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Objectives: Thyroid disease is managed by primary and a range of secondary care specialties. Interventions for common thyroid conditions are effective, but delays in diagnosis, ineffective or inappropriate treatment may affect outcomes and be subject to litigation. This study aimed to analyze trends in thyroid malpractice litigation in the UK over a 14-year period.Methods: This retrospective cohort study analyzed negligence claims recorded by the NHS Litigation Authority from 2002 to 2016. Data on incident details, outcomes, time to settlement, costs, and specialties involved were collected and analyzed.Results: Out of 189 cases reviewed, an outcome was decided in 134 cases; of which, 67.9% were successful for the claimant, resulting in compensation being paid. The most common reasons for successful claims were treatment complications (47 cases) and delay or failure of diagnosis (22 cases). Nerve and/or vocal cord damage and hypoparathyroidism were cited in 12 and 3 cases, respectively. Common specialties involved in successful claims were general surgery, ENT and endocrinology. The median (range) costs paid for compensation were £50,701.35 (£189.00 to £4.5 million). The median (interquartile range) time from incident to settlement was 1254 (992-1756) days. The number of claims (overall and successful) has reduced over the 14-year period, but there has been no change in the total cost per successful claim from 2002 to 2014 (p = 0.151).Conclusion: This overview demonstrates common causes and identifies trends in thyroid malpractice litigation in the UK, highlighting the significant costs incurred. The outcomes of the study will provide a basis to enable clinicians to avoid potential pitfalls and formulate guidelines to minimize risk. [ABSTRACT FROM AUTHOR]

In 1990 the national health services in the United Kingdom and Sweden started to split up in internal markets with purchasers and providers. It was also the year when Brazil started to implement a national health service (SUS) inspired by the British national health service that aimed at principles of universality, equity, and integrality. While the reform in Brazil aimed at improving equity and effectiveness, reforms in Europe aimed at improving efficiency in order to contain costs. The European reforms increased supply and utilization but never provided the large increase in efficiency that was hoped for, and inequities have increased. The health sector reform in Brazil, on the other hand, contributed to great improvements in population health but never succeeded in changing the fact that more than half of health care spending was private. Demographic and epidemiological changes, with more elderly people having chronic disorders and very unequal comorbidities, bring the issue of integrality in the forefront in all 3 countries, and neither the public purchaser provider markets nor the 2-tier system in Brazil delivers on that front. It will demand political leadership and strategic planning with population responsibility to deal with such challenges. [ABSTRACT FROM AUTHOR]

The article determines if an exercise program tailored to needs of older functionally impaired patients with heart failure (HF) could improve exercise capacity or reduce National Health Service costs. It is reported that Great Britain National Institute for Health and Clinical Excellence guidance recommends group-based exercise training to be offered to patients with stable heart failure. Results showed that 24-week exercise training did not improve quality of life in older patients with HF.

Abstract: Over the past decade in the United Kingdom, healthcare-associated infections (HCAIs) have been the target of significant health service targets and investment. Efforts to decrease the transmission of micro-organisms from person to person contact, and through contact with medical devices, continue to be a major priority of the National Health Service. It is important that all healthcare workers who come into contact with patients should have an understanding of the effectiveness of disinfection methods in decreasing person-to-person transmission of virulent organisms. Those working with medical equipment should also be aware of the techniques utilized to clean these devices. This article discusses the main methods of decontamination and sterilisation in current use in the UK. [Copyright &y& Elsevier]

The article discusses which countries around the world offer the best benefits for dying patients, with a focus on a study published by the British foundation Lien. Topics mentioned in the article include Britain as the best place for terminally ill patients, access to analgesics, and palliative treatment.

The purpose of this article is to assemble the information that can be gleaned from published sources on private general practice in Great Britain since 1948 and to discuss the role to be played by private general practice in a medical framework dominated by the National Health Service (N.H.S.). An extension of private practice would enable the rich to buy more medical services than the poor. As long as private practice exists, the rich, by definition, are able to buy all the medical services they desire. It is both inequitable and inefficient for governments to work with a wrong distribution of income and in consequence, to remove certain goods and services from the range of free choke by most people. As long as some choice is permitted as it still is in general practice the rich will look after themselves, as they always do. It is the middle and lower income groups whose freedom of choice is most seriously affected.

The article discusses a study to find out if a pharmacist-led pediatric commissioning service was more effective in getting individual funding requests (IFR) for Primary Care Trusts (PCTS), and reports that it improves the chances of doing so by 73%.