The Health service journal
-
The Bristol inquiry highlights the disjunction between ends and means in the NHS. It draws attention to the 'make do and mend' culture in the service. The ethos of 'getting by' is seen as the enemy of excellence. Its most radical theme is the separation of management and regulation.
-
Two major hospital moves in Lanarkshire were completed smoothly by predicting the number of emergency admissions likely over the crucial periods and involving GPs and all the hospitals concerned. An analysis of emergency admissions was one factor in deciding which days the moves should take place on. A workshop after the first move was finished proved important.
-
Joint working is likely to increase. But it does not necessarily improve efficiency. The essential change required is cultural, not structural.