Sir William Osler advocated the concept of a “quinquennial brain dusting“: which was my justification for taking a week out to visit some integrated care organisations on the West Coast of the USA, with a group from the NHS. I know we feel challenged in the UK, but the scale and nature of the challenge […]
Category: NHS
Chris Ham: Commonwealth Fund survey: If the NHS is doing well, why is it changing?
The Commonwealth Fund’s survey of the experience of adults with complex care needs, published last week, paints a remarkably positive picture of the NHS. The results show that, of the eleven countries surveyed, the number of patients reporting that they did not use services because of concerns about cost was lowest in the United Kingdom. […]
David Pencheon: What is it about large scale change that makes anaesthetists act?
Change may be the new constant, but it is always important to understand who embraces change most readily, and where. Doctors in general are traditionally conservative, as those outside the profession will be only too happy to confirm. We like to think we pioneer change both via behaviour (witness the change in smoking prevalence amongst […]
Martin McShane: A day at the Mid Staffordshire foundation trust enquiry
I was privileged to be invited to the patient experience seminar being held as part of the Mid Staffordshire enquiry. I felt as though I was participating in one of the best development sessions I have experienced as a clinician and manager. The morning was filled with three excellent presentations. First up was Paul Hodgkin […]
David Pencheon: Good general practice is sustainable general practice and vice versa
Once again the RCGP’s Annual conference last week in Liverpool produced a wealth of stimulating and topical debates – from the ethics of whether doctors should take a lead in commissioning (why do we always feel the need to “take the lead?”), to what constitutes sustainable general practice. The groups considering the latter issue, chaired […]
Edward Davies: The health bill: no trust and no U-turns
Last week marked a “humiliating climbdown” for the Health Secretary. Apparently. “Andrew Lansley is now in open retreat and is being forced to cave in on issues he previously fought to the hilt,” said his Labour nemesis Andy Burnham. And so why does his acquiescence to an amendment demanding he take ultimate responsibility for the […]
Martin McShane: Care and cure
We are coming up to the annual contracting round. This year it will be led by Clinical Commissioning Groups (CCGs). Last year GPs were involved in the difficult, detailed negotiations with the acute sector alongside PCT staff. As one of them said, emerging into daylight, somewhat pale and drained, “I never realised how hard it […]
Alison Spurrier: Caring for older people
To care for older people one vital ingredient is needed…time. Nothing can be rushed. Everybody needs to be washed, have their teeth cleaned, their mouths checked and cleaned, and their nails and hair sorted out. Don’t forget the never ending call for the commode, and if they don’t need help to get to the toilet they will need […]
Vidhya Alakeson and David Coyle: Personal health budgets
Last week the Secretary of State for Health announced that from 2014 onwards, all individuals receiving continuing healthcare will be entitled to take control of that support through a personal health budget. Based on figures for 2009/10, that’s more than 50,000 people. The government has made no secret of its commitment to personal health budgets […]
Martin McShane: Quis custodiet ipsos custodes?
There are about 38,000 primary care contracts. They are worth over £12 billion. All of them are going to be the responsibility of the National Commissioning Board. By 2013 every PCT cluster will have had to scrutinise every contract, blow the dust off the ones that no one has looked at in years, and make sure they are […]