Search results
1 – 10 of over 5000One of the most serious obstacles to the development of effectivehealth services is inadequate supply of trained health manpower. Anoverview is presented of the current numbers…
Abstract
One of the most serious obstacles to the development of effective health services is inadequate supply of trained health manpower. An overview is presented of the current numbers and types of health personnel, their roles and trends over time, their geographical distribution across Nigeria and efforts to influence it. It is indicated that in Nigeria the geographical distribution of medical personnel is extremely uneven and that there is a need for fundamental changes in health manpower policy.
Details
Keywords
JENNIFER MACDOUGALL, J. MICHAEL BRITTAIN and ROBERT GANN
This paper provides an overview of the range and development of health informatics, with examples from the literature world wide covering the types of information involved, the…
Abstract
This paper provides an overview of the range and development of health informatics, with examples from the literature world wide covering the types of information involved, the areas of application, the impact of evidence based medicine and other professional issues, integrated information systems, and the needs of the public, patients and their carers. While medical informatics certainly comprises a major part of health informatics it is not the main focus of this paper. Medical informatics is the older term and involves the use of information technology and computing specifically for medical science research, and the diagnosis and treatment of disease involving, for example, X‐rays, imaging, resonance, and magnetic scanning techniques. Rather, the scope of this review is the literature relating to the wider concept of the management of information through the interdisciplinary application of information science and technology for the benefit of patients, scientists, managers, staff, and carers involved in the whole range of healthcare activity.
James Sheffield, Asifa Hussain and Paul Coleshill
The NHS faces a crisis in terms of staffing and recruitment. Many of the ethnic minority GPs in inner city areas throughout the UK are coming up to retirement age, and there is an…
Abstract
The NHS faces a crisis in terms of staffing and recruitment. Many of the ethnic minority GPs in inner city areas throughout the UK are coming up to retirement age, and there is an insufficient supply of trainees to fill estimated vacancies. Over 2,000 nursing vacancies exist across the UK, and recruitment to the profession and retention within the profession are poor. Nurses have been recruited from overseas for the past 40 years, and are currently being recruited from Finland, Malaysia, and the West Indies, whilst doctors are being sought in India, Pakistan and Africa. Overseas recruitment is not a new phenomenon, and numerous studies have been carried out to examine equal opportunities and racial discrimination within the NHS. The aim of this paper was to examine ethnicity and equal opportunities within the Scottish NHS and record the levels of organisational awareness of ethnicity and equal opportunities’ issues. The paper also examines the link between health service delivery to ethnic minorities and internal cultural attitudes to staff.
Details
Keywords
Roselle Herring, Gordon Caldwell and Steve Jackson
In the changing environment of the National Health Service (NHS) medical ward rounds have become increasingly complex. With complexity comes the inevitable risk that things will…
Abstract
Purpose
In the changing environment of the National Health Service (NHS) medical ward rounds have become increasingly complex. With complexity comes the inevitable risk that things will go wrong. Serious failures in care can have important consequences for individual patients, their families, cause distress to health care staff and undermine public confidence in the NHS. The paper's aim is to introduce the concept of a medical ward round considerative checklist to improve ward round processes, effectiveness, reliability and efficiency, aid team working and foster better communication.
Design/methodology/approach
The checklist includes aspects of ward round preparation, the consultation, progress assessment, discharge planning and handover. It is a “considerative checklist” as it not simply checking if an essential component has been done but rather that it has been considered, discussed, action identified and communicated effectively and involves an “at the point of care check and correct” process.
Findings
The introduction of the checklist has provided a systemic approach to medical ward rounds, provided reassurance that quality care is given, aided active participation from all health care professionals and reignited team work. It has streamlined handover, improved patient and professional communication, improved medical documentation and provided an audit tool for ongoing improvement.
Research limitations/implications
The diversity of general medicine makes standard measures of quality of care such as length of stay, morbidity and mortality outcomes hard to measure; however, qualitative data can be obtained.
Originality/value
The authors have developed a systemic ward round approach which ensures attention to quality and safety at the point of care, encourages team working and improvements can be documented.
Details
Keywords
The purpose of this paper is to introduce the concept of the assumption of altruism argued by the author to be a tendency among both the lay public, professionals and politicians…
Abstract
Purpose
The purpose of this paper is to introduce the concept of the assumption of altruism argued by the author to be a tendency among both the lay public, professionals and politicians, a generalised assumption that contributes to the long standing and obstinate presence of abuse of adults who are at risk throughout England, particularly older people living in care and nursing homes.
Design/methodology/approach
By examining available figures that depict the continuing abuse of vulnerable adults, and by drawing on research, the author offers a partial explanation for the longevity of abuse in English society.
Findings
The paper demonstrates how the concept of the assumption of altruism can explain to a degree the apparent enduring levels of abuse of adults who are at risk.
Practical implications
The paper offers the opportunity for the reader to consider some of the fundamental, higher order reasons for the persistent levels of abuse in England, abuse that endures despite the oversight by government of care provided to adults who maybe at risk by virtue of the activities of the statutory regulator and health and social care commissioners.
Originality/value
By presenting the incontrovertible evidence of enduring abuse, the paper introduces the concept of the assumption of altruism as a partial explanation for its continuing occurrence despite decades of policy and practice guidance designed to overcome it.
Details
Keywords
Lynne Phair and Jill Manthorpe
The paper seeks to report on an audit undertaken in 2010 to support implementation of the Independent Safeguarding Authority (ISA) processes by National Health Service (NHS…
Abstract
Purpose
The paper seeks to report on an audit undertaken in 2010 to support implementation of the Independent Safeguarding Authority (ISA) processes by National Health Service (NHS) Trusts. The ISA was set up under the Safeguarding Vulnerable Groups Act (SVGA) 2006. Concern has been expressed that some NHS employers are not familiar with their new obligations to consider making referrals to the ISA.
Design/methodology/approach
This audit was designed to provide an estimate of possible NHS referrals to the enhanced vetting and barring scheme run by the ISA in England and Wales; and to explore two NHS Trusts' potential decision‐making and referrals to the ISA following disciplinary action or adverse events. The two NHS Trusts that participated engaged in a detailed review of incidents and their relationship to harm as defined in the SVGA 2006.
Findings
The simple number of how many incidents have been reported to the ISA by an NHS Trust will not equate to the same number of cases of individual patients being harmed or the number of events that have placed them at risk of harm. There are considerable differences in how reporting an incident is viewed, managed and dealt with among NHS Trusts. Following this audit, the best estimate of the number of potential NHS referrals from England, Wales and Northern Ireland to the ISA over one year is estimated to be about 712.
Research limitations/implications
This is a small audit of self‐selecting Trusts. The information is not examined in detail and the reasons for Trust decisions about disciplinary outcomes are not accessed or scrutinised; the indicative figures of numbers of referrals to the NHS are a simple indication of the levels of referrals that might be expected.
Practical implications
The audit results suggest a need for further work on what is most helpful in making the differential decisions about the type of harm that has occurred from an incident. NHS Trusts may need to assure themselves that their duties under the SVGA are fully understood and implemented.
Originality/value
The strength of the audit, and, therefore, this paper, is that a sample of Trusts have supplied a level of detail about their staff and Human Resource matters that is not generally available, as access to the DATIX system is not generally sought or permissions given.
Details
Keywords
It is believed that public sector auditing leads to a more efficient and effective performance of the public sector. This assumption recently has been challenged by adherents of…
Abstract
It is believed that public sector auditing leads to a more efficient and effective performance of the public sector. This assumption recently has been challenged by adherents of the new public management (NPM). Describes characteristics of NPM such as freeing up controls over and devolving greater responsibility to managers. Answers the question, why should performance auditors be interested in this phenomenon? Discusses the difficulties and challenges that performance auditors are confronted with when they want to contribute to the performance of the public sector. These refer to unintended side‐effects of auditing such as ossification but they also deal with the lack of communication between auditors and auditees. Challenges implicit feedback theory, which underlies work of auditors. Gives suggestions on how to handle some of these challenges.
Details
Keywords
National mental health policies in the UK have a common theme of seeking to develop working partnerships between people who use mental health services, their families and carers…
Abstract
Purpose
National mental health policies in the UK have a common theme of seeking to develop working partnerships between people who use mental health services, their families and carers and professionals. In Somerset, following a staff training programme, a Family Liaison Service has been developed whereby systemically trained staff work alongside inpatient staff to hold family meetings as part of the assessment and admission process on all wards for working age adults and older people. This article aims to focus on this initiative.
Design/methodology/approach
The article considers the development of the Family Liaison Service and evaluates its progress based on audit data, feedback from families using the service, and a survey of staff experience. Issues raised in developing family inclusive services are discussed.
Findings
Evaluation of the service suggests that, although there is still progress to be made, considerable success has been achieved in embedding the service on inpatient units with a substantial increase in meetings held between staff and families. Feedback from families is positive and staff report increased confidence in engaging with families and carers.
Originality/value
This article describes a transferable model for the implementation of national policy to develop working partnerships with families and carers in mainstream mental health services.
Details
Keywords
Peter Fisher, Simon Robson and Suzanne Todd
The purpose of this research is to investigate development competitions in England in order to uncover any shortcomings and point to improvements. A “development competition” is a…
Abstract
Purpose
The purpose of this research is to investigate development competitions in England in order to uncover any shortcomings and point to improvements. A “development competition” is a sale by tender of publicly‐owned land with development potential where bidders also submit designs.
Design/methodology/approach
First, an interview survey of local authorities in north‐east England; second an interview survey with developers in north‐east England; third a questionnaire survey of local authority estates officers and fourth an interview survey with London based property consultants.
Findings
Despite their theoretical attractions, some competitions have problems. Conflict exists between professions and agencies. Development competitions encounter difficulties between developer appointment and construction which may lead to delay or the developer pulling out.
Research limitations/implications
The data collected are biased in favour of the financial/property perspective. Further research is therefore still required.
Practical implications
Despite its practical significance, no literature exists on this specific topic. The results reveal delays, disputes and sub‐optimal use of resources. Further research is needed leading to new official guidance covering all aspects of this process.
Originality/value
Large numbers of competitions are held in the UK each year. The disposal of sites in this way has become more significant due to the concentration of activity on brown‐field land. In future, the need to assemble urban land using compulsory purchase powers is likely to make competitions more frequent. These results, which highlight best practice, will be of interest to all professional people involved.
Details
Keywords
It is difficult to get an adequate account of human needs but there are known needs which, for hundreds of millions of people, are not met. Can the present economic system meet…
Abstract
Purpose
It is difficult to get an adequate account of human needs but there are known needs which, for hundreds of millions of people, are not met. Can the present economic system meet them? Can any economic system meet them? Is simple economic growth the answer? The purpose of this paper is to explore some of the questions, emphasizing the problems and paradoxes.
Design/methodology/approach
The paper looks at India where poverty is rampant despite recent gains, and at Bhutan which ranks low in economic production but quite high on the “happiness scales”. It also looks at questions of the relation of economic inequality to social problems, citing recent studies.
Findings
The paper focuses on how well the world's economic systems address, or fail to address, human needs.
Originality/value
This paper is written by a philosopher and writer on social economics (and Editor of International Journal of Social Economics (IJSE )) who works in a variety of fields: metaphysics and its epistemological relations, the theory of the history of philosophy (focusing on the seventeenth and nineteenth centuries), and moral, social, and economic philosophy and their relations to culture and religion. The paper then introduces the papers in this special issue of the IJSE devoted to human needs.
Details