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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.

Waiting times for elective surgery are a key issue for the NHS. The principal policy response in the English NHS has been to introduce maximum waiting time targets against which performance is measured and rewarded. The aim of this paper is to identify the effect of government targets on the distribution of waiting times in the NHS. Specifically, we investigate the following questions: How does the probability of admission for any given patient vary during the time that they wait? How is the probability of admission for any given waiting time affected by the targets? Can variations in waiting times be explained by clinical, patient, or provider-level characteristics? What implications may be drawn from our results with respect to providers’ managerial responses to the targets? This paper investigates these questions by applying duration analysis techniques to waiting time data from 2001/2002 and 2002/2003 for three specialties: general surgery, trauma & orthopaedics and ophthalmology. Estimation of survival functions reveals considerable variations in waiting times between specialties, operative procedures and hospitals. Hazard rates vary over time and peaks in them—high probabilities of admission—coincide with targets and change when targets change. Amongst patient characteristics, whether they are NHS or private and whether they are day or inpatient cases both influence waiting times, but other characteristics such as age, sex and ethnicity do not. [ABSTRACT FROM AUTHOR]

Recent UK health policy initiatives promote a ‘no blame culture’ and learning from adverse events to enhance patient safety in the NHS. Similar initiatives exist in the USA and Australia. Changing the ‘blame culture’ in the NHS has been advocated in policy documents and inquiry reports for over a decade. Some key concepts that are used in the policy discourse –‘blame’; mistakes, errors and misdemeanours; and ‘culture’– are examined and considered in the light of pertinent social science literature to question some of the assumptions concerning these terms in the policy discourse, and to suggest some alternative questions and perspectives. The Three Inquiries, a recent series of statutory inquiries held in the UK, are used as a case study to explore some of the intra- and inter-professional difficulties of reporting errors and misconduct by medical practitioners. The paper offers an interpretive social science perspective as an alternative to more policy oriented and managerial approaches to patient safety issues, focusing on deeper structural aspects of organisational phenomena implicated in the ability or otherwise of medical and other healthcare staff to report mistakes and misconduct as one aspect of patient safety. [ABSTRACT FROM AUTHOR]

The core of this paper' is a case study of how a District Health Authority (Paddington and North Kensington, now Parkside DHA following a recent merger with Brent DHA) in Inner London responded to a major new health care issue of the 1980s-Aids, but the paper also seeks to locate this case study material within wider debates. What theories are there of organisational change which could be used to illuminate policy and service change in the health care sector? How, indeed, do we best study change in health care organisations? The paper is thus in three parts. In the first section we identify some streams of literature which act as a frame of reference defining our initial research question and discuss implications for methodology. The second section presents the case itself, while the last section discusses some emerging findings. [ABSTRACT FROM AUTHOR]

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]

Leaving the European Union (so-called ‘Brexit’) is a ‘critical moment’ for health policy reform which can pave the way to different pathways, including, a ‘critical juncture’. Given that Brexit cannot be undone without a second referendum, it opens up opportunities to elude European constraints for reform along the lines of equity, employment rights and patient choice. Brexit deepens the financial crisis of the National Health Service (NHS) by increasing hiring costs and imposing new transaction costs to accommodate patient cross-border mobility and international public health needs. Given the weak sustainability of the NHS, it could lead to major system reform. [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]

In this article we compare the pattern of service utilization in the period preceding the health-care reforms introduced by New Labour with service utilization following the refoms. Data from the 1997 and 2003 waves of the British Household Panel Survey are used to estimate a series of utilization functions. These show that GP utilization overall fell, for women more than men and for the sick more than others. The results suggest that GPs responded to the changing context the reforms created but there are different interpretations of that response. They support the contention that GPs devoted greater attention to preventative services post-reform than had previously been the case. They are also consistent with the contention that GPs responded less directly to the needs of their patients, either because they became more sophisticated in interpreting those needs or conscious of the increased opportunity costs of responding to them. [ABSTRACT FROM AUTHOR]

The social science literature on the comparative history of the welfare state offers conflicting accounts of the relationship between the United States and the United Kingdom. At first blush, the comparative history of health care policy in the United States and the United Kingdom seems to affirm the dominant view that the U.S. and U.K. welfare states have diverged substantially during the twentieth century. A comparison of U.S. and U.K. health policy, however, suggests that there are more parallels and points of tangency between the two systems than are readily apparent. The comparative history of health policy over the past century reveals common political and policy challenges and frequent interchanges of policy ideas, and helps uncover the political dynamics behind the development of health policy in the two countries, which can, in turn, help illuminate the contemporary politics of reform in both countries. [ABSTRACT FROM AUTHOR]

This article provides a time series analysis of NHS public inquiries and inquiries related to health against the background of recent policy changes which are centralizing hazardous incident investigations within agencies such as the Healthcare Commission. [ABSTRACT FROM AUTHOR]

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 reports on the Private Finance Initiative (PFI), one of the types of public-private partnerships being run by the government in Great Britain. In a PFI development, a consortium of private sector companies would finance, design and build the hospital and then run a range of services including maintenance and estate management, within it. Such engagement in which private sector's managerial, commercial and creative skills can be brought to bear in the task of modernizing and strengthening public sector services, offers the prospect of better value for money. The responsibility to manage such arrangements has been given to some Great Britain National Health Service managers.

The confirmation of NHS responsibilities for continuing health care has important implications for primary and community health services. In early 1996, during the period of consultation on draft local policies and eligibility criteria, exploratory interviews were carried out with general practitioners (GPs), community nursing managers, primary care development officers and social services purchasers in three health authority areas. The interviews indicated that few GPs had responded to local consultation and were only slowly becoming aware of the implications for the provision and purchasing of primary and community health services. Moreover, local continuing care policies had apparently not addressed two issues which GPs and community nursing staff indicated were currently highly problematic: their responsibilities in relation to independent sector residential and nursing home patients; and the consequences for primary health and community nursing services of hospital discharge decisions. The need for purchasers and commissioners of health services, whether health authorities or GPs, to begin collecting information on patients' potential needs for continuing care services was widely recognised as an urgent priority. [ABSTRACT FROM AUTHOR]

The article mentions that Professor Philp and National Director of Cancer Mike Richards have written the NHS report on end-of-life care. It also records the progress made during the past year since the End of Life Care Programme was introduced to the NHS. The goal is to train staff on issues of end of life care and communication with carers and patients. The program is funded with £12 million.