One may reasonably wonder who will have the upper hand in the end. If just a few days ago we had reviewed that the British Medical Association and the Royal College of General Practitioners were opposing the bill, now we have learnt that the Royal College of Nursing and the Royal College of Midwives. Although the secretary of Health has dismissed this last move as something actually more related to the issues of retirement pensions, the truth is that opposition is mounting.
Will he succeed in convincing an ever increasing front of health professionals opposing the reforms?
Thursday, January 19, 2012
Wednesday, January 18, 2012
The NHS PROMs programme
Prof. Nick Black (London School of Tropical Medicine and Hygiene) gave last night an excellent update on the status of the Patient Reported Outcome Measures (PROMs) Programme in a seminar hosted by the Royal Statistical Society. The PROMs programme is a prospective collection of PROMs data before and after elective surgical interventions.
In a nutshell, the programme is in good health, with variable response rates, very reasonable for joint replacements (hip & knee), less so for varicose veins and groin hernias. The programme is being expanded in at least three different ways: additional interventions (coronary revsacularization), and pilots in relation to Primary Care and Long Term Conditions (LTC) and in Emergency care. Prof. Ray Fitzpatrick (Oxford) also provided some information on the current status of the LTC pilot.
Some questions from the floor focussing on sampling and representativeness issues were convincingly addressed by the speaker. There were also questions in relation to how to guarantee better linkage of PROMs data with other clinical information (e.g., Primary Care records).
The issue of how this information could be used for clinical management of individual patients was central to some comments, recognizing the potential impact of these measurements for clinical practice. This is exactly the focus of our programme of research on the use of individualized and standardized PROMs for improving Primary Care for people with multi-morbidity.
In a nutshell, the programme is in good health, with variable response rates, very reasonable for joint replacements (hip & knee), less so for varicose veins and groin hernias. The programme is being expanded in at least three different ways: additional interventions (coronary revsacularization), and pilots in relation to Primary Care and Long Term Conditions (LTC) and in Emergency care. Prof. Ray Fitzpatrick (Oxford) also provided some information on the current status of the LTC pilot.
Some questions from the floor focussing on sampling and representativeness issues were convincingly addressed by the speaker. There were also questions in relation to how to guarantee better linkage of PROMs data with other clinical information (e.g., Primary Care records).
The issue of how this information could be used for clinical management of individual patients was central to some comments, recognizing the potential impact of these measurements for clinical practice. This is exactly the focus of our programme of research on the use of individualized and standardized PROMs for improving Primary Care for people with multi-morbidity.
Friday, January 13, 2012
UK physicians reject the Health and Social Care Bill.
Christmas has not been benevolent to the Andrew Lansley's brainchild. Pressure is mounting on the , Health and Social Care Bill, now that the report stage – further line by line examination - is about to be scheduled.
The British Medical Association, a voluntary association with over two-thirds of practising UK doctors in membership and an independent trade union, released in December a position statement "Why the BMA is opposing the whole Bill". The document calls for the "reform package as a whole" to be rethought. "It is not too late to think again. The Government’s reform approach is adversely affecting the ability of the health service to deal with the real priority of improving quality in the face of a massive financial challenge. This, rather than unnecessary and unwelcome restructuring, should be the priority."
Seven former presidents of the Faculty of Public Health (FPH), the standard setting body for specialists in public health in the United Kingdom, have recently written to prime minister David Cameron to warn that the proposals will damage the public’s health and that ‘the package of changes proposed in the NHS Health and Social Care Bill will disrupt and destabilise the health service and exacerbate inequalities in the health of the population of England.’ An extraordinary General Meeting of the has been called by the end of the month to discuss the FPH's position.
GPs might be expected to show much more enthusiastic support for a Bill that would put them in the driver's seat of the NHS. But they clearly do not.
A recent online poll conducted by the Royal College of General Practitioners among its members on the support and actions to be taken in the relation to the Health and Social Care Bill has included 2,625 self selected members from a membership of over 44,000 (about 7%). With this limitations in mind, the results show that about 5 out of 10 of the participants "strongly" support to seek the withdrawal of the bill, while about other 3 out of 10 would support it. and it did not really make much of difference whether this should be done in isolation (93%) or as part of a joint effort with other Colleges (98%).
If the bill is finally passed in its current format, the opposition of the very professionals that will have responsibility for its implementing casts serious doubts that it may achieve the stated objectives.
The British Medical Association, a voluntary association with over two-thirds of practising UK doctors in membership and an independent trade union, released in December a position statement "Why the BMA is opposing the whole Bill". The document calls for the "reform package as a whole" to be rethought. "It is not too late to think again. The Government’s reform approach is adversely affecting the ability of the health service to deal with the real priority of improving quality in the face of a massive financial challenge. This, rather than unnecessary and unwelcome restructuring, should be the priority."
Seven former presidents of the Faculty of Public Health (FPH), the standard setting body for specialists in public health in the United Kingdom, have recently written to prime minister David Cameron to warn that the proposals will damage the public’s health and that ‘the package of changes proposed in the NHS Health and Social Care Bill will disrupt and destabilise the health service and exacerbate inequalities in the health of the population of England.’ An extraordinary General Meeting of the has been called by the end of the month to discuss the FPH's position.
GPs might be expected to show much more enthusiastic support for a Bill that would put them in the driver's seat of the NHS. But they clearly do not.
A recent online poll conducted by the Royal College of General Practitioners among its members on the support and actions to be taken in the relation to the Health and Social Care Bill has included 2,625 self selected members from a membership of over 44,000 (about 7%). With this limitations in mind, the results show that about 5 out of 10 of the participants "strongly" support to seek the withdrawal of the bill, while about other 3 out of 10 would support it. and it did not really make much of difference whether this should be done in isolation (93%) or as part of a joint effort with other Colleges (98%).
If the bill is finally passed in its current format, the opposition of the very professionals that will have responsibility for its implementing casts serious doubts that it may achieve the stated objectives.
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