The Health service journal
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A remarkable photographic record of Bethlem Hospital patients of the mid-1850s, now on show in London, gives flesh and form to those who might otherwise have remained 'invisible'. Mark Crail took a look.
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The government should not increase funding to the NHS until it can be demonstrated that this will improve population health and that the money cannot be made available from reducing current inefficiencies. The absence of an information base in the NHS is one of the greatest challenges. ⋯ New untested organisational structures and policy stunts should be avoided. Waiting lists should be prioritised according to urgency and ability to benefit.
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A slot system allocating a set number of outpatient orthopaedic appointments to general practices in North West Anglia HA means all patients referred are seen in eight weeks. The system has provoked criticism from GPs on the grounds that the burden of waiting lists has shifted onto them, and it limits access to services. The scheme has improved communication between GPs and orthopaedic consultants.
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A primary care-led NHS has enjoyed gains, but at significant cost. The policy has failed to address public health issues, inequalities and problems in access to services. The policy has caused divisiveness and is seen as exacerbating deep-rooted competitiveness between GPs and consultants. A new concept is needed to unite the aspirations of the whole NHS.