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Patients could soon have to make co-payments for NHS care - but who will pay and for what? Francesca Robinson looks at the options The NHS system of charges has [...]

One year on from its launch, how is the Postgraduate Medical Education and Training Board (PMETB) performing? Francesca Robinson assesses its impact and finds a mixed reaction It is just [...]

How much time consultants will spend assessing Modernising Medical Careers trainees is the subject of much debate, with estimates ranging widely, depending on whom you are talking to. Francesca Robinson [...]

Is the private sector making a quick buck out of Private Finance Initiative hospitals or is PFI necessary to deliver high standards of care in modern settings? Francesca Robinson hears [...]

Patient choice is the buzzword at the Department of Health. So what is it exactly? Francesca Robinson reports From August this year, all patients who have waited over six months [...]

This article presents an interview with Alaeddin Faris Hatoum, a Syrian eye specialist who moved to Great Britain to become a National Health Service (NHS) consultant. He cites lessons he learned from his consultant colleagues in Norwich, England. He highlights his efforts to be admitted as an NHS consultant. He believes that one of the biggest factors in the success of his application was the support and the references he was given by consultant colleagues.

The article focuses on reports on the British Healthcare Commission's investigation into ten maternal deaths at Northwick Park Hospital in London, England. The commission found that the hospital suffered from a lack of clinical leadership, a poor working culture and an overloaded maternity unit. All ten women died at Northwick Park Hospital between April 2002 and April 2005, during pregnancy or within 42 days of giving birth. It outlines the cause of the death of the mothers at the hospital.

The article presents pieces of advice concerning the marketing of several medical innovations in Great Britain. The option for marketing a medical innovation are either to go to industry and license the idea with some form of royalty or to set up a company. Hence, it is stated that entrepreneurs who succeed have passion, determination and drive. INSET: CASE STUDY: OPTYSE OPHTHALMOSCOPE.

The article deals with the problems associated with the increasing population of medical graduates in Great Britain in 2006. The first signs of recruitment and retention problems were identified by the Royal College of Obstetricians and Gynecologists manpower census reports of 1988-91. A survey of medical students indicated that the attraction of the subject at undergraduate level had diminished and even more so by the pre-registration year.

The article scrutinizes the implementation of the Payment by Results (PbR) health care policy in Great Britain. Engagement in discussions about resources and clinical activity is needed by clinicians if PbR is to drive operational change according to the British Audit Commission. Budget devolving was made by some hospital trusts in order to comply with the PbR. The policy was claimed by Stephen Campion, CEO of the Hospital Consultants and Specialists Association, as significant to the modernization of the British National Heath Service.

Provides information on the efforts of the Royal College of Obstetricians and Gynaecologists to assist in rebuilding the medical services in Iraq as of May 2005. Mortality rates of pregnant women and newborn infants in Iraq; Information on a course called Managing Obstetric Emergencies and Trauma developed in Great Britain; Collaboration of the team with other agencies to rehabilitate the health care system in Iraq. INSET: WHY I VOLUNTEERED TO GO TO IRAQ.

Looks at the reactions of physicians in Wales to the report entitled "NHS Waiting Times in Wales," which describes a service where people had to wait significantly longer for elective treatment than in England. Factors behind the long waiting times; Reason behind the slow progress in improving health services in the country; View of Marcus Longley, co-author of the report "NHS Wales Barometer 2004," on the health services.

Reports on the Warwickshire and Worcestershire Basic Surgical Training Scheme (WWBST) Rob Benny Prize that will be awarded to medical trainees in Great Britain in honor of the late physician Robert Benny. Qualities of Benny; Reaction of Shelagh Macleod, the first recipient of the WWBST Rob Benny Prize, to the award; Statement issued by Karen Pereira-Benny, wife of Benny, regarding the death of her husband.

Reports on the increase in the number of doctors prosecuted for manslaughter following medical accidents in Great Britain. Punishments for doctors who were convicted for manslaughter; Estimated number of medical errors each year; Suggestions on reducing medical errors; Information on several medical manslaughter prosecutions. INSET: 'If I had gone to jail I don't think I would have survived'.

Reports on the efforts of the Great Britain Department of Health (DoH) to retain hospital doctors who are working under the National Health Service. Factors causing doctors to quit their work; Information on the Flexible Careers Scheme launched by the DoH in 2001 for hospital doctors; Advantages of the scheme; Background on the survey conducted by Catherine Nelson-Piercy, a flexible working officer at the Royal College of Physicians of London.

Investigates the effectiveness of using a job plan to reduce the busy workloads of physicians in Great Britain. Benefits of the job planning standards developed by the British Department of Health; Link of job planning to local incentive schemes and clinical excellence awards; Concerns of the Hospital Consultants and Specialists Association regarding the idea of job planning.

The article looks at a wealth of attractions in Northern Ireland. An overview of several hospital developments in the region is presented. Despite the common perception of political strife spilling out into unrest and violence on the streets, a United Nations report states that Northern Ireland has the second lowest crime rate in the developed world. Every large town has also a theater and theater company, and the province is a stop for touring West End musicals, drama and dance hits.

The article focuses on a government framework for commissioning mental health services for children and young people held in custodial settings in Great Britain. Most of these young people in the framework have difficulties with family and peer relationships, high levels of poverty and entrenched parental needs. The framework is part of a strategy for helping vulnerable children and families, tying in with the Every Child Matters program and the national service framework for children.

The article presents information on the Northern and Yorkshire region in England as career destination for physicians. It has six million population and highest rate of preventable ill health, long-term illness and premature deaths. One of the hospital developments being conducted in the region is a cancer centre at Castle Hill Hospital in East Yorkshire. It has four medical schools, education centres and scholarship schemes for undergraduates. Newcastle has been awarded with Biomedical Research Centres of Excellence.

The article focuses on systems of co-payments being proposed in Great Britain to address a shortfall in National Health Service (NHS) funding. It is said that the British government has rejected the findings of a Commons Health Committee inquiry that concluded the system of NHS charges was a mess. A report by the British United Provident Association (BUPA) Health Insurance suggests co-payments as a way of easing the funding pressure.

The article presents information on the British Healthcare Commission's new annual Health Check ratings system, a scheme which measure hospital trusts in the country. The scheme use a risk-based approach and focuses on self-assessment. The financial management rating takes into account both whether the National Health Services body has a deficit, and how it generally runs its finances.

The article presents information on the results of "The Provision of Out-of-Hours Care in England" report prepared by the British National Audit Office and a model of successful integration of primary care out-of-hours services with the accident and emergency (A&E) departments. It is discovered that the actual costs of providing the services are higher than expected. Every Monday at Nottingham Emergency Medical Services, a non-commercial general practitioners out-of-hours cooperative, an experienced primary care nurse works in its A&E. INSET: A MODEL OF SUCCESSFUL INTEGRATION OF PRIMARY CARE OUT-OF-HOUR...

The article highlights the disagreement on the argument of Doctors for Reform (DfR) group that Great Britain needs to move away from an entirely tax-funded health service. Karol Sikora, a cancer specialist and a member of the DfR steering committee, says that the British National Health Service is in a more parlous state as of May 4, 2006. It is said that the group refuses to specify problems in the hospitals where their members work. Patients are provided with limited choice in tax-funded health system according to the group. INSETS: CANCER SERVICES;WHO IS BEHIND REFORM?.

The article focuses on the need for local hospitals in Great Britain to consider how to deliver more acute services in the community in line with the policies on primary care, according to a report from the National Leadership Network (NLN). NLN identified a core of minimum services that must be provided at all hospitals with accident and emergency departments. Other services such as emergency surgery could be provided by clinical networks. NLN also said that ambulance services play a very important role in providing immediate care and making decisions on routing patients speedily and efficiently to the most appropriate provider. INSET: NEW MODELS OF A&E CARE.

Reports on the potential role of U.S.-style physician assistants (PA) in solving medical and nursing manpower problems in Great Britain. Qualifications that should be met by PA; Number of PA practising across the U.S.; Problems faced by such assistants employed in accident & emergency department providing medical supervision in Great Britain. INSET: CASE STUDY.

Focuses on several British junior doctors who consider a career outside medicine or even abroad. Difficulties faced by Doctor Ivo Dukic in finding institutions to practice; Plan of doctor Siddesh Shambhu to find work in the U.S. or New Zealand; Factors that contributed to the increased number of unemployed doctors in Great Britain according to the British Medical Association.

Examines the possible effects of the Postgraduate Medical Education and Training Board (PMETB) to be launched in September 2005 on medical royal colleges in Great Britain. Role of the colleges in the specialist training of doctors; Views of general surgeon Andrew McIrvine on the colleges; Possible benefit of the PMETB for staff and associate specialist doctors.

Examines the concern of orthopedic consultants on sending patients to independent sector treatment centers (ISTC) for waiting time prevention under the National Orthopaedic Project in Great Britain. Reduction of the number of patients who wait several months for an orthopedic surgery from January 2004 to February 2005; Support of the British Orthopaedic Association for the project according to former president Paul Gregg; Concerns of the association on ISTC. INSETS: BARKING, HAVERING AND REDBRIDGE HOSPITALS TRUST;ROYAL CORNWALL HOSPITALS TRUST.

Discusses issues concerning the resignation of Alan Burns, director of service implementation at National Health Service (NHS) Connecting for Health in Great Britain as of June 2005. Implication of the resignation for the credibility of the government's NHS information technology program; Statement issued by John Wood, an orthopedic surgeon at University Hospital Lewisham, about Burn's resignation; Reasons doctors are becoming disengaged with the program.

Presents an interview with John Smith, colorectal surgeon and president of the Royal College of Surgeons of Edinburgh in Scotland, about the role of the college in the medical world and surgery. Approach that colleges should undertake in amalgamating some of their administrative functions according to Smith; Academic and career background; Plans of Smith for the college's quincentenary celebrations.

Focuses on the impact of changes to the British immigration policy on the employment of international medical graduates (IMG) discussed by international doctors' associations in a meeting with National Health Service CEO Nigel Crisp. Result of a study on employment problems facing IMG conducted by the General Medical Council and the Royal College of Physicians; Implication of forcing overseas doctors to make multiple visa applications; Benefits of rationing the number of doctors taking the PLAB test.

Discusses the concerns raised by commentators on the introduction of the British National Health Service Foundation Trusts. Current number of foundation trusts in Great Britain, as of January 2005; Reasons behind the unease among the first trusts to gain independence; Impact of payment-by-results and competition with private sector on foundation trusts.

Explores issues concerning the Improving Working Lives (IWL) initiative, initially set up for nurses, domestic staff and various professions allied to medicine and later was extended to doctors, launched by the Great Britain Department of Health in 2001. Percentage of women doctors who are interested in working part-time at some point in their career, according to a survey conducted by the Royal College of Pathologists; Use of the survey results; View of Doctor Jo Hilborne, chairman of the British Medical Association Junior Doctors negotiating subcommittee, on IWL.

Focuses on the importance of a Fee for Service pilot scheme proposed by the National Health Services to the integration the delivery of healthcare services in Great Britain. Information on the scheme; Advantages and disadvantages of the scheme; Implications of the scheme for patients; Impact of the scheme on the efficiency of medical services in the country.

Reports on the use of a clinical network scheme in improving orthopaedic services in England. Benefits offered by the network; Performance of sub-specialty operations by doctors in the network; Concept of the network.

Focuses on the problem faced by the health care services in Great Britain about the accuracy of data needed to measure the performance of doctors. Basis of healthcare trusts in measuring performance of clinicians; Information on a Web-based real time performance monitoring system developed by Dr Forster, a commercial body that publishes and analyzes information about the quality of health care services; Application of the system at the St. Mary's Hospital in London.

Focuses on the issue over the pay cuts imposed on British junior doctors as National Health Service trusts restrict their hours in line with the terms of the 1991 New Deal and their new contract as of June 10, 2004. Motion made by delegates at the 2004 British Medical Association's Junior Doctors Conference calling for pay negotiations to be reopened; Provisions of the New Deal regarding British junior doctors' pay; Impact of the pay cuts on junior doctors.

Highlights the concerns of physicians about health services that are not in included in British government targets for action as of May 6, 2004. Example of the way the respiratory specialty loses out due to its lack of priority status; Complaints of the National Osteoporosis Society; Action taken by Member of Parliament Alice Mahon to pressure the government into providing sufficient funding to provide treatment to the people who need it.

Presents information on the launch of a national debate on the funding of the British National Health Service (NHS) and health care reform in Great Britain. Refusal of British health secretary John Reid to change the policy of the NHS; Concerns regarding the failure of the NHS; Alternative provided by the Institute of Economic Affairs concerning the future funding of the NHS.

Presents an interview with Peter Hutton, chairman of the National Clinical Advisory Board in Great Britain, about the IT revolution within the British National Health Service (NHS). Impact of the NHS IT initiative on the heath care sector; Value of the national NHS investment in IT; Risks involved in the NHS IT implementation.

Examines the lack of appointed physicians at top jobs in Great Britain's National Health Service (NHS) bodies. Representation of physicians in the Commission for Healthcare Audit and Inspection; Stance of the British Medical Association on the issue; Reasons for doctors being passed over at the highest level of the NHS. INSET: 'The locum business is too serious to be left tobusiness....

Discusses the launch of Casualty Plus center for private emergency health care in Great Britain in October 2003. Advantages of the facility as an alternative to emergency services in the National Health Services; Background on the services offered by Casualty Plus; Information on the doctors at the facility.

Discusses issues on the effect of the National Framework Agreement, a national contract for locums in Great Britain introduced in October 2002 to prevent agencies from over-charging the National Health Service for doctors. Comments on the agencies who bid blind to join the contract; Rise in costs for recruiting locum doctors; Analysis of the locum contract that preceded the 2002 agreement.

Provides information on foundation hospitals under the National Health Service (NHS) of Great Britain. Legislative bill behind the foundation hospitals policy; Power and freedom available to foundation hospitals; Number of NHS hospitals that applied for foundation status.

Speculates on the implications of the creation of Great Britain Commission for Healthcare Audit and Inspection for hospitals as of May 2003. Support of doctors to the commission; Roles and responsibilities of the commission; Challenges facing the commission.

Presents updates on the modernization and expansion of hospitals services in the North West of England. Redevelopment of the Hope Hospital site; Information on the Wolfson Molecular Imaging Center; Rehabilitation of the medical assessment unit of the Aintree Hospitals National Health Service Trust.

The article reports that a legal challenge to changes to immigration rules will be too late to prevent many graduates of foreign medical school having to leave Great Britain to work. Overseas doctors have been told that an appeal they are bringing against the Doll's decision to change the immigration rules is to be heard on October 30-31, 2007. The impact of the policy on permit-free training scheme is also reported.

An interview with Hamid Ghodse, psychiatrist and medical director of the Advisory Committee on Clinical Excellence Awards (ACCEA), is presented. He states that he believes in the merit of the clinical excellence awards (CEA) scheme introduced in Great Britain in 1948. He states that most minority doctors are reluctant to apply for CEA. He shares his plan to increase the employer-based awards.

The article focuses on the northwest of England. It states that a private finance initiative (PFI) scheme is in progress to redevelop Saint Helens and Whiston hospitals. It mentions that Blackpool Pleasure Beach is the most popular tourist attraction in the region. Other popular attractions in the region are Chester Zoo, Tare Liverpool, Blackpool Tower and the World Museum Liverpool.

The article highlights the "Investigation into Nature and Impact of Complaints Made Against Paediatricians Involved in Child Protection Procedures" report from the Royal College of Paediatrics and Child Health (RCPCH) in Great Britain. This report reveals that some doctors who had been involved in complaints had been threatened with murder or had received threatening and unpleasant letters, while others had been attacked and stalked.