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Domhnall MacAuley: If Ryanair ran the NHS….

12 Dec, 11 | by BMJ Group

Domhnall MacauleyNo frills: Basic services. Fast, efficient, and result driven. If you want business class comfort, you pay for a business class hospital. The NHS would provide hospital not hotel service. No optional extras—no lifestyle, cosmetic, or non core surgery. A non negotiable list of essential medications generated centrally. If you want medications not on the list—you pay. No more, no less. more…

Martin McShane: Execution

5 Dec, 11 | by BMJ Group

Martin McShaneThe operating framework for the NHS has now been published. Reading through the detail I was struck by the tasks laid at the door of PCT clusters. These transitional organisations know the date of their death. Despite that, there is an expectation they will continue to deliver, whilst acting as a catalyst for the reforms: go to paragraph 3.7, paragraphs 3.18 and 3.21, paragraphs 3.22 and 3.24 (and help me understand what the rules around that last paragraph are?). Paragraph 3.25 has enormous implications. More work is detailed in paragraphs 4.36 & 4.37, and so on. more…

Edward Davies: Cheerleading for Lansley at the NHS Alliance

2 Dec, 11 | by BMJ Group

Edward DaviesDavid Cameron’s oft-quoted assertion that the Health and Social Care Bill has now won the support of NHS professionals is much derided. And last week’s volte face from the BMA to actively oppose the bill only further undermines his optimism. In fact it’s hard to find much support anywhere.

But support there is and most of it was congregating at the NHS Alliance conference in Manchester this week. The NHS Alliance is the perky puppy dog of primary care. Its conferences are always unusually optimistic for a gathering of NHS dwellers – it’s an organisation built largely in the image of its cheerful bow-tied GP chairman Michael Dixon, who set the upbeat tone for the conference by bursting onto the stage through a paper banner screaming “Breakthrough.” Yes, it was as odd as it sounds, but for many delegates at this conference (GPs and primary care management on the whole) the Health and Social Care Bill is what they’ve spent 14 years pushing for. This is their moment. more…

David Kerr: Complaints via social media

2 Dec, 11 | by BMJ Group

David KerrSocial media seems to be the modern equivalent of the stocks. The main objective of the stocks was public humiliation. Nowadays, any member of the public can use social media to highlight grievances they might have against companies, organisations, and institutions and post them for all to see and comment on. more…

Ken Taylor: Dr Foster on inpatient hospital mortality

30 Nov, 11 | by BMJ Group

On the Today programme on Radio 4 on Monday morning there was a feature on these recently released data. Two areas were discussed. Hospital mortality is higher out of hours ie nights and weekends. The other item discussed was the smaller number of senior doctors in the hospital out of hours.

John Humphrys interviewed a spokesman for Dr Foster and one for the NHS Confederation. Unfortunately nobody who knows anything about the working of a hospital was interviewed. There is nothing unusual about this state of affairs. more…

Edward Davies: Cuts, pensions, and perspective

30 Nov, 11 | by BMJ Group

Edward DaviesWalking to the NHS Alliance’s annual conference through Manchester this morning, the streets were peppered with small pickets. University staff, civil servants, transport workers, all sorts of folk objecting to public sector cuts in general and in particular to their potentially diminished pensions.

One chap thrust a leaflet at me deploring the effect that cuts would have on his university’s provision and told me of the need to “fight for our lives.” more…

Martin McShane: Integrated reflections concluded

28 Nov, 11 | by BMJ Group

Martin McShaneHere is my third and final blog on the USA trip: After Seattle’s integrated care organisations, we visited CalPERS. They fund $6.7bn worth of healthcare for 1.3 million people (roughly twice what we have per person in Lincolnshire). They see themselves as “active” purchasers: managing the market to reduce costs. About two thirds of their members are in capitated plans (for instance Kaiser) whilst the remainder are in a PPO plan (Preferred Provider Organisation). Simple examples of their interventions were to remove co-pay from preventative care for members, to have fiscal and chronic disease management targets and to set a tariff for knee replacement–it all felt familiar. What wasn’t was their analysis by price for knee replacement. It revealed a staggering variation from $15k to $120k. With 46 hospitals they agreed a tariff of $30k but patients could choose to use hospitals that refused the tariff – so long as they paid the difference. It made me think why a tariff for planned procedures may not be such a bad idea. more…

Edward Davies: The health service that cried wolf

23 Nov, 11 | by BMJ Group

Edward DaviesToo much hysteria is clouding reasonable criticism

If you watched Channel 4 news last night, you could only come away with the impression that the government is waging a secret war to privatise the entire NHS. You see, Channel 4 were “exclusively” “leaked” “proof” that “the government is planning to privatise the NHS.”

The proof was so exclusive and so leaked that a couple of weeks ago you could only read about it on dozens of websites including here, here, here, here, and here and you could only read the draft version over a month ago here after it was first published over a month ago…. here. more…

Richard Smith: Can information technology improve healthcare?

22 Nov, 11 | by BMJ Group

Richard SmithI doubt that anybody within airlines, financial services, or manufacturing goes to meetings to debate whether information technology can improve what they do. It already has. But in healthcare we’ve grown very sceptical about information technology.

In fact information technology already has improved healthcare and much of what is done now could not be done without the technology, pointed out Patrick Carter from McKesson, one of the world’s largest logistics companies, at the Cambridge Health Network meeting in London last week. But, he continued, the industry has “overpromised and underdelivered,” destroying trust. more…

Chris Ham: Commonwealth Fund survey: If the NHS is doing well, why is it changing?

16 Nov, 11 | by BMJ Group

The Commonwealth Fund’s survey of the experience of adults with complex care needs, published last week, paints a remarkably positive picture of the NHS. The results show that, of the eleven countries surveyed, the number of patients reporting that they did not use services because of concerns about cost was lowest in the United Kingdom. And while the absence of user charges in the NHS (with the exception of some prescription charges) means that this finding is not surprising, other results are equally encouraging. more…

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