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The article references the paper published by the journal in 2015 on the association between day of admission and mortality, which health secretary Jeremy Hunt apparently used in his House of Commons speech on July 16, 2015, claiming that 6,000 people die yearly because of lack of a proper seven day service in hospitals. Topics discussed include where the 6,000 figure came from, whether the Department of Health (DH) commissioned the new analysis, and whether data were shared with the DH.

Focuses on the final session of the Chichester Conference of the National Health Service organization in Great Britain. Discussion on the status of natural units of health organization; Sense of professional identification among the members; Delegation to divisions and working units.

Presents comments on the impact of white paper on the National Health Service (NHS) of Great Britain. Assertions on the significance and focus of the paper in specialist services; Comments on the significance of chapters four, five and six of the paper; Account on the effect of the paper on minority groups.

Focuses on the alternative of the white paper regarding the improvement of the effectiveness of clinical care in the National Health Service in Great Britain. Definition of quality of care; Increase of the annual rate of medical care expenditure; Standardization of diagnostic methods.

Examines the reaction of general practitioners towards the proposals contained in the white paper 'Working for Patients' in Great Britain. Rejection of the proposals by general practitioners; Criticisms on the implementation of fixed budgets for specified surgical operations; Concerns on the cost effectiveness of the National Health Service.

Focuses on the growth and restructuring of the National Health Service (NHS). Impact of medical insurance and hospital independent revenues; Role of the NHS as the catalysts; Collaboration of top companies for better hospitals.

The article reports on the joint campaign launched by British trade unions including Unison, Unite and the GMB, in September 2010 to block the coalition government's health white paper "Equity and Excellence: Liberating the NHS." The campaign aims to encourage National Health Service (NHS) staff and patients against the white paper. Further, the unions argue that all hospitals are being turned into independent businesses, and that the scheme will revert back wealth-based healthcare. The Royal College of General Practitioners also raised concerns.

Focuses on the funding of the National Health Service in Great Britain. Response of the government to the problem of NHS crisis in 1987 to 1988 period; Proposals for efficient NHS; Significance of white paper on the performance of medical professionals; Need of measures of patient satisfaction to medical services.

The article suggests that the efforts of the British government to reform the National Health Service (NHS) are under threat from other factors that aim to hasten competition in the health service, according to the British Medical Association (BMA) in October 2010. As mentioned in the government's White Paper "Equity and Excellence: Liberating the NHS," reform efforts will allow more control to patients and frontline clinicians and promote stronger attention on public health. The other arguments of BMA are further explained by chairman Hamish Meldrum.

The article presents blogs from health care professionals on the 80 billion British pound National Health Service (NHS) commissioning budget and the white paper "Equity and Excellence: Liberating NHS."

Reports on the move of doctors not to cooperate in the implementation on proposal to reform National Health Services (NHS) in Great Britain. Arguments to persuade government and public on impracticality of proposal; Failure on acknowledging NHS problem; Impairment of the ability of hospital authorities to coordinate services effectively.

Focuses on the campaign against the white paper related to patient care in the National Health Service in Great Britain. Debate on the proposals by the British Medical Association council; Discussions on the letter from the chief medical officer; Implications of the white paper to professional awareness.

Focuses on the publication of the working papers of the National Health Service (NHS) in Great Britain. Renegotatiation of the contracts of general practitioners; Implementation of the NHS review; Role of the Department of Health in the distribution of the working papers to general practitioners.

Focuses on the white paper negotiations of the General Medical Service Committee in Great Britain. Completion of the Health and Medicine Bill committee stage; Review of the long term funding of the National Health Service (NHS); Reference term of the prime minister on the internal review of the NHS.

Reports on professional organizations' welcoming of proposals in the December 1997 white paper on the National Health Service (NHS) in England. Promotion of clinical and cost effectiveness of treatments by the National Institute for Clinical Excellence; Support for the dismantling of the internal market; Need for more capital investments if services were to be improved.

Presents the response related to the government's white paper proposals for the National Health Services in Great Britain. Scrutiny on the composition of self-governing hospitals and general practitioners' budgets; Interrelations of the program with two-tier system in the medical field; Need to prioritize primary care for elderly and the sick.

Reports on the plans of the restructuring of the National Health Service (NHS) in Great Britain. Effects of the plans on health authorities, hospital managers and family doctors; Speculations of the changes on the NHS Management Board; Uncertainty of the decisions of NHS Chief Executive Duncan Nichol.

The article reports on a legal challenge launched by the British public service union Unison to the healthcare reforms proposed by the coalition government. The basis for the legal challenge was the failure of Health Secretary David Nicholson to consult the public on the plans. The union warned that the proposals would entail fundamental changes to the operation of the National Health Service (NHS) and that the public should be given an opportunity to comment on them. In response, the Department of Health claimed it is engaging fully on the issue.

Focuses on the medical issues presented at the meeting of the Association of Community Health Councils in Great Britain. Emphasis of John Patter, health minister on the services of physician to patients; Arguments related to pay awards initiated by the National Health Services; Controversies concerning termination of pregnancy practices.

Presents a letter for Health Secretary Frank Dobson pertaining to ideas on how to improve the National Health Service (NHS) in Great Britain. View on the machinery of the health authority; Suggestion on how to change the culture within the NHS.

Discusses the British government's ten year plan for the National Health Service on the . Focus of the programme; Key feature of the programme; Aim of the plan. INSET: Key components of the ten year plan....

The author outlines some of the things that have been observed in ward care for older people, from the study "Dignity in Practice," which focused on failing to see patients as individuals. Topics mentioned include mission statements in the National Health Service in England, passing of referrals to intermediate care services in the community, and refusal to take patients back into their residential homes from hospital until they have been reassessed.

Focuses on the rejection of the general practitioners of the government's National Health Service (NHS) in Great Britain. Rejection of the government's proposal for general practitioners; Views regarding the white paper of the NHS; Compatibility of the concepts of the white paper with the principles of the NHS.

BACKGROUND: Smoking is one of the biggest avoidable causes of morbidity and mortality in the United Kingdom. This paper quantifies the current health and economic burden of smoking in the UK. It provides comparisons with previous studies of the burden of smoking in the UK and with the costs for other chronic disease risk factors. METHODS: A systematic literature review to identify previous estimates of National Health Service costs attributable to smoking was undertaken. Information from the World Health Organization’s Global Burden of Disease Project and routinely collected mortality data were used to calculate mortality due to smoking in the UK. Population-attributable fractions for smoking-related diseases from the Global Burden of Disease Project were applied to NHS cost data to estimate direct financial costs. RESULTS: Previous studies estimated that smoking costs the NHS about £1.4 billion to £1.7 billion in 1991 and has been responsible for about 100 000 deaths per annum over the past 10 years. This paper estimates that the number of deaths attributable to smoking in 2005 was 109 164 (19% of all deaths, 27% deaths in men and 11% of deaths in women). Smoking was directly responsible for 12% of disability adjusted life years lost in 2002 (15.4% in men; 8.5% in women) and the direct cost to the NHS was £5.2 billion in 2005–6. CONCLUSION: Smoking is still a considerable public health burden in the UK. Accurately establishing the burden in terms of death, disability and financial costs is important for informing national public health policy. [ABSTRACT FROM AUTHOR]

The NHS in England is an organisation undergoing substantial change. The passage of the Health and Social Care Act 2012, consolidates and builds on previous health policies and introduces further 'market-style' reforms of the NHS. One of the main aspects of these reforms is to encourage private and third sector providers to deliver NHS services. The rationale for this is to foster a more competitive market in healthcare to encourage greater efficiency and innovation. This changing healthcare environment in the English NHS sharpens the need for attention to be paid to the ethical operation of healthcare organisations. All healthcare organisations need to consider the ethical aspects of their operation, whether state or privately run. However, the changes in the type of organisations used to provide healthcare (such as commercial companies) can create new relationships and ethical tensions. This paper will chart the development of organisational ethics as a concern in applied ethics and how it arose in the USA largely owing to changes in the organisation of healthcare financing and provision. It will be argued that an analogous transition is happening in the NHS in England. The paper will conclude with suggestions for the development of organisational ethics programmes to address some of the possible ethical issues raised by this new healthcare environment that incorporates both private and public sector providers. [ABSTRACT FROM AUTHOR]

Background Health systems worldwide are increasingly holding boards of healthcare organisations accountable for the quality of care that they provide. Previous empirical research has found associations between certain board practices and higher quality patient care; however, little is known about how boards govern for quality improvement (QI). Methods We conducted fieldwork over a 30-month period in 15 healthcare provider organisations in England as part of a wider evaluation of a board-level organisational development intervention. Our data comprised board member interviews (n=65), board meeting observations (60 hours) and documents (30 sets of board meeting papers, 15 board minutes and 15 Quality Accounts). We analysed the data using a framework developed from existing evidence of links between board practices and quality of care. We mapped the variation in how boards enacted governance of QI and constructed a measure of QI governance maturity. We then compared organisations to identify the characteristics of those with mature QI governance. Results We found that boards with higher levels of maturity in relation to governing for QI had the following characteristics: explicitly prioritising QI; balancing short-term (external) priorities with long-term (internal) investment in QI; using data for QI, not just quality assurance; engaging staff and patients in QI; and encouraging a culture of continuous improvement. These characteristics appeared to be particularly enabled and facilitated by board-level clinical leaders. Conclusions This study contributes to a deeper understanding of how boards govern for QI. The identified characteristics of organisations with mature QI governance seemed to be enabled by active clinical leadership. Future research should explore the biographies, identities and work practices of board-level clinical leaders and their role in organisation-wide QI. [ABSTRACT FROM AUTHOR]

The model for delivery of primary eye care in Europe varies from country to country with differing reliance on ophthalmologists, optometrists and dispensing opticians. Comparative analysis of models has tended to focus on inter professional working arrangements, training and regulatory issues, rather than on whether a particular model is effective for delivering public health goals for that country. National Health Service (NHS) primary eye care services in the UK are predominantly provided under a General Ophthalmic Services (GOS) Contract between the NHS and practice owners (Contractors).Over two-thirds of sight tests conducted in England,Wales and Northern Ireland and all in Scotland are performed under a GOS Contract, however many people entitled to a GOS sight test do not take up their entitlement. The fee paid for sight tests conducted under a GOS Contract in England, Wales and Northern Ireland does not cover the full cost of conducting the examination. The shortfall must be made up through profits of sale of optical appliances but this business model can be a deterrent to establishing practices within socioeconomically deprived communities, and can also be a barrier to uptake of sight tests, even though many people are entitled to a NHS optical voucher towards the cost of spectacles or contact lenses. This paper critiques the GOS Contracts within the UK. We argue that aspects of the way the GOS Contract is implemented are contrary to the public health interest and that different approaches are needed to address eye health in equalities and to reduce preventable sight loss. [ABSTRACT FROM AUTHOR]

There is currently an unrecognised conflict between the utilitarian nature of the overall NHS and the basic deontology of the doctor-patient interaction. This conflict leads to mistrust and misunderstanding between managers and clinicians. This misunderstanding is bad for both doctors and managers, and also leads to waste of time and resources, and poorer services to patients. The utilitarian thinkers (mainly managers and politicians) tend to value finite, short term, evidence based technical interventions, delivered according to specifications and contracts. They appear happy to break care up into smaller pieces, which can then be commissioned from multiple providers. The deontological thinkers (mainly doctors and other clinicians) tend to think about care delivered through a long term continuous relationship, and regard that relationship as therapeutic and salutogenic in itself. To them breaking care up into smaller fragments is a denial of what caring is really about. Very rarely are either or both sides of this debate fully aware of where their powerfully felt and often well argued positions start from. In this paper we offer an appraisal of the strengths and weaknesses of both moral viewpoints as applied in the UK NHS context and we suggest a way in which they can be reconciled, provided neither is pushed too far or too hard against the other. We believe this reconciliation would be good for patients, doctors, managers and improve the service as a whole. [ABSTRACT FROM AUTHOR]

The article highlights the views of various commentators on the white paper "Equity and Excellence: Liberating the NHS." John Appleby, chief economist of The King's Fund, argues that choice has never been a reality for most patients and primary care trusts in Great Britain. Consultant chest physician Peter Davies claims that reorganization is irrelevant to the needs of the health service. While Jacky Davis, co-chair of the NHS Consultants' Association, argues that the white paper will improve the commissioning and delivery of National Health Service (NHS) care by the private sector.

Significant changes are proposed for the research ethics system governing the review of the conduct of medical research in the UK. This paper examines these changes and whether they will meet the aimed-for goal of improving the efficiency of the research ethics system. The author concludes that, unfortunately, they will not and thus should be rejected. [ABSTRACT FROM AUTHOR]

The objective of this paper is to apply a framework for country-level performance assessment to the cities of Montreal, Canada, and Barcelona, Spain, and to use this framework to explore and understand the differences in their health systems. The UK National Health Service Performance Assessment Framework was chosen. Its indicators went through a process of selection, adaptation and prioritisation. Most of them were calculated for the period 2001-3, with data obtained from epidemiological, activity and economic registries. Montreal has a higher number of old people living alone and with limitations on performing one or more activities of daily life, as well as longer hospital stays for several conditions, especially in the case of elderly patients. This highlights a lack of mid-term, long-term and home care services. Diabetes-avoidable hospitalisation rates are also significant in Montreal, and are likely to improve following reforms in primary care. Efficient health policies such as generic drug prescription and major ambulatory surgery are lower in Barcelona. Rates of caesarean deliveries are higher in Barcelona, owing to demographics and clinical practice. Waiting times for knee arthroplasty are longer in Barcelona, which has triggered a plan to reduce them. In both cities, avoidable mortality and the prevalence of smoking have been identified as areas for improvement through preventive services. In conclusion, performance assessment fits perfectly in an urban context, as it has been shown to be a useful tool in designing and monitoring the accomplishment of programmes in both cities, to assess the performance of the services delivered, and for use in policy development. [ABSTRACT FROM AUTHOR]

The UK government has recently taken steps to exclude certain groups of migrants from free treatment under the National Health Service, most controversially from treatment for HIV. Whether this discrimination can have any coherent ethical basis is questioned in this paper. The exclusion of migrants of any status from any welfare system cannot be ethically justified because the distinction between citizens and migrants cannot be an ethical one. [ABSTRACT FROM AUTHOR]

Presently, there is a movement in the UK research governance framework towards what is referred to as proportional ethical review. Proportional ethical review is the notion that the level of ethical review and scrutiny given to a research project ought to reflect the level of ethical risk represented by that project. Relatively innocuous research should receive relatively minimal review and relatively risky research should receive intense scrutiny. Although conceptually attractive, the notion of proportional review depends on the possibility of effectively identifying the risks and ethical issues posed by an application with some process other than a full review by a properly constituted research ethics committee. In this paper, it is argued that this cannot be achieved and that the only appropriate means of identifying risks and ethical issues is consideration by a full committee. This implies that the suggested changes to the National Health Service research ethics system presently being consulted on should be strenuously resisted. [ABSTRACT FROM AUTHOR]

Background: Despite evidence that physical inactivity is a risk factor for a number of diseases, only a third of men and a quarter of women are meeting government targets for physical activity. This paper provides an estimate of the economic and health burden of disease related to physical inactivity in the UK. These estimates are examined in relation to current UK government policy on physical activity. Methods: Information from the World Health Organisation global burden of disease project was used to calculate the mortality and morbidity costs of physical inactivity in the UK. Diseases attributable to physical inactivity included ischaemic heart disease, ischaemic stroke, breast cancer, colon/rectum cancer and diabetes mellitus. Population attributable fractions for physical inactivity for each disease were applied to the UK Health Service cost data to estimate the financial cost. Results: Physical inactivity was directly responsible for 3% of disability adjusted life years lost in the UK in 2002. The estimated direct cost to the National Health Service is £1.06 billion. Conclusion: There is a considerable public health burden due to physical inactivity in the UK. Accurately establishing the financial cost of physical inactivity and other risk factors should be the First step in a developing national public health strategy. [ABSTRACT FROM AUTHOR]

The author discusses a paper related to clinical care to patients in Great Britain and failures of various health institutions within the National Health Service (NHS) to provide adequate levels of clinical care in Staffordshire, England. He mentions that authors of the paper, C. Newdick and C. Danbury possible defines possible reasons behind serious failures of care within the NHS such as financial pressures.

The UK National Health Service (NHS) has long espoused patient and public engagement. Recent years have seen increasing use of internet-based methods of collecting feedback about patient experience and public and staff views about NHS services and priorities. Often hailed as a means of facilitating participative democratic patient engagement, these processes raise a number of complex issues. A key aspect of it is the opportunity for comment to be made anonymously. Our research reveals an anonymity paradox whereby patients clearly demonstrate a perception that anonymity is a prerequisite for effective use of these feedback processes, whereas professionals demonstrate a perception that patient anonymity is a barrier to effective use. The risks of anonymity are constructed very differently by patients and professionals. Patient concerns around anonymity were not motivated by a general concern about a loss of privacy, but more that a positive identification might compromise future care. For professionals, concerns were voiced more around risks of reputational damage for specific practitioners or practices (in that anyone could say anything) and also that this anonymous feedback was available publicly and that it might go against the medical opinion of the professional. These concerns pointed to important differences in perceptions of patient and professional vulnerability. In the qualitative analysis that follows the key finding was that while anonymity makes service users feel less vulnerable, it can have the opposite effect on managers and clinical staff. This raises important implications for the use and utility of internet-based methods of collecting patient feedback. [ABSTRACT FROM AUTHOR]

Objective: To assess the utilisation of and funding structure for fertility preservation for children diagnosed with cancer in the UK.Design: Survey of paediatric oncologists/haematologists. Questionnaires were sent electronically with reminder notifications to non-responders.Setting: UK Paediatric Oncology Principal Treatment Centres (PTCs).Participants: Paediatric oncologists/haematologists with an interest in the effects of treatment on fertility representing the 20 PTCs across the UK.Main Outcome Measures: Referral practices, sources and length of funding for storage of gametes or gonadal tissue for children diagnosed with cancer in the preceding 12 months.Results: Responses were received from 18 PTCs (90%) with responses to 98.3% of questions. All centres had referred patients for fertility preservation: ovarian tissue collection/storage 100% (n=18 centres), sperm banking 100% (n=17; one centre was excluded due to the age range of their patients), testicular tissue storage 83% (n=15), mature oocyte collection 35% (n=6; one centre was excluded due to the age range of their patients). All centres with knowledge of their funding source reported sperm cryopreservation was NHS funded. Only 60% (n=9) centres reported the same for mature oocyte storage. Of the centres aware of their funding source, half reported that ovarian and testicular tissue storage was funded by charitable sources; this increased in England compared with the rest of the UK.Conclusions: Inequality exists in provision of fertility preservation for children with cancer across the UK. There is lack of formalised government funding to support international guidelines, with resultant geographical variation in care. Centralised funding of fertility preservation for children and young adults is needed alongside establishment of a national advisory panel to support all PTCs. [ABSTRACT FROM AUTHOR]

Background: In the UK, the number of junior doctors completing foundation programme, and the number of trainees applying to paediatrics has been in decline in recent years. The NHS is at 'breaking point', exacerbated by workforce shortages, chronic underfunding, increasing service demand and poor job satisfaction within healthcare workers. Issues in recruitment and retention of paediatricians 'threaten the safety of our children's health', according to the Royal College of Paediatrics and Child Health.Aim: To explore what strategies have been described in the literature to enhance recruitment and retention in paediatrics.Methods: A scoping review methodology was conducted, employing a qualitative approach to review the literature. The studies included were English-language studies. 16 full-text articles were reviewed and analysed.Study Findings: There is a paucity of data in the literature that describes evidence-based approaches to enhancing retention and recruitment in paediatrics. The most important strategies employed to help are identified and grouped into six main themes. These include professional advocacy, workforce diversity, mentorship, improving working conditions, career flexibility and enhancing educational opportunities. The authors have created a 'paediatric pipeline' paradigm of 'identify, engage, recruit, retain and champion', which allow us to present these themes in a pragmatic way for paediatricians and policymakers.Conclusions: While some issues share similarities with other specialties in difficulty, much of the context and potential remedies within paediatrics are distinct. A strategic, multi-agency collaborative approach is required urgently to address the significant issues that face both paediatrics and the healthcare system. [ABSTRACT FROM AUTHOR]

Research ethics review is an important process, designed to protect participants in medical research. However, it is increasingly criticised for failing to meet its aims. Here, two researchers reflect on their experiences of applying for ethical approval of observational research in clinical settings. They highlight some problems faced by reviewers and researchers and propose a two-stage ethical review process that would alert researchers to the committee's concerns and allow them to give a more considered response. [ABSTRACT FROM AUTHOR]

Objective To assess the cost-effectiveness of transcatheter aortic valve implantation (TAVI) compared with medical management in patients with severe aortic stenosis who are ineligible for conventional aortic valve replacement (SAVR) from the perspective of the UK National Health Service Design Probabilistic decision analytical model Methods A decision analytical model was developed to assess the costs and benefits associated with both interventions over a 10-year time horizon. A literature review was performed to identify relevant clinical evidence. Health-related quality of life and mortality were included using data from the PARTNER clinical trial (cohort B). Unit costs were taken from national databases. Costs and benefits were discounted at 3.5% per year, and extensive sensitivity analyses (probabilistic and deterministic) were performed to explore the impact of uncertainty on the cost-effectiveness estimates Main outcome measure Incremental costeffectiveness ratio (ICER) with benefits expressed as quality-adjusted life years (QALYs Results The base case ICER was approximately £16 100 per QALY gained. At a cost-effectiveness threshold of £20 000 per QALY gained, the probability that TAVI was cost-effective compared with medical management was 1.00. The results were robust to changes in key clinical parameters as well as choice of baseline survival data. The observed PARTNER survival data only have to be extrapolated for 2 years to generate an ICER below £30 000 per QALY gained, which is the upper value of the threshold range used by the National Institute for Health and Clinical Excellence in the UK. Conclusions TAVI is highly likely to be a cost-effective treatment for patients with severe aortic stenosis who are currently ineligible for SAVR [ABSTRACT FROM AUTHOR]

Reports on the activities of the British Medical Association. Concern of medical academics over white paper; Future of general practice training; Opposition of junior doctors to the National Health Service (NHS); Emphasis on the organizational change of NHS.

Focuses on a review by the National Health Service (NHS) on its research and development priorities in the interface between primary and secondary care. Research paper `Research for Health'; Criteria of research and development potential; Setting up the advisory group; Determination of 21 priority topics. INSET: Summary points..

The article comments on the paper "Implementation of the Healthcare Recommendation Arising from the Victoria Climbié report" that was published within the issue. The author questions the real commitment of British health organizations in protecting children, considering the constantly changing format of the National Health Service.

This article discusses a 2006 white paper from Great Britain's Department of Health which recommended a major transfer of National Health Service functions to the community. This transfer would move as many as 15 million outpatient attendances to community settings. The paper also named a variety of clinical activities and procedures that could be performed outside the acute hospital setting.

This article comments on two different papers on neonatal care in great Britain by S.J. Oddie and G.J. Escobar. The studies differ significantly in their objectives and methods, so direct numerical comparisons may not be valid. Oddie looked at over 11 000 births in the Northern National Health Services region of Great Britain in 1998, excluding infants less than 35 weeks gestation. They concentrated on factors associated with early neonatal discharge, and then looked at what influenced readmission to hospital within 28 days. Escobar looked at a different range of factors influencing readmission in the first two weeks. As in the British study lower gestations were more likely to be readmitted including those that had avoided the neonatal intensive care unit, as were those who were sicker at birth.

BACKGROUND: The English network of stop-smoking services (SSSs) is among the best-value life-preserving clinical intervention in the UK NHS and is internationally renowned. However, success varies considerably across services, making it important to examine the factors that influence their effectiveness. METHODS: Data from 126 890 treatment episodes in 24 SSSs in 2009–10 were used to assess the association between intervention characteristics and success rates, adjusting for key smoker characteristics. Treatment characteristics examined were setting (eg, primary care, specialist clinics, pharmacy), type of support (eg, group, one-to-one) and medication (eg, varenicline, single nicotine replacement therapy (NRT), combination of two or more forms of NRT). The main outcome measure was abstinence from smoking 4 weeks after the target quit date, verified by carbon monoxide concentration in expired air. RESULTS: There was substantial variation in success rates across intervention characteristics after adjusting for smoker characteristics. Single NRT was associated with higher success rates than no medication (OR 1.75, 95% CI 1.39 to 2.22); combination NRT and varenicline were more successful than single NRT (OR 1.42, 95% CI 1.06 to 1.91 and OR 1.78, 95% CI 1.57 to 2.02, respectively); group support was linked to higher success rates than one-to-one support (OR 1.43, 95% CI 1.16 to 1.76); primary care settings were less successful than specialist clinics (OR 0.80, 95% CI 0.66 to 0.99). CONCLUSIONS: Routine clinic data support findings from randomised controlled trials that smokers receiving stop-smoking support from specialist clinics, treatment in groups and varenicline or combination NRT are more likely to succeed than those receiving treatment in primary care, one-to-one and single NRT. All smokers should have access to, and be encouraged to use, the most effective intervention options. [ABSTRACT FROM AUTHOR]