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At least 163 records · Page 9Linked to original sources
PubMed2003

[Incorporation of cardiac rehabilitation programs and their characteristics in the Spanish National Health Service].

OBJECTIVES: To estimate the degree of incorporation of cardiac rehabilitation in the Spanish National Health Service, to describe the characteristics of the programs, and to report on the opinions of those responsible for them regarding their progress. PATIENTS AND METHOD: Cardiac rehabilitation centers were identified from different sources. A questionnaire which included items about coverage, resources, activities and services, selection of patients, and opinions was mailed to the heads of all units. RESULTS: Twelve public centers with cardiac rehabilitation programs were identified. Cardiac rehabilitation was offered to 53% of all eligible patients. All units treated patients with myocardial infarction, 64% treated those with heart failure; and 60% high risk patients. Approximately 10-19% of all patients were women. The physicians involved most frequently in programs were cardiologists; nonmedical professionals who participated most often were physiotherapists, and 64% of all units had a staff psychologist. Phase II rehabilitation was provided by all units, and phase III treatment was provided mainly by units that operated in coordination with out-patient services (45%). All units provided physical exercise training and counseling about the disease and risk factors, and 73% of them provided psychological support. The main reasons cited for providing rehabilitation were its efficacy and ability to prevent illness; and the main barriers to more widespread use were lack of resources and support. About three-fourths (73%) of all doctors interviewed thought that primary health care centers could play an important role in rehabilitation programs. CONCLUSIONS: Cardiac rehabilitation is poorly implemented in the Spanish National Health Service. The most significant differences between programs were related to the inclusion of high risk patients and with a diagnosis other than myocardial infarction, coordination with out-patient services, and provision of phase III rehabilitation.

Cardiology Service, Hospital↗
PubMed1981

Drug information network in the United Kingdom National Health Service.

The drug information network is the United Kingdom National Health Service (NHS) is described. The NHS was reorganized in 1974 resulting in the creation of 14 regions, which were further divided into areas. Drug information services provided within the regions and coordination between regions have evolved into a decentralized national drug information network. In this network, regional centers provide support to their area centers; difficult questions received by area centers may be referred to the regional center. Additionally, some regional centers have become specialized in particular fields. All regional centers have access to data held by other regional centers. Activity is further coordinated by a literature abstracting service in which each regional center has certain responsibilities; a code of practice for drug information pharmacists; production of specialty bulletins; and standardized education and training. Future plans for expanded services are described.

Drug Information Services↗
PubMed1976

Unions and strikes in the National Health Service in Britain.

This article outlines the origins of the main manual and white-collar trade unions in the British Health Service, traces their growth after the establishment of the National Health Service in 1949, and examines the wave of industrial action in British hospitals in the seventies. It is argued that although strike action inside hospitals in the early seventies was a novel tactic adopted as a last resort by manual workers pressing for wage increases, industrial action over a wide range of political and medical issues has now been taken by all types of hospital worker in Britain and plays a central part in the national debate over the future of the National Health Service.

Collective Bargaining↗
PubMed2002

British National Health Service's and women's costs of antenatal ultrasound screening and follow-up tests.

OBJECTIVE: To estimate resource use and costs associated with routine obstetric ultrasound and follow-up tests from both the British National Health Service and women's perspectives. METHODS: Women attending Liverpool Women's Hospital (UK) in 1998 and 1999 were involved in the study. Bottom-up and top-down costings of National Health Service resources using questionnaires and diaries to record staff time associated with procedures were performed. Questionnaires were used to assess women's costs of attending for antenatal ultrasound scans. RESULTS: Routine antenatal ultrasound scans at Liverpool Women's Hospital cost the National Health Service between 14 pounds sterling and 16 pounds sterling per scan. More detailed secondary scans and other follow-up procedures cost substantially more. Costs to women, their families and their employers were estimated at between 9 pounds sterling and 15 pounds sterling per scan, depending on assumptions about the opportunity costs of time when not in paid employment and costs to employers of women who were in paid employment. CONCLUSIONS: Accurate estimates of costs to the National Health Service associated with routine antenatal ultrasound scanning are substantially lower than that cited in much of the literature. Costs to women are very similar to National Health Service costs. Economic evaluations should attempt to include costs to users of the service, particularly when the burden of cost is likely to shift.

Adult↗
PubMed2005

Medication management in English National Health Service hospitals.

PURPOSE: The methods currently used by English National Health Service (NHS) hospitals to manage the use of medicines were studied. METHODS: A questionnaire was mailed to directors of pharmacy at all English NHS hospitals in May 2001. RESULTS: The response rate was 57% (157/ 275). Sixty-six percent of the responding hospitals provided general acute care services, and 34% provided mental health services. About 1 responder in 5 (19%) was a specialty hospital functioning either as a freestanding institution or alongside other hospitals. The average total expenditure by the hospital trusts was pound 94 million (dollar 175 million), of which drugs accounted for pound 3.5 million (dollar 6.5 million). Many hospitals either had formularies or were constructing them (86%), and most hospitals used a process to manage the introduction of new medicines. About three fourths of the hospitals had < or = 20 pharmacist full-time equivalents. The implementation of national guidelines was variable, although some of this variation may have been due to differences in service provision. Few hospitals were actively monitoring compliance with guidelines (31%), but audits of current care were common (72%). CONCLUSION: A survey of English NHS hospitals provided information on pharmacy staffing, drug expenditures, and measures taken to ensure rational medication use.

Committee Membership↗
PubMed2002

The role of ritualistic ceremonial in removing barriers between subcultures in the National Health Service.

The role of ritualistic ceremonial in removing barriers between subcultures in the National Health Service Background. One of the ways in which it is possible to achieve successful organizational change is through the elimination of those ceremonies that reinforce or preserve the negative aspects of professional and work group autonomy, thus maintaining the barriers between subcultures. Conversely, the encouraging of ceremonies which reinforce positive aspects is likely to achieve more flexible, team-orientated changes. Aim. The paper considers those ceremonies, which perpetuate barriers in a National Health Service (NHS) Trust, and explores new ceremonies which may question, weaken or eliminate current dysfunctional practices. Design. Our research approach was mainly phenomenological, as we wished to elicit the symbolic significance of organizational routines. The primary source of data was spoken language. The findings are based on purposive sampling of informants by means of semi-structured interview and observation. Other types of information were also collected, including business plans, reports and brochures. Informants included the Chief Executive and four Board members, three consultants, the director of nursing and midwifery, 10 middle managers and eight junior, nonmedical and nonmanagerial employees. Findings. Two broad bands of ceremonies have been identified - those which preserve the existing norms and autonomy of professional and worker groups, which we have named Ceremonies of Preservation, and those which encourage change, which we have called Ceremonies of Change. Considerable data are provided to help to 'tell the story'. Conclusion. The paper argues that attention to ceremonial in the wider change process may facilitate the desired, specific change or changes in practice. It suggests that changes which confront unnecessary demarcation, but which do not undermine professional integrity, can create real benefits for NHS hospitals.

Attitude of Health Personnel↗
PubMed2000

Indicator-based systems of performance management in the National Health Service: a comparison of the perceptions of local- and national-level managers.

Historically, the UK Government has policed the use of National Health Service (NHS) resources through the centralization of control. With the majority of resource-draining decisions being taken by clinicians, however, professional financial accountability is becoming more important within the NHS management structure. Variations in clinical performance can be monitored through the use of performance indicators, although these are not without their problems. The use of league tables of such indicators in the national press is now infamous and there is much anecdotal evidence about the intraorganizational conflict arising from the use of such tables. A questionnaire survey and interview study of clinical directors, clinical service directors and business managers in several Scottish NHS Trusts was undertaken to ascertain the perceptions of local-level managers on the issue of performance indicators. Interviews were also carried out with a number of personnel in the Scottish Office Department of Economics and Information, the Division of Health Gain and the Finance Directorate. This paper explores the differences between the perceptions of the managers at these two levels of the NHS with regards to issues of performance measurement, intraorganizational conflict and corporate vision.

Administrative Personnel↗
PubMed2006

New localism in the English National Health Service: what is it for?

This paper discusses the decentralisation in the English National Health Service (and the new organisational form of Foundation Trusts, in particular) in the context of the trend for decentralising public services generally since the New Labour government started its second term of office in 2001. It considers the likelihood of decentralisation achieving the aims policy makers have set: these are better services and an increase in local people's participation in the planning and running of services (active citizenship). Looking at the evidence to date, both about decentralisation of health services and about Foundation Trusts, the achievement of these goals seems uncertain.

Policy Making↗
PubMed1998

Orthodontics in the National Health Service.

In order to, understand the development of the National Health Service, we need to look at the state of orthodontics in the country prior to its introduction in 1948. This article considers the various factors which contributed to orthodontics' development in the NHS. The progress of this specialty is described together with comments on its future in the NHS.

Certification↗
PubMed1999

The culture of midwifery in the National Health Service in England.

The culture of midwifery in the National Health Service was examined in order to foster understanding of the context of midwifery practice. In-depth interviews were conducted with midwives in five, very different, sites across England. The culture which emerged was one of service and sacrifice where midwives lacked the rights as women which they were required to offer to their clients. There was a lack of mutual support and of positive role models of support with considerable pressure to conform. Guilt and self-blame were common as was learned helplessness and muting. The dilemmas of this culture are considered and the resistance which it offered to change in relationships. Change was either resisted, brought about by stealth or strategically planned to equip midwives to change their culture.

Clinical Nursing Research↗