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Emerald Group Publishing Limited
Copyright © 2008, Emerald Group Publishing Limited
Article Type: Editorial From: Clinical Governance: An International Journal, Volume 13, Issue 3
We have all heard of parents moving house or renting a second home to try and get their children into better schools. We are now hearing of similar house moves to try and access better care or drugs of choice; particularly amongst older people. My local estate agent, who reluctantly embraced the Home Information Pack (HIP) has now adopted the American practice of an ultra polite property listing service with care and quality of life factors attached as selling points. These HIPs are proving very popular.
Access to new drugs was hard enough to understand under the old NICE rules and guidance and the public perception was one of a postcode lottery. Now we hear PCTs and the new public health networks will also be evaluating the evidence and adding to the confusion of entitlements which will have such a significant and often geographical effect on patient access to health care. One poorly understood procedure being replaced by two equally confusing parallel processes, does not bode well for patient choice and is hardly clinical governances’ finest hour. I read, for example, that Scotland spends 14 percent more NHS money per head on patient services than England, that Wales is more likely to prescribe those hard to get drugs and the South of England provides the highest generic quality of life scores. Not exactly the most helpful Health Information Pack as I plan my next house move.
This number also contains contributions that typifies mixed messages for patients: from adequacy of voice in the survey of service user involvement in clinical audit (Moore); in clinical governance views on culture and quality improvement (Konteh et al.); to patient experiences of delays (Exton et al.) and waits (O’Neil et al.) in plastic surgery services. The patient might also be concerned at some of the findings in the national survey exploring the management of the safety alert broadcast system (Lankshear et al.), an international perspective on the DoH recruitment strategy for consultant psychiatrists (Gupta et al.) and the do not attempt resuscitation orders (Samanta et al.), all of which have key messages for clinical governance. But in the spectrum of evidence, an improvement for patients is reported by Dahlmann-Noor et al. in their article on “Streamlining the patient journey in eye care”.
So where should I move to, to get the best of care for my family and how do I interpret the often conflicting messages within the surfeit of evidence? I think estate agents in the future are likely to adopt the American practice of the fixed smile offering comprehensive advice. Whether it will be to everyone’s liking, only time will tell, in the meantime,
HIP, HIP hooray and have a nice day.