Health services management最新文献

In common with many other trusts, East Surrey Hospital and Community Health Services is faced with a budget deficit that means staff redundancies are among the measures proposed to deal with it. For Gary Needle, Director of Service Development and Deputy Chief Executive, its back to the drawing board with the business plan -- but personnel issues and purchaser relationships need some careful handling.

Plastic surgery is all too often thought of as an indulgence of the rich and famous with little attention paid to the repair of bodies and limbs disfigured or deformed by accident or illness. Surgeons look to management to address those issues that create an insecure base for planning the service and for its organisation nationwide.

Peter Dunham and Sally Smith have experienced at first hand the changing role of community health councils and the opportunities that exist for collaborative working arrangements. Here, they define the progress that can be made in a relatively short period of time when empathy and trust exists between a CHC and its local health authority.

Old age never harmed anyone - but the problems that may arise in the elderly of multiple illnesses, social isolation and poverty conspire to present clinicians and managers with a challenge: an increasing challenge, as the number of people over the age of 85 by the year 2000 will be in the order of a million.

As an executive director of King's Healthcare, Heather-Jane Sears combines her responsibilities for the professional leadership of nursing and midwifery and quality improvement with general management. A typical day will combine all three elements, but always there is the need to provide a top-class service to patients - and to spot opportunities to expand the business.

Across the world, health care continues to consume ever-increasing amounts of nations' wealth. Different societies are grappling with the problem of how to define and constrain the burgeoning demand on their resources. The DoH has stated that there should be no blanket ban on any service; some RHAs have sought a consensus among district health authorities and many district health authorities are setting out their own conclusions. If each purchaser is free to form a distinctive view on what constitutes need in their population, the range of available services, and balances within that range, may vary from place to place. Should society accept those variations? asks Adrian Bull.

Shared personal and professional awareness of and commitment to HIV issues in employment prompted Sue Ellis and Liz Smart to set up a project which, through collaborative working between health promotion, personnel functions and trade unionists, would devise training materials to address employment issues and reduce concern about HIV infection in the workplace.

Some 25% of those over 80 suffer from dementia -- just one of the mental health problems that affect elderly people. Their care is compounded by physical difficulties and ill health and, often, by the lack of relatives to assist in their care.

Educational programmes for nurses and the allied professions have increasingly been located within the marketplace through the introduction of educational contracts. But the use of clinical placements and related costs are not addressed within such contractual arrangements. Dawn Forman and Jane Fox assess the advantages and disadvantages.

It has almost become a cliché now that the changes the NHS is currently undergoing are the most far reaching since its inception in 1948. Some say that the NHS and Community Care Act represents the greatest opportunity for improvement: Rosemary Gillespie looks at the means to better the NHS's poor record on provision for ethnic minorities.