As independent contractors, GPs cannot be instructed to take up innovation. They will adopt innovations that they can see will benefit their patients and also their practices in terms of finance or efficiency. They can be given financial incentives, but there is a limit to the funds available and Quality Outcome Frameworks (QOFs) have historically […]
Category: NHS
David Wrigley: How to fast track hospital closures—use clause 118
Like a baby throwing their toys out of a pram, Jeremy Hunt is using the blunt instrument of legislation to hit back at patients and campaigners who beat him in the High Courts over his attempt to close Lewisham Hospital. Lewisham was a successful, popular, high quality, and solvent London hospital. A neighbouring hospital was […]
Richard Vize: Are clinical commissioners improving patient services?
Clinical commissioners are beginning to demonstrate how they are improving patient services, countering the lack of attention they are getting from politicians. The health reforms were intended to put clinical commissioners at the heart of the drive to improve quality and reconfigure services. But since they took over from primary care trusts in April, clinical […]
Marc Wittenberg on taking part in a CQC inspection
In September 2013, shortly after starting in post as a national medical director’s clinical fellow at the BMJ and NHS England, I received an email inviting applicants to join “Mike’s army” as a junior doctor on a CQC (Care Quality Commission) inspection. My application was duly accepted and I was signed up to inspect one […]
Sean Roche: In order for patients to be valued, we must begin by valuing staff
Since the Francis report there has been much discussion about the need to disseminate “compassion” in the NHS. While there has been a great deal of moralistic rhetoric extolling the virtues of this noble and uniquely human quality, and its indispensible role in a caring health system, there is relatively little analysis of those organisational […]
David Zigmond: We need an appointment with Dr Finlay
A recent article by Stephen Moss (“Pills, bills and bellyaches: a peek behind the scenes at a GP surgery,” Guardian.) is a vivid Hogarthian portrait of a frontline of our current NHS. As a long serving inner city GP there is much I can endorse, amplify, or dispute. One strand is of interest and illuminates […]
Billy Boland: Live at the NHS Leadership Academy
It’s taken me a while to write about my first residential for the NHS Leadership Academy Bevan Programme. So much went on there, I’ve needed a bit of time to come down from the whole thing. It was a dark day in November that found me racing through the English countryside to get to Leeds, […]
Katherine Sleeman: Dying people need care, not just care plans
Exactly three months after Julia Neuberger recommended that the Liverpool Care Pathway (LCP) should be phased out in the UK, the first randomised controlled trial (RCT) of the LCP was published in the Lancet. [1] The cluster randomised trial, carried out in Italy among patients with cancer, showed little benefit of the LCP in improving […]
Billy Boland: The answer to leadership is greater than 7.3
Multi-source feedback and I didn’t get off to a great start when I found out that, when it came to being a doctor, my colleagues rated me as 7.3. I think my response at the time was something like “huh?” or perhaps “uh-huh.” Or maybe “uhh…” I can’t remember. I was gathering opinions for my […]
Richard Vize: The only chance for GPs to lead the NHS
Just seven months ago, GP commissioners were poised to lead a clinically driven revolution in the NHS. Their deep understanding of the needs of patients and ability to eyeball hospital clinicians on service quality were billed as the levers for radical improvements. But there is a grave danger that much of the early ambition around […]