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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 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.

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 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]

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.

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.

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.

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]

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]

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]

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.

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 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.

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]

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 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.

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]

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]

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]

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.

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 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]

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]

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.

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]

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.

Focuses on the publication of two government White Papers, emphasizing their implications for the quality of primary care in the United Kingdom. Factors which motivated the introduction of the White Papers; Role of the National Health Service; Reference to contractual arrangements governing the provision of primary care; Details on legislation which resulted from the White Papers.

The article discusses the cost and effectiveness of in vitro fertilization (IVF) technique in Great Britain. The development of IVF presents the providers of health care with several problems. Inequality of distribution will become a problem if the new technique would be taken up by the private sector. In the present financial climate of the country it appears that National Health Service funding will be available to meet the demand for IVF.

The article focuses on medical specialists. It says that patients are given an abysmally low standard of care by being given various prescriptions and by being referred to a narrow-minded specialist. It mentions that most of the costs of the British National Health Service are committed to specialist care although there are only few patients who need it.

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.

Taking the idea of refugee 'journeys to health' (Newbold and McKeary, 2018) as a point of departure this paper examines the case of Chilean exiles in the UK. Reflecting on interviews conducted with Chilean exiles the analysis highlights how the health-related challenges that many people have experienced change over time. For some the passing of time has enabled people to make sense of what happened to them following the military coup in Chile in 1979 and this has helped them to 'move on'. For others, on-going challenges remain, for example a number of people still experienced PTSD. The paper also reflects on the difficulties encountered by refugees when dealing with formal health providers. While all of the respondents had full entitlements to NHS services the paper reflects on the informal barriers that continue to shape refugees' engagement with health care providers and limit their ability to address health concerns. [ABSTRACT FROM AUTHOR]

The article discusses the campaign of Unite unions against the White Paper National Health Services (NHS) reforms. It mentions that the proposed reforms on the NHS White Paper are geared towards privatization, increased competition, and exclusion of health services to communities. Details on the concerns of Unite members on the terms and conditions of the White Paper reforms are discussed. According to Unite, the effect of reforms could result into inequalities among patients needing service.

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.

The article presents a memorandum of the Royal Medico-Psychological Association on the Second Green Paper on the future of the National Health Service in Great Britain. The association aims to coordinate the National Health Service and the Local Government services and welcome the participation of legal professionals and consumers. Policies concerning the management are given more importance rather than the daily administration activities. Furthermore, a single authorities should be recognized in each areas of the Health Service, including the social work and medical services.

The article discusses the memorandum of the Royal Medico-Psychological Association. It focuses on the green paper that indicates the administrative structure of the medical services in England and Wales. It is explained that any attempt to integrate the present tripartite administration into a single authority for a single community would be accepted by the Association, if satisfactory arrangements may be made that surpass the existing ones. Moreover, it should take responsibility for all the health functions of present local health authorities. Thus, it is stated that the unification of the tripartite structure of the National Health Service, by the development of Area Health Boards, are supported by them.

Background: COVID 19 is still presenting a clear and dynamic global threat. The United Kingdom remains one of the hardest hit countries from the pandemic. In January 2021 parliament announced that the UK will be entering a full national lockdown. This paper explores what effect lockdown measures had on rates of deliberate self-harm presentations to one NHS trust in Manchester UK. Methods: This paper compared the number of cases of deliberate self-harm which presented to the emergency department of Manchester Royal Infirmary for March-May in 2018, 2019 and 2020. This was achieved by utilising coding from emergency department data and reviewing hospital records surrounding each case. Results: 2018 recorded a total of 101 admissions as a result of DSH with all causes admissions of 8,514 making the proportions of admissions due to self-harm 1.19%. In 2019, 9,038 patients were admitted, of these, 130 (1.44%) were identified as DSH. In 2020 the total number of admissions fell to 5,676 with 118 admitted due to self-harm, representing 2.08% of admissions. The absolute number of admissions remained stable however the proportion of admissions due to self-harm was significantly higher in 2020 (p < 0.001). Other significant findings include a higher proportion of male admissions compared to females in 2020 (58.5%) and a decrease in the normal of cases relating to paracetamol overdose in 2020. Discussion: The findings demonstrated by this study do not indicate that lockdown is an absolute risk for DSH behaviours however it does illustrate the stable nature of these cases despite and dramatic decline in all cause admissions. The rate of increase of deliberate self-harm accelerated significantly between March and May in 2020. Steps must be taken to avoid a similar situation following the 2021 lockdown and beyond – focus on improving access to certain virtual services may help to achieve this goal. [ABSTRACT FROM AUTHOR]

The role of lifestyle on mental health in the ambulance worker population is unclear. The aim of this paper is to explore the role and impact of lifestyle on the mental health of ambulance workers within the United Kingdom (UK). Participants (N = 160) were recruited from 4 NHS ambulance trusts in England. Data were collected on lifestyle factors (sleep, physical activity and alcohol use) and mental health outcomes (trauma, anxiety, depression and stress); these were assessed by use of various questionnaires including validated measures. Sleep was shown to be the single biggest unique and significant predictor to all mental health outcomes. Suggestions for future research and intervention are considered. [ABSTRACT FROM AUTHOR]

Background: In Britain's National Health Service (NHS), medical consumerism is disliked by many doctors but managed by NHS leaders. Managed consumers have choices about treatment options, but are expected to help contain costs, improve quality of care, take part in clinical research and advocacy, and increase productivity. There are so many meanings for medical consumerism that it can be categorized, in post‐structuralist terms, as a 'symbol without meaning', but meanings are plentiful in the NHS. Policy expectations: Choices made by discriminating consumers were expected to improve the quality of medical care for all. Extending choice to the many, and not restricting options to the few, would allow gains from choices to accumulate, so that choice would sustain social solidarity. Managed consumerism would in theory, therefore, instil reasonable choices and responsible behaviours in a moralized citizenry, across the nation. The advocates of New Labour's espousal of medical consumerism expected the accumulative effects of customer choices to challenge professional and occupational power, erode the medical model of health and illness, constrain professional judgements, and open the NHS to new ways of working. Almost all their expectations have been thwarted, so far. Conclusions: Managed consumerism is far from being a meaningless symbol. This discussion paper explores the territory of managed consumerism and suggests realistic ways to make it more effective in shaping the NHS. Patient & Public Contribution: We developed the arguments in this discussion paper with insights provided by a lay expert (see Acknowledgements) with experience of consumerism in both public sector management and a disease‐related charity. [ABSTRACT FROM AUTHOR]

This paper explores changes in age-specific mortality risk across periods and cohorts during the twentieth century in the developed world. We use and compare two approaches—one graphical (Lexis plots) and one statistical (an adapted Hierarchical age-period-cohort model)—that control out overall trends in mortality, to focus on discrete changes associated with specific events. Our analyses point to a number of key global and local events in the Twentieth Century associated with period and/or cohort effects, including the World Wars and the influenza pandemic of 1918–19. We focus particularly on the UK but look at other countries where results are particularly noteworthy, either substantively or methodologically. We also find a decline in mortality in many western countries, specifically in the 1948 birth cohort, which may be associated with the development of post-war social welfare policies, the economic investment in Europe by the United States, the accessibility of antibiotics such as penicillin, and, in the UK, the founding of the NHS. We finish by considering the advantages and disadvantages of using the two methods with different sorts of data and research questions. [ABSTRACT FROM AUTHOR]

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]

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.

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.

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.

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.

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 article examines the issues surrounding White Paper's uncovering of the proposal to reforming the health professionals' Trust, Assurance and Safety regulation in Great Britain. The White Paper expressed that to reform, the importance of perceptions must be rightly emphasized as public needs to perceive that the regulatory system is operating in the interests of patients. It also stresses that the General Medical Council's (GMC) four functions must be integrated in the regulatory framework.

After 13 years as editor of the British Medical Journal, Richard Smith is leaving to become head of the European arm of a U.S.-based health care company. Smith will link up with Simon Stevens, who is stepping down as British Prime Minister Tony Blair's senior health policy adviser, to run the new subsidiary of the UnitedHealth Group Inc. The company will help Great Britain's National Health Service (NHS) in providing patient care by commissioning at-home care for elderly patients and improving data management for clinicians and health care managers. Smith says the new company aims to strengthen the NHS by helping it coordinate health care services, although critics see Blair's reforms as a step toward privatizing British health care.

Liver transplantation (LT) for unresectable colorectal liver metastases (CRCLM) demonstrates good overall survival for selected patients in contemporary studies, with 5-year survival of 80%. A Fixed Term Working Group (FTWG), set up by NHS Blood and Transplant (NHSBT) Liver Advisory Group (LAG), advised whether CRCLM should be considered for LT in United Kingdom. Their recommendation was that LT may be undertaken for isolated and unresectable CRCLM using strict selection criteria as a national clinical service evaluation. Opinions were sought from colorectal cancer/LT patient representatives, experts in colorectal cancer surgery/oncology, LT surgery, hepatology, hepatobiliary radiology, pathology, and nuclear medicine, and appropriate patient selection criteria, referral and transplant listing pathways were identified. This paper summarises selection criteria for LT in United Kingdom for isolated and unresectable CRCLM patients, and highlights referral framework and pre-transplant assessment criteria. Finally, oncology-specific outcome measures to be utilised for assessing applicability of LT are described. This service evaluation represents a significant development for colorectal cancer patients in United Kingdom and a meaningful step forward in the field of transplant oncology. This paper details the protocol for the pilot study, scheduled to begin in the fourth quarter of 2022 in United Kingdom. [ABSTRACT FROM AUTHOR]

Background: 2022 marks a decade since the profession of podiatry secured independent prescribing rights in the UK. Widely viewed as a significant milestone, its advent appeared to herald a new age of practice, with increased autonomy, a broader scope of practice and improved patient care. Access to any medicine within the British National Formulary (with a few notable exceptions) seemed to signal an end to the perennial difficulties and frequent disappointments in obtaining ease of access to medicines necessary for effective practice. Main body: Recent attempts to expand the scope of prescribing practice to include access to a broader range of controlled drugs (CDs) have led to unanticipated complications which may even threaten existing rights. These issues highlight the limitations of current independent prescribing and the continuing inability of podiatrists to access certain key medicines, primarily controlled drugs. Reliance on specified 'lists' of approved medicines, whether a controlled drug list for prescribers or the use of statutory exemptions by non-prescriber podiatrists, remain inflexible and difficult to change. The data underpinning much of this paper is derived from the work undertaken by the authors as representatives of podiatry on NHS England's Chief Professions' Officers' Medicines project, in particular involving submissions to the Commission on Human Medicines and the Advisory Council on the Misuse of Medicines, spanning the years 2017–2021. It describes a complex process, and highlights a misalignment between two legislative frameworks that threaten to unravel existing rights. Short conclusion: Ongoing difficulties relating to controlled drugs illustrate the problematic nature of current supply, administration and prescribing rights in podiatry. Efforts to keep pace with periodic legal reclassifications of medicines are constrained by limited and inflexible legal mechanisms, and formal approval for extended access via prescribing remains unpredictable and complex. For prescriber and non-prescriber1 (1Non- prescriber podiatrists are those who are neither supplementary or independent prescribers, but do enjoy existing administration and supply rights to certain medicines.) podiatrists alike, the profession of podiatry faces a new challenge to its ability to access medicines, and to realise its full clinical potential. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to study the pandemic from the perspective of the UK health-care system and risk management. Design/methodology/approach: This paper follows a storytelling perspective. The author reflects on his experiences through the lens of research on health care and risk management. Findings: The impact of the pandemic has been so massive that it has challenged the capacity of the UKs National Health Service. The political influences at work have not always promoted best practice in risk management and indicate blame-avoidance strategies by politicians. Research limitations/implications: A single country experience of COVID-19. Practical implications: There are major issues of asset management, of delays in decision-making, of supply chain problems and the need to reform processes of handling of crisis management. Originality/value: This is an individual account of experiences of the pandemic. [ABSTRACT FROM AUTHOR]

This article reports findings from a scoping review of the literature on good practice in social care for disabled adults and older people with severe and complex needs. Scoping reviews differ from systematic reviews, in that they aim to rapidly map relevant literature across an area of interest. This review formed part of a larger study to identify social care service models with characteristics desired by people with severe and complex needs and scope the evidence of effectiveness. Systematic database searches were conducted for literature published between January 1997 and February 2011 on good practice in UK social care services for three exemplar groups: young adults with life-limiting conditions; adults who had suffered a brain injury or spinal injury and had severe or complex needs; and older people with dementia and complex needs. Five thousand and ninety-eight potentially relevant records were identified through electronic searching and 51 by hand. Eighty-six papers were selected for inclusion, from which 29 studies of specific services were identified. However, only four of these evaluated a service model against a comparison group and only six reported any evidence of costs. Thirty-five papers advocated person-centred support for people with complex needs, but no well-supported evaluation evidence was found in favour of any particular approach to delivering this. The strongest evaluation evidence indicated the effectiveness of a multidisciplinary specialist team for young adults; intensive case management for older people with advanced dementia; a specialist social worker with a budget for domiciliary care working with psycho-geriatric inpatients; and interprofessional training for community mental health professionals. The dearth of robust evaluation evidence identified through this review points to an urgent need for more rigorous evaluation of models of social care for disabled adults and older people with severe and complex needs. [ABSTRACT FROM AUTHOR]

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.

Background: The COVID-19 pandemic has presented unique challenges for rapidly designing, initiating, and delivering therapeutic clinical trials. PRINCIPLE (Platform Randomised Trial of Treatments in the Community for Epidemic and Pandemic Illnesses) is the UK national platform investigating repurposed therapies for COVID-19 treatment of older people in the community at high risk of complications. Standard methods of patient recruitment were failing to meet the required pace and scale of enrolment. This paper describes the development and appraisal of a near real-time, data-driven, ethical approach for enhancing recruitment in community care by contacting people with a recent COVID-19 positive test result from the central NHS Test and Trace service within approximately 24-48 h of their test result.Methods: A multi-disciplinary team was formed to solve the technical, ethical, public perception, logistical and information governance issues required to provide a near-real time (approximately within 24-48 h of receiving a positive test) feed of potential trial participants from test result data to the research team. PRINCIPLE was also given unique access to the Summary Care Record (SCR) to ensure safe prescribing, and to enable the trial team to quickly and safely bring consented patients into the trial. A survey of the public was used to understand public perceptions of the use of test data for this proposed methodology.Results: Prior to establishing the data service, PRINCIPLE registered on average 87 participants per week. This increased by up to 87 additional people registered per week from the test data, contributing to an increase from 1013 recruits to PRINCIPLE at the start of October 2020 to 2802 recruits by 20 December 2020. Whilst procedural caveats were identified by the public consultation, out of 2639 people contacted by PRINCIPLE following a positive test result, no one raised a concern about being approached.Conclusions: This paper describes a novel approach to using near-real time NHS operational data to recruit community-based patients within a few days of presentation with acute illness. This approach increased recruitment and reduced time between positive test and randomisation, allowing more rapid evaluation of treatments and increased safety for participants. End-to-end public and patient involvement in the design of the approach provided evidence to inform information governance decisions.Trial Registration: PRINCIPLE is funded by UK Research and Innovation and the Department of Health and Social Care through the National Institute for Health Research. EudraCT number: 2020-001209-22 . 26/03/2020 ISRCTN registry: ISRCTN86534580 . 20/03/2020 REC number: 20/SC/058 IRAS number: 281958. [ABSTRACT FROM AUTHOR]

This paper is a slightly revised version of a Memorandum requested by the House of Commons Social Services Select Committee to assist the Committee in its analysis of the White Paper Working for Patients (Cm 555). It was submitted to the Committee on 28 February 1989. The paper follows up the author's earlier study of the reform of the NHS (Barr, Glennerster and Le Grand, 1988), prepared at the request, of the Select Committee prior to the publication of the White Paper. The success or failure of the White Paper depends crucially on the precise details of the way in which its proposals are implemented. The Working Papers, although providing some more information as to how the White Paper's proposals will be implemented, do not in the main address the issues that concern us here. Given the inescapable tension between cost and quality, quality control will be absolutely critical if the incentives to economize on the use of resources are not on occasion to lead to unacceptable reduction in quality-reduction which might well apply differentially by socioeconomic group. [ABSTRACT FROM AUTHOR]

The UK's publically available blood stem cell infrastructure has undergone significant transformation in recent years as umbilical cord blood has joined adult donors as a viable clinical stem cell source. This paper describes the development of a collaborative governance arrangement between the UK's two domestic providers of blood stem cells: a public body and a charity. The paper argues that the collaborators, who stand to benefit from the alignment, legitimize their work through appeals to public good. It suggests that appeals to buy British obscure an inevitable requirement to cultivate international, networked stem cell exchange; the paper also explores collaborators' reinforcement of a supposed connection between human leukocyte antigen tissue type and ethnicity through claiming that the UK's ethnic minorities face an “unmet need.” By way of this, the paper demonstrates the interconnection of collaborators' institutional interests with concerns for national health equity. [ABSTRACT FROM PUBLISHER]

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....

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.

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.

The article focuses on a paper about the interrelation between the status and work of surgeons, limitation of resources and the impact of the introduction of general management in the British National Health Service (NHS). The author mentions that it is illusory to expect the separation of the NHS from the elements of politics.

Several letters to the editor and a reply are presented regarding the article in previous issues such as the White Paper entitled "Healthy lives, healthy people: our strategy for public health in England" released in July 14, 2011 and the "Move to local councils is 'misguided'" in August 2011 issue.

The article focuses on medical electronic document management (EDM) and how it could deliver clear and calculable benefits to Trusts in Great Britain's National Health Service (NHS). A common problem in document management is the confusion in the minds of some NHS trust managers between scanning and EDM. Scanning will clear the medical library shelves by converting physical documents into digital images, but only if coupled with an EDM solution it can be effective and economical.

Healthcare accounts for approximately 5% of emissions in developed nations, and the public healthcare provider in the United Kingdom (UK), the National Health Service (NHS), has set a target to reach net-zero emissions by 2040 without detriment to its quality of patient care. With Uncrewed Aerial Vehicles (UAVs; a.k.a. drones, UAS, or RPAS) starting to be used in healthcare systems outside the UK, there is interest in how they could be integrated into NHS operations to transport diagnostic specimens. Reflecting on a business-as-usual analysis of current NHS diagnostic specimen logistics across the Solent region (southern UK), this paper critically evaluates the practical reality of integrating UAV deliveries of this commodity, identifying the benefits and challenges that must be addressed to realise commercial services, including dangerous goods legislation, cargo stability, routing, and weather. In the analysis, 14 out of 79 surgeries could be realistically served by a 5m wingspan vertical take-off/landing (VTOL) UAV: seven directly, and seven via ground-based transfers. The results suggested that an average of 1,628 samples could be served by UAV each week, resulting in 42 flights/week with 10 taxi services to cover periods where weather limited flying. This equated to an approximate total service cost of £2,964/week if regulations develop to relax UAV personnel constraints. The introduction of UAVs reduced the marginal external costs (greenhouse gas emissions, congestion, and air pollution) by £196 per week and cut travel times to UAV served sites by 72% (weather permitting). Tailpipe emissions (excl. taxis), vehicle-kilometres travelled, and van costs were reduced by 20%, 20%, and 23% (respectively), but the overall system cost increased by 56%. Whilst this increase is likely to make the introduction of UAV services financially challenging, the benefits in terms of emissions and journey time savings may offset some of the additional cost and warrant further investigation. [ABSTRACT FROM AUTHOR]

Healthcare on both sides of the Atlantic is a highly charged political and economic subject. This work considers US media coverage of the UK's National Health Service (NHS), an under-researched area. We assess the framing of the NHS in editorials, opinion and feature articles during the time of the Obama administration to show how media can perform the role of lesson-drawing, a theory adopted from public policy research. The study also applies the notion of journalistic habitus in this context. Using these ideas, we address a hypothesis which holds that US coverage is framed around the flaws of the UK's NHS. The paper considers how intermedia editorial and news values operate, with commentators drawing a range of negative lessons in both the Democrat- and Republican-supporting press. We find that the NHS was often posited as a flawed international variant of the single-payer model, where newspapers employed an ahistoric explanation of failure and decline. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses various reports within the issue on topics including the treatment of personality disorders, the use of psychoanalytic psychotherapy in mental disorders, and addictions, compulsions and fetishism.

Aims and objectives To explain how the healthcare needs of transgender personnel are met within the United Kingdom Armed Forces. Background It may be that when transgender people disclose their gender preference that they are at increased risk of social exclusion. The United Kingdom Armed Forces has an inclusive organisational policy for the recruitment and management of transgender personnel. Design This is a position paper about how the healthcare needs of transgender military personnel are met by the United Kingdom Armed Forces. Methods United Kingdom Armed Forces policy was placed into context by reviewing current research, discussing medical terminology and describing the policy. This was followed by an account of how UK AF policy is applied in practice. Discussion Where armed forces had an inclusive policy for the management of transgender personnel, there seemed to be little cause for secrecy and zero tolerance of discrimination when compared to nations where this was not the case. Medical terminology has changed to reflect a more inclusive, less stigmatising use of language. The United Kingdom Armed Forces policy has been described as progressive and inclusive. The application of this policy in practice may be dependent upon strong leadership and training. The wider United Kingdom Armed Forces seems capable of adopting a pragmatic and flexible approach to meeting the healthcare needs of transgender personnel. Conclusion The United Kingdom Armed Forces value diversity within their workforce and have a progressive, inclusive policy for the recruitment and management of transgender personnel. Relevance to Clinical Practice When supporting a transgender military person, healthcare professionals, civilian organisations and military line managers should consider referring to United Kingdom Armed Forces policy as early as possible. Other military and uniformed services may wish to examine the United Kingdom Armed Forces exemplar in order to consider the applicability within their own organisational setting. [ABSTRACT FROM AUTHOR]

Focuses on the White Paper issued by the British Labor government in 1997 titled 'The New National Health Service: Modern, Dependable.' Review of health care reforms of the previous Conservative government in the context of international reforms; Contents on the White Paper.

The author comments on the White Paper from the National Health Services (NHS) of Great Britain, titled "Equity and Excellence: Liberating the NHS," which proposes changes in the way decisions about health services are made. The author points out the lack of clarity on how the NHS Commissioning Board will promote involvement in research and the use of research evidence. The author discusses how research is funded and facilitated, topics for research, and the involvement of general practitioners (GPs).

Several letters to the editor are presented in response to article "The White Paper: A Framework for Survival?," by Roger Jones in the September 2010 issue.

Campaigns against the privatisation of healthcare in the UK have often focused on saving, or preserving, the post-war National Health Service (NHS) of the 1950s. They talk of it as a 'national treasure', which has long given the UK some moral high ground over countries such as the United States. I argue that seductively simplified campaign slogans can also be blunt – they can carry with them more opaque messages such as those that encourage the maintenance of a patriarchal healthcare system. As a result, campaigns to save the NHS of the 1950s also preserve the nationalism, as well as the class and gendered staffing hierarchies, which (as I illustrate) come to reproduce inequalities in the care that is delivered. Through a multi-cited ethnography focused on the delivery of hip replacements in the NHS, I argue that a more complex form of political activism is needed to bring about the equality in healthcare that the NHS promises. In this paper, I flatten assumed hierarchies of power, to highlight some ethnographic examples of how everyday actions can come to reshape antiquated power structures. I conclude by suggesting we look to how power is pieced together across networks – and how we can re-locate collective agency to within and amongst ourselves to bring about a more equal, and less nationalistic, healthcare service. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to analyse the levels of access to healthcare available to undocumented migrants in the Italian and British health systems through a comparative analysis of health policies for this population in these two national health systems. Design/methodology/approach - It builds on textual and legal analysis to explore the different meanings that the principle of universal access to healthcare might have according to literature and legal documents in the field, especially those from the human rights domain. Then, the concept of universal access, in theory, is contrasted with actual health policies in each of the selected countries to establish its meaning in practice and according to the social context. The analysis relies on policy papers, data on health expenditure, legal statutes and administrative regulations and is informed by one research question: What background conditions better explain more universal and comprehensive health systems for undocumented migrants? Findings - By answering this research question the paper concludes that the Italian health system is more comprehensive than the British health system insofar it guarantees access free of charge to different levels of care, including primary, emergency, preventive and maternity care, while the rule in the British health system is the recovering of charges for the provision of services, with few exceptions. One possible legal explanation for the differences in access between Italy and UK is the fact that the right to health is not recognised as a fundamental constitutional right in the latter as it is in the former. Originality/value - The paper contributes to ongoing debates on Universal Health Coverage and migration, and dialogues with recent discussions on social justice and welfare state typologies. [ABSTRACT FROM AUTHOR]

The article focuses on the White Paper on community care titled "Caring for People" in relation to the 1990 National Health Service and Community Care Bill pending in the House of Lords. Criticisms levelled against the White Paper, particularly the issue of grant aid, are misplaced. The White Paper's outstanding value is that it outlines a clear structure and a set of general principles which should grant local authorities greater autonomy, authority and responsibility in healthcare administration.

The article reports on the likelihood for the government of Great Britain to publish a white paper on the future of the National Health Services (NHS) and community services.

The UK government and NHS Blood and Transplant have introduced a number of policies and organisational changes to the organ donation system following the 2008 recommendations of the Organ Donor Taskforce, which aim to increase the number of available donor organs and tackle transplant waiting lists. However, little is known about how these policy and organisational shifts influence how healthcare professionals experience delivering end-of-life care in the context of organ donation. In this paper, we examine ICU, Emergency Medicine, and Theatre staff's experiences of organ donation in one NHS Trust following the 2008 changes. We focus upon their decision making when caring for patients at the end of life to highlight the tensions between health professionals' beliefs-in-principle about organ donation and their everyday moral and common sense practices when caring for patients at the end of life. We explore how we might understand and interpret this 'troubling' of organ donation through applying the concept of 'conscience', and consider whether a conscientious objection around organ donation could exist. [ABSTRACT FROM AUTHOR]

Generating negative news coverage of state welfare provision has been identified as a strategy designed to create public support for radical policies aimed to reduce such provision. To date, research of this kind has focused on scandals and crises. However, little is known about the complex relationship between media representations of specific events, and those of media representations in the lead up to these events, what we refer to as periphery representations. Employing a content and frame analysis, this paper analyses the frequency and intensity of peripheral representations of the National Health Service (NHS) in the British print media for 1 week a month before and for 1 week during three key events in recent NHS history: the official consultation period for the Health and Social Care Act; the publication of Five-Year Forward View, and the first Junior Doctor Strike. This article finds that negative NHS representations in articles that are peripheral to particular topical issues of controversy evidence fluctuations, amplifications and intensities across time periods, depending on the particular context. The paper concludes by arguing that repetition of negative themes in news helps to build a sensibility of 'inadequacy' of vital services. We hope that this focus on the ways in which amplifications and de-amplifications in negative intensity of peripheral NHS representations across time and content, helps to contribute to debate about the complex interplay between public health services, media representation and policy consent. [ABSTRACT FROM AUTHOR]