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Aim: The Counterweight‐Plus weight management programme achieved 46% remission of Type 2 diabetes at 1 year in the DiRECT trial. We estimated the implementation costs of the Counterweight‐Plus programme and its 1‐year cost‐effectiveness in terms of diabetes remission, compared with usual care, from the UK National Health Service (NHS) perspective. Methods: Within‐trial total costs included programme set‐up and running costs (practitioner appointment visits, low‐energy formula diet sachets and training), oral anti‐diabetes and anti‐hypertensive medications, and healthcare contacts. Total costs were calculated for aggregated resource use for each participant and 95% confidence intervals (CI) were based on 1000 non‐parametric bootstrap iterations. Results: One‐year programme costs under trial conditions were estimated at £1137 per participant (95% CI £1071, £1205). The intervention led to a significant cost‐saving of £120 (95% CI £78, £163) for the oral anti‐diabetes drugs and £14 (95% CI £7.9, £22) for anti‐hypertensive medications compared with the control. Deducting the cost‐savings of all healthcare contacts from the intervention cost resulted an incremental cost of £982 (95% CI £732, £1258). Cost per 1 year of diabetes remission was £2359 (95% CI £1668, £3250). Conclusions: Remission of Type 2 diabetes within 1‐year can be achieved at a cost below the annual cost of diabetes (including complications). Providing a reasonable proportion of remissions can be maintained over time, with multiple medical gains expected, as well as immediate social benefits, there is a case for shifting resources within diabetes care budgets to offer support for people with Type 2 diabetes to attempt remission. (Clinical Trial Registry No.: ISRCTN03267836) What's new?: Diabetes and its complications account for about 10% of healthcare budgets worldwide.The Counterweight‐Plus weight management programme in DiRECT achieved 46% remissions of Type 2 diabetes and improved cardiovascular risk factors at 1 year.One‐year incremental cost for the intervention group was estimated at £982 (95%CI £732, £1,258) per participant compared to the control arm.Providing the DiRECT/Counterweight‐Plus intervention in primary care incurs a cost (£2359 per 1‐year diabetes remission) below the average annual direct cost of managing a person with Type 2 diabetes (including its complications), and has the potential for long‐term cost‐effectiveness.Providing that a reasonable proportion of remissions can be maintained over time, with multiple medical gains expected, and immediate social benefits, there is a case for shifting resources within diabetes care budgets to offer support for people with diabetes to attempt remission as early as possible after diagnosis. [ABSTRACT FROM AUTHOR]

This article argues that the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 are fatally flawed notwithstanding the apparent rigour of the process which produced them. These Regulations were the product of considerable deliberation following a sensitively executed public inquiry yet, it is argued, they rely too heavily on the rhetoric of criminal law while failing to take into account the competing norms for compliance and the impact of NHS budget constraints. Further, they push the CQC towards a heavy-handed deterrence approach to enforcement, which will increase hostility between regulatees and the inspectorate, and ultimately reduce the scope for developing the transparency about failures which is sorely needed in the NHS. This article challenges the contemporary wisdom that it is primarily knee-jerk regulatory responses that suffer from fatal flaws of this nature. [ABSTRACT FROM AUTHOR]

There is considerable evidence to suggest that racial and ethnic disparities exist in the provision of emergency and wider healthcare. The importance of collecting patient ethnic data has received attention in literature across the world and eliminating ethnic and racial health equalities is one of the primary aims of healthcare providers internationally. The poor health status of certain racial and ethnic groups has been well documented. The improvement of racial and ethnic disparities in healthcare is at the forefront of many public health agendas. This article addresses important policy, practice, and cultural issues confronted by the pre-hospital emergency care setup. This aspect of care plays a unique role in the healthcare safety net in providing a service to a very diverse population, including members of ethnic and racial minorities. Competent decision making by the emergency care practitioners requires patient-specific information and the health provider's prior medical knowledge and clinical training. The article reviews the current ethnicity trends in the UK along with international evidence linking ethnicity and health inequalities. The study argues that serious difficulties will arise between the health provider and the patient if they come from different backgrounds and therefore experience difficulties in cross-cultural communication. This adversely impacts on the quality of diagnostic and clinical decision making for minority patients. The article offers few strategies to address health inequalities in emergency care and concludes by arguing that much more needs to be done to ensure that we are hearing the voices of more diverse groups, groups who are often excluded from engagement through barriers such as language or mobility difficulties. [ABSTRACT FROM AUTHOR]

This paper explores the place that qualified social workers will have in the world of self-directed support and personalisation. Using material from two case studies it argues that continued social work assistance is needed for many service users given the levels of complexity that typify their lives. It also notes that numerous local authorities are reducing the involvement of qualified social workers, citing the need to maximise the levels of choice and control that people have over their lives by reducing external involvement while responding to major financial cuts. It suggests that the consequences of this could be serious for many people, given the chaotic and dangerous nature of their life choices. However, since the allocation of social workers rests with bodies outside of the profession itself it has little direct control of the sorts of practice with which it is engaged. [ABSTRACT FROM AUTHOR]

The author discusses the changes made to the National Health Service (NHS) in Great Britain. She mentions that a key alteration is to shift duty for commissioning services to general practitioners (GPs) responsible for determining how to spend approximately 80% of the budget of the NHS. She states that organizations owned by NHS that operate hospitals will be converted to the status of independent Foundation Trust.

The purpose of this paper is to provide information about cost-effectiveness analysis and the roles of clinical pharmacologists generally in providing efficient health care. The paper highlights the potential consequences of ‘off-label prescribing’ and ‘indication creep’ behaviour given slower growth (or potential cuts) in the NHS budget. This paper highlights the key roles of clinical pharmacologists in delivering an efficient health care system when resources are allocated using cost-effectiveness analyses. It describes what cost-effectiveness analysis (CEA) is and how incremental cost-effectiveness ratios (ICERs) are used to identify efficient options. After outlining the theoretical framework within which using CEA can promote the efficient allocation of the health care budget, it considers the place of disinvestment within achieving efficient resource allocation. Clinical pharmacologists are argued to be critical to providing improved population health under CEA-based resource allocation processes because of their roles in implementation and disinvestment. Given that the challenges facing the United Kingdom National Health Service (NHS) are likely to increase, this paper sets out the stark choices facing clinical pharmacologists. [ABSTRACT FROM AUTHOR]

The article discusses the need of taking an active approach to medicines management. Topics discussed include value out of medicines and National Health Society (NHS) resources is a key determinant of sustainable healthcare in Great Britain; notes that NHS culture prevent evidence based evaluations from being maximized in clinical practice; and importance of training and educating patients.

This article provides an overview of the growing importance of measuring quality in primary care nursing. Many of the tools used in practice centre on demonstrating certain patient safety indicators, care outcomes and patient experience indicators. The limitations of current measurement tools are discussed. Quality tools will evolve as the evidence base around effectively measuring quality in community practice grows. The tools discussed in this paper relate primarily to those used in England, but they have resonance to practitioners working across the UK. [ABSTRACT FROM AUTHOR]

By 2014 the NHS is expected to make £21 billion in efficiency savings and increase productivity by 6% per annum, while maintaining or improving the quality of care. Given that the cost of the 1.7 million strong workforce represents 60% of the NHS budget, changes are likely. This context of innovation and cost-effectiveness has resulted in an ever greater emphasis to fully engage and support community nursing. [ABSTRACT FROM AUTHOR]

Emeritus Professor Alan Glasper, from the University of Southampton, discusses the recently published government mandate for the NHS which sets out seven priority objectives to meet by 2020 [ABSTRACT FROM AUTHOR]

The article reports that National Health Service England has called on to form a nursing well-being reference group to advise on improving working conditions. Topics mentioned include an increase in the number of student places in England by 25 percent, thoughts from Royal College of Nursing official Sally Bassett on the impact of high vacancy rates on nurse leaders, and percentage of decrease in the number of new joiners from other countries in the European Economic Area.

Focuses on the budgeting scheme adopted by the National Health Services in Great Britain. Impact of the fundholding technique to patient care; Appropriations for the health care system; Efficacy of the budget holding practices.

The article focuses on the changes made in medical service in Great Britain. Doctors are more worried on the available budget for heath care than their technical competence when providing their service. The creation of the National Health Service (NHS) in 1948 and other reorganizations and the availability of medical benefits have affected the physician-patient relationship. The emergence of new technology and knowledge influences how young doctors think and communicate.

John Tingle discusses, in the first of a two-part column, a report from the NIHR Patient Safety Translational Research Centre on the priorities and direction that the patient safety movement should follow going towards 2030 [ABSTRACT FROM AUTHOR]

The article reports that the British National Health Service (NHS) is expected to overspend by 2.3 billion British pounds in 2016. Topics covered include the result of King Fund's survey that finance directors believe that it is highly unlikely to meet NHS England's goal of limiting overspending to 1.8 billion British pounds, impact of financial stress on patient care and the opinion of King's Fund chief economist John Appleby.

The article reports that nurses belonging to health trade unions such as the Royal College of Nursing held protests in some parts of London, England in February 2018 to demand better funding for the National Health Service.

The article focuses on the Care Quality Commission's (CQC) report "Right Here Right Now," related to people facing mental health crises. It noted that 42% of patients with mental health conditions did not receive car that could resolve their crisis. It also mentions rise in declines in funding, referrals to community mental health teams and need for increase funding to tackle the pervasive, chronic, systematic neglect of psychiatric patients in the community.

The article presents the author's comments on the results of the general election in Great Britain on patient safety and justice. The author says that the Queen's speech mentioned the NHS Bill which may contain more details on the drive towards a seven-day-a-week NHS. The author highlights the absence of a Health Professional Regulation Bill and the Medical Innovation Bill in the Queen's speech.

An editorial is presented which discusses the rise in mortality rate in England and Wales during 2015 and the reasons for this rise. It mentions the performance of the National Health Service (NHS) of Great Britain and the budgetary reasons that led to the failure to achieve performance markers.

The article highlights the rising cases of dementia among Great Britain elderly population and its impact on the social funding. Details related to the statistics involved in the number of dementia patients, comments made by medical experts, the medical costs involved in dementia patient care, along with possible solutions are discussed.

The article presents the principles that underlie the personal health budget pilot program of the Department of Health in Great Britain. These includes the need to inform patient on the size of the budget before the support or care planning stage. It notes that patients are encourage to play an important role in the planning process of care. It mentions allowing patient to choose how they manage their personal health budget.

The article discusses the report which focuses on the effects of the Care Bill in Great Britain. It reveals that spending on social care services for elderly has dropped by 769 million British pounds since 2010. Topics discussed include concerns on funding cuts, its impact on orders placed for specialist equipment such as wheelchairs and that older people deemed in "moderate" need are more likely to be affected by the cuts than those in "critical" and "substantial" need.

The article reports on efforts that three primary medical care trusts in England are making in 201 to investigate and pilot personal health budget initiatives. The work that National Health Service (NHS) Bedfordshire is doing with budgets for stroke and Parkinson's disease, NHS Norfolk is doing with chronic obstructive pulmonary disease and NHS Mid-Essex is doing with dementia, is discussed. The impact that personal health budgets may have on British patients is examined.

The article discusses the state of funding for public services in Great Britain, particularly for the National Health Service (NHS). The British government is opposing the report for the King's Fund, Social Care Funding and the NHS: An Impending Crisis?, and claiming that there is no funding gap because efficiency savings in social service groups suggest that they will get more of the funds. A discussion on the report released by the government, Social Care--the Continuing Crisis, is also presented.

The author examines whether British general practitioners (GPs) are capable of managing National Health Service (NHS) budgets. According to the author, several GPs have problems managing their own finances. He points out that better pay and conditions for GPs are usually under the disguise of improved services for patients. Particular focus is given to the extent of the British Medical Association's militancy throughout history. He argues that GPs are not fit to hold NHS budgets since they cannot be trusted collectively.

The author reflects on the British government's goal to be the best country for dementia care, support and awareness by 2020. Topics covered include the measures needed to achieve the goal such as earlier diagnosis and better research, the need for funding to enable health and social care professionals to deliver higher quality care and the continued reduction in the social care budget. Also mentioned is the need for a sustainable dementia workforce.

The author discusses the problems facing general practice medicine in Great Britain. He highlights the high levels of stress among general practitioners (GP) who conduct about 60 million consultations per year and the need for urgent funding or rescue package for general practice. He also discusses the factors affecting the GP problem including cuts to social care and the reduction in health care spending as a percentage of gross domestic product.

A letter to the editor is presented in response to Iacobucci's investigation about public health in the "Feature" section in the January 23, 2016 issue.

Despite assurances that primary health care services will not be cut in this year's budget, Christian Duffin reports on warnings that they will be squeezed in the coming years. [ABSTRACT FROM AUTHOR]

The article reports the claim by Royal Society president Paul Nurse on September 29, 2015 that the government of Great Britain would be behaving like the Neanderthal people if it will implement a sharp reduction to the science budget.

The article presents an overview of the impact increased costs in Great Britain's National Health Service (NHS) have had on the service's budget and on medical care in the country. A discussion of the impact patient demands and budget constraints may have on the service and on the comprehensiveness of medical care in Great Britain is presented. Different treatments, including alternative treatments, unproven treatments and lifestyle support programs, which may be implemented in the NHS in the future, are discussed.

Editorial. Comments on chancellor's budget statement in Great Britain that plans to increase funding to the National Health Service. Concern that economic growth has been overestimated; Medical workforce shortages; Suggestion that increased spending may not lead to better quality care.

The article discusses the health and social care budget in Manchester, England. The author comments on the economic aspects of medical care and health services administration in Great Britain, practical politics, and financial management. Other topics include the role of the National Health Services and social services.

The article discusses the National Health Services in Great Britain, maternal health services, and the occupational role of midwives. The author comments on decision making in medical care, shortage of medical personnel, and job stress. Other topics include patient-centered care, childbirth at home, and practical politics.

The author explores the issues surrounding the decision of Greater Manchester city council and National Health Service (NHS) England to merge the region's health and social care budgets. Topics covered include the benefits of integrating health and social care in Greater Manchester and the concerns raised on the issue which includes the future of the NHS and how it will play locally and the role to be played by health leaders in decision making.

Reports on issues involving the financial crisis in the National Health Service (NHS). Discussion on the changes in funding and health services; Impact of internal market pressures on services offered in hospitals; Problems on manpower in providing adequate services.

Focuses on the budget holding of the National Health Service in Great Britain. Proposition on the rule for outpatient and inpatient services; Decline in outpatient referral and laboratory examination; Alternations in drug prescription policies.

The article reports the survey conducted by the non-profit organization National Development Team for Inclusion on the use of personal budgets by handicapped individuals in Great Britain.

The article addresses the need for voluntary sector organisations to work closely together with equipment services to provide quality and prompt service for people requiring equipment. The author suggests raising the awareness of the National Association of Equipment Providers (NAEP) within the voluntary sector. She recommends getting to know and supporting local charities involved in providing equipment, including the Royal British Legion, Disabled Living Foundation, and British Red Cross.

The article focuses on the Better Care Fund, effective 2015 to 2016, which is a pooled budget of 3.8 billion British pounds of funding for health and social care services in Great Britain including Carers' Breaks, clinical commissioning group re-ablement, and Disabled Facilities Grant.

The author discusses the cuts made to health and social care services to transfer funds to preventative services run by local authorities: and highlights the effect of the cuts on the services of Association of Directors of Social Services (ADASS) and the possible solutions.

The article reports that British Government is seeking public views on implementation of personal health budgets 2013 in England.

The article focuses on the advantage of the Personal Health Budgets of the Department of Health in Great Britain in 2013. According to Ray Hodgkinson of the British Healthcare Trades Association (BHTA), Personal Health Budgets can entail better value for money to the National Health Service (NHS) if people are less to be dependent on hospitals. He adds that they are pleased that the Department of Health acknowledges that the benefits of the programme are for people with the highest needs.

The article discusses benefits of diverting resources from hospital delivery out to the community. Healthcare is facing difficult times because of spending cuts. The NHS spends nearly 60% of its budget on paying its staff. Therefore, the alternative of the transfer of care from hospital to community has arisen. The change will be difficult but it will provide better healthcare outcome and will help NHS in managing its finances.