Latest news – Page 2796
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Days like this
As the final draft of the NHS white paper went to the Cabinet, shadow health secretary Robin Cook released an 'authoritative' summary. It included plans for managers to be given greater pay bargaining flexibility, and tax relief for people over 65 taking out private health insurance. Mr Cook condemned it ...
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Private eye
The government has been coy about releasing its long-awaited review of the private finance initiative. Ann Dix reveals what is in it
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Lucky bar steward
A new trust chair is confident of grappling with a £90m turnover - he manages the finances of the Labour club in the PM's constituency. Patrick Butler reports
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The way forward: proposed 'improvements' to PFI procurement
A halving of trusts' PFI procurement costs (from 3 or 4 to 2 per cent of capital cost) and the time from when a project is first advertised to financial close (from an average of three years to 18 months).
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Dig the new breed?
When health secretary Frank Dobson declared he would purge 'Tory deadbeats' from trust boards 18 months ago, he made it clear that a new type of chair would succeed them.
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1999 start-date for CHI looks doubtful
Doubts are emerging that the Commission for Health Improvement, the government's key quality body, will be set up this year as promised in The New NHS white paper.
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'Weak' managers failed abused elderly patients
Health secretary Frank Dobson has 'utterly condemned' standards of care and 'weak management' detailed in a report about a hospital in his constituency.
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Leadership academy seeks rise in standards
Plans to set up a 'leadership academy' aimed at raising standards of management across all NHS professions are being considered by the NHS Executive and the NHS Confederation.
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Unlicensed and off-label
Off-label means the drug is being prescribed outside the terms of its product licence. In Professor Choonara's study, the commonest reasons for off-label use were that the child was outside the specified age range, or that the drug was used for some purpose other than that referred to on the ...
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Licensing flaws
There is a lack of incentive for firms or hospitals to change an unsatisfactory status quo when it comes to unlicensed drug use in children,
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Bangs and M*A*S*H
It may be treating the victims of landmines and helicopter crashes in an old factory, but the UK field hospital in Sipovo, Bosnia, is not immune from more familiar NHS problems.
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TA for nothing: combining NHS work with military service
The more mundane issues which affect the NHS also have an impact in Bosnia. The Ministry of Defence admits that its medical services have only half the doctors they need and three-quarters of the nurses. The worst shortages are among orthopaedic surgeons and anaesthetists.
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Strain of thought
The findings of a study on hernia operations come at a time when the DoH is keeping an eye on success rates as proposed high-level performance indicators. Jenny Bryan explains
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Anatomy of a hernia
A hernia is a rupture or tear in a piece of tissue (usually muscle) inside the body which allows some underlying structure to protrude through the hole. Common sites include where the oesophagus passes through the diaphragm (hiatus hernia); the belly button (umbilical hernia); and the groin (inguinal and femoral ...
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The operation
Hernia can be repaired under general or local anaesthetic but, in its 1993 guidelines, the RCS advised against local anaesthesia in obese, anxious or unco-operative patients. Inguinal hernias can be repaired in several different ways but the three main methods are:
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What can go wrong?
Wound complications, post-operative pain and recurrence are the main problems associated with groin hernia repair. As with other laparoscopic surgery, there have been reports of major internal damage associated with keyhole hernia operations (eg: perforated intestine, haemorrhage and nerve damage).
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Chief causes of wasteful radiology - and six questions doctors should ask
Investigation when results are unlikely to affect patient management because the result is usually irrelevant. For example, degenerative spinal disease is as normal as grey hairs in middle age.
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Sound advice: ultrasound checks for pregnant women
One or more ultrsound checks are now routine in pregnancy. The Royal College of Radiologists guidelines say these are useful because they provide information about the expected date of delivery and multiple pregnancies, but they admit the scientific basis remains controversial.2
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Monitor
Monitor is delighted to bring news, not so much from the cutting edge as the ready-sliced front line of hospital catering: NHS Supplies has signed the 'first ever national contract for prepared sandwiches'. The health service spends £8m to £10m a year on its bagels, baps and bread rolls, and ...