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This book explores the Care Trust concept promoted by central government for improving partnership working between health and social care. Using case studies and examples to raise current issues related to partnership working, it explains how Care Trusts are bridging the gap between health and social care, and considers how they are delivering more co-ordinated services and improved outcomes. All healthcare and social care professionals with responsibility for, involved in or affected by the new partnership working arrangements will find this book useful reading.
NHS Primary Care Trusts (PCTs) were created in 2002 to commission health services for their local populations, and are currently responsible for controlling about 80 per cent of the £76 billion NHS annual budget. In addition, PCTs have responsibility for public health, and many also provide community-based health services such as district nursing and community hospitals. The Committee's report examines the Government's proposals (set out in the Department of Health paper 'Commissioning a Patient-led NHS' published in July 2005, which can be downloaded at http://www.dh.gov.uk/assetRoot/04/11/67/17/04116717.pdf) to cut the number of PCTs and to contract out community health services by the end of 2008. The report raises a number of serious concerns about the proposals, including in relation to: failings in the consultation process; the impact of PCT restructuring and divestment of provider services; and the likelihood that the estimated financial savings of £250 million will be achieved.
In this supplement to the main report 'Listening and learning: the Ombudsman's review of complaint handling by the NHS in England in 2010-11' (HC 1522, session 2010-12, ISBN 9780102975086) the Ombudsman publishes more detailed data on complaints about primary care trusts and relevant care trusts. For each trust the data shows how many complaints: were received; resolved through intervention; accepted for investigation; and reported on (with the percentage upheld, partly upheld and not upheld). The data is presented in four categories, according to whether the complaint was about: the trust itself (PCT or care trust); a GP or GP practice; a dentist of dental practice; or opticians, pharmacies or healthcare funded by the trust but provided by a private company.
This handbook describes how primary care trusts works as organizations and offers guidelines for present and future development through the process of change towards PCT status.
Written in clear, conversational English, this book can help anyone understand how a living trust avoids the complications, expenses, and delays of probate at times of incapacity and death.
Advances in medical, biomedical and health services research have reduced the level of uncertainty in clinical practice. Clinical practice guidelines (CPGs) complement this progress by establishing standards of care backed by strong scientific evidence. CPGs are statements that include recommendations intended to optimize patient care. These statements are informed by a systematic review of evidence and an assessment of the benefits and costs of alternative care options. Clinical Practice Guidelines We Can Trust examines the current state of clinical practice guidelines and how they can be improved to enhance healthcare quality and patient outcomes. Clinical practice guidelines now are ubiquitous in our healthcare system. The Guidelines International Network (GIN) database currently lists more than 3,700 guidelines from 39 countries. Developing guidelines presents a number of challenges including lack of transparent methodological practices, difficulty reconciling conflicting guidelines, and conflicts of interest. Clinical Practice Guidelines We Can Trust explores questions surrounding the quality of CPG development processes and the establishment of standards. It proposes eight standards for developing trustworthy clinical practice guidelines emphasizing transparency; management of conflict of interest ; systematic review-guideline development intersection; establishing evidence foundations for and rating strength of guideline recommendations; articulation of recommendations; external review; and updating. Clinical Practice Guidelines We Can Trust shows how clinical practice guidelines can enhance clinician and patient decision-making by translating complex scientific research findings into recommendations for clinical practice that are relevant to the individual patient encounter, instead of implementing a one size fits all approach to patient care. This book contains information directly related to the work of the Agency for Healthcare Research and Quality (AHRQ), as well as various Congressional staff and policymakers. It is a vital resource for medical specialty societies, disease advocacy groups, health professionals, private and international organizations that develop or use clinical practice guidelines, consumers, clinicians, and payers.
Even though primary and community care managers face the same challenges as their hospital counterparts they’ve never had an equivalent range of methods for evaluating workforce size and mix. So this book aims to set the record straight by explaining community demand and supply side workforce planning and development. Eight chapters set out the main variables, from dependency and workload, activity and performance, staff education, recruitment and retention, before the most recent data are synthesised into a set of software-supported algorithms that managers can easily adopt. The book and software enable readers to not only compare their organisations with those in the same socio-economic group but also against ‘best-practice’ staffing and performance. Both help managers determine if their stock of workers is equitable, efficient and effective. Finally, a large annotated bibliography helps users locate relevant publications, and readers should look out for workshops in 2006 designed take them through the book’s methods.
Circle is the first private company to assume the management functions of an NHS Trust. This report examines how the NHS East of England Strategic Health Authority designed, initiated and managed the project to franchise Hinchingbrooke Health Care NHS Trust, and highlights early lessons that can be learnt. The Trust developed a cumulative deficit of £39 million between 2004-05 and 2007-08, on an annual income of around £73 million. This report finds that the Trust's performance against standards for cancer and accident and emergency waiting times has improved since the franchise began in February 2012. However, the Trust had generated an in-year deficit of £4.1 million by September 2012, which was £2.2 million higher than planned to that point. Circle plans to achieve £311 million in projected savings over the ten-year life of the franchise, which is unprecedented. However, Circle is not committed to delivering the proposed savings initiatives submitted during bidding, such as reducing the lengths of hospital stays. Most of the savings are expected to be made in the later years of the ten-year franchise. Although the Authority assessed the reasonableness of bidders' savings proposals, it did not fully consider the relative risks. However the agreement transfers all demand and financial risk up to £5 million to Circle. The Authority also rejected a guaranteed payment towards the Trust's cumulative deficit in favour of an ambitious bid that aimed to repay the debt in full. The cumulative debt stood at £38 million at the end of March 2012
World-renowned behavioral scientists Jane Goodall and Marc Bekoff have set forth ten trusts that we must honor as custodians of the planet. They argue passionately and persuasively that if we put these trusts to work in our lives, the earth and all its inhabitants will be able to live together harmoniously. The Ten Trusts expands the concept of our obligation to live in close relationship with animals -- for, of course, we humans are part of the animal kingdom -- challenging us to respect the interconnection between all living beings as we learn to care about and appreciate all species. The world is changing. We are gradually becoming more aware of the damage we are inflicting on the natural world. At this critical moment for the earth, Goodall and Bekoff share their hope and vision of a world where human cruelty and hatred are transformed into compassion and love for all living beings. They dream of a day when scientists and non-scientists can work together to transform the earth into a place where human beings live in peace and harmony with animals and the natural world. Simple yet profound, The Ten Trusts will not only change your perspective regarding how we live on this planet, it will establish your responsibilities as a steward of the natural world and show you how to live with respect for all life.