A Guide to the NHS PDF
Preview A Guide to the NHS
A Guide A Guide to the ‘Rather than long narrative histories or complex explanations, the author signposts readers to sources of further information, to the making this book the quick guide so many of A us need.’ G From the Foreword by U Sir Ian Carruthers I D E T To maximise the effectiveness of their work, NHS employees OTHER RADCLIFFE BOOKS O need a clear understanding of the structures and systems of OF RELATED INTEREST T the organisation in which they work. However, this information H can be widely spread, hard to access and diffi cult to gain a NHS JARGON EXPLAINED E working overview of, and the pace of changes and initiatives TONY WHITE N can seem almost dizzying. THE NEW POLITICS OF H S THE NHS This book draws together a clear picture of the modern from creation to NHS, from funding and governance to reports, inquiries reinvention and overarching legislation. The book is clear and easy to Sixth Edition understand and crucially includes full references to provide a one-stop point of access to the most detailed and up-to- RUDOLF KLEIN date information available. EFFECTIVE PEOPLE leadership and This book is essential reading for workers in the NHS at organisation development all levels, including managers, administrators and clinical in healthcare T professionals. It is vital reading for managers and staff at Second Edition O commercial companies working with the NHS. It will also N STEPHEN PROSSER Y be of interest to campaigners, patient interest groups, W researchers and journalists with an interest in the NHS. WRITE EFFECTIVELY H Specialty registrars and consultants can also fi nd the a quick course for busy I T information from the book, and much more, in The Doctor’s health workers E Handbook Parts 1 and 2, by the same author. TIM ALBERT TONY WHITE Foreword by Sir Ian Carruthers www.radcliffepublishing.com Electronic catalogue and worldwide online ordering facility. A Guide to the NHS A Guide to the NHS TONY WHITE PhD FRCS MB BS AKC Consultant Otolaryngologist (retired) Foreword by SIR IAN CARRUTHERS Chief Executive South West Strategic Health Authority Radcliffe Publishing Oxford (cid:129) New York CRC Press Taylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742 © 2010 by Tony White CRC Press is an imprint of Taylor & Francis Group, an Informa business No claim to original U.S. Government works Version Date: 20160525 International Standard Book Number-13: 978-1-138-03123-4 (eBook - PDF) This book contains information obtained from authentic and highly regarded sources. While all reasonable efforts have been made to publish reliable data and information, neither the author[s] nor the publisher can accept any legal responsibility or liability for any errors or omissions that may be made. The publishers wish to make clear that any views or opinions expressed in this book by individual editors, authors or contributors are personal to them and do not necessarily reflect the views/ opinions of the publishers. The information or guidance contained in this book is intended for use by medical, scientific or health-care professionals and is provided strictly as a supplement to the medical or other professional’s own judgement, their knowledge of the patient’s medical history, relevant manufacturer’s instructions and the appropriate best practice guidelines. Because of the rapid advances in medical science, any information or advice on dosages, procedures or diagnoses should be independently verified. The reader is strongly urged to consult the relevant national drug formulary and the drug companies’ and device or material manufacturers’ printed instructions, and their websites, before administering or utilizing any of the drugs, devices or materials mentioned in this book. This book does not indicate whether a particular treatment is appropriate or suitable for a particular individual. Ultimately it is the sole responsibility of the medical professional to make his or her own professional judgements, so as to advise and treat patients appropriately. The authors and publishers have also attempted to trace the copyright holders of all material reproduced in this publication and apologize to copyright holders if permission to publish in this form has not been obtained. If any copyright material has not been acknowledged please write and let us know so we may rectify in any future reprint. Except as permitted under U.S. Copyright Law, no part of this book may be reprinted, reproduced, transmitted, or utilized in any form by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying, micro- filming, and recording, or in any information storage or retrieval system, without written permission from the publishers. For permission to photocopy or use material electronically from this work, please access www.copyright.com (http://www. copyright.com/) or contact the Copyright Clearance Center, Inc. (CCC), 222 Rosewood Drive, Danvers, MA 01923, 978-750- 8400. CCC is a not-for-profit organization that provides licenses and registration for a variety of users. For organizations that have been granted a photocopy license by the CCC, a separate system of payment has been arranged. Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identifi- cation and explanation without intent to infringe. Visit the Taylor & Francis Web site at http://www.taylorandfrancis.com and the CRC Press Web site at http://www.crcpress.com Contents Foreword vii Preface viii About the author ix Abbreviations x 1 Understanding the NHS 3 A statistical picture of the NHS 3 The NHS structure 7 Management of the NHS at national level 9 Management at commissioning level 32 Providers, trusts and the independent sector 42 Other topics and notes on recently published plans and reforms 54 Healthcare in other parts of the UK 64 A brief historical review of UK healthcare 74 2 Clinical governance and quality 79 The elements of clinical governance 80 Risk management 85 Clinical audit 86 Evidence- based clinical practice 89 NHS quality initiatives 90 Safeguarding Patients 96 High Quality Care for All 98 3 The future 101 Changing cultures and expectations 102 NHS resources 102 The future of general practice 103 The future of general hospitals 103 The future of doctors 110 Standing Medical Advisory Committee (SMAC) 114 The development of paramedical personnel 119 v vi CONTENTS 4 Funding and the NHS 123 The fi nances of the NHS 124 Distribution of NHS funds 127 Funding for NHS in devolved parts of the UK 138 Capital in the NHS 140 Public Private Partnership and Private Finance Initiative 140 Local Improvement Finance Trust (NHS LIFT) 143 The National Audit Offi ce (NAO) 143 Audit Commission 144 Offi ce for National Statistics 144 Finances at local level 144 Healthcare worldwide 148 Funding in the future 152 5 Acts, circulars, reports and inquiries 154 Health- related Acts of Parliament and legislation including Statutory Instruments 154 Various health- related Regulations, Guidance Notes and Codes of Conduct and Good Practice 174 Key health- related reports 192 Foreword When it comes to navigating our way around the health service, those of us work- ing in the NHS are only too well aware of how we can suddenly become aware of gaps in our knowledge in such a fast moving environment. This is a refl ection of the constant rigours of change and improvement. The persistent pace of change has been a challenging feature of the NHS throughout its 62- year history. I personally see such resilient fl exibility and determined self-i mprovement as one of the greatest strengths of our modern health service. As the NHS continues to become more open and transparent there is no more important time than now to have a contemporary guide that enables the greatest number of people to quickly understand its structure, organisations and governance. Our time- poor culture demands ever faster yet better information so I welcome this guide for being both comprehensive and concise. Rather than long narrative histories or complex explanations, the author signposts readers to sources of fur- ther information, making this book the quick guide so many of us need to fully appreciate the workings of our greatly admired National Health Service. Sir Ian Carruthers Chief Executive South West Strategic Health Authority August 2010 vii Preface I often meet doctors, nurses and others working in the health services who express a wish that they had received a broader range of non- clinical information earlier in their careers. Others who are committed to continuing professional develop- ment seek learning material that will enable them to handle the wider issues they confront on a day-t o- day basis, and for which initial education failed to prepare them. Many trainers can also fi nd it diffi cult to access a single source that provides material for non-c linical training. The Doctor’s Handbook was written to address these and other needs revealed by research. Since publication there has been positive feedback received from specialist trainees and other grades of doctors, including many consultants and, surprisingly, NHS managers. At the same time there remained other groups where certain sections of the original Doctor’s Handbook were not required. The sections likely to appeal to these groups have therefore been published separately as A Guide to the NHS (to include the structure and organisation of the NHS, and health-r elated Acts, Reports, Guidance Notes and Codes of Conduct) and NHS Jargon Explained (to include the glossary of NHS terms and acronyms). Both books provide information not only to workers in the NHS at all levels, but also to managers and staff of com- mercial companies working with the NHS, and campaigners, patient interest groups, researchers and journalists who wish to understand it better. As time passes further changes in the structure, funding and governance of the NHS continue and Acts, Reports and acronyms are added constantly, so with these more compact books the task of keeping things up to date will be made easier. Where possible, readers are guided to original sources for the latest infor- mation that is often readily available on various websites. You will fi nd this small book valuable in your current role and a quick source of useful information and support. Tony White August 2010 viii About the author Tony White is a retired consultant otolaryngologist appointed in Bath, where he was clinical director for seven years. He has a PhD from Bath University with a thesis on ‘The Role of Doctors in Management’. Together with John Gatrell he undertook a three-y ear research project into the non-c linical development needs of doctors that resulted in publication of the NHS Training Directorate report, Medical Student to Medical Director. He has written several books on medical management and contributed to and edited several other textbooks as well as writing numerous papers. He has lectured widely and organised many workshops on doctors’ management develop- ment issues. He was a member of a number of national advisory committees to develop doctors’ non-c linical skills and acted as regular tutor on training courses in various regions. ix
The list of books you might like
