This book is written for health and social services staff at all levels, including those involved in policy making and management. It sets out a clear framework for understanding carers' needs and describes practical ways to begin to meet them. Each chapter deals with one major need expressed by carers ...
This workshop was arranged to bring together those who were at the leading edge of developing quality assurance in community care for people with learning difficulties, those with mental health problems, people with physical disabilities and frail elderly people. Three main issues were examined: the definition of quality assurance in ...
This pamphlet gives an account of a meeting whose aim was an exchange of information between those with experience of care attendant schemes and those with experience of the needs of those with learning difficulties and their families.
The aim in producing the document has been to offer a quick reference tool for practitioners and others to indicate the sorts of people working in the 'quality' areas and their levels of interest. The entries have been supplied by individual practitioners and managers, as well as being drawn from ...
This document is the result of a working group who had a shared commitment and concern for the lives of people living in long-stay psychiatric wards. The group wishes to acknowledge that for some people a psychiatric hospital will continue to be their home and that the service they receive ...
This booklet is published for S.O.P.H.I.E. (Society of Parents Helping in Education) by the King's Fund. It accompanies a video `Shared Concern' which tackles the difficulties doctors experience when they face the task of informing parents that their baby or young child has a disability. S.O.P.H.I.E. believes this video and ...
In 1977 an exploration into the use of counselling of visually impaired adult persons began in Richmond Adult College, Surrey, where it continued for 2 years. It moved to the ophthalmic department, King's College Hospital in 1980 and continued until 1987. The author formed a group in Richmond for people ...
This publication comprises of two background papers for the colloquium - (1) Continuing professional education for qualified nurses; and (2) A study in staff preparation - a necessity. The first is on the importance of continuing professional education and a study into how this is done. The second paper is ...
This publication, building on the Ordinary Life initiative, describes a project undertaken with 2 community services - one for adults and one for children. A P.A.S.S. evaluation of each service yielded detailed information on what life was really like for service users and pinpointed priority areas for further training and ...
These seven papers detail key lessons from the work of the King's Fund College, which since 1983 has been mounting a programme of educational and field development activities designed to assist networks of local people in addressing the challenges involved in managing psychiatric services in transition. The papers suggest a ...
In 1988 the King's Fund covered a multi-disciplinary panel to consider the following questions and to prepare a statement for discussion at a consensus conference: is there scientific evidence that ICUs cause a decrease in morbidity and mortality; what criteria should be set for admission and discharge to intensive care ...
This paper looks at the attitudes and behaviour in seeking health care of all the general medical practitioners in one family practitioner area - Avon. The results show that this group of doctors find difficulty in receiving help from other doctors, particularly for conditions to which doctors are most susceptible. ...
This paper looks at the role of health authority equal opportunities committees and the part they can play in facilitating the implementation of an equal opportunities policy. It details the circumstances in which equal opportunities committees can be useful, and makes recommendations to improve their effectiveness.
This conference proceedings report is an edited compilation of papers given at a conference for World A.I.D.S. Day. Topics covered at the conference included - resources for the 1990s, community care, role of the voluntary sector and an agenda for the 1990s.
This study describes the various approaches adopted by some DHAs in separating responsibility for purchasing and providing services. The approach finding most favour involves separating the purchaser and provider functions below the DGM (District General Manager) level. The strength of this approach is in enabling the purchaser and provider functions ...
This report presents a number of papers and workshop reports from a conference on family based respite care. The workshop reports discuss: the implications of the Children Bill for children in residential schools and local authority care; respite care and welfare rights; raising the profile of family based respite care; ...
Rising health care costs now confront policy makers and planners with serious dilemmas of choice. This publication seeks to help formulate principles by which choices can be made. It begins with the premise that health demands will outstrip available resources, but argues that this should not mean that every allocation ...
The seventh King's Fund Forum was held in London from 18th to 20th June. The panel was asked to address four questions: (1) Would the detection and breakout of polyps reduce the incidence of cancer of the colon and rectum? (2) Are there other preventive measures which will safely reduce ...
The report attempts to review the main issues surrounding the funding and management of units providing dialysis services to people suffering from end-stage renal failure in the UK for the benefit of health service managers, renal physicians and other staff. The objective is to review the experience and information currently ...
This report examines the kind of work facilitators do, their achievements and the factors that help or hinder progress in a rapidly changing world. Three different models are described - Oxford, Best Friend and Camberwell.
In March 1990 the King's Fund College and NAHA were commissioned by the Department of Health to undertake a survey of the training and development needs of the now DHAs. The survey follows on from the discussion paper 'Managing with authority'. This report presents the results of the survey and ...
The Relief Care Support Group first met in December 1980 when there were a number of workers involved in London relief care schemes. It aims to enable people to get together more formally and spend time sharing and learning from each other. The group was started as a support group ...
This project was undertaken to collect information on the services offered to people with learning difficulties. During the course of the project the idea of collecting `critical incidents' was suggested by some of the participants to elicit gaps in coordination. (For the purpose of this project a critical incident is ...
The primary aim of this workbook is to provide managers, front-line workers, external and internal 'inspectors', informal carers and service users, with a shared framework for consultation and evaluation of the quality of services. It is predominantly concerned with community care; however, it has applications in acute and community services ...
The Mental Health Foundation funded a project to improve working relations between voluntary and statutory agencies in the field of community care, focussing primarily on people with long term mental health problems. This paper is laid out as a series of chapters covering aspects of collaborative work. Each is followed ...
The purpose of this manual is to provide a comprehensive set of organisational standards covering the major aspects of an acute general hospital. This will form the basis of a professional peer review (the survey) the aim of which is to support the staff of hospitals in the provision of ...
Designed to be of practical use to all those with responsibilities for developing medical audit and quality assurance in primary health care, the book describes what is meant by audit, its purpose and who should be included. It reviews the range of activities being used. The report is based on ...
This is a report on the first year of the Organisational Audit project. It describes the project set up by the Quality Improvement Programme to test the applicability of an 'accreditation' type approach to the UK health system.
This report is a selection of keynote papers and reports from workshops held as part of the King's Fund Primary Health Care Group's conferences on quality in community nursing. The papers describe examples of good practice which concern management structures, staff performance, and ways of identifying patient needs and planning ...
This research report attempts to clarify key issues in British nursing for health policy makers. It is specifically aimed at a non-nursing audience, in the hope that it will illuminate important aspects of workforce planning, management and health care delivery for NHS managers and other people concerned with British health ...
This book describes in detail the routine administrative tasks that have to be done in hospital after a patient dies and suggests systems which will ensure that the tasks are carried out efficiently. It lays down clear standards for bereavement officers and hospital staff to enable them to provide the ...
This book is described as being a 'reflective tour of where the NHS is coming from, the world it is likely to face in the 1990s, and some ways in which we could strengthen it'. It covers demography, social and environmental stress, medical developments, public expenditure constraints, and likely themes ...
This paper explains initially why health authority management should introduce ethnic monitoring systems and deals in later sections with how members and managers should use the data to measure and improve their authority's equal opportunity performance. The bulk of the paper is, however, addressed to personnel and other officers who ...
This second edition reflects the significant growth in quality assurance activity, and an increased willingness to share experience and expertise amongst those involved in the field. The directory covers the 192 DHAs in England, and provides comprehensive data from Scotland, Northern Ireland and Wales. It includes a barchart comparing the ...
This paper is intended as a contribution to the Prime Minister's Review of the NHS. It argues that the use of incentives, competition and better management has already led to significant progress in improving efficiency, effectiveness and consumer responsiveness within the NHS. The key challenge now is to build on ...
This training manual has been written over many months by a group of people who brought with them a healthy scepticism of the concept of quality circles. It is offered as a model, no way suggesting a blueprint, but it contains many good ideas which may be adapted to any ...
In this book, top clinicians and senior managers in health services from the UK, the US, Canada, Australia and New Zealand write about their experiences in solving difficult problems in a way that ensures that their organisations continue to strive towards quality services. They describe how they try to resolve ...
This history begins with the foundation of the Lancet in 1823, and ends in 1982 with the restructuring of the National Health Service, when the management of hospitals in isolation from other health services had ceased. The opening chapters consider the endowed and voluntary hospitals, the poor law infirmaries and ...
This document reviews some elements of health services which have been or may be the subject of standards and some characteristics of the standards themselves.
The care given to a random sample of adults who died in 1987 is described retrospectively by relatives and others who had known them. Most praised, or were satisfied with, the care given by general practitioners but both the statistics and the quotations reveal some disconcerting inadequacies in this care, ...
This paper aims to present two main types of information. Firstly, it aims to identify the various factors - demographic, economic and ideological - which have come together to create an unprecedented crisis for those involved in the provision of health and social services to the elderly population. Secondly, it ...
This resource list contains information on selected books, journal articles, films, tapes and exercises which may be useful in training staff or volunteers who are working with `confused', `mentally infirm' or `mentally ill' elderly people. It does not set out to provide a blue print for a programme of training ...
This book is an account of the St. Christopher's Hospice Bereavement Service given by the volunteer visitors. It describes one of the important services developed by the hospice in the care of the dying and the continued care of the bereaved. It is hoped that it will be a guide ...
This report is an in-depth, comparative study of the UK plans and US experience of competition in the supply of hospital services. It shows how both competition and regulation policies have been used to contain escalating costs in the US. American experience raises concerns about the impact of competition on ...
In its report, the Royal Commission on the NHS stated that the NHS should "encourage and assist individuals to remain healthy." These papers describe two means towards achieving that objective: health education and the development of self-help groups. The first paper written by the principal research officer of the Royal ...
This is a report about a group of researchers, all of whom had undertaken studies related to the role of the ward sister. The group was originally formed to discuss the results of their own research. Later they shared their work with triads of professionals in the field, with the ...
This publication consists of a check list for ensuring that telephonists, receptionists and hall or gate porters are able to give a service which maintains the good reputation of a hospital.
This report is an evaluation of a ten week scheme by two artists in residency at St John's Hospice, Lancaster. It assesses the effect, beneficial or otherwise, the scheme had on the patients, staff and visitors at the hospice. The report explains the background to the project, then describes the ...
This paper gives a framework for thinking about new sorts of training needs for community services in the field of mental health. It describes what a good community service should look like; it looks at what people need to learn about if they are to provide effective help to people ...
This report summarises the literature on geographical variations in hospital admission rates in the UK and internationally. It is restricted to studies of inpatient admissions. It concludes that the examination of the variations provides invaluable insights into the nature and extent of medical uncertainty, and that this information is essential ...
The purpose of this booklet is to outline the issues that have to be addressed by service users, politicians and providers following the publication of the White Paper 'Caring for People'. The key questions raised by the White Paper are illustrated by some of the leading edge work currently taking ...
The future of community services was the title of a conference held in November 1988 at the King's Fund. This report follows the format of the conference, with speakers' presentations followed by reports of the discussions which took place in the afternoon workshops. Also explored are the role of the ...
This report provides an account of how New South Wales and Victoria have gone about establishing large-scale strategies for deinstitutionalisation of people with learning difficulties and the governmental leadership this has required. The analysis of the Australian experience draws attention to the magnitude of the social changes implied by these ...
Through the leadership of a local voluntary agency, a consortium of voluntary and public sector organisations has achieved rapid growth in decent quality housing and support services, and promoted complementary daytime opportunities. This report is a brief narrative account of Southwark Consortium and first three years.
The Health Advisory Service has been operating for almost 20 years. This is the first detailed study of its effectiveness. The authors describe how the Health Advisory Service works and reflect upon what they saw and heard in their investigation. They considered three questions - how well does the Health ...
The DHSS funded three development workers to work in three differing health authorities to explore the possibilities for improving primary health care in the inner city by developing patch or locality management and planning of services work more closely together; and to establish three local experiments with different approaches to ...
The Continuing Care Project (CCP) is concerned with improving the quality of the arrangements made for support and care in the community when elderly people are discharged from hospital. This current study, which describes practices in use in 1982, shows that whilst significant progress has been made in tackling the ...
Decisions on education for health currently take place against a background of conflicting policy and practice. So to clarify some of the main issues, this review sets out to identify trends in policy and practice in Britain in recent years, to summarise the evidence on effectiveness on some of the ...
This is a fully revised and updated version of the 1987 edition. It describes applications of DRGs at hospital level and examines their use in policy matters at all levels of health services. It is for everyone interested in and responsible for the way resources are used.
Written for managers of community health services, this book offers practical help on how to make services user friendly and more responsive to the needs of people who use them. Detailed case studies provide ideas for people 'getting started' as well as describing some common pitfalls. The particular problems associated ...
These guidelines have been compiled in response to an assessed need from hospitals for help with commissioning arts and artists. It is divided into seven chapters and includes guidance on the need for a committee; choosing a site; the commissioning process; fundraising. Its recommendations are based on 10 years of ...
The 'keepers' mentioned in the title of this book are workers in prisons, long-stay hospitals, homes for mentally retarded people and other total institutions. Their feelings about their work and about the institutions are presented here in twelve monologues selected from more than 60 interviews with workers in 27 different ...
The Living Options In Practice project aims to help service planners and providers in statutory and voluntary agencies build effective and comprehensive services to meet the needs of people with severe physical and sensory disabilities. It has developed an outline of the elements that should be encompassed within a comprehensive ...
This is the story of a King's Fund project and of the attempts of Haringey health authority to improve the services it offers to its multi-racial community. Haringey approached the challenge by appointing an ethnic minorities development officer whose job it was to help develop an equal opportunities policy. The ...
Following approaches by many people concerned about racial inequality in the nursing profession, this paper documents some of the issues which concern the Task Force. It reaches the conclusion that the service which black and ethnic minority nurses have been under-valued and their talent has been squandered. The paper includes ...
The closure or change of use of all or part of a hospital or health facility used to be relatively rare and straight forward. Relatively little has been written about ways in which health service changes have been carried through effectively and to the satisfaction of the different parties concerned. ...
This report is concerned with efforts to assure quality in medical care, focussing on quality assurance efforts affecting care provided by doctors and hospitals (and to a lesser extent nursing homes). The study examines quality assurance in Sweden, Federal Republic of Germany, Belgium and England as these represent a range ...
This paper reviews the available evidence on medical negligence and analyses the options facing policy makers. It shows that claim rates in the United Kingdom are much lower than in the United States. Differences between the two countries in legal, health care and social insurance systems mean that it is ...
This document looks at collaboration in mental health services between service providers and service users, although much will be of interest to all groups involved in collaborative ventures. There are two components in the process of collaboration: firstly, users need to work together to find a collective voice; and secondly, ...
The briefing paper provides a constructive analysis of the White Paper (Working for Patients). It argues that the White Paper outlines an ambitious and high risk strategy. The paper identifies main themes underlying the White Paper proposals: new institutional arrangements for the health services; the management of clinical activity; responsiveness ...
This project paper outlines some of the initiatives undertaken in the field of education and prevention of HIV infection in an area of low prevalence (Northern Ireland) and attempts to adduce some of the factors critical to achieving implementation of the programme, planning for which started at the end of ...
This is the third volume of King's College Studies in medical law and ethics. The following topics are covered: A.I.D.S.; contraception and family planning; human rights and the role of the judiciary in medical law; a national commission for medical ethics; defensive medicine and medical malpractice; the ethics of the ...
In this publication the author states:- A new approach is needed for agenda-setting in primary health care. It should draw on the public health and participatory model espoused by W.H.O.; build on the experiences of local projects and initiatives, and seek to create planning and management structures which achieve change ...
The Task Force first published guidance about the role of the health service equal opportunities advisers in 1988. At that time only 8 advisers had been appointed. Since then the number has more than doubled and appointments at regional and unit as well as district level have been made. This ...
Managers may not be covered by the codes of practice of doctors and nurses but they are having to consider the ethical framework within which they work. This book examines ethical issues in a practical manner. It covers a wide field of concern to managers with responsibilities they have to ...
This paper was partly derived from the proceedings of a conference on Acute Care at Home, held in the King's Fund Centre in June 1989. The report states that Hospital at Home (HAH) services should be made available throughout the country. It shows that many patients prefer the provision of ...
This briefing paper sets out to review the literature on models of assessment and case management in order to identify key issues which will need to be addressed as Social Services Departments implement the changes outlined in 'Caring for People' and the NHS and Community Care Act 1990. It attempts ...
This is the third paper by the authors on managing the relocation of psychiatric services from large institutions to new patterns of local provision. It offers a summary of their current thinking about the characteristics of an assessment and resettlement model which would be compatible with the wider planning issues ...
The Sheffield Development Project arose from the thinking behind the 1971 White Paper "Better Services for the Mentally Handicapped", which was a government effort to provide clear leadership and a long-term strategy for the development of services for people with learning difficulties. The Sheffield Development Project has been a major ...
This project paper is the product of a working party convened by the King's Fund Centre to examine the provision of day services for people with mental handicaps. The importance of work in society and for people with mental handicaps is discussed and principles of service design described. Problems with ...
This book is about helping people with learning difficulties to develop their ties and connections with others and the community. It explores the many different ways in which people meet and develop relationships with others. It makes practical suggestions for people with learning difficulties themselves, families, service workers and other ...
This report reviews the performance of health services in Sweden, Holland, West Germany, Canada and USA. The main aim has been to identify the countries' studies, to draw parallels with the UK, and to establish the lessons, if any, from abroad. Chapter one traces the origins of the Prime Minister's ...
This publication was commissioned by the King's Fund Informal Caring Support Unit. It is the first book on support groups for carers, whether small and informal or well-established. The author offers suggestions, encouragement and inspiration to all carers. Whether they are starting a new group or helping their own group ...
This publication offers guidelines for statutory and voluntary agencies on the preconditions to and ingredients of a quality housing and care support service for physically disabled people. It presents case histories from the project research, and documents some of the innovative schemes and services that are helping disabled adults to ...
In this book the objectives and implications of research on cleaving embryonic cells are described, and an argument is sketched why such research should be permitted. The argument is then examined from the perspective of the traditions mainly formative of our culture - Greek, Jewish Christian, Hippocratic. A philosopher then ...
The thesis of this paper is that an analysis of the GP budget holding proposal (in 'Working for Patients'), in the light of the US HMO movement and the managed care industry it has spawned, will provide valuable insight into how the British innovation might function, or not. The paper ...
This book has been written to provide practical help for people working in and around the health service who are keen to enhance users' experiences. A number of developments which are contributing to more responsive services have been gathered together and, by focusing on practicalities, the book helps to unravel ...
This paper is not intended as a critique of government policy, but rather as an exploration of the opportunities and constraints inherent in that policy and some of the processes which may be required to put the policy into effect. A fundamental tenet of this paper is that the needs ...
This paper presents the results of a Task Force survey of the health authority members, and the efforts which have been made by the health service to include black and ethnic minority communities in membership. The report includes information about the responsibilities of health authorities, the duties of members, appointment ...
This working paper sets out some new thinking about the future role of district health authorities. It is intended to introduce into the wider discussion about the future of the NHS some specific ideas about the business of meeting health needs of the local population. As a set of proposals ...
Recent changes in the administrative structure of the NHS seem to have been accompanied by a more marked degree of stress related behaviour. There has been specific concern about nurses and in 1983 the King's Fund awarded a grant to investigate the job-related problems of nurse managers at ward sister ...
This paper is concerned with policy making in the Swedish health service. The paper begins with a description of the organisation of the Swedish health service and a brief summary of the main issues of debate within the service. This is followed by an examination of the role of the ...
The four essays in this volume offer some insights into the following issues: clinical directors, from the view point of a clinician and a manager; USA experience of physician as managers in hospitals and the implementation of such a system; an assessment of the options for the NHS with doctors ...
This report suggests ways in which managers and professionals can make community care more responsive to elderly people. The first part of the report examines ageism and its effects on health care. It describes how elderly people from black and ethnic minority groups are effected by racism. Part Two is ...