Journal of health services research & policy
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The National Health Service (NHS) in England is not only a commissioner and provider of health care to the sick, but also offers certainty and peace of mind to all citizens--even those who do not use the health service in any year. However, due to the recent dominance of cost-effectiveness and cost-utility analysis as the central factors determining resource allocation decisions in the NHS, this second role--which we term its 'insurance value'--has increasingly become neglected. ⋯ These include requiring commissioners to take explicit account of how denial of service undermines peace of mind; requiring the National Institute for Health and Clinical Excellence (NICE) to calculate not just the health benefits, but also the peace of mind benefits of health technologies; and establishing a formal NHS 'insurance regulator' analogous to the Financial Ombudsman Service. Insurance value should be a guiding principle for NHS decision-makers.
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J Health Serv Res Policy · Apr 2010
When policy meets the personal: general practice nurses in Australia.
A significant focus of current health policy in Australia is to expand both the number and role of general practice nurses. Multiple new payment incentives have been instituted to encourage the use of practice nurses. This study explored the way these policies have framed their work. ⋯ Policy development and funding structures would benefit from better understanding of nurses as agents of connectivity (rather than simply as performers of tasks) as well as the nature of teamwork in practices.
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J Health Serv Res Policy · Apr 2010
Accountability of foundation trusts in the English NHS: views of directors and governors.
To map and describe the formal accountability relationships of foundation trusts in England and to explore the interpretations of these relationships by the key actors. ⋯ Contrary to the major policy objectives of giving greater autonomy to foundation trusts and making them more accountable to the local population, they continue to look towards the Department of Health rather than to the local population and its representatives. The accountability of foundation trusts needs to be simplified, clarified and strengthened.
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J Health Serv Res Policy · Apr 2010
Consensus methods to identify a set of potential performance indicators for systems of emergency and urgent care.
To identify a comprehensive set of indicators to enable Primary Care Trust (PCT) commissioners in England and other NHS decision-makers to monitor the performance of systems of emergency and urgent care for which they are responsible. ⋯ System-wide measures to monitor performance across multiple services should encourage providers to work for patient benefit in an integrated way. They will also assist commissioners to monitor and improve emergency and urgent care for their local populations. The indicators are now being calculated using routinely available data, and tested for their responsiveness to capture change over time.