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National Health Service Trust (national + health_service_trust)
Selected AbstractsThe Role of Gender in Varying Forms of Flexible WorkingGENDER, WORK & ORGANISATION, Issue 6 2009Carol Atkinson In this article we present empirical data from a research study investigating the implementation of the flexible working policies that emanate from the improving working lives standard in a National Health Service Trust in the UK. We argue that gender is accorded insufficient focus in the literature, considering the barriers that create a take-up gap in formal flexible working practices. We further argue that gendered perceptions render unworkable attempts to portray flexible working as a gender-neutral issue and demonstrate that such perceptions mean that formal mechanisms for flexible working continue to be considered to be a women's issue. We present data on informal flexible working mechanisms and suggest that a greater focus on combining these mechanisms with formal flexibility may help provide working time flexibility for a greater proportion of the workforce. [source] Working at Intimacy: Gay Men's Workplace FriendshipsGENDER, WORK & ORGANISATION, Issue 1 2008Nick Rumens Despite scholarly efforts to challenge the dualistic stereotype of men as rational and women as emotion experts, academics have paid little attention to the issues that arise when gay and lesbian sexualities are introduced into such debates. This article highlights the heterosexist content of much of the research on gender, emotion and organization, and argues the relevancy of investigating the largely neglected topic of intimacy and friendship in the work lives of gay men. Engaging with feminist, queer and sociological research that examines friendship in the lives of individuals who belong to sexual minority groups, I explore in this study the diversity in the way gay men find and work out intimacy in the context of workplace friendships with other gay men and with heterosexual men and women. The data for this article are drawn from in-depth interviews with ten gay men employed in one UK National Health Service Trust. Study findings problematize conceptualizations of friendships at work as being bereft of intimacy, of little value and clearly distinguishable from business relationships. Dichotomous modes of thinking about the impact of gender and sexuality on intimacy and friendship are also challenged. [source] Concordance with community mental health appointments: service users' reasons for discontinuationJOURNAL OF CLINICAL NURSING, Issue 7 2004Tony Hostick MSc Background., Quality issues are being given renewed emphasis through clinical governance and a drive to ensure service users' views underpin health service development. Aims., To establish service users' reasons for discontinuation of community based mental health appointments in one National Health Service Trust. Method., A two-phase survey of all non-completers over a year. Phase one using a structured postal questionnaire. Phase two using structured interviews with respondents to phase one by post, telephone and face to face. Results., A total of 243 discharges because of non-completion were identified by local services over the 12 months of the study and followed up by initial questionnaire. This represents 8.19% of all discharges (2967) within the same period. Forty-four users were engaged and followed up within phase two of the survey. Data were subject to both quantitative and qualitative analysis. Conclusions., Analysis of responses suggests that the main reasons for non-completion are because of dissatisfaction although the reasons are varied and the interplay between variables is complex. Whilst this user group are not apparently suffering from ,severe mental illness', there is clear, expressed need for a service. Relevance to clinical practice., Whoever provides such a service should be responsive to expressed need and a non-medical approach seems to be favoured. If these needs are appropriately met then users are more likely to be engaged and satisfaction is likely to be improved. Although this in itself does not necessarily mean improved clinical outcomes, users are more likely to stay in touch until an agreed discharge. Practical problems of applied health service research are discussed and recommendations are made for a review of referral systems, service delivery and organization with suggestions for further research. [source] Recognition and management of critical illness by midwives: implications for service provisionJOURNAL OF NURSING MANAGEMENT, Issue 3 2007ENB 100, PGDipHE, SUZANNE BENCH RGN Aim, The aim of this study was to explore midwives' recognition and management of critical illness in obstetric women in order to inform service provision. Background, Critical illness is not confined to Intensive Care. Limited published work was located examining factors affecting critical care provision by midwives. Methods, A multi-method design incorporating a paper and pencil simulation (n = 11) and in-depth interviewing (n = 5) was conducted with midwives from a large London National Health Service Trust. This study details and discusses the findings. Results, Findings indicated that frequency and type of critical illness experience impact upon midwives' critical care knowledge and skills. Midwives, especially those who were more junior, expressed anxiety regarding this aspect of practice, and considered the support of senior midwives, medical and nursing staff as crucial to effective client management. Conclusion, This study has yielded important insights into midwives' management of critical illness. Possible mechanisms to enhance the quality of service provision, and midwife support in this area are highlighted. [source] Association of British Clinical Diabetologists (ABCD) and Diabetes-UK survey of specialist diabetes services in the UK, 2006.DIABETIC MEDICINE, Issue 6 2008Abstract Aims To identify the views and working practices of consultant diabetologists in the UK in 2006,2007, the current provision of specialist services, and to examine changes since 2000. Methods All 592 UK consultant diabetologists were invited to participate in an on-line survey. Quantitative and qualitative analyses of responses were undertaken. A composite ,well-resourced service score' was calculated. In addition to an analysis of all respondents, a sub-analysis was undertaken, comparing localities represented both in 2006/2007 and in 2000. Results In 2006/2007, a 49% response rate was achieved, representing 50% of acute National Health Service Trusts. Staffing levels had improved, but remained below recommendations made in 2000. Ten percent of specialist services were still provided by single-handed consultants, especially in Northern Ireland (in 50% of responses, P = 0.001 vs. other nations). Antenatal, joint adult,paediatric and ophthalmology sub-specialist diabetes services and availability of biochemical tests had improved since 2000, but access to psychology services had declined. Almost 90% of consultants had no clinical engagement in providing community diabetes services. The ,well-resourced service score' had not improved since 2000. There was continued evidence of disparity in resources between the nations (lowest in Wales and Northern Ireland, P = 0.007), between regions in England (lowest in the East Midlands and the Eastern regions, P = 0.028), and in centres with a single-handed consultant service (P = 0.001). Job satisfaction correlated with well-resourced service score (P = 0.001). The main concerns and threats to specialist services were deficiencies in psychology access, inadequate staffing, lack of progress in commissioning, and the detrimental impact of central policy on specialist services. Conclusions There are continued disparities in specialist service provision. Without effective commissioning and adequate specialist team staffing, integrated diabetes care will remain unattainable in many regions, regardless of reconfigurations and alternative service models. [source] More aspiration than achievement?HEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 6 2006Children's complaints, advocacy in health services in Wales Abstract The present paper reports on key results from a government-funded survey of all National Health Service trusts, local health boards and community health councils in Wales, which was conducted in 2004,2005 to identify the characteristics of complaints involving children, and the use of professional advocacy services in these complaints and their role in supporting children in relation to health service matters more generally. Findings from the survey are presented which reveal the marginal take-up of professional advocacy services in health complaints, and the slender resource in professional advocacy for children commissioned by a small number of health bodies. Advocacy support for users of health services typically focuses upon adult-related issues. The needs of children, particularly those who may have special requirements because of disability, being looked after, or having language or cultural needs are not well met according to the present survey. This raises the question of whether recent policy and guidance on advocacy (particularly for children and vulnerable groups) is seen by health bodies as warranting decisive action and dedicated investment, or whether rhetoric and modest change is the more likely outcome in the face of other pressing demands on health budgets. [source] Evaluating the impact of integrated health and social care teams on older people living in the communityHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 2 2003Louise Brown CQSW BSc(Hons) MSc Abstract Although it is perceived wisdom that joint working must be beneficial, there is, even at this stage, little evidence to support that notion. The present study is an evaluation of two integrated co-located health and social care teams which were established in a rural county to meet the needs of older people and their carers. This study does identify that patients from the ,integrated teams' may self-refer more and are assessed more quickly. This might indicate that the ,one-stop shop' approach is having an impact on the process of service delivery. The findings also suggest that, in the integrated teams, the initial stages of the process of seeking help and being assessed for a service may have improved through better communication, understanding and exchange of information amongst different professional groups. However, the degree of ,integration' seen within these co-located health and social care teams does not appear to be sufficiently well developed to have had an impact upon the clinical outcomes for the patients/service users. It appears unlikely from the available evidence that measures such as co-location go far enough to produce changes in outcomes for older people. If the Department of Health wishes to see benefits in process progress to benefits to service users, then more major structural changes will be required. The process of changing organisational structures can be enhanced where there is evidence that such changes will produce better outcomes. At present, this evidence does not exist, although the present study does suggest that benefits might be forthcoming if greater integration can be achieved. Nevertheless, until the social services and National Health Service trusts develop more efficient and compatible information systems, it will be impossible to evaluate what impact any further steps towards integration might have on older people without significant external resources. [source] Local and marginal control charts applied to methicillin resistant Staphylococcus aureus bacteraemia reports in UK acute National Health Service trustsJOURNAL OF THE ROYAL STATISTICAL SOCIETY: SERIES A (STATISTICS IN SOCIETY), Issue 1 2009O. A. Grigg Summary., We consider the general problem of simultaneously monitoring multiple series of counts, applied in this case to methicillin resistant Staphylococcus aureus (MRSA) reports in 173 UK National Health Service acute trusts. Both within-trust changes from baseline (,local monitors') and overall divergence from the bulk of trusts (,relative monitors') are considered. After standardizing for type of trust and overall trend, a transformation to approximate normality is adopted and empirical Bayes shrinkage methods are used for estimating an appropriate baseline for each trust. Shewhart, exponentially weighted moving average and cumulative sum charts are then set up for both local and relative monitors: the current state of each is summarized by a p -value, which is processed by a signalling procedure that controls the false discovery rate. The performance of these methods is illustrated by using 4.5 years of MRSA data, and the appropriate use of such methods in practice is discussed. [source] Becoming a new doctor: a learning or survival exercise?MEDICAL EDUCATION, Issue 7 2007Jeremy Brown Objective, This study set out to establish why some new doctors view their training as a valuable period in their professional development, whereas others see it as a year to be endured and survived. Methods, This multi-method case study focused on the interaction of key participants within 1 deanery, sampling the 237 pre-registration house officers (PRHOs) and 166 educational supervisors populating the associated 12 National Health Service trusts at the time (2001). The design of the case study was predicated on gathering the views of both teachers and learners in a way that allowed each stage of the data collection process to inform and influence the next phase. Results, Lack of formal guidance and support were common characteristics associated with the first few days in post. The first day in post as a doctor is, for most, an experience that is hard to prepare for, even after a useful induction period. Those PRHOs who felt they were not guided or advised on how to undertake their new professional responsibilities tended to feel undervalued and under-recognised as individuals. Conclusions, Without the support of senior colleagues who can help the new doctor reflect on quite difficult and uncertain situations, new doctors will almost certainly perceive the first year of the new Foundation Programme as a survival exercise. If new doctors are working in an environment where their learning is properly facilitated, they are more likely to recognise their progress in their professional development and be more proactive in addressing concerns about professional expectations. [source] | ||||||||||