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NHS research governance makes it almost impossible to collect certain kinds of data on the everyday life of hospitals and the experience of patients. Fortunately, those of us who get sick enough to be admitted can write about the experience without fear of regulation. This paper presents some observations on clinical ethics, ward organization and infection control that would have been difficult to obtain in any other way, but which illustrate the policy and information costs of the present system. While not personally recommending this as a research strategy, the paper identifies a growing evidence gap and comments on its implications for the delivery of humane and well-organized care. [ABSTRACT FROM AUTHOR]

The article discusses the relevance of diagnosis in general practice to implications for quality of care in Great Britain. It examines studies that concentrate on respiratory and non-respiratory illnesses which reveal the factors that affect the making of diagnostic and management decisions in general practice. It notes the policies enacted to improve public health in the area which include a strong focus on the long-term health needs of patients.

In recent years, the English NHS has achieved substantial reductions in waiting times for hospital treatment. This paper considers first whether the data used by the Government provide an accurate description of changes in waiting times and identifies some of the limitations of the measures used. It then attempts to identify how reductions have been achieved. It argues that some features of central government policy have been important - such as the use of targets - others, such as the introduction of new private sector capacity have not. It also shows that changes at local level have been critical to achieving the recorded improvements, but the precise impact of these is hard to identify. [ABSTRACT FROM AUTHOR]

Introduction: Nursing has come to play a prominent role in government health policy since 1997. Extending the scope of nursing practice into activities previously carried out by doctors can assist a managerialist and 'modernizing' project of increasing National Health Service (NHS) efficiency by removing demarcations between professional groups. Methods: Drawing on elements of poststructuralist linguistics, this paper presents an analysis of a key government speech in the context of a discussion of overall policy intentions. Results: The speech can be seen as an example of how government has attempted to use rhetoric to make its goals attractive to nurses. Conclusion: Policy-makers have to make their policies acceptable to those whom they expect to implement them. In this case, organizational efficiency, chiefly in terms of broader access to NHS services, as well as role substitution, is aligned with government policy promoting social enterprise and 'sold' to the nursing profession as enhancing its status compared with medicine. [ABSTRACT FROM AUTHOR]

The article presents a study which assessed the cost-effectiveness of conducting a randomized controlled trial (RCT) of medical screening for glaucoma within the framework of the National Health Service (NHS) in Great Britain. The researchers revised the Glaucoma Screening Model, conducted sensitivity analyses and calculated quality adjusted life years (QALY). The test paradigms for glaucoma were either optic nerve photography (ONP) or screening mode perimetry.

Objective: Government policies and initiatives in England have promoted the involvement of patients in the management of their own health care. Copying clinical letters to patients may improve patients' understanding of their health and the care they receive. Although the National Health Service (NHS) Plan describes copying letters to patients as a 'right', the process of copying letters to patients remains an example of good practice rather than a requirement. We review the literature to explore whether letters should be copied to patients and in what circumstances. Methods: Review of published literature and evidence from 12 pilot projects funded by the Department of Health (DH) for and against copying letters to patients from the perspective of patients and health professionals. Results: Patients generally find copies of letters beneficial, and tend to be more satisfied with their consultation and report benefits in terms of involvement in their own health care when letters are copied. Health professionals generally have concerns about the relative benefits to the patient and remain concerned about the resource implications of copying letters. Conclusions: On balance, the limited evidence on copying clinical letters to patients favours copying letters, or at least offering copies, although health professionals are less keen than patients. [ABSTRACT FROM AUTHOR]

The article presents the author's opinion on the potential value of historical research for studying health services and for influencing health care policy in Great Britain. According to the author, Policy-makers have generally either shown little interest in historical evidence or they have rejected it. He comments that historians have tended to feel unvalued and disadvantaged due to being discouraged by health care policy-makers' lack of interest in history.