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This purpose of this study is to look at the availability of routine antenatal anti‐D prophylaxis (RAADP) in the maternity units within the North‐west Deanery, England five years after the publication of this technology appraisal guideline (no. 41) by the National Institute for Clinical Excellence (NICE).

Antenatal clinics of all the major 18 maternity hospitals were contacted about their existing practice on RAADP. Responses were obtained by facsimile and telephone.

A total of 11 of the 18 units had implemented the practice between April 2003 and May 2007. Some had changed their practice from two doses to a single dose on the grounds of logistics. Cost appeared to be the most important reason in non‐user units. The practice is under consideration in two units.

There may be difficulty in universal implementation of NICE guidelines despite the supporting evidence.

This study demonstrates the issue of difficulty of local health economies in supporting national guidelines.

The paper's aim is to determine the quality of transfer of information in relation to NHSLA criterion “on site handover of patient care” between doctors on delivery suite of a UK teaching hospital.

A pilot project, supplemental to the existing system, was trialled on delivery suite to assess the usefulness of a locally modified, standardised instrument (CHAPS) tested previously among midwives at a UK hospital. This was a retrospective audit of the hard copies of the forms available over a period of six weeks.

A total of 69 (82 per cent) forms were available for analysis. Obstetric registrar did the handover in 45(65 per cent) while no information was available in 32 per cent. Satisfactory assessment of clinical picture and history was possible in 96 per cent and 90 per cent cases respectively. Patient assessment was deemed satisfactory in 90 per cent cases. Management plan was satisfactory in 88 per cent. Documentation regarding date and time of handover was present in 84 per cent and 77 per cent cases respectively. Signature of the personnel handing and taking over were identifiable in 64 per cent and 55 per cent cases respectively.

This pilot study was done in one clinical area at a single hospital over a short period. Wider use in other clinical areas treating different conditions is required to demonstrate global applicability.

This small study demonstrates good quality of transfer of information regarding patient care with the modified CHAPS instrument for handover between doctors on a delivery suite. It also raises the issues regarding poor documentation.

This is the only study of its kind hence comparisons could not be made. However it highlights the multiple issues regarding the complexities of handover of patient care between medical personnel.

The purpose of this study is to determine the effectiveness of incident reporting within the Department of Gynaecology at Trafford General Hospital.

A list of all reported clinical incidents in relation to gynaecology at the Trafford General Hospital over a period of two years (January 2005 to December 2006) was obtained. The complaints and claims related to gynaecology were also obtained for the same time period. All complaints and claims were correlated with the reported adverse incidents.

Of the reported 111 adverse incidents, none resulted in either complaint or claim. None of the complaints resulted in claims but there was no corresponding incident reporting. All the claims were directly related to surgical procedures but no incident reporting was done either. The nursing staff filled in all the 111 adverse incident forms.

This study is only limited to adverse incidents in gynaecology over a short period of time (two years) at a District General Hospital.

This study demonstrates the need to stress the importance of incident reporting to the doctors. It is suggested that a session be dedicated to incident reporting as a part of in‐house training for medical staff of all grades.

This paper highlights the need to impress on the medical staff about the importance of adverse clinical incident reporting.

The performance of NHS UK hospitals is under continuous scrutiny as they are constantly under pressure to perform well. A recent document published by an independent body has recommended a host of clinical indicators to assess non‐financial performance of hospitals. This study aims to critically analyse the performance of a single UK hospital against several of these recommended indicators.

Data presented to the Hospital Trust Board for 12 months were used for this study. Previous years' data were used wherever available.

Based on data analysis, this hospital's performance is extremely difficult to calculate. The indicators use complex ratios and due to lack of standardisation, the hospital performance could be interpreted as better, worse or indifferent.

This study analyses most of the recommended indicators. Literature review did not reveal a similar analysis of another hospital against these indicators which precludes comparison.

This study highlights the difficulty in comparing the performance of hospitals due to the inherent lack of consistency. Therefore it is apparent that any reward‐rebuke system linked to performance should interpret the data with caution. It is therefore suggested that easy to control single value activities and standardised routine activities could be used to measure hospital performance. Alternatively, the hospital could compare with its own statistics from previous years.

Literature acknowledges the difficulties in measuring clinical performance. This paper elucidates these difficulties applied to the NHS and suggests alternatives.

The purpose of this paper is to determine the prevalence of feedback following adverse clinical incident reporting among trainee doctors in obstetrics and gynaecology within the Northwestern Deanery of England.

An anonymous questionnaire was circulated among the Specialist Registrar trainees within the specialty attending a regional teaching session. The questionnaire was analysed.

There were 50 responses, of those 45 (90 per cent) had been involved in an adverse clinical incident; 44 had submitted an incident form related to the incident. Three had submitted incident forms without being involved in an adverse incident. Most (80 per cent) had submitted an incident form as well as a related statement. Feedback was available to 23 (51 per cent) of those involved in adverse incidents. More of the senior trainees received feedback than the junior ones. A lecture on clinical incident reporting was available to only 35(70 per cent) of the respondents on the hospital induction day at their latest clinical placement.

This study is limited to adverse clinical incident reporting among the trainees in a single specialty within one deanery in UK; hence the small numbers.

This study demonstrates the presence of awareness regarding adverse incident reporting among the trainees in a high‐risk specialty. It also shows the suboptimal rate of feedback following adverse incident reporting, which does not encourage a learning environment. It is suggested that a lecture should be dedicated to incident reporting at the junior doctors' induction day programme in every hospital.

This paper highlights the lack of adequate feedback following adverse clinical incident reporting.

The locational disadvantage of a health-care centre often restricts adequate delivery of health-care services in an area. The purpose of this study is to examine the status of primary health-care services in such a geographically disadvantageous area which is confined by forests, tea gardens and undulating topography.

Necessary secondary data of 13 primary health centres and 236 sub-centres has been collected from the Office of the Chief Medical Officer of Health. Based on obtained data, Health-care Infrastructure Index has been prepared which has been validated by an expert panel, and subsequently, the Thiessen Polygon method has been applied through Arc GIS software to show spatial variation of health-care services delivered by different health-care centres.

In the study area, there is wide variation found in the case of physical facilities, caregivers and connectivity of road networks, which altogether affect the overall status of health-care services. Among all the indicators, some health-care centres experience staff shortages for prolonged non-recruitment, inaccessibility and inconsistent patient load in different health centres.

In spite of the unfavourable geographical landscape, health-care centres have to be set up wherever possible. There is a need to make new roads and simultaneously the existing road connectivity should be improved so that patients and caregivers can move quickly whenever required. Existing physical facilities need to be renewed or redeveloped along with increasing the number of doctors and other health-care providers as per the need of people with an adequate and optimum level of services.

In the past three centuries in India, outsiders have dominated economic fortunes. Yet, for a brief interlude for two decades (i.e. in the 1830s and 1840s), the Bengalis from Eastern India played a dominant role in the modern business sector of the economy as partners of the British. The singular reason behind this phenomenon was the role of Dwarkanath Tagore (DT) in building multiple multiracial business partnerships in a myriad of businesses. This study aims to demonstrate how all of these activities were synthesized in an integrated marketing approach and how DT was the catalyst in forging these partnerships with the British East India Company and other enterprises.

A historical research method is used in critically examining the business practices of DT. Resources include a few biographies about him as well as several print sources, including several publications owned by him.

DT’s approach to an integrated marketing approach in the nineteenth century, involved the traditional production, distributional and promotional components, and he understood the significance of using all tools at his disposal to reach his market using these synergies, each reinforcing his main self-identify was that of an entrepreneur. He used forward integration techniques in running other operations, e.g. distribution, publishing, advertising and promotion of his products. His multiracial social networks for business and social activities are also identified.

This study synthesizes different sections of DT’s businesses and illustrates how he used integrated marketing to build an enterprising, profit-making business, which was good for both the economy of Bengal and that of the British East India Company and his other partners. The study also establishes him as a pioneering Indian entrepreneur and identifies major social networks with other business partners (both Indian and British).

This qualitative research examines the varied reasons for relocation to old age homes (OAHs) in contemporary India. The purpose of this study investigates the acceptance of institutional living in Lucknow (a Tier II city of India) and whether migration to OAHs is a voluntary decision. This study also examines the lifeworld of the older adult in these OAHs in an attempt to find out whether OAHs are conducive to positive ageing. Derivatively, the authors study their engagement/time use pattern and social networking patterns in the OAHs. Finally, the research seeks to learn whether OAHs are slowly substituting older adult care given within the family by offering the best of the facilities and services.

This qualitative research was conducted in two private OAHs in Lucknow, India. The findings of the study are based on 28 qualitative interviews conducted with the inmates, administrative staff and caretakers. The interviews were unstructured and open-ended and were supported by observations. The observation was not only made of the social setting but also the reaction of the participants. The idea was to develop an emic view of the subject by exploring valid narratives. Pseudonyms were used to report the finding so as to maintain the confidentiality of the research subjects.

This research moves beyond the traditional wisdom that people move to OAH because of the push factors within the family. OAHs in India have evolved over the years and high-end OAHs are equipped with modern amenities to cater to the upper class in their twilight years. Residents were found to lead active lives in OAHs and their common habitus and bonding capital helped them to face the vagaries of old age more confidently. Their active life and membership in various civic organizations challenge the contention of the role theory that the aged are more prone to lose rather than gain roles.

The originality of the research lies in the fact that the authors are extending the arguments made by the role theory of social ageing. The theory proposes that aged people are more likely to lose out roles rather than gain new ones. This study finds that the elderly tend to live a very active life in OAHs and engaged various civic organizations. Although they may lose/voluntarily give up the roles like the head of the household, spouse, etc., they acquire new roles in the context of OAHs.