08701 555455)
Links: Report (pdf) | DH press release | HDA press release | Rethink press release | Guardian report
Date: 2005-Mar
A report examined gender issues in healthcare. It said that promoting gender equality could transform cancer, mental health, sexual health services, and coronary care.
Source: Improving the Health of Men + Women, Equal Opportunities Commission (0161 833 9244) and Gender and Health Partnership
Links: Report (pdf) | EOC press release
Date: 2005-Mar
A report by a committee of Welsh Assembly members examined the interface between health and social care, and made recommendations for improvements.
Source: Report of Review of the Interface between Health and Social Care, Health and Social Services Committee/National Assembly for Wales (029 2089 8148)
Links: Report (pdf)
Date: 2005-Mar
The government announced that funding for health services for people with learning disabilities would be doubled in 2005-06, to over 41 million. The extra funding was allocated to primary care trusts to provide services through the Learning Disabilities Development Fund.
Source: Press release 17 February 2005, Department of Health (020 7210 4850)
Links: DH press release
Date: 2005-Feb
The government announced the creation of a National Strategic Partnership Forum, which would be responsible for reviewing how the strategic agreement between the Department of Health, the National Health Service, and the voluntary and community sector was working.
Source: Press release 14 February 2005, Department of Health (020 7210 4850)
Links: DH press release
Date: 2005-Feb
Researchers investigated five multi-agency teams operating in children's services in England, covering youth crime, mental health, special needs provision for under-fives, neuro-rehabilitation, and assessment of child development. The research found confusion between the concepts of multi-disciplinary and multi-agency work; and it identified lack of training in effective management of multi-agency teams and managing change as two key issues which needed to be addressed.
Source: Angela Anning, New Forms of Professional Knowledge and Practice in Multi-agency Services, Economic and Social Research Council (01793 413000)
Links: ESRC press release
Date: 2005-Feb
An article said that government plans to use community matrons to help keep older people out of hospital might be based on misleading data. The plans aimed to cut hospital stays by tracking admission rates among older patients and then using specially trained nurses to care for them at home: but admissions would probably decline anyway, without intervention.
Source: Martin Roland, Mark Dusheiko, Hugh Gravelle and Stuart Parker, 'Follow up of people aged 65 with a history of emergency admissions: analysis of routine admission data', British Medical Journal, 5 February 2005
Links: Article | BMJ press release
Date: 2005-Feb
An interim report said that the Evercare programme, combining nurse-led care and case management as a way of reducing the number of unplanned emergency admissions of frail elderly people, might not be as effective as first thought.
Source: Ruth Boaden et al., Evercare Evaluation Interim Report: Implications for supporting people with long-term conditions, National Primary Care Research and Development Centre (0161 275 0611)
Links: Report (pdf) | Guardian report
Date: 2005-Feb
A report described the early implementation of children s trusts in all 35 pathfinders in England. Most pathfinders had aimed for an approach which emphasized the importance of views of children, young people, and their parents and carers from the outset. All pathfinders stated aims covered the five key areas: being healthy, staying safe, enjoying and achieving, making a positive contribution, and economic well-being. But they attached a lower priority to economic well-being relative to other outcomes.
Source: University of East Anglia with National Children s Bureau, Children's Trusts: Developing integrated services for children in England, Research Report 617, Department for Education and Skills (0845 602 2260)
Links: Report (pdf) | Brief (pdf)
Date: 2005-Feb
The government said that more than 120,000 patients had been treated since the launch of new 'treatment centres' in 2002, at a rate up to eight times faster than traditional National Health Service providers. But doctors warned that the centres were 'destabilizing' NHS hospitals. (Treatment centres are streamlined units that provide pre-booked surgery and diagnostic tests for patients, often concentrating on procedures with the highest historic waiting times.)
Source: Treatment Centres: Delivering faster, quality care and choice for NHS patients, Department of Health (08701 555455) | Press release 7 January 2005, British Medical Association (020 7383 6244)
Links: Report (pdf) | DH press release | BMA press release | NHS Confed press release | Guardian report
Date: 2005-Jan
A report said that remoteness, lack of public transport services, and the centralization of health services meant that many people in rural areas could have difficulties in accessing healthcare. There was evidence that some health outcomes for rural patients were poor compared with those from urban areas.
Source: Healthcare in a Rural Setting, British Medical Association (020 7383 6164)
Links: Report (pdf) | BMA press release | Guardian report
Date: 2005-Jan
The government published a blueprint to support local health and social care organizations in improving local services for people with long-term conditions. It drew on existing successes and innovations from in the National Health Service and social care, and international experience, to help local health communities to develop a more integrated and systematic approach. At the heart of the new system was the community matron , a new type of health professional whose role would be to give one-to-one support to the most vulnerable patients with long-term conditions: the NHS was committed to having 3,000 community matrons in place by March 2007. Doctors said that the matrons system would not work unless it were fully integrated into primary care.
Source: Supporting People with Long Term Conditions: An NHS and social care model to support local innovation and integration, Department of Health (08701 555455) | Press release 5 January 2005, British Medical Association (020 7383 6244)
Links: Report (pdf) | DH press release | BMA press release | Kings Fund press release | NHS Alliance press release | NHS Confed press release | RPSGB press release (pdf) | Guardian report
Date: 2005-Jan
