Journal of health services research & policy
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J Health Serv Res Policy · Jul 2012
Comparative StudyThe health care experiences of Travellers compared to the general population: the All-Ireland Traveller Health Study.
Travellers are a minority population in Ireland and Great Britain, who have poorer health status than the general population. This study aims to investigate Traveller health service utilization and experiences of health service quality. ⋯ Travellers report greater use of and adequate access to health services, but describe a consistently poorer quality health care experience. This quality gap has implications for Traveller engagement with health care professionals.
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J Health Serv Res Policy · Jul 2012
Are nurse and pharmacist independent prescribers making clinically appropriate prescribing decisions? An analysis of consultations.
Legislation and health policy enabling nurses and pharmacists to prescribe a comprehensive range of medicines has been in place in the UK since 2006. Our objective was to evaluate the clinical appropriateness of prescribing by these professionals. ⋯ Nurses and pharmacists are generally making clinically appropriate prescribing decisions. Decisions about the cost of drugs prescribed and assessment and diagnostic skills are areas for quality improvement.
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The world class commissioning (WCC) programme was introduced in the English NHS in 2007 to develop primary care trust (PCT) commissioning of health services. There has been limited evaluation of health commissioning initiatives over the years and in particular little is known about how commissioners interpret and implement initiatives and guidance intended to strengthen commissioning. This research explores the development and implementation of WCC and draws implications for future commissioning arrangements. ⋯ The findings have implications for emerging clinical commissioning groups (CCGs) in the English NHS. Specifically, the research highlights the need for a system-wide approach to improving commissioning, including appropriately aligned policy and objectives underpinned by a co-ordinated and supportive organizational culture.
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J Health Serv Res Policy · Jan 2012
Effects of the Blair/Brown NHS reforms on socioeconomic equity in health care.
The central objectives of the 'Blair/Brown' reforms of the English NHS in the 2000s were to reduce hospital waiting times and improve the quality of care. However, critics raised concerns that the choice and competition elements of reform might undermine socioeconomic equity in health care. By contrast, the architects of reform predicted that accelerated growth in NHS spending combined with increased patient choice of hospital would enhance equity for poorer patients. ⋯ Study three found that potential incentives for public hospitals to select against socioeconomically-disadvantaged hip replacement patients were small, compared with incentives to select against elderly and co-morbid patients. Taken together, these findings suggest that the Blair/Brown reforms had little effect on socioeconomic equity in health care. This may be because the 'dose' of competition was small and most hospital services continued to be provided by public hospitals which did not face strong incentives to select against socioeconomically-disadvantaged patients.