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The article references the paper published by the journal in 2015 on the association between day of admission and mortality, which health secretary Jeremy Hunt apparently used in his House of Commons speech on July 16, 2015, claiming that 6,000 people die yearly because of lack of a proper seven day service in hospitals. Topics discussed include where the 6,000 figure came from, whether the Department of Health (DH) commissioned the new analysis, and whether data were shared with the DH.

Focuses on the final session of the Chichester Conference of the National Health Service organization in Great Britain. Discussion on the status of natural units of health organization; Sense of professional identification among the members; Delegation to divisions and working units.

Presents comments on the impact of white paper on the National Health Service (NHS) of Great Britain. Assertions on the significance and focus of the paper in specialist services; Comments on the significance of chapters four, five and six of the paper; Account on the effect of the paper on minority groups.

Focuses on the alternative of the white paper regarding the improvement of the effectiveness of clinical care in the National Health Service in Great Britain. Definition of quality of care; Increase of the annual rate of medical care expenditure; Standardization of diagnostic methods.

Examines the reaction of general practitioners towards the proposals contained in the white paper 'Working for Patients' in Great Britain. Rejection of the proposals by general practitioners; Criticisms on the implementation of fixed budgets for specified surgical operations; Concerns on the cost effectiveness of the National Health Service.

Focuses on the growth and restructuring of the National Health Service (NHS). Impact of medical insurance and hospital independent revenues; Role of the NHS as the catalysts; Collaboration of top companies for better hospitals.

The article reports on the joint campaign launched by British trade unions including Unison, Unite and the GMB, in September 2010 to block the coalition government's health white paper "Equity and Excellence: Liberating the NHS." The campaign aims to encourage National Health Service (NHS) staff and patients against the white paper. Further, the unions argue that all hospitals are being turned into independent businesses, and that the scheme will revert back wealth-based healthcare. The Royal College of General Practitioners also raised concerns.

Focuses on the funding of the National Health Service in Great Britain. Response of the government to the problem of NHS crisis in 1987 to 1988 period; Proposals for efficient NHS; Significance of white paper on the performance of medical professionals; Need of measures of patient satisfaction to medical services.

The article suggests that the efforts of the British government to reform the National Health Service (NHS) are under threat from other factors that aim to hasten competition in the health service, according to the British Medical Association (BMA) in October 2010. As mentioned in the government's White Paper "Equity and Excellence: Liberating the NHS," reform efforts will allow more control to patients and frontline clinicians and promote stronger attention on public health. The other arguments of BMA are further explained by chairman Hamish Meldrum.

The article presents blogs from health care professionals on the 80 billion British pound National Health Service (NHS) commissioning budget and the white paper "Equity and Excellence: Liberating NHS."

Reports on the move of doctors not to cooperate in the implementation on proposal to reform National Health Services (NHS) in Great Britain. Arguments to persuade government and public on impracticality of proposal; Failure on acknowledging NHS problem; Impairment of the ability of hospital authorities to coordinate services effectively.

Focuses on the campaign against the white paper related to patient care in the National Health Service in Great Britain. Debate on the proposals by the British Medical Association council; Discussions on the letter from the chief medical officer; Implications of the white paper to professional awareness.

Focuses on the publication of the working papers of the National Health Service (NHS) in Great Britain. Renegotatiation of the contracts of general practitioners; Implementation of the NHS review; Role of the Department of Health in the distribution of the working papers to general practitioners.

Focuses on the white paper negotiations of the General Medical Service Committee in Great Britain. Completion of the Health and Medicine Bill committee stage; Review of the long term funding of the National Health Service (NHS); Reference term of the prime minister on the internal review of the NHS.

Reports on professional organizations' welcoming of proposals in the December 1997 white paper on the National Health Service (NHS) in England. Promotion of clinical and cost effectiveness of treatments by the National Institute for Clinical Excellence; Support for the dismantling of the internal market; Need for more capital investments if services were to be improved.

Presents the response related to the government's white paper proposals for the National Health Services in Great Britain. Scrutiny on the composition of self-governing hospitals and general practitioners' budgets; Interrelations of the program with two-tier system in the medical field; Need to prioritize primary care for elderly and the sick.

Reports on the plans of the restructuring of the National Health Service (NHS) in Great Britain. Effects of the plans on health authorities, hospital managers and family doctors; Speculations of the changes on the NHS Management Board; Uncertainty of the decisions of NHS Chief Executive Duncan Nichol.

The article reports on a legal challenge launched by the British public service union Unison to the healthcare reforms proposed by the coalition government. The basis for the legal challenge was the failure of Health Secretary David Nicholson to consult the public on the plans. The union warned that the proposals would entail fundamental changes to the operation of the National Health Service (NHS) and that the public should be given an opportunity to comment on them. In response, the Department of Health claimed it is engaging fully on the issue.

Focuses on the medical issues presented at the meeting of the Association of Community Health Councils in Great Britain. Emphasis of John Patter, health minister on the services of physician to patients; Arguments related to pay awards initiated by the National Health Services; Controversies concerning termination of pregnancy practices.

Presents a letter for Health Secretary Frank Dobson pertaining to ideas on how to improve the National Health Service (NHS) in Great Britain. View on the machinery of the health authority; Suggestion on how to change the culture within the NHS.

Discusses the British government's ten year plan for the National Health Service on the . Focus of the programme; Key feature of the programme; Aim of the plan. INSET: Key components of the ten year plan....

The author outlines some of the things that have been observed in ward care for older people, from the study "Dignity in Practice," which focused on failing to see patients as individuals. Topics mentioned include mission statements in the National Health Service in England, passing of referrals to intermediate care services in the community, and refusal to take patients back into their residential homes from hospital until they have been reassessed.

Focuses on the rejection of the general practitioners of the government's National Health Service (NHS) in Great Britain. Rejection of the government's proposal for general practitioners; Views regarding the white paper of the NHS; Compatibility of the concepts of the white paper with the principles of the NHS.

The author examines the implications of the white paper "Transparency in Outcomes--A Framework for the NHS" for hospital consultants. He discusses four broad themes of the white paper released by the coalition government of Great Britain which are important in addressing issues concerning hospital consultants and their patients. He describes changes in the country's health system under the proposals from the white paper.

BACKGROUND: Smoking is one of the biggest avoidable causes of morbidity and mortality in the United Kingdom. This paper quantifies the current health and economic burden of smoking in the UK. It provides comparisons with previous studies of the burden of smoking in the UK and with the costs for other chronic disease risk factors. METHODS: A systematic literature review to identify previous estimates of National Health Service costs attributable to smoking was undertaken. Information from the World Health Organization’s Global Burden of Disease Project and routinely collected mortality data were used to calculate mortality due to smoking in the UK. Population-attributable fractions for smoking-related diseases from the Global Burden of Disease Project were applied to NHS cost data to estimate direct financial costs. RESULTS: Previous studies estimated that smoking costs the NHS about £1.4 billion to £1.7 billion in 1991 and has been responsible for about 100 000 deaths per annum over the past 10 years. This paper estimates that the number of deaths attributable to smoking in 2005 was 109 164 (19% of all deaths, 27% deaths in men and 11% of deaths in women). Smoking was directly responsible for 12% of disability adjusted life years lost in 2002 (15.4% in men; 8.5% in women) and the direct cost to the NHS was £5.2 billion in 2005–6. CONCLUSION: Smoking is still a considerable public health burden in the UK. Accurately establishing the burden in terms of death, disability and financial costs is important for informing national public health policy. [ABSTRACT FROM AUTHOR]

The author argues that the National Health Service (NHS) in Great Britain needs general practitioners (GP) who are focused on patient-centered values. He emphasizes the role of GP in providing high quality care. He claims that the GP leaders needed by the NHS are those who are motivated to improve patient care and those who are committed to care for individual patients. The author also suggests ways in which GP can perform their commissioning responsibility under the British government's practice-based commissioning scheme.

Cognitive behavioural therapy (CBT) has risen to prominence as an orthodox treatment option which is commonly recommended to patients with anxiety and depressive disorders. Mainstream healthcare institutions (including the National Health Service in the UK (NHS) and National Institute for Mental Health (NIMH)) assume that CBT works by helping patients to challenge and overcome 'faulty cognition'. Even if we accept the empirical evidence which shows that CBT (like other forms of psychotherapy) is a beneficial treatment there are still problems with this therapy: mainstream medicine and psychotherapy are continuing to ignore established research that CBT does not work according to its core theoretical tenets. This paper presents evidence that psychotherapy is entrenched in such conventional 'wisdom' and that practitioners are failing to meet their own codified requirement of informed consent. I examine ethical arguments for and against upholding current informed consent procedures and focus, in particular, on the relationship between respect for patient autonomy and the duty of beneficence. I argue that (so far) there are no strong grounds for the claim that patient autonomy undermines therapeutic outcome. The modest conclusion of this paper is that psychotherapy (including CBT) needs to begin to adapt informed consent procedures to comply with ongoing scientific research into its efficacy. [ABSTRACT FROM AUTHOR]

Editorial. Discusses the National Health Service (NHS) in the United Kingdom. Emphasis of NHS reform proposals; Responsibility of primary care groups; What was intended for primary care groups; Clarification requested by the General Medical Services Committee from the federal government.

The NHS in England is an organisation undergoing substantial change. The passage of the Health and Social Care Act 2012, consolidates and builds on previous health policies and introduces further 'market-style' reforms of the NHS. One of the main aspects of these reforms is to encourage private and third sector providers to deliver NHS services. The rationale for this is to foster a more competitive market in healthcare to encourage greater efficiency and innovation. This changing healthcare environment in the English NHS sharpens the need for attention to be paid to the ethical operation of healthcare organisations. All healthcare organisations need to consider the ethical aspects of their operation, whether state or privately run. However, the changes in the type of organisations used to provide healthcare (such as commercial companies) can create new relationships and ethical tensions. This paper will chart the development of organisational ethics as a concern in applied ethics and how it arose in the USA largely owing to changes in the organisation of healthcare financing and provision. It will be argued that an analogous transition is happening in the NHS in England. The paper will conclude with suggestions for the development of organisational ethics programmes to address some of the possible ethical issues raised by this new healthcare environment that incorporates both private and public sector providers. [ABSTRACT FROM AUTHOR]

The authors assess the health care reform proposal of the new British government for the National Health Service (NHS) in 2010. Accordingly, the government aims to promote the involvement of public sector in influencing public health policy. They explain the advantage of placing public health directors and their teams in the council architecture. For comparison, the authors reference the health care reform efforts in the U.S.

The health of the medical workforce, within the UK, has been described as an unmet public health need. Reports of stress, burnout and ill health are continuing to rise. Burnout is when meaningful and challenging work becomes unpleasant and unfulfilling; energy turns into exhaustion; enthusiasm turns into cynicism and efficacy turns into ineffectiveness. Stress is an individual's physical and psychological response to single or multiple pressures. Low-level stress, or 'healthy stress', is essential. Stress becomes unhealthy when pressures exceed one's perceived ability to cope and the response to the pressures becomes counterproductive, leading to a decrease in performance. Resilience is the capability to develop and adapt to challenges and discover new ways forward, without negative consequences on one's well-being. This paper discusses stress and burnout within the healthcare profession; strategies to cope with the demands of the workplace through a reflective scenario, along with well-being and mindfulness resources for managing stress and promoting resilience. The five ways to well-being and mindfulness practice are simple measures that can be built into one's daily life to increase resilience against excess stress and pressures. The coping matrix is a practical tool to encourage reflecting upon and developing one's own coping strategies. A good healthcare professional is one who is compassionate to themselves and their own well-being, enabling them to care and treat their patients. [ABSTRACT FROM AUTHOR]

Background Health systems worldwide are increasingly holding boards of healthcare organisations accountable for the quality of care that they provide. Previous empirical research has found associations between certain board practices and higher quality patient care; however, little is known about how boards govern for quality improvement (QI). Methods We conducted fieldwork over a 30-month period in 15 healthcare provider organisations in England as part of a wider evaluation of a board-level organisational development intervention. Our data comprised board member interviews (n=65), board meeting observations (60 hours) and documents (30 sets of board meeting papers, 15 board minutes and 15 Quality Accounts). We analysed the data using a framework developed from existing evidence of links between board practices and quality of care. We mapped the variation in how boards enacted governance of QI and constructed a measure of QI governance maturity. We then compared organisations to identify the characteristics of those with mature QI governance. Results We found that boards with higher levels of maturity in relation to governing for QI had the following characteristics: explicitly prioritising QI; balancing short-term (external) priorities with long-term (internal) investment in QI; using data for QI, not just quality assurance; engaging staff and patients in QI; and encouraging a culture of continuous improvement. These characteristics appeared to be particularly enabled and facilitated by board-level clinical leaders. Conclusions This study contributes to a deeper understanding of how boards govern for QI. The identified characteristics of organisations with mature QI governance seemed to be enabled by active clinical leadership. Future research should explore the biographies, identities and work practices of board-level clinical leaders and their role in organisation-wide QI. [ABSTRACT FROM AUTHOR]

This paper examines the UK Supreme Court decision in Montgomery v Lanarkshire Health Board, which deals with consent and information disclosure in medical treatment and care. It signaled a move away from a 'doctor knows best' approach to one that focuses on disclosing information to which particular patients would attach significance. Notwithstanding concerns about increased litigation and loss of professional autonomy, the reality is that the decision will make little difference to healthcare practice and consent in the UK. The Supreme Court has endorsed a view that most lawyers and doctors thought already prevailed, and it reflects the General Medical Council's guidance on the issue of consent in any case. Given recent healthcare scandals in the National Health Service (NHS), the Supreme Court's legal recognition of the importance of recognizing patient autonomy in disclosing risks about medical treatment and care is a welcome development. [ABSTRACT FROM AUTHOR]

The model for delivery of primary eye care in Europe varies from country to country with differing reliance on ophthalmologists, optometrists and dispensing opticians. Comparative analysis of models has tended to focus on inter professional working arrangements, training and regulatory issues, rather than on whether a particular model is effective for delivering public health goals for that country. National Health Service (NHS) primary eye care services in the UK are predominantly provided under a General Ophthalmic Services (GOS) Contract between the NHS and practice owners (Contractors).Over two-thirds of sight tests conducted in England,Wales and Northern Ireland and all in Scotland are performed under a GOS Contract, however many people entitled to a GOS sight test do not take up their entitlement. The fee paid for sight tests conducted under a GOS Contract in England, Wales and Northern Ireland does not cover the full cost of conducting the examination. The shortfall must be made up through profits of sale of optical appliances but this business model can be a deterrent to establishing practices within socioeconomically deprived communities, and can also be a barrier to uptake of sight tests, even though many people are entitled to a NHS optical voucher towards the cost of spectacles or contact lenses. This paper critiques the GOS Contracts within the UK. We argue that aspects of the way the GOS Contract is implemented are contrary to the public health interest and that different approaches are needed to address eye health in equalities and to reduce preventable sight loss. [ABSTRACT FROM AUTHOR]

Decisions on which new health technologies to provide are controversial because of the scarcity of healthcare resources, the competing demands of payers, providers and patients and the uncertainty of the evidence base. Given this, additional information about new health technologies is often considered valuable. One response is to make access to a new health technology conditional on further research. Access can be restricted to patients who participate in a research study, such as a randomised controlled trial; alternatively, a new treatment can be made generally available, but only on condition that further evidence is collected (eg, on long-term outcomes and adverse events, in patient registries). The National Institute for Health and Clinical Excellence (NICE), which provides guidance on which new health technologies to make available under the UK's NHS, for example, has made some research conditional recommendations, and the current interest in such options suggests that they are likely to become more prevalent in the future. This paper identifies and discusses the main ethical issues created by this distinctive range of recommendations. We argue that decisions to put research conditions on access to new technologies are compatible with widely accepted values, principles and practices relevant to resource allocation. However, there are important features of these distinctive judgements that must be taken into account by resource allocation decision-making bodies and research ethics committees, and that require new sorts of empirical data. [ABSTRACT FROM AUTHOR]

There is currently an unrecognised conflict between the utilitarian nature of the overall NHS and the basic deontology of the doctor-patient interaction. This conflict leads to mistrust and misunderstanding between managers and clinicians. This misunderstanding is bad for both doctors and managers, and also leads to waste of time and resources, and poorer services to patients. The utilitarian thinkers (mainly managers and politicians) tend to value finite, short term, evidence based technical interventions, delivered according to specifications and contracts. They appear happy to break care up into smaller pieces, which can then be commissioned from multiple providers. The deontological thinkers (mainly doctors and other clinicians) tend to think about care delivered through a long term continuous relationship, and regard that relationship as therapeutic and salutogenic in itself. To them breaking care up into smaller fragments is a denial of what caring is really about. Very rarely are either or both sides of this debate fully aware of where their powerfully felt and often well argued positions start from. In this paper we offer an appraisal of the strengths and weaknesses of both moral viewpoints as applied in the UK NHS context and we suggest a way in which they can be reconciled, provided neither is pushed too far or too hard against the other. We believe this reconciliation would be good for patients, doctors, managers and improve the service as a whole. [ABSTRACT FROM AUTHOR]

The article highlights the views of various commentators on the white paper "Equity and Excellence: Liberating the NHS." John Appleby, chief economist of The King's Fund, argues that choice has never been a reality for most patients and primary care trusts in Great Britain. Consultant chest physician Peter Davies claims that reorganization is irrelevant to the needs of the health service. While Jacky Davis, co-chair of the NHS Consultants' Association, argues that the white paper will improve the commissioning and delivery of National Health Service (NHS) care by the private sector.

The discourse on the failings of the National Health System often cites lack of compassion as an important factor. This has resulted in proposals to enact rules which aimed at enforcing compassion in healthcare workers so as to improve the quality of healthcare and avoid future scandals. This paper argues that compassion cannot be enforced by any rule. Moreover, the contractual nature of the current doctor-patient relationship does not foster it. Experience from other service industries shows that attempts to enforce compassion in workers are futile. Rather than improving service, these attempts result in a culture of perfunctoriness and cynicism. [ABSTRACT FROM AUTHOR]

The author reflects on how micromanagement has turned the "seven day NHS (National Health Service)" idea into a battle. Topics discussed include a 2015 article published in the journal showing excess mortality in patients admitted at weekends, which was used by health secretary Jeremy Hunt in his speech attacking senior doctors for resisting a seven day contract, the concern on authors possibly sharing their main findings before publication, and Hunt's apparent wrong usage of the information.

Significant changes are proposed for the research ethics system governing the review of the conduct of medical research in the UK. This paper examines these changes and whether they will meet the aimed-for goal of improving the efficiency of the research ethics system. The author concludes that, unfortunately, they will not and thus should be rejected. [ABSTRACT FROM AUTHOR]

The objective of this paper is to apply a framework for country-level performance assessment to the cities of Montreal, Canada, and Barcelona, Spain, and to use this framework to explore and understand the differences in their health systems. The UK National Health Service Performance Assessment Framework was chosen. Its indicators went through a process of selection, adaptation and prioritisation. Most of them were calculated for the period 2001-3, with data obtained from epidemiological, activity and economic registries. Montreal has a higher number of old people living alone and with limitations on performing one or more activities of daily life, as well as longer hospital stays for several conditions, especially in the case of elderly patients. This highlights a lack of mid-term, long-term and home care services. Diabetes-avoidable hospitalisation rates are also significant in Montreal, and are likely to improve following reforms in primary care. Efficient health policies such as generic drug prescription and major ambulatory surgery are lower in Barcelona. Rates of caesarean deliveries are higher in Barcelona, owing to demographics and clinical practice. Waiting times for knee arthroplasty are longer in Barcelona, which has triggered a plan to reduce them. In both cities, avoidable mortality and the prevalence of smoking have been identified as areas for improvement through preventive services. In conclusion, performance assessment fits perfectly in an urban context, as it has been shown to be a useful tool in designing and monitoring the accomplishment of programmes in both cities, to assess the performance of the services delivered, and for use in policy development. [ABSTRACT FROM AUTHOR]

The UK government has recently taken steps to exclude certain groups of migrants from free treatment under the National Health Service, most controversially from treatment for HIV. Whether this discrimination can have any coherent ethical basis is questioned in this paper. The exclusion of migrants of any status from any welfare system cannot be ethically justified because the distinction between citizens and migrants cannot be an ethical one. [ABSTRACT FROM AUTHOR]

Presently, there is a movement in the UK research governance framework towards what is referred to as proportional ethical review. Proportional ethical review is the notion that the level of ethical review and scrutiny given to a research project ought to reflect the level of ethical risk represented by that project. Relatively innocuous research should receive relatively minimal review and relatively risky research should receive intense scrutiny. Although conceptually attractive, the notion of proportional review depends on the possibility of effectively identifying the risks and ethical issues posed by an application with some process other than a full review by a properly constituted research ethics committee. In this paper, it is argued that this cannot be achieved and that the only appropriate means of identifying risks and ethical issues is consideration by a full committee. This implies that the suggested changes to the National Health Service research ethics system presently being consulted on should be strenuously resisted. [ABSTRACT FROM AUTHOR]

Background: Despite evidence that physical inactivity is a risk factor for a number of diseases, only a third of men and a quarter of women are meeting government targets for physical activity. This paper provides an estimate of the economic and health burden of disease related to physical inactivity in the UK. These estimates are examined in relation to current UK government policy on physical activity. Methods: Information from the World Health Organisation global burden of disease project was used to calculate the mortality and morbidity costs of physical inactivity in the UK. Diseases attributable to physical inactivity included ischaemic heart disease, ischaemic stroke, breast cancer, colon/rectum cancer and diabetes mellitus. Population attributable fractions for physical inactivity for each disease were applied to the UK Health Service cost data to estimate the financial cost. Results: Physical inactivity was directly responsible for 3% of disability adjusted life years lost in the UK in 2002. The estimated direct cost to the National Health Service is £1.06 billion. Conclusion: There is a considerable public health burden due to physical inactivity in the UK. Accurately establishing the financial cost of physical inactivity and other risk factors should be the First step in a developing national public health strategy. [ABSTRACT FROM AUTHOR]

The author discusses a paper related to clinical care to patients in Great Britain and failures of various health institutions within the National Health Service (NHS) to provide adequate levels of clinical care in Staffordshire, England. He mentions that authors of the paper, C. Newdick and C. Danbury possible defines possible reasons behind serious failures of care within the NHS such as financial pressures.

Digital health education develops an understanding of the pragmatic use of digital technologies, including health apps, artificial intelligence and wearables, in the National Health Service (NHS). Staff should feel confident accessing up-to-date, quality-assured digital health solutions. Digital health is a high priority in government, NHS organisations and Royal Colleges. However, there is a gap between what is expected and the education of staff or medical students to enable implementation. Digital health education needs to be up to date and universally included within training, continuing professional development activities and medical school curriculums. During COVID-19, more families across the UK became digitally enabled with school, council, charities and governments providing access to devices, WiFi and mobile data for those that needed it. Improved digital access brings equalities in access to health information and healthcare professionals. Health app use sharply rose during COVID-19, as patients self-managed and took control of their conditions, but most health apps do not reach NHS standards. Paediatricians are well positioned to advise on appropriate health app use and advocate for improved patient access to solutions. Many paediatricians adopted remote video consultations during the COVID-19 pandemic but could soon adopt more digital health strategies to remotely track, monitor and manage conditions remotely. Patient management now includes remote consultations and digital health solutions; therefore, medical histories should capture digital access, environments and literacy. This article explains the importance of digital health education, lists accessible resources and provides examples of health apps that can be recommended. [ABSTRACT FROM AUTHOR]

The UK National Health Service (NHS) has long espoused patient and public engagement. Recent years have seen increasing use of internet-based methods of collecting feedback about patient experience and public and staff views about NHS services and priorities. Often hailed as a means of facilitating participative democratic patient engagement, these processes raise a number of complex issues. A key aspect of it is the opportunity for comment to be made anonymously. Our research reveals an anonymity paradox whereby patients clearly demonstrate a perception that anonymity is a prerequisite for effective use of these feedback processes, whereas professionals demonstrate a perception that patient anonymity is a barrier to effective use. The risks of anonymity are constructed very differently by patients and professionals. Patient concerns around anonymity were not motivated by a general concern about a loss of privacy, but more that a positive identification might compromise future care. For professionals, concerns were voiced more around risks of reputational damage for specific practitioners or practices (in that anyone could say anything) and also that this anonymous feedback was available publicly and that it might go against the medical opinion of the professional. These concerns pointed to important differences in perceptions of patient and professional vulnerability. In the qualitative analysis that follows the key finding was that while anonymity makes service users feel less vulnerable, it can have the opposite effect on managers and clinical staff. This raises important implications for the use and utility of internet-based methods of collecting patient feedback. [ABSTRACT FROM AUTHOR]