John Hughes: The UK will slip from world leaders in palliative care if complacency replaces progress

The Quality of Death Index report from The Economist Intelligence Unit once again ranks the UK as providing the best “quality of death” and “quality of palliative care” as compared with 80 countries around the world. The report uses a number of indices to reach its conclusions in what is an extremely well researched document. […]

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Emma Ladds: Remembering to care

There is something both heartwarming and heartbreaking about the sight: an older man, so stooped he is bent almost double, pushing an empty wheelchair down the pavement. His wristband marks him out as a hospital inpatient. Step by faltering step, he totters back towards the large white building and the awaiting ward. A woman—his wife I […]

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David Zigmond: Competence or compliance? The corrosive cost of professional practitioner appraisals

Current appraisal systems sacrifice more of value than they can assure. Clarifying why and how this happens gives us wider insights into our ill faring welfare systems. “The more laws, the less justice” German Proverb Some healthcare management axioms seem incontestable: all our healthcarers should have a good standard of human and technical competence; these […]

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#imajuniordoctor: Junior doctors respond to the new junior doctor contract on social media

An online petition has already collected over 50,000 signatures calling for the BMA to support doctors taking strike action against the planned introduction of new junior doctor contracts. Doctors are concerned that a recent government decision to impose new junior doctor contracts will result in lower pay and increased hours. This has been met with huge […]

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Hugh Alderwick: Is the NHS delivering enough things right?

Recently, I’ve written blogs about overuse and underuse in the NHS—the problems of doing too much of the wrong things and not enough of the right ones. The final chapter in this story is misuse: when health services are poorly delivered, resulting in preventable harm to patients. In reality, the distinctions between these three concepts […]

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Edward Ng: Quality assessments in general practice—have we gone too far?

UK general practice receives an unprecedented level of scrutiny to verify that quality is maintained. We have the Quality and Outcomes Framework (QOF) to incentivise GPs to provide better quality care; we have NHS England Area Team visits for contract breaches; we have Care Quality Commission (CQC) inspections; we have appraisals and revalidation; and, depending […]

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