Journal of health services research & policy
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J Health Serv Res Policy · Oct 2013
EditorialEvaluating the Labour Government's English NHS health system reforms: the 2008 Darzi reforms.
Starting in 2002, the UK Labour Government of 1997-2010 introduced a series of changes to the National Health Service (NHS) in England designed to increase patients' choices of the place of elective hospital care and encourage competition among public and private providers of elective hospital services for NHS-funded patients. In 2006, the Department of Health initiated the Health Reform Evaluation Programme (HREP) to assess the impact of the changes. In June 2008, the White Paper, High quality care for all, was published. ⋯ For the rest of the changes, impacts ranged from little or none (CQUIN and care planning for people with chronic conditions) to patchy and highly variable (instilling a culture of quality in acute hospitals) in the three years following the publication of the White Paper. On the other hand, each of the studies identifies important insights relevant to modifying and improving the policies. These findings have continuing relevance since both the 2008 White Paper's policies, and the issues they were focused on remedying, remain central to the current Coalition Government's reform agenda.
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J Health Serv Res Policy · Jan 2013
Clinical focus and public accountability in English NHS Trust Board meetings.
Previous studies have suggested that greater focus on clinical matters in NHS commissioner and provider Trust Board meetings might improve the range, quality or cost of clinical care. This study reports the extent of clinical focus in Board meetings in three types of NHS Trust and considers the implications for public accountability. ⋯ Findings illuminate important transparency issues which should be given careful consideration in the English NHS.
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J Health Serv Res Policy · Oct 2012
Reconfiguring the emergency and urgent care workforce: mixed methods study of skills and the everyday work of non-clinical call-handlers in the NHS.
To examine the skills and expertise required and used by non-clinical call-handlers doing telephone triage and assessment, supported by a computer decision support system (CDSS) in urgent and emergency care services. ⋯ Clinical assessment and triage by non-clinical staff supported by a CDSS represents a major change in urgent and emergency care delivery, warranting a detailed examination of call-handlers' skills and expertise. We found that this work appears to have more in common with clinical work and expertise than with other call-centre work that it superficially resembles. Recognizing the range of skills call-handlers demonstrate and developing a better understanding of this should be incorporated into the training for, and management of, emergency and urgent care call-handling.
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J Health Serv Res Policy · Oct 2012
Worrying about the wrong thing: patient mobility versus mobility of health care professionals.
Patients and health care professionals in the European Union (EU) benefit from legislation on the freedom of movement between Member States. In relative terms, many more doctors and nurses move within the EU than patients. ⋯ On the one hand, the scope of patient mobility is narrow and self-limited. On the other hand, current and forecasted health care workforce shortages across the EU, global competition for health care professionals, and current economic pressures are all good reasons to start worrying about the mobility of health care professionals and its implications for health systems.