Local accountability has been a significant policy issue within the NHS generally. However, primary care trusts are in the main accountable to the centre and there have been calls to review this. This paper discusses a range of options for reforming the relationships between PCTs and their public. It explores ...
An independent NHS board has been advocated by a number of commentators, who believe it will reduce both micromanagement and day-to-day political interference in the running of the health service. This report argues that an independent board would be limited in its ability to achieve these aims. It suggests a ...
There are unprecedented challenges arising for the medical profession from the changing expectations of patients, government and managers. Doctors remain 'professionals' but the traditional image of what this means in practice is increasingly outdated. While individual doctors remain highly trusted, the profession as a whole needs to demonstrate better its ...
A wide range of public services - including higher education, housing associations and public service broadcasting - are now either funded, delivered, or regulated through agencies working at 'arm's length' from government. Is it time to consider a similar model for the modern NHS? Does the health service need to ...
Since 1997, the Labour government has made some momentous changes to the way primary care is managed and delivered. The creation of Primary Care Groups, the development of NHS Direct and the implementation of clinical governance will all have an effect on GP services for decades to come. In "What ...
This paper is for chief executives and clinical governance leads in trusts, policy makers and academics. It simplifies clinical governance as a policy and identifies questions that need answering if policy aims are to be met, reports on the development of clinical governance on the ground and highlights gaps between ...
This Review is based on the financial year 1996 to 1997. The first part examines the main events of the year in five key policy areas: creating the new NHS ; community care ; public health strategy; serving the consumer; and clinical knowledge. The second part of the work contains ...
This paper explores the many meanings of democracy, seeks to define some criteria for assessing whether or not there is a 'democratic deficit' in the NHS, and examines the policy options that have been put forward for making the NHS more 'democratic'. The first section analyses the various ways in ...
This paper looks at definitions of different types of accountability, political and administrative, and at the accountability of health authorities, GP fundholders and the pilot projects for total purchasing. The research has revealed models of financial, managerial and public accountability which are described. The paper concludes with discussion of the ...
This Review is based on the financial year 1996 to 1997. The first part examines the main events of the year in five key policy areas: creating the new NHS ; community care ; public health strategy; serving the consumer; and clinical knowledge. The second part of the work contains ...