The need for a National Service Framework for leg ulcers

2010 ◽  
Vol 25 (1_suppl) ◽  
pp. 68-72 ◽  
Author(s):  
R A Bulbulia ◽  
K R Poskitt
Keyword(s):  
Quality Of Care ◽  
Standards Of Care ◽  
Ulcer Recurrence ◽  
Leg Ulcers ◽  
National Service ◽  
National Service Framework ◽  
Assessment And Treatment ◽  
The Uk ◽  
Service Framework

Leg ulcers are common and costly to treat, and the quality of care provided to patients with this condition varies widely across the UK. The introduction of specialized community-based leg ulcer clinics in Gloucestershire has been associated with increased ulcer healing rates and decreased rates of ulcer recurrence, but this model of care has not been widely replicated. One way of ending this ‘postcode lottery’ is to produce a National Service Framework for leg ulcers, with the aim of delivering high-quality evidence-based care via such clinics under the supervision of local consultant vascular surgeons. Existing National Service Frameworks cover a range of common conditions that are, like leg ulceration, associated with significant morbidity, disability and resource use. These documents aim to raise quality and decrease regional variations in health care across the National Health Service, and leg ulceration fulfils all the necessary criteria for inclusion in a National Service Framework. Centrally defined standards of care for patients with leg ulceration, and the reorganization and restructuring of local services to allow the accurate assessment and treatment of such patients are required. Without a National Service Framework to drive up the quality of care across the country, the treatment of patients with leg ulcers will remain suboptimal for the majority of those who suffer from this common and debilitating condition.

scholarly journals Effectiveness of UK provider financial incentives on quality of care: a systematic review

2017 ◽  
Vol 67 (664) ◽  
pp. e800-e815 ◽  
Author(s):  
Rishi Mandavia ◽  
Nishchay Mehta ◽  
Anne Schilder ◽  
Elias Mossialos
Keyword(s):  
Systematic Review ◽  
Health Care ◽  
Quality Of Care ◽  
Quality Of Health Care ◽  
Financial Incentives ◽  
Healthcare Quality ◽  
Standards Of Care ◽  
Positive Effects ◽  
The Uk

BackgroundProvider financial incentives are being increasingly adopted to help improve standards of care while promoting efficiency.AimTo review the UK evidence on whether provider financial incentives are an effective way of improving the quality of health care.Design and settingSystematic review of UK evidence, undertaken in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations.MethodMEDLINE and Embase databases were searched in August 2016. Original articles that assessed the relationship between UK provider financial incentives and a quantitative measure of quality of health care were included. Studies showing improvement for all measures of quality of care were defined as ‘positive’, those that were ‘intermediate’ showed improvement in some measures, and those classified as ‘negative’ showed a worsening of measures. Studies showing no effect were documented as such. Quality was assessed using the Downs and Black quality checklist.ResultsOf the 232 published articles identified by the systematic search, 28 were included. Of these, nine reported positive effects of incentives on quality of care, 16 reported intermediate effects, two reported no effect, and one reported a negative effect. Quality assessment scores for included articles ranged from 15 to 19, out of a maximum of 22 points.ConclusionThe effects of UK provider financial incentives on healthcare quality are unclear. Owing to this uncertainty and their significant costs, use of them may be counterproductive to their goal of improving healthcare quality and efficiency. UK policymakers should be cautious when implementing these incentives — if used, they should be subject to careful long-term monitoring and evaluation. Further research is needed to assess whether provider financial incentives represent a cost-effective intervention to improve the quality of care delivered in the UK.

scholarly journals Community Diabetes: An East London Perspective

2005 ◽  
Vol 98 (3) ◽  
pp. 96-100 ◽  
Author(s):  
Susan V Gelding ◽  
Shanti Vijayaraghavan ◽  
Clare Davison ◽  
Tahseen A Chowdhury
Keyword(s):  
Type 2 Diabetes ◽  
Primary Healthcare ◽  
Diabetes Care ◽  
Healthcare Professionals ◽  
National Service ◽  
High Quality ◽  
National Service Framework ◽  
The Uk ◽  
Service Framework

The rising prevalence of type 2 diabetes in the UK has necessitated a change in the delivery of diabetes care, with a shift of focus from hospital to community. The National Service Framework for Diabetes has enshrined this approach, and the new General Medical Services (GMS2) contract rewards primary healthcare professionals for developing high-quality diabetes care. New approaches cross the primary/secondary care divide and are patient focused. The evolution of diabetes care in the UK is illustrated by service developments in Newham, East London.

A Model to Assess the Cost Effectiveness of Statins in Achieving the UK National Service Framework Target Cholesterol Levels

2003 ◽  
Vol 21 (Supplement 1) ◽  
pp. 1-11 ◽  
Author(s):  
Koo Wilson ◽  
John Marriott ◽  
Stephen Fuller ◽  
Loretto Lacey ◽  
David Gillen
Keyword(s):  
Cost Effectiveness ◽  
National Service ◽  
Cholesterol Levels ◽  
National Service Framework ◽  
The Uk ◽  
The Cost ◽  
Service Framework

Dignity in health care: reality or rhetoric

2002 ◽  
Vol 12 (1) ◽  
pp. 1-4 ◽  
Author(s):  
Win Tad ◽  
Tony Bayer ◽  
Paul Dieppe
Keyword(s):  
Health Care ◽  
Older People ◽  
Old Age ◽  
National Service ◽  
Death With Dignity ◽  
National Service Framework ◽  
The Uk ◽  
The Right ◽  
Right To Dignity ◽  
Service Framework

Increasingly, the term ‘dignity’ is becoming a part of contemporary discussions of health care. Phrases such as ‘respect for human dignity’, ‘treatment with dignity’, ‘death with dignity’ and the ‘right to dignity’ are so commonplace as to have almost become clichés. This is especially so in the context of older people. In the UK, the NHS Plan uses the term ‘dignity’ on a number of occasions (Chapter 15 is entitled ‘Dignity, security and independence in old age’) and the National Service Framework for Older People explicitly mentions dignity in relation to person-centred care. However, practice has often failed to measure up to this much-cited aspiration.

Falls

2002 ◽  
Vol 12 (3) ◽  
pp. 221-232 ◽  
Author(s):  
N Colledge
Keyword(s):  
Older People ◽  
Routine Clinical Practice ◽  
National Service ◽  
Major Health ◽  
The Past ◽  
National Service Framework ◽  
Serious Injury ◽  
The Uk ◽  
Major Health Issue ◽  
Service Framework

Falls have always been a major health issue for older people, but over the past few years there has been an explosion of interest in their prevention. We are now at the challenging stage of incorporating best evidence into routine clinical practice. This has been recognized by the UK government in its National Service Framework for Older People in England, which has set targets to reduce the number of falls that result in serious injury, and to ensure effective treatment and rehabilitation for those who have fallen.

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