This second edition reviews recent reforms and the likely impact of future developments in management and competition in the NHS. In particular, it reflects the growing importance of primary care and the continuing debates about health care rationing. It concentrates on the realities and how they can be interpreted to help strategists, managers, clinicians, students and those supplying the NHS understand the mechanism of efficient health care delivery.
This annotated indexed anthology deals with doctor-patient interactions as portrayed in novels short stories and plays especially where these are unsatisfactory. This book is unique among medical anthologies in that readers can look up medical topics as they appear in fiction. It analyses sources of conflict such as the fee the doctor's perceived l
This second edition reviews recent reforms and the likely impact of future developments in management and competition in the NHS. In particular, it reflects the growing importance of primary care and the continuing debates about health care rationing. It concentrates on the realities and how they can be interpreted to help strategists, managers, clinicians, students and those supplying the NHS understand the mechanism of efficient health care delivery.
Productivity in hospitals has been falling by around 1.4 per cent a year since 2000 whilst NHS expenditure has increased by over two thirds in ten years. The Department of Health has achieved significant improvements in such areas as waiting times, healthcare associated infection rates, patient outcomes, reduced cancer mortality and the patient experience. However, the NHS pay contracts introduced since 2003 have increased costs but are not always used effectively by hospitals to drive productivity improvements. The NHS needs to deliver between £15 billion and £20 billion of efficiency savings per year by 2013-14. Around 40 per cent of these savings are expected to come from increasing efficiency in hospitals, requiring productivity gains of approximately six per cent per annum. The 'Payment by Results' system of setting national tariffs has promoted some efficient practice, but there is still substantial variation between hospitals. If all hospitals performed at the level of the top 25 per cent in respect of staff costs, use of estate, control of emergency admissions and bed management, the NAO estimates that the NHS could save around £1.6 billion a year. The Department has launched a national initiative (QIPP) to help the NHS deliver annual savings of up to £20 billion. There are risks to the delivery of the initiative, which is the responsibility of Strategic Health Authorities and Primary Care Trusts, whose focus may be distracted by the proposals for their closure by 2013.
The Government's NHS reforms pave the way for more competition and a more locally managed health service. They also take place at a time when the NHS in England is faced with saving an estimated £15 to £20 billion by 2015. Achieving savings of this level will require a radical overhaul of how services are designed and delivered. Critical to this is creating the right incentives for the NHS to develop, in ways that promote creativity and innovation.
This book provides a broad overview of what is needed to run hospitals and other health care facilities effectively and efficiently. All of the skills and tools required to achieve this aim are elucidated in the book, including business engineering and change management, strategic planning and the Balanced Scorecard, project management, integrative innovation management, social and ethical aspects of human resource management, communication and conflict management, staff development and leadership. The guidance offered is exceptional and applicable in both developed and developing countries. Furthermore, the relevant theoretical background is outlined and instructive case reports are included. Each chapter finishes with a summary and five reflective questions. Excellence can only be achieved when health care professionals show in addition to their medical skills a high level of managerial competence. High performance in Hospital Management assists managers of health care providers as well as doctors and nurses to engage in the successful management of a health care facility.
UK health care specialists discuss reforms in the NHS and the associated managerial and conceptual issues in this volume. Both theoretical and practical aspects are covered, including quality, consumer choice, medical audits, strategic information systems planning and ideology.
