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58 p. : ill. ; 30 cm.
This is the second report by the National Audit Office on this subject, the first ("The National Programme for IT in the NHS (HC 1173)", ISBN 9780102938289) was followed by the Committee of Public Accounts report ("Department of Health: The National Programme for IT in the NHS (HC 390)", ISBN 9780215033628) and the Government response (included in "Cm. 7152", ISBN 9780101715225), all of which are available below. This further study reviews the response to the Committee's conclusions and recommendations and examines more generally the progress being made in delivering the Programme.While some parts of the Programme are complete or well advanced, the original timescales for the Care Records Service - one of the key components of the Programme - have not been met. Currently it seems likely to take four years more than planned - until 2014-15 - before every NHS Trust has fully deployed the care records systems.The estimated cost of the Programme is currently GBP 12.7 billion (at 2004-05 prices), which is broadly unchanged. It remains difficult to produce a reliable estimate of local costs. Some benefits from the Programme, including financial savings, are starting to emerge. Suppliers have largely met the targets for service availability and performance deductions have been applied where there have been service failures.The challenges to be managed for the successful delivery of the Programme are: achieving strong leadership and governance; maintaining the confidence of patients that their records will be secure; securing the support and involvement of NHS staff; managing suppliers effectively; and, deploying and using the systems effectively at local level.Overall, all elements of the Programme are advancing and some are complete. For the Care Records Service, the original timescales proved to be unachievable, raised unrealistic expectations, and put confidence in the Programme at risk. While the Programme costs have largely held, the timetable for the Care Records Service has slipped. The original vision for the Programme nevertheless remains intact and still appears feasible.An accompanying volume containing progress report sheets on the 14 main components of the programme and background information is also available ('The National Programme for IT in the NHS: Project Progress Reports (HC 484-II)', ISBN 9780102954135).
(source: Nielsen Book Data)9780102954128 20160527
Green Library
Book
51p ; 30cm.
The term 'out-of-hours care' refers to primary medical care services available from 6.30pm until 08.00am on weekdays, and on all weekends, bank holidays and public holidays. This NAO report on the quality of out-of-hours services includes that there were some shortcomings in the initial commissioning process.
(source: Nielsen Book Data)9780102937589 20160527
Green Library
Book
59 p. : 30 cm.
In 1997, the Dartford & Gravesham NHS Trust awarded the first NHS private finance initiative (PFI) contract for a new hospital at Darent Valley, to a company now known as The Hospital Company (Dartford) Limited. This NAO report examines the value for money the Trust is receiving now that the PFI hospital has been in operation for three years. Findings include that the new hospital has been delivered to time and cost in accordance with the PFI contract. The Trust received a reduction in the overall contract price through a refinancing deal, with THC Dartford shareholders receiving much quicker and larger profits than had been projected when the contract was awarded. However, the refinancing deal has brought the Trust new risks as well as benefits, and this highlights the need for authorities to fully assess risks involved before agreeing to a refinancing deal, including the significant senior management effort required to manage a PFI contract in the early years.
(source: Nielsen Book Data)9780102932195 20160527
SAL1&2 (on-campus shelving)
Book
42 p. : col. ill. ; 30 cm.
SAL1&2 (on-campus shelving)
Book
37 p. : col. ill. ; 30 cm.
Four years into the 10-year life of the NHS Cancer Plan, this report concludes that the Plan is impressive in its coverage and has resulted in better cancer services. There is still more to be done, however. Substantial progress has been made in meeting the Plan's targets. However, the thirty-four cancer networks - partnerships of local NHS organisations providing cancer services - are not always as effective as they should be. Resources are not always sufficient and not all of the networks plan effectively. The networks need to develop partnership working further if the targets in the Cancer Plan are to be fully met by 2010. Decisions need to be taken now on how to update and bring together all elements of the current cancer strategy in a unified way that ensures it remains the central guiding approach for improving cancer services and outcomes.
(source: Nielsen Book Data)9780102932379 20160527
SAL1&2 (on-campus shelving)
Book
40 p. : ill. ; 30 cm.
In 2000 the Department of Health (DH) announced the establishment of NHS Local Improvement Finance Trusts (LIFT) to develop primary and social care services buildings and facilities in England. LIFT is based on long term joint ventures at national and local level: nationally, Partnerships for Health is a joint venture between DH and Partnerships UK (itself a joint venture between the Treasury, Scottish ministers and the private sector): locally the local joint venture company (the LIFTCo) is owned by representatives of the local health economy, Partnerships for Health and a private sector partner. Unlike PFI deals, LIFT deals are based on the local LIFTCo owning the premises which it builds and refurbishes. This report examines whether LIFT will meet local needs and provide value for money, 42 local schemes had been approved by August 2002, mostly in deprived inner city areas, with a total capital value of GBP 711 million. Most LIFTCos are operational, though few buildings are open: most of the developments have been well received by local stakeholders. NAO conclude that LIFT will work. Nationally it is an attractive way of securing improvements, and local schemes appear to be effective and offer value for money. Local management frameworks need to be strengthened.
(source: Nielsen Book Data)9780102932799 20160527
SAL1&2 (on-campus shelving)
Book
26 p. : ill. ; 30 cm.
The Norfolk & Norwich University Hospital NHS Trust currently pays GBP 38.7 million a year to a private sector consortium, Octagon, for the building and maintaining of a new hospital. This pathfinder PFI contract was entered into in 1998 but in 2003 Octagon was able to refinance their deal and gain GBP 81 million (some of which was shared with the Trust). This report examines whether the large private sector gains indicates some inadequacy in the initial PFI deal and how the price the Trust is paying compares to current PFI hospital deals. The overall findings were that Trust continues to pay a premium on financing costs compared to current deals and it might have improved the original deal with greater competition and better defined requirements. However the Trust believes it gained benefit from the early provision of facilities in a deal that had previously been assessed as good value for money.
(source: Nielsen Book Data)9780102933055 20160527
SAL1&2 (on-campus shelving)
Book
58 p. ; 30 cm.
There were about 12.7 million visits to accident and emergency (A&E) services in the last year, and in around a fifth of these, patients were admitted to hospital. A&E departments are only one in a variety of NHS emergency care providers, which include ambulance services, GPs, primary care trusts, out-of-hours services; NHS Direct; and open access minor injury centres. This NAO report examines the extent of progress made towards achieving the key target for maximum total time spent waiting for A&E services, as well as with the wider modernisation of emergency care. The report's conclusions include that, given the high level of demand, there has been a significant and sustained progress towards reducing waiting times in A&E departments and improving the patient's experience, largely due to improved working practices and increased local investment. However, there is further room for improvement in the case of patients with more complex needs, such as older people and those with mental health needs; and regional variations still exist with the performance of the worst performing trusts still some way behind. Further major improvements will depend on tackling the remaining bottlenecks and barriers to modernisation within wider emergency care services. The establishment of local emergency care networks is highlighted as a promising development, as a means to secure greater emergency care service integration and joint-working.
(source: Nielsen Book Data)9780102930214 20160527
Green Library
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68 p. ; 30 cm.
Green Library
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63 p. ; 30 cm.
There is a strong rationale for modernising NHS dentistry, but significant risks will have to be managed if the new arrangements announced by the Department of Health are to be effective and provide value for money, according to the National Audit Office. In particular, given the scepticism of some dentists compounded by a lack of detail on how the new system will operate, there is a risk that dentists will reduce their NHS commitments. Today's report to Parliament by head of the NAO Sir John Bourn points out that modern dental practice emphasises prevention rather than intervention; but that the current piecework remuneration system - whereby NHS dentists are paid a fee for each NHS item of treatment they carry out - does not provide sufficient incentives for such an approach. Given the overall shortages of dentists and the difficulties some patients are experiencing in accessing NHS dental treatment, NHS dentistry needs to provide a more responsive service.
(source: Nielsen Book Data)9780102930337 20160527
SAL1&2 (on-campus shelving)
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64 p. ; 30 cm.
The NAO will produce three studies on cancer services in England. This is the first and looks at whether survival rates are being improved. One person in three will develop cancer at some point in their life, and in the 1990s England suffered from a higher mortality rate than other European countries. However the survival rate is improving and the latest figures show that 36 per cent of men and 49 per cent of women will survive for 5 years or more. England's position in terms of the proportion of people who die from cancer is improving relative to other comparable countries. There is though a class divide, with the better off improving more than the less well off. There are variations in service but one of the factors is that people in more deprived areas are likely to have their cancer identified at a more advanced stage. The recommendations from this report cover the need to be more effective in stopping smoking, ways of identifying cancer earlier and the need for national clinical audits.
(source: Nielsen Book Data)9780102927573 20160527
SAL3 (off-campus storage)
Book
53 p. : 30cm.
SAL3 (off-campus storage)
Book
38p ; 30cm.
SAL3 (off-campus storage)
Book
51 p. : ill. ; 30 cm.
NHS Trusts may exclude clinical staff (including consultants, doctors, dentists and nurses) from work or restrict their activities where there are concerns about patient safety or where there are allegations of gross misconduct. Between April 2001 and July 2002, over 1,000 clinical staff were excluded on full pay from the NHS at an estimated annual additional cost of some [pound]29 million. 55 per cent of the doctors were excluded for more than six months and a small number of clinical staff have been excluded for as long as four years. 40 per cent of excluded doctors and 44 per cent of other clinical staff returned to work in the NHS. The numbers of exclusions and their length suggest that basic management principles are not being followed. Alternatives (such as restricting the clinician from certain clinical activities or types of patient) could be used more than at present. It is important for trusts to inform other trusts and potential employers, the regulatory bodies and the Department of Health, but this is not always being done. For example, when staff resign during an investigation, one fifth of trusts do not conclude the investigation which may not make it possible to alert prospective employers. There are concerns that ethnicity and gender are factors in doctor exclusion cases, and that the psychological well-being of excluded staff is monitored and that they have the opportunity to maintain their clinical skills.
(source: Nielsen Book Data)9780102923551 20160527
SAL3 (off-campus storage)
Book
39 p. : ill. ; 30 cm.
SAL3 (off-campus storage)
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50 p. ; 30 cm.
Green Library
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50p ; 30cm.
SAL3 (off-campus storage)
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86p ; 30cm.
SAL3 (off-campus storage)
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49 p. : col. ill. ; 30 cm.
This report highlights key trends and variations in the delivery of healthcare across the four nations of the UK. Life expectancy varies significantly across the UK - from 75.9 in Scotland to 78.6 in England for men, and from 80.4 in Scotland to 82.6 in England for women. Spending on health services in the UK more than doubled in cash terms in the last decade. In 2010-11, despite devoting a higher proportion of total public spending to health, England spent the least on health per person. NHS staff has also increased over the last decade. Scotland has the most GPs per person (80 per 100,000 people in 2009 compared with 70 in England and 65 per 100,000 in both Wales and Northern Ireland). Scotland also has the most medical hospital staff and nursing, midwifery and health visiting staff per person. Comparable data on the efficiency and quality of healthcare are patchy. In 2008-09, average hospital lengths of stay varied from 4.3 days in England to 6.3 days in Wales. Hospital waiting times have fallen in all four nations in recent years, although there are notable variations in how long patients wait for common procedures. In 2009-10 waiting times tended to be lower in England and Wales. There have been significant improvements in levels of healthcare associated infections with rates of MRSA infection dropping by a third or more in all nations. The NAO considers that there would be value in the health departments in the four nations carrying out further work to investigate the variations in performance and identify how they can learn from each other.
(source: Nielsen Book Data)9780102977189 20160609
SAL3 (off-campus storage)
Book
50 p. : ill., ports. ; 30 cm.
NHS trusts in England spent about GBP 8.3 billion on nursing staff in 2004-05, with about GBP 790 million (or 9.4 per cent) of this spent on temporary nursing cover. The NAO report examines how trusts determine demand for temporary staff, the extent and costs of procurement and the impact of initiatives to improve performance quality and benchmark good practice. Overall, the report finds that whilst the NHS has successfully reduced its expenditure on temporary agency staff, the use of temporary staff still remains a key aspect of the ability of NHS trusts to be flexible in order to cover staff vacancies and absence through sickness and to meet fluctuations in activity levels. Many NHS trusts lack robust management information systems to help determine cost-effective staffing levels or to understand their real staffing needs. The report estimates that between GBP 38 million and GBP 85 million a year can be saved by better procurement of temporary nursing staff and better management of permanent nursing staff.
(source: Nielsen Book Data)9780102939316 20160527
Green Library

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