Bma's Dilemma

He claimed that a new shift system had caused at least one death and one unnecessary operation taking place, and said that he and a small number of consultants were overworked and patient safety and continuity of care were compromised. The claimant had told the Manchester hearing he raised his concerns about the new ‘Consultant of the Day’ system with the trust clinical director Mr Watson and then the trust medical director Mrs Schram; however, he was reprimanded and told not to voice concerns again. The consultant said he was then investigated over a series of ‘malicious, vexatious and frivolous’ allegations and ‘imaginary deaths and complications had been conjured up’ to create a case against him. He believed that the investigation and the process from the beginning was about punishment for raising his clinical concerns, and he argued that the investigation did not examining the veracity’ of the allegations against

NHS cuts to continuing healthcare. This has led to disputes between NHS and social care professionals and shunted costs on to councils, who often have to fund care packages for people no longer fully funded by the NHS.

The first strength of this method is that the NHS England offers an advocacy service. This will ensure that patients that may not be able to speak for themselves still have the same chance at complaining as they can have help. Another strength is that NHS England has more power than a GP surgery and they have the power to

The government White Paper (2006) focuses on the need for individualised care and calls for service to be tailored around the needs of the individual and not the service provider. It aims to place the individual in control of their life and promote independence, by providing a more flexible service, with a view to a reaching and fulfilling a healthy old age. In addition, violence, stress and abuse which pose a threat to an individual’s overall well being, must be identified and addressed. The nurses did not view Joe as an individual because they did not give him the opportunity to choose what he wanted to eat, or allow him to get dressed before leaving his room. To adopt a more individualised approach, the nurses should have let him choose what tine to get up in a morning, allowing him to get dressed and further choose what he wanted to eat for breakfast, therefore adhering to The White Paper guidelines.

All aspects of Mrs A’s personal care will be met whilst in hospital this is something that that Mrs A has in place in her home life with the support of a home care team. The White Paper caring for people (DoH 1989b, paragraph 11), placed as a priority: “the promotion and development of domiciliary, day and respite services to enable sick and dependant people to continue living in their own homes wherever possible and sensible” (Kenworthy,Snowley,Gilling,p244.) After having a chat with Mrs A she has told me that the hours she receives are being cut due to socio economic factors with funding within her community this is something that upsets her.

Frontline employee’s are best placed to understand the needs of patients, and have the skills and knowledge to develop innovative services to meet those needs. We need to devolve power in the NHS so that frontline staff has a greater say in how services are delivered and resources are allocated. Each of the health care professionals holds a level of power according to their profession.

In 2000, an effort was made by the UK government to resolve certain inequalities that had developed within the NHS by releasing the “NHS Plan of 2000.” This plan greatly increased spending on employee pay, infrastructure, and access to services. Despite almost doubling spending in a ten year period,

The Health and Social Care Act. (2012), is to bring the NHS to the 21st century to meet the challenge facing it and safeguarding its future. Help professionals at the centre of commissioning.

Later, findings from a series of reports including report from Royal commission on National Health Insurance in 1926; The Sankey Commission on Voluntary Hospitals in 1937; and reports from British Medical Association (BMA) in 1930 and 1938, all collectively indicated that inadequacy existed in the pattern of the services (Christopher, 2004; Webster, 2002). Evident were reports of conflicting care and duplication of work between the municipal and voluntary hospitals (Wheeler & Grice, 2000). Additionally, world war had a huge impact on the health services and the conditions in which hospitals, theatres, radiology and pathology department operated was very poor. Thus, no machinery existed that supported running of a coordinated healthcare system, hence a need for unified, simplified and cohesive system was felt (Smith, 2007). Furthermore, Royal Commission’s report suggested that funding for the health services might benefit from general taxation rather than its basis on insurance principle (Christopher, 2004). However, it was not until the Beveridge report in 1942, which provided a huge drive and momentum for a movement of change in the health services. And within subsequent years seen were the proposals for NHS drawn through the White Paper in 1944, then in 1946 the National Health Service Act and at last in 1948 the establishment of the NHS

Doctors were unwilling to join the NHS at first and this lead to a shortage of GP’s but with practice mangers being appointed and a change in the training of nurses, hospitals

In 1974 reform of the NHS seen eliminated the involvement of local authorities in health, set up community health councils, introduced area health authorities and changed the management of family doctor services (JISC 2015). The conservative Government reforms of the NHS bought much controversy, supporters claimed the reforms brought increased efficiency and effectiveness, but opponents said they undermined the founding principles of the health service (BBC 1999). However the spending cost of the NHS was a concern, with an ageing population and increase of new advance technology, experts said that the NHS needed above inflation increases of at least 1% a year simply to stand still (BBC 1999). The government, inspired by the Griffiths Report (1983), blamed disorganised management and structures within the NHS for the cash problems (BBC 1999). The National Health Service and Community Act of 1990 was the future explanation (BBC

After the serious shortcomings within the Mid-Staffordshire NHS Trust came to light, The Francis Report (Francis, 2013) investigated how the conditions of inexcusable care could prevail within the trust. The Francis Report proposed several extensive changes that could improve the National Health Service (NHS). Garner (2014) informs that these changes include that leaders need to be effective and accountable, staff should be empowered to work in partnership, each trust should aim to improve innovation and quality, whilst putting the patient first. The Department of Health (DH) reflected on the findings and in response to The Francis

In October 1998 the new European Working Time Directive was implemented. Its purpose was to prevent employers from expecting their employees to work excessively long hours. This meant that doctors were only allowed to work an average of 48 hours a week. As a result Registered Nurses had to take on tasks that were previously only performed by doctors taking them away from the patient’s bedside. In March

The Health and Social Care Act 2012 came into force with crucial principles including new structures and arrangements in health care services to safeguard and strengthen the future of NHS and maintain the modernisation plan. In this Act, many new changes has been made to a number of existing Acts, National Health Services Act (NHS 2006), in order to enable health care system to tackle the existing challenges and also avoid any potential crisis in future. It has also introduced the proper allocation of NHS fund and budget, and improved the integrated care between NHS and social care services to promote patients’ choice in terms of delivering quality care.

described as the worst care that the NHS has seen for many years, and became an issue of public concern when it was