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Readers' letters

Letters to Health Service Journal's editor.
  • Lamb admits integration evidence is still 'embryonic'

    24-Oct-2014 11:12 pm

    Needs to start with legislation. Please don't expect much under current arrangements. Too many barriers, too many perverse incentives... and too much time spent trying and failing. Of course it will save money. It will greatly reduce management costs and the economies of scale will bring efficiencies currently unimaginable.

  • A&E emergency admissions at highest ever level

    24-Oct-2014 9:27 pm

    Primary care has seen an equally rapid increase in activity per annum if not more so within a very largely capitated budget. 90% of all consultations happen in the community but no winter pressures funding there. If you want to make an impact on A&E, let's stop talking about A&E all the time and start turning our attention and and intention towards the community. If only the politicians and mdia could be less obsessed by A&E....

  • Forward view: Unprecedented call for NHS funding growth

    24-Oct-2014 5:22 pm

    I share the scepticism about the system's ability to save £22bn. It will only be even remotely possible through measures which the politicians will never allow: 1. Major consolidation of services and building closures - thereby compromising ease of access 2. Rationing 3. Income generation (eg by fining patients for missing appointments) It's a pickle and no mistake...

  • Secure hospitals staff to strike

    24-Oct-2014 4:45 pm

    Why was this reported so late by HSJ?

  • The future begins in Stevenstown

    24-Oct-2014 4:20 pm

    Alastair, some reassurance will be appreciated on the possible repercussions for NHS employees. The last reforms had a catastrophic effect on managerial structure and we lost some outstanding administrators.

  • Bullying and race discrimination alleged at Barts, report finds

    24-Oct-2014 3:50 pm

    “In some instances bullying was alleged following attempts to manage performance and/or conduct”. Isn't this a big part of the problem? There are bullies and there are bullying cultures/processes. But might there sometimes be an element of managers caught between the rock of productivity pressure and the hard place of belligerent staff? All bullying as diagnosed by this study's approach looks remarkably similar. But bullying fundamentally represents a dysfunctional relationship and not always a dysfunctional person. Considering bullying in terms of relationship not only helps distinguish the bullies from the culture but also gives you some very real levers for change - inactivity by trusts (as alluded to in the comments above) is sadly too common.

  • NHS plans 'radical upgrade' in public health

    24-Oct-2014 3:29 pm

    0.17am - no chip there sounds like a whole plank! 5.10 pm here. I am not a PH Medic by the way, just observing from a CCG perspective the value a medically trained PH Physician can give to our work. My original comment also pointed out the effect the move to LAs has on all Public Heath staff not just Medical Consultants.

  • West Midlands trust could be forced to change leadership

    24-Oct-2014 3:29 pm

    I thought takeovers were now the answer to everything and that the bigger the better. Perhaps there is some learning to be done here.

  • Care UK surgery growth 'slower' than expected

    24-Oct-2014 1:51 pm

    Chutzpah by Care UK's Philippa Slinger. Why she thinks any sensible Trust CEO would go near her offer of helping hospitals run their elective services after the shocking CQC reports in her last year at Heatherwood and Wexham Park I have no idea. Stay away I suggest?

  • The NHS shouldn't accept failure to learn from preventable errors

    24-Oct-2014 1:45 pm

    Some really important points in this excellent article.I do agree with the need for independent investigations in the more complex cases. As an independent consultant who has done a few of these, I see all the shortcomings mentioned in this article. Clearly my services come at a cost to the Trust and there may be merit in a more affordable in-house peer service. The biggest problem I see is key staff just being too pressurised in their "day job" to commit the time and effort needed to undertake a proper investigation. This leads to delays, short cuts and inadequate investigation. Clearly a higher priority needs to be given to this by leaders and busy clinicians.

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