A 'Yes' vote for independence will break up the UK single market and in the short-term could leave Scottish businesses uncertain of their position in Europe, says the Business, Innovation and Skills Committee in this report. A protracted Scottish negotiation over EU membership, and the uncertain investment environment arising from a 'Yes' vote, will have a damaging impact on businesses in Scotland, as well as other parts of the UK. The Committee raises serious concerns that a 'Yes' vote may also leave Scotland facing a currency 'limbo' and in the short term unable to join a sterling currency union and without the prospect of adopting the Euro. Also, the Scottish Government's stated intention to renationalise the Royal Mail upon achieving independence is an un-costed aspiration, bereft of any detail of how it is to be paid for or how it would be done. The Committee also fears for the future of the Universal Postal Obligation in an independent Scotland with its continued survival likely to be secured only at significant additional cost. On higher education, the Committee explored the topics of student fees and UK research collaboration. The central plank of the Scottish Government's HE policy, to charge tuition fees to students from other parts of the UK, was likely to be illegal under EU law. The Committee also expressed concerns this policy would result in Scottish universities facing a financial shortfall, given the significant income currently received for non-domiciled UK students.

This report highlights key trends and variations in the delivery of healthcare across the four nations of the UK. Life expectancy varies significantly across the UK - from 75.9 in Scotland to 78.6 in England for men, and from 80.4 in Scotland to 82.6 in England for women. Spending on health services in the UK more than doubled in cash terms in the last decade. In 2010-11, despite devoting a higher proportion of total public spending to health, England spent the least on health per person. NHS staff has also increased over the last decade. Scotland has the most GPs per person (80 per 100,000 people in 2009 compared with 70 in England and 65 per 100,000 in both Wales and Northern Ireland). Scotland also has the most medical hospital staff and nursing, midwifery and health visiting staff per person. Comparable data on the efficiency and quality of healthcare are patchy. In 2008-09, average hospital lengths of stay varied from 4.3 days in England to 6.3 days in Wales. Hospital waiting times have fallen in all four nations in recent years, although there are notable variations in how long patients wait for common procedures. In 2009-10 waiting times tended to be lower in England and Wales. There have been significant improvements in levels of healthcare associated infections with rates of MRSA infection dropping by a third or more in all nations. The NAO considers that there would be value in the health departments in the four nations carrying out further work to investigate the variations in performance and identify how they can learn from each other

The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.

This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.

Healthcare decision makers in search of reliable information that compares health interventions increasingly turn to systematic reviews for the best summary of the evidence. Systematic reviews identify, select, assess, and synthesize the findings of similar but separate studies, and can help clarify what is known and not known about the potential benefits and harms of drugs, devices, and other healthcare services. Systematic reviews can be helpful for clinicians who want to integrate research findings into their daily practices, for patients to make well-informed choices about their own care, for professional medical societies and other organizations that develop clinical practice guidelines. Too often systematic reviews are of uncertain or poor quality. There are no universally accepted standards for developing systematic reviews leading to variability in how conflicts of interest and biases are handled, how evidence is appraised, and the overall scientific rigor of the process. In Finding What Works in Health Care the Institute of Medicine (IOM) recommends 21 standards for developing high-quality systematic reviews of comparative effectiveness research. The standards address the entire systematic review process from the initial steps of formulating the topic and building the review team to producing a detailed final report that synthesizes what the evidence shows and where knowledge gaps remain. Finding What Works in Health Care also proposes a framework for improving the quality of the science underpinning systematic reviews. This book will serve as a vital resource for both sponsors and producers of systematic reviews of comparative effectiveness research.

In its 75th anniversary year, this book examines the history, evolution and future of the NHS. With contributions from leading researchers and experts across a range of fields, such as finance, health policy, primary and secondary care, quality and patient safety, health inequalities and patient and public involvement, it explores the history of the NHS drawing on narrative, evaluative and analytical approaches. The book frames its analysis around the four key axes from which the NHS has evolved: governance, centralisation and decentralisation, public and private, and professional and managerial. It addresses the salient factors which shape the direction and pace of change in the NHS. As such, the book provides a long-term critical review of the NHS and key themes in health policy.

For adults. There is a pressing need for methodologically sound RCTs to confirm whether such interventions are helpful and, if so, for whom.