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The coronavirus (COVID-19) pandemic disrupted all surgical specialties significantly and exerted additional pressures on the overburdened United Kingdom (UK) National Health Service. Healthcare professionals in the UK have had to adapt their practice. In particular, surgeons have faced organisational and technical challenges treating patients who carried higher risks, were more urgent and could not wait for prehabilitation or optimisation before their intervention. Furthermore, there were implications for blood transfusion with uncertain patterns of demand, reductions in donations and loss of crucial staff because of sickness and public health restrictions. Previous guidelines have attempted to address the control of bleeding and its consequences after cardiothoracic surgery, but there have been no targeted recommendations in light of the recent COVID-19 challenges. In this context, and with a focus on the perioperative period, an expert multidisciplinary Task Force reviewed the impact of bleeding in cardiothoracic surgery, explored different aspects of patient blood management with a focus on the use of haemostats as adjuncts to conventional surgical techniques and proposed best practice recommendations in the UK. [ABSTRACT FROM AUTHOR]

Application for Research Ethics Committee (REC) approval and the conduct of medical research is paper intensive. This retrospective study examined all applications to a single REC in the south of England over one year. It estimated the mass of paper used, comparing the proportional paper consumption of different trial types and during different stages of the research process, quantifying the consumption in terms of carbon dioxide emissions. In 2009, 68 trials were submitted to the REC. Total paper consumption for the REC process and study conduct was 176,150 sheets of A4 paper (879 kg), equivalent to an estimated 11.5 million sheets (88 tonnes, 2,100 trees) a year for the UK; the REC process accounted for 26.4%. REC applications and the conduct of approved trials generate considerable environmental impact through paper consumption contributing to the NHS's carbon footprint. Paper use might be reduced through the implementation of digital technologies and revised research methods, namely changing attitudes in both researchers and ethics committees. [ABSTRACT FROM AUTHOR]

The article presents the summaries of papers on dermatology presented at the main plenary sessions. The National Health Service (NHS) Plan 2000 proposed the development of specialist general practitioners (GPs) to take referrals from other GPs in specialties including dermatology. The NHS Modernization Agency Action on Dermatology program funded pilot site studies of dermatology GPwSI, services and preliminary results were encouraging. By the end of 2005, all referrals from primary care will be performed electronically using a referral template. Currently only a proportion of referrals are electronic, allowing comparison with established paper referrals.

Context The White Paper, The New NHS: Modern, Dependable, once again heralds change and new expectations of primary care in the UK. Objectives This discussion paper aims to encourage reflection on the implications for primary care teams of current governmental strategy, and to address the pivotal role which education can play in equipping practitioners for their roles. Key areas The paper examines the opportunities and threats for primary care in the new NHS developments, the strengths and weaknesses of the role that education currently plays in primary care, and how recent innovations might be used to give a more holistic approach to the needs of practitioners. The challenges for clinical governance of lay engagement and ethical decision making are seen as two crucial outcomes for an educational strategy which must be practice-led, and must interface individual practitioner education with the needs of the team and the community as a whole. I draw on a range of policy documents and educational literature to alert the reader to the different choices which can be made when thinking about appropriate educational models and methods; and offer a detailed structure for a practical educational strategy that may effectively unite theory and practice. The key elements are a three-tier link between practices, primary care groups, and district-level resources for all educational and training activity, and the aim of continuing multiprofessional development which will underpin the new NHS. [ABSTRACT FROM AUTHOR]

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.

Health inequalities research has a long history in the United Kingdom, and the development of government policies that are intended to explicitly address the existing health inequalities has been gathering pace since the Labour Party returned to power in 1997. In this paper, using the influential Acheson Report as a reference point, one of us (D.N.) describes how health inequalities policies have been developed, and the other (A.O.) assesses how, ideally, such policies ought to be developed. Although progress in the development of health inequalities policies has been made, the policies, and the evidence that has informed them, have been less than ideal. [ABSTRACT FROM PUBLISHER]

In the developed world, the demand for healthcare is rising faster than supply, so that governments are faced with the need to allocate limited resources for maximum benefit. Many governments are responding to these pressures by developing health technology assessment agencies, which evaluate the cost effectiveness of new pharmaceutical and medical products relative to existing interventions. In England and Wales, the agency concerned with health technology assessment is the National Institute for Clinical Excellence (NICE). NICE brings together evidence of clinical and cost effectiveness to judge the value of the treatment relative to alternative uses of National Health Service (NHS) resources and makes recommendations on use of the treatment by the NHS in England and Wales. NICE evaluates technologies where they may result in significant impact on NHS resources or key healthcare policy. The health technology assessment includes a review of the clinical effectiveness, cost effectiveness and service impact of the technology under consideration. This health technology assessment report, together with submissions from the technology manufacturer, and patient and healthcare professionals groups, is then considered by an appraisal committee that formulates guidance to the NHS and is ultimately published by NICE.A number of countries have formal guidelines on the use of outcome measures and economic evaluations in the submissions required for health technology assessment prior to market access. These guidelines vary in both the detail and level of mandatory requirement to be followed by technology manufacturers. NICE has recently updated its guidance to technology manufacturers on their submissions. These guidelines, developed in consultation with the healthcare industry, provide detailed specification of the requirements of NICE for health outcomes data and economic evaluation. These details are described in more detail in this paper. [ABSTRACT FROM AUTHOR]

The article explores the challenges and risk for the potential development of a new public health system in England in 2011. It says that the decision to implement a radical change in the system is due to several indicators and facts such as the dependency of 1.6 million people on alcohol. It also mentions that the change is in line with the aim of government to address the problems regarding long-term poor mental health in the country. According to the author, the improved health system is expected to enhanced the lifestyle of families in the poorest areas.

The article presents several commentaries on dentistry which are published within the issue. The paper discusses a qualitative study to develop a tool to examine patients' perceptions of the British National Health Services orthodontic treatment. The paper also reports on questionnaire-based survey of orthodontists' opinion regarding aspects of patient management.

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.

The 1944 Wartime Coalition White Paper, "A National Health Service" is unlikely to be celebrated among the spate of golden anniversaries of welfare reforms in the 1990s. However, a study of this document may be of interest for two main reasons. First, it has some parallels with the reformed National Health Service of the 1990s and, second, there have been recent calls for a local government-based health service, as was envisaged in 1944. The White Paper is examined in the context of evolving plans for the NHS, and is compared with the actual shape of the NHS as introduced by the Labour Minister of Health, Aneurin Bevan, in 1948. Four themes are drawn out. First, the White Paper should not be seen as the embodiment of a political consensus. Second, a Conservative Health Service would have differed from the NHS in fundamental aspects. Third, the conceptual advantages of a local government-based health service were outweighed by practical politics. Fourth, although the Labour Party made a difference to the shape of the NHS, that shape did not simply follow from party policy. This implies that medical pressure was successful, to some extent, in defining the limits of the new service. [ABSTRACT FROM AUTHOR]

This paper summarises and discusses some of the aspects of the Public Health White Paper, Healthy Lives, Healthy People, published for consultation at the end of 2010, and the framework of the Public Health Responsibility Deal, published in March 2011 by the UK government. Healthy Lives, Healthy People emphasises that a one-size-fits-all approach to public health improvement has been shown not to work as challenges vary from one neighbourhood to the next, and a new approach that empowers individuals to make healthy choices and gives communities the tools to address their own needs is required. It highlights the government's intention to shift power and decision making on public health matters to local authorities, with ring fenced budgets. A feature of the document that has proved controversial is the proposal to work collaboratively with business and the voluntary sector to deliver the government's ambition, through the Public Health Responsibility Deal, launched on 15 March, which comprises a series of 5 networks on food, alcohol, physical activity, health at work, and behaviour change, and the associated pledges. The initial pledges for the food network focus on salt and trans fatty acid reduction, and out-of-home calorie labelling of foods. [ABSTRACT FROM AUTHOR]

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.

Investigates the National Health Service white paper on the political economy of health care markets in Great Britain. Analysis of the potential consequences of the reforms to introduce supplier competition in health care; Implication of a conventional welfare framework of efficiency and the distribution of resources on consumer choice; Assessment of the scale economics in the production of health care.

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.

Background Whilst there has been recognition of the need to strengthen the evidence base for occupational health in the UK, it is not clear how much different groups contribute to the emerging research.Aims To establish the research contribution from different types of organization and how this has changed.Methods All original research papers published in Occupational Medicine in the 5-year periods July 1996 to June 2001 and July 2006 to June 2011 were reviewed. The lead authors’ affiliations were classified in the most relevant sector.Results The number of research papers published by authors affiliated to UK organizations was greater in the past 5 years than in a similar period a decade ago. The increase is wholly explained by a large increase in papers from universities. About one-fifth of all papers published in Occupational Medicine from UK sources had a principal affiliation with the National Health Service (NHS). The number of papers affiliated to large private sector companies reduced from 14 to 2. No papers arose from the work of established specialists employed by the large commercial providers of occupational health services.Conclusions Services provided in the NHS and other public sector organizations are important contributors of new evidence in occupational health. Commissioners of public sector services should take account of the importance of this to the research and innovation in occupational health. [ABSTRACT FROM PUBLISHER]

This paper discusses margins in the context of building services, where the capacity in many buildings, such as hospitals, exceeds the requirements by huge amounts. This oversizing has a direct impact on building efficiency, capital, maintenance and operational costs, as well as environmental and societal impacts throughout its lifecycle. This paper analyses two in-depth case studies of oversized boiler and chiller systems within NHS hospitals, whereby a number of key factors leading to the oversized systems are identified. The excessive and uncoordinated use of margins that are applied during the various stages of building service projects for a variety of reasons, is one significant factor. The lack of requirements information such as energy demand profiles and the use of vague and unreliable data for initial project requirements specifications, is also a major contributing factor. The paper points to the need to develop robust processes that capture the scope and rationale for the margins applied, to communicate project assumptions and stakeholder requirements in a clear and unambiguous format and to develop systems for improved data capture and analysis. [ABSTRACT FROM AUTHOR]

A persistent problem in UK hospitals is that of delayed discharges, where patients who are fit for discharge continue to occupy beds whilst awaiting care packages from Social Care. Integrated Care Systems (ICSs) in which Health and Social Care collaborate are now a major NHS initiative, the thinking being that such spending will have direct cost savings to health by freeing up expensive beds. The premise of this paper is that the benefits to health of assisting Social Care could also reduce a number of serious indirect costs and provide wide-ranging benefits to hospital patients, staff and budgets. This is accomplished by reducing the congestion arising from the use of many painful internal coping strategies and unintended consequences, which hospitals have to resort to when constrained by a lack of discharge solutions. The paper explores new and novel ways of using generic systems archetypes to create a hypothesis linking general Integrated Care Systems to congestion reduction throughout hospitals. Rather than use archetypes individually, they are applied here collectively in tandem. These are named 'cascaded archetypes', where the unintended consequence of one archetype becomes the driver for the next and are useful where fundamental solutions to problems are difficult to implement and unintended consequences must be dealt with. [ABSTRACT FROM AUTHOR]

Abstract: In July 2010, the new Coalition Government unveiled its plans to make major changes to the English National Health Service (NHS). This paper, which provides a commentary on the NHS White Paper, Equity and Excellence: Liberating the NHS, casts doubt upon the extent to which the proposals will bring about the fundamental reform that the Government intends, not least because both the British public and GP commissioners (who are expected to play a central role in transforming the NHS) appear to have a limited appetite for radical market reform. The paper also identifies a number of unintended risks, including the large transitional costs and organisational turbulence resulting from further NHS reorganisation; and the fact that key aspects of the White Paper proposals could result in significant financial instability. Given the real world limitations to translating a rhetoric of localism and democratic legitimacy into reality and a lack of hard evidence about the benefits of market reform, the Government would be well advised to take a more cautious approach to health policy formulation and implementation and to ensure that any further changes to the NHS are based on evidence, piloting and evaluation. [Copyright &y& Elsevier]

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.

The article explores the advantages and disadvantages of the white paper on primary care released by the British government in 2006. The white paper entitled, Our Health Our Care Our Say: A New Direction for Community Services, could create opportunities for nurses to ape community health and social care services. However, nursing leaders fear that primary care nurses may be overlooked as additional provider enter the National Health Services with new facilities.

Background: The United Kingdom (UK) has a significant and rising population of refugees and asylum seekers, including many who have previously worked as healthcare professionals. Evidence shows they have struggled to join and successfully work in the UK National Health Service (NHS) despite initiatives designed to improve their inclusion. This paper presents a narrative review based on research surrounding this population to describe the barriers that have impeded their integration and possible ways to overcome them. Methods: We conducted a literature review to obtain peer-reviewed primary research from key databases (PubMed, Web of Science, Medline, EMBASE). The collected sources were individually reviewed against predetermined questions to construct a cohesive narrative. Results: 46 studies were retrieved, of which 13 satisfied the inclusion criteria. The vast majority of literature focussed on doctors with minimal research on other healthcare workers. Study review identified numerous barriers impeding the integration of refugee and asylum seeker healthcare professionals (RASHPs) into the workforce that are unique from other international medical graduates seeking employment in the UK. These include experiences of trauma, additional legal hurdles and restrictions on their right to work, significant gaps in work experience, and financial difficulties. Several work experience and/or training programs have been created to help RASHPs obtain substantive employment, the most successful of which have involved a multifaceted approach and an income for participants. Conclusions: Continual work towards improving the integration of RASHPs into the UK NHS is mutually beneficial. Existing research is significantly limited in quantity, but it provides a direction for future programs and support systems. [ABSTRACT FROM AUTHOR]

The article presents a speech delivered before The Royal Statistical Society on January 26, 2011 at an Ordinary Discussion Meeting on "Resource allocation models" prepared by Jane Galbraith and Mervyn Stone of the University College London, England. It is a response to the paper of the Department of Health in Great Britain in 2007. It contends that the basis of the allocation formulae in the National Health Service is inaccurate. It argues on the misuse of regression analysis in the formulae.

Psychologist resourcing across the United Kingdom (UK) spinal cord injury centres (SCICs) varies considerably, which has detrimentally impacted standardising service provision for people with spinal cord injuries/disorders (PwSCI/D) compared with other nations. This paper presents the outcome of a project involving the Spinal Cord Injury Psychology Advisory Group (SCIPAG) and NHS England Clinical Reference Group/SCI transformation groups to agree upon screening and standards and shares data from the National Spinal Injuries Centre (NSIC) and the Yorkshire and Midlands Regional SCICs. Inpatients completed the GAD-7, the PHQ-9, and the short form of the Appraisals of DisAbility: Primary and Secondary Scale (ADAPSSsf), assessing adjustment. A total of 646 participants were included, with 43% scoring above the clinical threshold on at least one of the measures on admission. A subset of 272 participants also completed discharge measures and 42% remained above the threshold on discharge, demonstrating sustained psychological need. This paper provides support for services to move to a screen-and-assessment model supplemented by referral options for those with changing needs or who present with difficulties outside the remit of screening. The findings also support the efficacy of universal screening across the system and consideration of screening and standards for psychological care by the wider psychology community. [ABSTRACT FROM AUTHOR]

This paper evaluates ways in which labour issues in global value chains for medical gloves have been affected by, and addressed through, the COVID‐19 pandemic. It focuses on production in Malaysia and supply to the United Kingdom's National Health Service and draws on a large‐scale survey with workers and interviews with UK government officials, suppliers and buyers. Adopting a Global Value Chain (GVC) framework, the paper shows how forced labour endemic in the sector was exacerbated during the pandemic in the context of increased demand for gloves. Attempts at remediation are shown to operate through both a reconfigured value chain in which power shifted dramatically to the manufacturers and a context where public procurement became higher in profile than ever before. It is argued that the purchasing power of governments must be leveraged in ways that more meaningfully address labour issues, and that this must be part of value chain resilience. [ABSTRACT FROM AUTHOR]

The article presents developments in the healthcare sector in Great Britain in the past 20 years as of December 2016. Also cited are the thee white papers released under Prime Minister John Major in 1996, the enactment of the National Health Service (NHS) Primary Care Act in 1997, and the approval of the Health and Social Care Act of 2001.

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.

Aims Recent UK legislation allows dental therapists or jointly-qualified dental hygienist-therapists to work in the general dental service. This study aimed to investigate the extent of dentists' knowledge of the clinical remit of jointly qualified hygienist-therapists, their willingness to consider employing such a professional, and factors associated with these two measures.Materials and methods A postal questionnaire was sent to 616 NHS-registered dentists in South-East Scotland. Analysis and classification of responses to open-ended questions used standard non-parametric statistical tests and quantitative techniques.Results Following two mailings, a 50% (n = 310) response rate was obtained. A total of 65% of dentists worked in a practice employing a dental hygienist, while only 2% employed a dental therapist. Hygienists tended to work in larger practices. Dentists' knowledge of the clinical remit of the dually-qualified hygienist-therapist was found to be limited, reflecting a restricted and inaccurate view of the professional remit of a hygienist-therapist. The majority (64%) said they would consider employing a hygienist-therapist in their practice, rising to 72% amongst dentists already working with a hygienist. Reasons given by dentists who were negative about this prospect were sought. Those who worked with a hygienist tended to refer to lack of physical space, whilst those who did not tended to cite reservations on clinical skills, competence and responsibilities, or on the costs involved.Conclusions This study identified considerable ignorance and negativity among dentists about the nature and clinical remit of this group of professionals. Dually-qualified hygienist-therapists will be in a position to treat much of the routine disease that exists within the population, and dentists may benefit from education in relation to the substantial contribution these individuals could potentially make to patient care. [ABSTRACT FROM AUTHOR]

The platform is emerging as a key organizational form and operational logic of contemporary capitalism, intimately tied to financialization and assetization. However, discussions to date have focused on platforms and platformization in the context of the private, corporate, and technology sectors. In this paper, we develop an analysis of how platformization operates in the context of public policy. Using the UK's National Health Service as a case study, we explore how platformization is altering the form and function of the state. The platformization of the NHS has its roots in the UK government's strategic interest in the development of the bioeconomy. This led to the creation of a research infrastructure within the health service. Subsequently, the NHS has leveraged various assets into a range of data- and technology-focused initiatives. We argue that platformization has been a major form of neoliberalization within the NHS. The paper concludes with a discussion of what an analysis of public platformization can teach us about ongoing transformations of the state. [ABSTRACT FROM AUTHOR]

Focuses on Great Britain's White Paper on Public Health document entitled "Choosing Health White Paper," led by Health Secretary for England John Reid. Focus of the document; Opinion of the mental health organizations on the subject of the document; Statement of Angela Greatley, chief executive at the Sainsbury Center for Mental health on the prevalence of the document.

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 statement issued by practice nurses to express support to the government's white paper on public health in Great Britain. List of policies that would reinforce health promotion; Role of nurses in providing sexual health programs in primary care; Advantage of the creation of a national taskforce to increase the effectiveness of the British National Health Service Stop Smoking Services.

Provides information on the strategy of the National Health Service of Great Britain to manage its paperworks. Role of nurse managers in paperwork management; Practices that contributed to paper load in the agency.

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.

Background: The unprecedented rapid re-deployment of healthcare workers from different care pathways into newly created and fluid COVID-19 teams provides a unique opportunity to examine the interaction of many of the established non-technical factors for successful delivery of clinical care and teamwork in healthcare settings. This research paper therefore aims to address these gaps by qualitatively exploring the impact of COVID work throughout the pandemic on permanent and deployed personnel's experiences, their ability to effectively work together, and the effect of social dynamics (e.g., cohesion, social support) on teamwork and mental health. Methods: Seventy-five interviews were conducted across the UK between March and December 2021 during wave 2 and 3 of COVID-19 with 75 healthcare workers who were either permanent staff on Intensive Care/High Dependency Units used as COVID wards, had been rapidly deployed to such a ward, or had managed such wards. Work Life Balance was measured using the WLB Scale. Interview transcripts were qualitatively coded and thematic codes were compared using network graph modeling. Results: Using thematic network analysis, four overarching thematic clusters were found, (1) teamwork, (2) organizational support and management, (3) cohesion and social support, and (4) psychological strain. The study has three main findings. First, the importance of social factors for teamwork and mental health, whereby team identity may influence perceptions of preparedness, collaboration and communication, and impact on the collective appraisal of stressful events and work stressors. Secondly, it demonstrates the positive and negative impact of professional roles and skills on the development of teamwork and team identity. Lastly the study identifies the more pronounced negative impact of COVID work on deployed personnel's workload, mental health, and career intentions, exacerbated by reduced levels of social support during, and after, their deployment. Conclusion: The thematic network analysis was able to highlight that many of the traditional factors associated with the successful delivery of patient care were impeded by pandemic constraints, markedly influencing personnel's ability to work together and cope with pandemic work stressors. In this environment teamwork, delivery of care and staff well-being appear to depend on relational and organizational context, social group membership, and psycho-social skills related to managing team identity. While results hold lessons for personnel selection, training, co-location, and organizational support during and after a pandemic, further research is needed into the differential impact of pandemic deployment on HCWs mental health and teamwork. [ABSTRACT FROM AUTHOR]

As described in the first paper of this two-part series, increasing difficulties in recruitment and retention of dentists and dental care professionals (DCPs) in general dental practice in the UK is affecting delivery of NHS dental services. There is a significant risk to the future dental workforce supply which will affect access to dental care and worsen oral health inequalities. Understanding what factors contribute to job satisfaction and prevent job dissatisfaction of dental professionals would be useful in managing recruitment and retention issues. The aim of this literature review was to identify factors which contribute to job satisfaction of DCPs in general dental practice. Database searching was conducted systematically through PubMed/Medline, Scopus, Ovid, and the National Grey Literature Collection. Eleven relevant articles were identified, which were qualitatively analysed using Herzberg's motivation-hygiene theory as an analysis tool. Unfair remuneration is a major contributor to dissatisfaction of DCPs, but job satisfaction could be promoted through increased recognition, variety of work, and opportunities to progress. Dental contract reform in the UK should aim to minimise factors contributing to dissatisfaction and increase factors which increase satisfaction, including the development of an acceptable remuneration model for NHS dentistry that facilitates skill mix. [ABSTRACT FROM AUTHOR]

Background: Pregnancy weight management interventions can improve maternal diet, physical activity, gestational weight gain, and postnatal weight retention. UK guidelines were published in 2010 but health professionals report multiple complex barriers to practice. GLOWING used social cognitive theory to address evidence-based barriers to midwives' implementation of weight management guidelines into routine practice. This paper reports the pilot trial outcomes relating to feasibility and acceptability of intervention delivery and trial procedures. Methods: GLOWING was a multi-centre parallel-group pilot cluster RCT comparing the delivery of a behaviour change intervention for midwives (delivered as training workshops) with usual practice. The clusters were four NHS Trusts in Northeast England, randomised to intervention or control arms. Blinding of allocation was not possible due to the nature of the intervention. We aimed to deliver the intervention to all eligible midwives in the intervention arm, in groups of 6 midwives per workshop, and to pilot questionnaire data collection for a future definitive trial. Intervention arm midwives' acceptability of GLOWING content and delivery was assessed using a mixed methods questionnaire, and pregnant women's acceptability of trial procedures by interviews. Quantitative data were analysed descriptively and qualitative data thematically. Results: In intervention arm Trusts, 100% of eligible midwives (n = 67) were recruited to, and received, the intervention; however, not all workshops had the planned number of attendees (range 3–8). The consent rate amongst midwives randomised (n = 100) to complete questionnaires was 74% (n = 74) (95% CI 65%, 83%), and overall completion rate 89% (n = 66) (95% CI 82%, 96%). Follow-up response rate was 66% (n = 49) (95% CI 55%, 77%), with a marked difference between intervention (39%, n = 15) and control (94%, n = 34) groups potentially due to the volume of research activities. Overall, 64% (n = 47) (95% CI 53%, 75%) completed both baseline and follow-up questionnaires. Midwives viewed the intervention as acceptable and directly relevant to routine practice. The least popular components related to scripted role-plays. Pregnant women viewed the recruitment and trial processes to be acceptable. Conclusions: This rigorously conducted pilot study demonstrated feasibility intervention delivery and a high level of acceptability amongst participants. It has provided information required to refine the intervention and trial protocol, enhancing confidence that a definitive trial could be carried out. Trial registration: ISRCTN46869894; retrospectively registered 25th May 2016, www.isrctn.com/ISRCTN46869894. [ABSTRACT FROM AUTHOR]

Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder affecting a large percentage of the adult population. A series of ongoing efforts has led to the development of a hybrid AI algorithm (a combination of a machine learningmodel and a knowledge-basedmodel) for assisting adult ADHDdiagnosis, and its clinical trial currently operating in the largest National Health Service (NHS) for adults with ADHD in the UK. Most recently, more data was made available that has lead to a total collection of 501 anonymized records as of 2022 July. This prompted the ongoing research to carefully examine the model by retraining and optimizing the machine learning algorithm in order to update the model with better generalization capability. Based on the large data collection so far, this paper also pilots a study to examine the effectiveness of variables other than the Diagnostic Interview for ADHD in adults (DIVA) assessment, which adds considerable cost in the screenining process as it relies on specially trained senior clinicians. Results reported in this paper demonstrate that the newly trained machine learning model reaches an accuracy of 75.03% when all features are used; the hybrid model obtains an accuracy of 93.61%. Exceeding what clinical experts expected in the absence of DIVA, achieving an accuracy of 65.27% using a rule-based machine learning model alone encourages the development of a cost effective model in the future. [ABSTRACT FROM AUTHOR]

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.