NHS managers could do with a facelift. Cure the NHS with far fewer managers and It is nurses working at the coalface of the NHS that we need, not more bosses are commonplace headlines. And cynicism about NHS managers is not limited to the media. Two years ago, the then minister for health, Jeremy Hunt, wondered whether the NHS had made a mistake in the 1980s “by deliberately creating a manager class who were not clinicians”. Both Labour and Conservative governments have tried (unsuccessfully) to reduce their number. Continue reading
When the NHS turned 70 this year, I was reminded of another anniversary which has had an enormous impact on healthcare over many years. Penicillin is 90 this year.
Discovered in September 1928 by Alexander Fleming, it was first used as a cure when George Paine treated eye infections with it in 1930. A method for mass production was devised by Howard Florey and Ernst Chain in 1940, and it was first mass produced in 1942, with half of that total supply used for one patient being treated for streptococcal septicaemia. Continue reading
As the NHS celebrates its 70th birthday, I hope that in another 58 years there will be similar celebrations and appreciation when its research arm, the National Institute for Health Research (NIHR), turns 70. Continue reading
Ian Kirkpatrick, Andrew Sturdy, and Gianluca Veronesi
A recent study on the impact of management consultants on public service efficiency, published in Policy & Politics, prompted this letter from the authors calling for a moratorium on their use until effective governance is established.
Open letter to the Rt Hon Jeremy Hunt MP, Secretary of State for Health and Social Care
2nd July, 2018
Dear Mr Hunt,
Re Calling for a moratorium on the use of external management consultants in the NHS until effective governance is established
We recently conducted independent research on the use of external management consultants in the NHS in England. This was subjected to peer review to establish the rigour of its analysis and published in an academic journal (Policy & Politics). Since then, it was mentioned in a parliamentary debate (23rd April, 2018, Hansard Volume 639) and widely reported in the media (21st February, 2018), including in The Times, which has also seen this letter. Continue reading
Photo Credit: Christopher Gross/Released
Dr Fiona Lithander, Senior Research Associate, NIHR Bristol Biomedical Research Centre.
Fiona explains how a new questionnaire could be used to increase healthy food and drink options in hospital retail outlets
At the National Institute for Health Research (NIHR), Bristol Biomedical Research Centre we are interested in the role the NHS plays in promoting good nutrition and health in children. Recent reports have shown a quarter of children in the UK are overweight or obese; a worrying statistic in itself, and the problem doesn’t appear to be getting any better.
NICE guidelines say that retail outlets in hospitals such as shops, cafes, restaurants and vending machines should offer healthy food and drink options, and that these options should be prominently displayed. They also say that nutritional information about the foods on their menus should be available. These guidelines do not refer to foods served to patients, although patients may have access to foods and drinks for sale onsite.
At NIHR Bristol Biomedical Research Centre we developed a new questionnaire to help NHS Trusts assess how healthy their food and drink options are. This differs from other questionnaires in that it allows Trusts to compare their findings with the NICE guidelines. Trusts can use this questionnaire to measure how healthy prepared foods for sale are, and can make changes accordingly. These changes may involve, replacing sugary drinks with sugar-free options such as water, and replacing chocolate bars with more healthy options such as unsalted nuts.
Using this questionnaire, we measured how healthy the foods and drinks were in two Trusts, and how closely they followed NICE guidelines. Our findings showed a lack of healthy food and drink options for sale in vending machines. Nutritional information on menus was minimal, and there was limited promotion and advertising of healthy foods and drinks. Since the findings were published, both of the Trusts have made improvements.
Our plan is to further develop the questionnaire in conjunction with the NICE guidelines, so that it can be used more widely in NHS Trusts and in local authority settings, such as leisure centres. Making it easier for parents to direct their children to healthier choices should be a central element of our healthcare system.
Disclaimer: This study was supported by the NIHR Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol. The views expressed in this article are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health.
This blog was originally published by the National Institute for Health and Care Excellence (NICE)
Over a billion NHS prescription medicines are issued by pharmacists in England every year – at a cost of over £9 billion. Many of these are prescribed by GPs to manage long-term health conditions, such as diabetes or cardiovascular disease.
The current “repeat prescription” system allows patients to request a further supply of medicines without the inconvenience of another doctor’s appointment. Continue reading
Few topics in the NHS have provoked as much controversy as the use of external management consultants. They provide advice on strategy, organisation and financial planning, and help implement new IT systems and other changes.
While some claim that this brings much needed improvements, critics question their value – particularly at a time when the NHS is strapped for cash. Even Patrick Carter, recently charged with reviewing NHS efficiency, admits that he has “a bugbear with employing management consultants”. Continue reading
As winter continues, so does the usual soul searching about the state of the UK’s National Health Service (NHS). Images of ambulances backing up outside emergency departments and patients lying on trolleys in corridors haunt politicians and the public alike.
Demand on the NHS, which is always high, increases over the coldest of seasons, when threats to health are greatest. Generally, more than 20,000 extra deaths occur from December to March than in any other four-month period in England and Wales. That number varies considerably, however – from 17,460 in 2013-4 to 43,850 in 2014-5 (which was not even a particularly cold winter). And there has been no evidence of a decreasing trend since the early 1990s, despite the national flu immunisation programme. Continue reading
The 9th-15th October is Baby Loss Awareness Week, which provides a chance to raise awareness about the issues surrounding pregnancy and baby loss in the UK. Our team has over 10 years of research experience in what makes effective training for staff involved in care for bereaved parents, and seven years working to end preventable harm related to stillbirth.
Author: Dr Dimitrios Siassakos, Consultant Senior Lecturer in Obstetrics, Department of Obstetrics and Gynaecology, The Chilterns, Southmead Hospital and Bristol Medical School
We welcome the House of Commons debate on Tuesday 10th October 2017 as part of Baby Loss Awareness Week, and have drawn on our recent research at the University of Bristol to contribute to this debate.
Our research has found that bereavement care is inconsistent across UK hospitals, and variable in quality. Bereaved parents are not always involved in decision-making, and parents may not be aware of the process when hospitals review their baby’s death. Healthcare staff may not be supported in caring for parents.
Our research on what makes training effective highlights that not all training is equal.
How we would like our MPs to help:
Multimorbidity is one of the biggest challenges facing healthcare. In recent years, a succession of research studies have shown that people with multiple health problems are more likely to have a worse quality of life, worse mental health and reduced life expectancy. The more health problems someone has, the more drugs they are likely to be prescribed and the more frequently they are likely to consult a GP or be admitted to hospital.
You might think this is all rather self-evident – it’s hardly a surprise that sick people get ill, take medicines and go to doctors more often than healthy people.
So why has multimorbidity become so prominent in discussions about healthcare over the last decade?