Search

This dissertation study investigates the ways that NHS libraries are currently marketing their services within their organisation and was submitted as part of the MA Library and Information Management at the University of Sheffield in 2019. This paper presents the findings from twelve semi‐structured interviews carried out with NHS library managers in the East of England to identify the most and least successful methods, and in comparison with that which is currently in the general marketing literature. The study found that outreach marketing was the most effective and that librarians are currently conducting marketing to the best of their ability, but they lack time and funding to be able to make the most of their promotional campaigns. F.J. [ABSTRACT FROM AUTHOR]

The National Institute for Health Research (NIHR) aims to improve national 'health and wealth' by providing infrastructural support to enable clinical research in National Health Service settings in England and Wales. Cognisant of the consequences of studies' failure to achieve required numbers of participants, it also actively campaigns to promote patient awareness of research, and willingness to participate in trials. In this paper, we analyse recent NIHR campaigns and policies designed to encourage patients to participate in clinical research to interrogate how they are implicated in the national bioeconomy. In doing so we expand the notion of 'clinical labour' to include the work of patient recruitment and highlight an emergent obligation on patients to contribute to research processes. Whereas once patient knowledge and experience may have been devalued, here we draw on the concept of 'assetisation' (Birch 2012) to explore the emergent relationship between healthcare system and patient as research participant. We consider how patients' contribution goes beyond the provision of standardised objects of valuation so that patients themselves may be perceived as assets to, not only recipients of, the national healthcare system. [ABSTRACT FROM AUTHOR]

This paper concerns the use of photo-elicitation interviews in constructing migrant narratives of health and well-being. It argues that photo-elicitation can be particularly effective in producing nuanced understandings about relationships among culture, place and health. It explores how, through this method, subject-centred understandings of health and well-being are able to challenge dominant discursive constructions that tend to ‘other’ and potentially stereotype minority groups in explanations of health behaviour. The paper includes discussion of issues of power and representation in research with marginalized populations, which further elaborates the value of photo-elicitation in developing a non-essentializing view of minority groups. The paper concludes with comment on the potential value of this method in the formulation of health and social policies aiming to incorporate the views and needs of marginalized or minority groups. [ABSTRACT FROM PUBLISHER]

Summary The publication of Best Research for Best Health highlighted the need for the NHS Service and Delivery Organisation (SDO) Programme to develop a programme of research on public health service delivery and organization. This paper reviews the need for this research by reviewing recent policy documents and public health research activity. The paper outlines the rote of the SDO Programme in relation to other current developments and discusses how these respond to the need to develop research on public health and what the research priorities are. [ABSTRACT FROM AUTHOR]

Background: Pay and pay systems are a critical element in any health sector human resource strategy. Changing a pay system can be one strategy to achieve or sustain organizational change. This paper reports on the design and implementation of a completely new pay system in the National Health Service (NHS) in England. 'Agenda for Change' constituted the largest-ever attempt to introduce a new pay system in the UK public services, covering more than one million staff. Its objectives were to improve the delivery of patient care as well as enhance staff recruitment, retention and motivation, and to facilitate new ways of working. Methods: This study was the first independent assessment of the impact of Agenda for Change at a local and national level. The methods used in the research were a literature review; review of 'grey' unpublished documentation provided by key stakeholders in the process; analysis of available data; interviews with key national informants (representing government, employers and trade unions), and case studies conducted with senior human resource managers in ten NHS hospitals in England Results: Most of the NHS trust managers interviewed were in favour of Agenda for Change, believing it would assist in delivering improvements in patient care and staff experience. The main benefits highlighted were: 'fairness', moving different staff groups on to harmonized conditions; equal pay claim 'protection'; and scope to introduce new roles and working practices. Conclusion: Agenda for Change took several years to design, and has only recently been implemented. Its very scale and central importance to NHS costs and delivery of care argues for a full assessment at an early stage so that lessons can be learned and any necessary changes made. This paper highlights weaknesses in evaluation and limitations in progress. The absence of systematically derived and applied impact indicators makes it difficult to assess impact and impact variations. Similarly, the lack of any full and systematic evaluation constrained the overall potential for Agenda for Change to deliver improvements to the NHS. [ABSTRACT FROM AUTHOR]

This paper reports the findings from an evaluation of a pilot interprofessional training ward project for pre-qualification medical, nursing, occupational therapy and physiotherapy students. This initiative required sustained collaboration from staff based in two National Health Service (NHS) trusts and four schools in three universities. The ward was based on a model of interprofessional education developed in Sweden, but adapted in the light of this experience and also to meet the needs and aspirations of the training ward stakeholders in London. The training ward was evaluated using a multi-method design. Data were collected from all participants involved in this pilot: students, facilitators and patients. The findings from the evaluation are presented and discussed. This paper pays particular attention to the collaborative experiences of the students, staff and institutions involved in this initiative. In addition, 1-year follow-up data collected from the students who had, by then, qualified as clinical practitioners are reported. The paper presents conclusions from the evaluation, and comments on the training ward's strengths, limitations and future development. [ABSTRACT FROM AUTHOR]

This paper discusses the topic of the relationship between organisational structure and information and communication systems by presenting a study of the organisational changes currently underway in the provision of NHS cancer services in the county of Kent. The paper describes the reasons for considering changes in the provision of services and outlines the major direction of change. It then links an earlier concern of information systems designers with 'Business Process Re-engineering' with the current concern with e-commerce and the redesign of systems prompted by the popularity of the Internet. It then presents possible organisations of an information system for a networked cancer service based on current organisational models used in e-commerce. [ABSTRACT FROM AUTHOR]

Background: The UK National Health Service Health Checks programme aims to reduce avoidable cardiovascular deaths, disability and health inequalities in England. However, due to the reported lower uptake of screening in specific black and minority ethnic communities who are recognised as being more at risk of cardiovascular disease, there are concerns that NHS Health Checks may increase inequalities in health. This study aimed to examine the feasibility and acceptability of community outreach NHS Health Checks targeted at the Afro-Caribbean community.Methods: This paper reports findings from an ethnographic study including direct observation of four outreach events in four different community venues in inner-city Bristol, England and follow up semi-structured interviews with attendees (n = 16) and staff (n = 4). Interviews and field notes were transcribed, anonymized and analysed thematically using a process of constant comparison.Results: Analysis revealed the value of community assets (community engagement workers, churches, and community centres) to publicise the event and engage community members. People were motivated to attend for preventative reasons, often prompted by familial experience of cardiovascular disease. Attendees valued outreach NHS Health Checks, reinforcing or prompting some to make healthy lifestyle changes. The NHS Health Check provided an opportunity for attendees to raise other health concerns with health staff and to discuss their test results with peers. For some participants, the communication of test results, risk and lifestyle information was confusing and unwelcome. The findings additionally highlight the need to ensure community venues are fit for purpose in terms of assuring confidentiality.Conclusions: Outreach events provide evidence of how local health partnerships (family practice staff and health trainers) and community assets, including informal networks, can enhance the delivery of outreach NHS Health Checks and in promoting the health of targeted communities. To deliver NHS Health Checks effectively, the location and timing of events needs to be carefully considered and staff need to be provided with the appropriate training to ensure patients are supported and enabled to make lifestyle changes. [ABSTRACT FROM AUTHOR]

Background: Public health provision in England is undergoing dramatic changes. Currently established partnerships are thus likely to be significantly disrupted by the radical reforms outlined in the Public Health White Paper. We therefore explored the process of partnership working in public health, in order to better understand the potential opportunities and threats associated with the proposed changes. Methodology/Principal Findings: 70 participants took part in an in-depth qualitative study involving 40 semi-structured interviews and three focus group discussions. Participants were senior and middle grade public health decision makers working in Primary Care Trusts, Local Authorities, Department of Health, academia, General Practice and Hospital Trusts and the third sector in England. Despite mature arrangements for partnership working in many areas, and much support for joint working in principle, many important barriers exist. These include cultural issues such as a lack of shared values and language, the inherent complexity of intersectoral collaboration for public health, and macro issues including political and resource constraints. There is particular uncertainty and anxiety about the future of joint working relating to the availability and distribution of scarce and diminishing financial resources. There is also the concern that existing effective collaborative networks may be completely disrupted as the proposed changes unfold. The extent to which the proposed reforms might mitigate or potentiate these issues remains unclear. However the threats currently remain more salient than opportunities. Conclusions: The current re-organisation of public health offers real opportunity to address some of the barriers to partnership working identified in this study. However, significant threats exist. These include the breakup of established networks, and the risk of cost cutting on effective public health interventions. [ABSTRACT FROM AUTHOR]

The use of skill mix in medicine is now widespread, yet it appears that its use in dentistry is not as prominent. Unlike doctors, dentists are required to mitigate the financial risk produced by their capital investment and ensure an adequate cash flow to cover their annual running costs. Examining the financial incentives for employing dental care professionals is therefore an important step to understand why dentistry appears to lag behind medicine in skill mix. It is also apposite, given the announcement of the coalition government to develop a new contract, which could introduce incentives for the use of dental care professionals in this way. The purpose of this short paper is to examine whether skill mix is profitable for general dental practices under the existing NHS contract in England. [ABSTRACT FROM AUTHOR]

This paper reports on the findings of work to develop a Clinical Leadership Competency Framework (CLCF) that will be used by all the regulated clinical professions across the UK. The CLCF was created, with the agreement of the NHS Institute for Innovation and Improvement and the Academy of Medical Royal Colleges, from the Medical Leadership Competency Framework (MLCF), which was created and developed and is owned jointly by the NHS Institute for Innovation and Improvement and the Academy of Medical Royal Colleges. Although the context and scenarios described in the MLCF are particular to doctors, the generic leadership competences were considered potentially applicable to all clinicians in their practitioner roles. The aim of this project was to work with the clinical professions to build leadership awareness and capability across the health service, by assessing the readiness of the clinical professions to embed leadership competences in undergraduate education, postgraduate training and continuing professional development. The work that has been undertaken to date shows that there is widespread recognition that leadership is important, and that the development of clinical leadership is viewed as absolutely critical. It represents a fundamental change in the way we train and educate clinicians. The next step for the CLCF project team is to work with professional bodies, regulators and education establishments to help them to embed the CLCF effectively, and this work is already under way. [ABSTRACT FROM AUTHOR]

The article presents a research paper which describes a postcode lottery effect in relation to the national health services (NHS) Health Checks Programme in eight Primary Care Trusts (PCTs) in the North West sector of London, England. It mentions that postcode lotteries in health refer to differences in health care between different geographic areas. It reports that the program provides tools which are used to identify and measure risk of cardiovascular disease and diabetes.

Abstract: Reducing avoidable inequalities in health is a priority in many health care systems, including the NHS in Great Britain. Evidence suggests that lifestyle factors may play a role in explaining socioeconomic inequalities in health. In this paper we measure the contribution of smoking and obesity to income-related inequality in health. We use the corrected concentration index to measure inequality across time and areas of England, and decomposition methods to quantify directly the contribution of smoking and obesity to income-related inequality. Instrumental variables regression is used to test the endogeneity of smoking and obesity. We use data from nine rounds of the Health Survey for England (1998–2006). The results show that there are significant income-related health inequalities in England, that the extent of the inequality varies by area, and that in some areas it has increased over time. Nationally, smoking and obesity make a significant but modest contribution to income-related inequality in health (2.3% and 1.2%, respectively). Despite the reduction in smoking prevalence, the contribution of smoking has slightly increased over time, due to its increasing concentration among the poor and its negative effect on health. While the prevalence of obesity is increasing, it is more equally distributed across society. The prevalence of these problems varies between areas, and so does the contribution they make to income-related inequalities in health. [ABSTRACT FROM AUTHOR]

Since the murder of Steven Hoskin, there have been considerable changes in the way that agencies in Cornwall operate. In order to prevent further tragedies on such a scale, a protocol was agreed by the agencies about when an alert should be triggered (Cornwall and Isles of Scilly Safeguarding Adults Board, 2008). This paper describes the process and implications of the protocol from the perspective of Devon and Cornwall Police, South Western Ambulance Service Trust and Cornwall and Isles of Scilly Primary Care Trust. The protocol has improved and encouraged information sharing within and between agencies, which will help to identify and reduce the risks to vulnerable adults. [ABSTRACT FROM AUTHOR]

This paper explores the compatibility of the recently modernized NHS pay structure, “Agenda for Change” (AfC) with the workforce flexibilities arising within intermediate care services in the NHS in England. The findings reported here were an unanticipated outcome of a larger, Department of Health (England) study which explored the impact of workforce flexibility on the costs and outcomes of older peoples' community-based services. The research coincided with the introduction of AfC, and, as such pay modernization was a strongly emergent theme from focus groups that involved 11 teams as part of the larger study. In principle, it appears that both intermediate care and AfC should support the concepts of interprofessional working, blurring of role boundaries and role substitution, however the findings from this study suggest otherwise. In particular, intermediate care was described as a largely non-hierarchical service structure where staff roles expand horizontally to take on a broad plethora of generic tasks. In contrast, AfC promotes a hierarchical framework for career progression that recognizes and rewards defined skills, expertise and responsibility. From this perspective, AfC was seen to reward specialization rather than skill sharing, and had difficulty differentiating between and rewarding staff with broad generalist roles. [ABSTRACT FROM AUTHOR]

With the increase in 'lifestyle' diseases linked to poor diet, obesity and lack of exercise, the NHS and UK Government face a significant challenge. This paper examines the development and impact of a social marketing programme -- Liverpool's Challenge -- to reduce obesity in Liverpool. Recognising that government campaigns promoting healthy eating and exercise tend to have limited success, Liverpool PCT's social marketing team focused on developing insights into the factors that motivate people to change their habits. They found that while most people were aware of the benefits of a healthier diet and were keen to lose weight, they found it difficult to stick to a long-term regime and often felt isolated and therefore unmotivated. The subsequent social marketing programme that was developed formed relationships with the target audience using customer relationship management techniques more commonly used in the commercial sector, to provide people with ongoing support and feedback within the framework of a city-wide challenge to residents to pledge to lose weight. [ABSTRACT FROM AUTHOR]

Recent health policy in England has demanded greater involvement of patients and the public in the commissioning of health and social care services. Public involvement is seen as a means of driving up service quality, reducing health inequalities and achieving value in commissioning decisions. This paper presents a summary and analysis of the forms that public involvement in commissioning are to take, along with empirical analysis from a qualitative study of service-user involvement. It is argued that the diversity of constituencies covered by the notion of 'public involvement', and the breadth of aims that public involvement is expected to achieve, require careful disaggregation. Public involvement in commissioning may encompass a variety of interest groups, whose inputs may include population needs assessment, evaluation of service quality, advocacy of the interests of a particular patient group or service, or a combination of all of these. Each of these roles may be legitimate, but there are significant tensions between them. The extent to which the structures for public involvement proposed recognize these possible tensions is arguably limited. Notably, new Local Involvement Networks (LINks), which will feed into commissioning decisions, are set as the arbiters of these different interests, a demanding role which will require considerable skill, tenacity and robustness if it is to be fulfilled effectively. [ABSTRACT FROM AUTHOR]

Background: This paper presents the methods and findings of a survey of current service configuration in tuberculosis screening, treatment and prevention in England and Wales, which was conducted as part of the development of the National Institute for Health and Clinical Excellence guidelines on tuberculosis for the country. Methods: A random sample of health protection units (HPUs) was surveyed (stratified geographically) in England. For Wales, National Health Service boundaries were used. There was a 100% sample of HPUs (33 clinics) in London and a 50% sample (81 clinics) outside London. The survey was completed by nurses in tuberculosis clinics. The questionnaire asked for details of caseload in terms of active disease (notified cases) and talent infection (screening and chemoprophylaxis), and the different types of specialist tuberculosis services offered. Results: Completed surveys were obtained from 67 of 81 clinics outside London and all 33 clinics in London. An association was found between the number of notifications and personnel, in line with previous British Thoracic Society guidelines. Higher notification areas, especially in London, provide additional specialist services such as human immunodeficiency virus/tuberculosis clinics and specialist paediatric clinics. Clinics in London also reported higher usage of incentives, directly observed therapy (DOT) and free prescriptions. Low notification areas outside London tend to see more patients at home for contact tracing and treatment review. However, there is considerable variation in the use of DOT and chemoprophylaxis that is not entirely explained by differences in caseload. Conclusions: The survey showed that service configuration was organized in different ways in both high and low incidence areas. There is a need to share good practice and explore ways to configure services effectively in line with local needs. [ABSTRACT FROM AUTHOR]

Objective: Delayed hospital discharges are a key concern in a number of industrialized nations and are the subject of a range of government initiatives in the English National Health Service. The aim of this paper was to review the UK literature on delayed hospital discharges and older people in order to identify and explore the rate and causes of delayed hospital discharges, together with policies and practices that may reduce delayed discharges and improve the experiences of older people. Methods: Literature review based on searches of major health/social-care databases. Sources which explore the rate and cause of delayed discharges in the UK were included. Relevant documents were categorized using the research hierarchy set out in the National Service Framework for Older People and analysed according to criteria for appraising the quality of qualitative research proposed by Mays et al. Results: The review identified 21 studies, which suggest very different rates and causes of delayed discharge in different settings. The studies reveal the importance of rehabilitation services to reduce the rate of delayed discharge, the prevalence of delayed discharges caused by internal hospital factors, and the complex and multi-faceted nature of the factors contributing to delayed discharge. Despite this, the studies have a number of methodological flaws and often fail to include a patient perspective or to consider detailed policies and approaches to reduce the number of delayed discharges. There is also a failure to consider the needs of older people with mental health problems or people from minority ethnic communities. Conclusion: The evidence, as it currently stands, raises a number of issues about current hospital discharge policy, supporting some aspects of the current government agenda in England, but questioning other aspects. [ABSTRACT FROM AUTHOR]

This article outlines the historical context that led to an employee counselling service in an NHS Trust in the North East of England being established. It describes the process of implementation and development of the Service. It evaluates the Service using data collated from those using the Service and also client evaluation reports. It critically analyses the data collated from use of the Service after two years. The paper concludes that one of the key issues of the 'Health at Work in the NHS' Initiative—that of staff support—is continuing to be appropriately addressed through the presence of the Service. Although the future of the service is uncertain due to mergers within the Health Trust, indicators still show that staff value and benefit from the Service. [ABSTRACT FROM AUTHOR]

This paper outlines the author's attempt to design and introduce a corporate identity into the Department of Medical Illustration at the South Buckinghamshire NHS Trust. It is intended to furnish the reader with an insight into the process of designing a corporate identity and to relate one department's experience. This may be useful for those who wish to develop a corporate identity of their own or contribute, as a department, towards an identity for their own Trust or other institution. A major change in government policy about the identity of NHS Trusts has meant that use of the department's new logo has had to be abandoned in favour of the new NHS corporate identity. [ABSTRACT FROM AUTHOR]

Neurorehabilitation usually has two objectives: Managing the initial phase of patient improvement and ensuring long-term support for continuing disability. The UK National Health Service (NHS) provides acute neurorehabilitation within general hospital wards and specialist units, but arrangements for long-term placement are less satisfactory. NHS health authorities, administrative agencies responsible for the health of defined local populations of about half a million, hold resources for purchasing both acute and long-term medical and nursing services; long-term care usually also requires financial support from municipal social services departments. The patient's health status may be used in assessing the need for services, but little information on clinical outcome is available for purchasers. This paper describes purchasing for neurorehabilitation in a London health authority, and suggests how the arrangements could be improved. [ABSTRACT FROM AUTHOR]

The article analyses British Health Secretary Andrew Lansley's privatisation plans for National Health Service (NHS). In a white paper presented by Lansley on July 12, 2001, the health secrerary noted that any willing healthcare provider will be allowed to deliver services to NHS patients as long as they provide high quality standards of care. Information is presented on the failure of Hinchingbrooke, a 369 bed complex in Cambridgeshire, England, which could be the first to be privatised under the initiative.

Green paper introduces proposals that will see older people being means tested for accommodation fees. [ABSTRACT FROM AUTHOR]