Compared to other health services, outpatient departments attract high levels of patient dissatisfaction and yet surveys of outpatients with the aims of improving services have been taking place for several years. So why is there still a high level of dissatisfaction? One of the reasons is that surveys are not ...
The boundaries between home and hospital care are constantly shifting. Care in the community for people with long term dependencies, and increasingly sophisticated primary care service and the expansion of outreach care and day surgery have all contributed to a reassessment of the central role of the hospital. This research ...
Medical technology, defined broadly to include drugs, procedures and equipment used singly or in combination, has been of enormous benefit in improving the quality of health care. It has, however, raised many issues about how society can afford to pay for these often expensive developments and about associated ethical problems ...
This book describes the experiences of twenty families who have, living at home, a teenager or young adult with severe learning difficulties who has been classified by professionals as 'severely' or 'profoundly' mentally handicapped, and who also has 'serious behavioural problems'. It documents the lives of these families, and the ...
This paper traces the origins of the Oregon plan, explains how it works and passes judgment on its worth. The Oregon plan is a controversial health rationing plan for the poor under America's Medicaid system. Over 700 services have been ranked in priority order and the state legislature has said ...
The phasing in of the National Health Service reforms over two years from April 1991 to 1993 has a number of implications. The uncertain climate which has long surrounded community care will be protracted, and financial pressures will increase as the demand driven social security budget continues to rise. The ...
This report looks at the new role of district health authorities as purchasers of services for their residents. The report shows that non-executive members have the following contributions to make to the work of their authorities: bringing a wider range of experience than is available among the executive members; ensuring ...
The successful implementation of the NHS reforms hinges on the development of district health authorities as effective purchasers of health care for their residents. The NHS has always been provider driven and if services are to be delivered more efficiently and responsively then it is essential that health authorities are ...
The first part of this briefing looks at the implications of the NHS reforms in theory and in practice and presents the six lines of enquiry which might be pursued. The second section discusses the particular impact of the NHS reforms on London which has maintained a very significant number ...