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What are the political forces which drive the process of change in the health service? How do these forces impact on existing structures of power, policy and organisation? In addressing these questions, Brian Salter applies an original theory of political change to key areas of NHS activity. He shows how the escalating demand for health care combined with recent radical policy initiatives has posed different problems for politicians, doctors, bureaucrats and managers. Out of the accommodations reached, a new shape has emerged for the NHS.
Today’s health care systems need doctors and consultants to act as leaders, within the multi-disciplinary team, in addition to carrying out their clinical role. This book identifies the key elements of successful leadership through 'medically led' service development and systems transformation and shows how this benefits patient care, particularly when patients become partners in the process. The authors provide a conceptual framework of medical leadership and a set of scientific methods and tools that make a significant contribution to advancing quality and transforming services in healthcare. On top of this, they present analytical tools which medical professionals can use to support their own improvement or system transformation strategy, including ways of measuring improvement and the returns on investment of medical leadership. Woven throughout the book are real-life case studies from medical leaders across the world, providing students with valuable practical insights. Chapter summaries and reflections are provided to support learning. Medical Leadership will be essential reading for students on medical and clinical leadership courses internationally as well as for all practising doctors, consultants and General Practitioners.
The Institute of Medicine study Crossing the Quality Chasm (2001) recommended that an interdisciplinary summit be held to further reform of health professions education in order to enhance quality and patient safety. Health Professions Education: A Bridge to Quality is the follow up to that summit, held in June 2002, where 150 participants across disciplines and occupations developed ideas about how to integrate a core set of competencies into health professions education. These core competencies include patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics. This book recommends a mix of approaches to health education improvement, including those related to oversight processes, the training environment, research, public reporting, and leadership. Educators, administrators, and health professionals can use this book to help achieve an approach to education that better prepares clinicians to meet both the needs of patients and the requirements of a changing health care system.
Americans are accustomed to anecdotal evidence of the health care crisis. Yet, personal or local stories do not provide a comprehensive nationwide picture of our access to health care. Now, this book offers the long-awaited health equivalent of national economic indicators. This useful volume defines a set of national objectives and identifies indicatorsâ€"measures of utilization and outcomeâ€"that can "sense" when and where problems occur in accessing specific health care services. Using the indicators, the committee presents significant conclusions about the situation today, examining the relationships between access to care and factors such as income, race, ethnic origin, and location. The committee offers recommendations to federal, state, and local agencies for improving data collection and monitoring. This highly readable and well-organized volume will be essential for policymakers, public health officials, insurance companies, hospitals, physicians and nurses, and interested individuals.
Employment relations within the health sector have undergone radical reform over recent years. This book is an important new study that examines the responses of managers and workers to these different reforms, at both national and local level. Bringing together analyses of both employment relations and public sector management, the book focuses on understanding why certain initiatives have been adopted, how managers have responded to them and the consequences of the HR modernisation agenda. Topics covered include: HR strategy and structure at the workplace employee involvement and union influence pay modernisation management of work. Featuring detailed case study research in three NHS trusts, the book illustrates precisely how government policies are implemented in the workplace and in doing so offers a unique insight into the sector's changing work environment. A comprehensive study of atopical area, this book will be of interest to students and academics in health service management, human resource management and employment relations.
This book is for anyone who is interested in the leadership and management of the National Health Service at the start of the 21st century. At a time when the NHS, the biggest organisation in the UK, is facing massive change through modernisation, the authors represent the positive and constructive approaches many clinical leaders and senior managers are taking to become better leaders. It is hoped that the book will contribute to a better understanding of the need to work with complexity and change in a radically different way. The separate chapters of this book have been contributed by practitioners who are - or who have recently been - senior managers and professionals in the National Health Service. They have been asked to write for people like themselves - practical, experienced contributors to the NHS, who know there are no instant solutions, no magic cures, and are prepared to spend a little time standing back for a moment from the bustle of immediate demands to understand the patterns and the problems and the possibilities of leadership in the health service. Clinicians and managers in the UK healthcare system have been subjected to a relentless stream of changes imposed by one political initiative or another over the past twenty years. This has made some practitioners passive. Even at senior levels in some organisations we find managers who say: 'I can't influence strategy. I can't lead. I can't innovate. I'm told what to do.' In these challenging times, we believe that healthcare organisations need more than ever people who are prepared to take what opportunities they can find to lead, rather than just to follow, who are pre- pared to develop the new ideas and practices that will shape their organisations. These leaders are needed at every level. Those at the top of the organisation's structures have the added responsibility of creating sufficient space for leaders at lower levels to be able to take action. Effective leadership is not the business of minutely directing the behaviour of others, as many of our contributors make clear. Effective leadership in modern healthcare is more about working well in partnership, influencing others and also being prepared to influence, working cooperatively rather than in competition.
Until now little attention has been paid by sociologists to health policy issues. The Sociology of the Health Service provides an analysis of current policy and covers such topics as privatisation, health education and management.
This bestselling book provides an accessible introduction to the concepts and practicalities of research methods in health and health services.
A growing reliance on market disciplines and incentives characterised health care reform strategies in many countries in the 1990s, yet the country which relies most heavily on private health care - the U.S.A. - is the most expensive in the world and still fails to deliver affordable health care to millions of its citizens. This apparent paradox is the starting point for Markets and Health Care: A Comparative Analysis.