|The NHIS update is intended to give a monthly overview of some key issues affecting the NHS. Full access to the National Health Intelligence Service allows these stories to be put into context, by providing background information and facilitating on-going investigation.
The Public Health White Paper was the dominant event in November. This will need a culture change to deliver the promises, but there is now an urgency which has been lacking. The job of piloting the Paper’s initiatives is being focused on PCTs in 88 of the most deprived areas in Britain. At the end of the month the framework was published aiming to cut bureaucracy by culling the number of Arms- Length Bodies. If such a profusion of organisations had been allowed to be created by a commercial company, top management heads would roll. But this being the NHS, those facing disruption are only the many who have worked hard to create something only to find it being carved up or destroyed, and who now have an uncertain future with the prospect of their job being moved hundreds of miles away. There is no doubt that a cull has become necessary, the problem arises from the basic lack of professional management that allowed the situation to arise. The University has been a splendid example, initially perceived of as something grand, competing with established academia, it was demoted to a single U, as the NHSU, and now will be found buried within NILSI - another winner resulting from the application of the Department’s Acronym Forming Technology! Also one wonders what will be the cost/benefit balance of renaming NICE as NIHCE? But at the coalface where the real work is done things have been going well. The unions endorsed Agenda for Change which is now being rolled out across the country. So that is one problem out of the way. There will be others concerned with finding the money, but . . . A DoH report "Better Health in Old Age" said that the elderly were living longer, being happier and healthier and were blocking far less hospital beds. A report Making Progress on Prostate Cancer was published which, while reviewing the progress that had been made, acknowledged the scale of the remaining challenge. The sexual health services will be helped to modernise and transform with a £300 million programme Waiting lists fell again - but it would be alarming if they didn’t. However, allergy sufferers, the numbers of which are on the increase, are getting a raw deal according to the Select Committee on Health, which demanded a more intensive service uniformly across the country. The cause of the increases, of which the rise in the number of peanut allergy sufferers is a good example, is not clear. The task of fighting MRSA is now being shared across some one million NHS staff, so that everyone understands what to do, and more importantly what not to do. At the interface with the commercial sector: • the Government appears to have won a battle as far as drug prices are concerned. The new pharmaceutical price regulation scheme to start in January 2005 will save £370 million a year. • a deal with Microsoft on desk-top software was report to save £330 million over nine years • a deal with Xansa was completed to allow NHS organisation to outsource their finance and accounting services • bids are being invited to be able to provide more, and more convenient, access with commuter Walk-in Centres. To help users get the best out of www.nhis.info an expanded user manual is now available under the Datasources link at Using nhis. If you have problems email firstname.lastname@example.org
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|cdm Monitor Keeping the NHS up-to-date about Research and Development issues Informing the NHS about key resource developments for the management of chronic disease
In a report on Case Management, the Kings Fund said that the evidence of the effectiveness of Evercare and other such schemes was weak. It points out that in the USA the patients are generally in nursing homes, but here they are living in the community, which raises different problems. But it will need some concrete evidence using defined criteria before sensible conclusions can be drawn. Therefore the current lull as far as chronic disease management is concerned is welcome because uninformed discussion can only serve to entrench existing prejudices.
|R & D Update keeping the NHS up-to-date about Research and Development issues
GlaxoSmithKline is reported to be planning to offshore around a third of its clinical trials. Trial volunteers, for example, in India, cost a fraction of that in this country and with drug development costs rising inexorably, it is an inevitable move which will be copied by others - providing that valid results can be achieved. Among the recommendations of the final report of the Healthcare Industry Taskforce were the creation of an Innovation Centre to promote and stimulate innovation, piloted healthcare technology cooperatives, and the building of R&D capacity for medical devices through UKCRC. But even before the Innovation Centre saw the light of day it was buried in NILSI, in which, from July 2005, you will find the erstwhile NHSU and the Modernisation Agency. In effect NILSI will become the NHS’s development department, but we doubt if its interface with the NHS production department has yet been thought through very carefully. A SDO programme is looking for innovative new research linked to the priority areas of Alzheimer’s, stroke disease, mental health and medicines for children. There was a call by a cancer research scientist for more clinical trials looking at the benefits of complementary therapies for cancer patients.
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