At once a novel and a guide, this book takes the reader on a fictional journey through the life of Daniel, a child with cystic fibrosis.

Equity and Excellence : Liberating the NHS: Presented to Parliament by the Secretary of State for Health by Command of Her Majesty

This review incorporates the views and visions of 2,000 clinicians and other health and social care professionals from every NHS region in England, and has been developed in discussion with patients, carers and the general public. The changes proposed are locally-led, patient-centred and clinically driven. Chapter 2 identifies the challenges facing the NHS in the 21st century: ever higher expectations; demand driven by demographics as people live longer; health in an age of information and connectivity; the changing nature of disease; advances in treatment; a changing health workplace. Chapter 3 outlines the proposals to deliver high quality care for patients and the public, with an emphasis on helping people to stay healthy, empowering patients, providing the most effective treatments, and keeping patients as safe as possible in healthcare environments. The importance of quality in all aspects of the NHS is reinforced in chapter 4, and must be understood from the perspective of the patient's safety, experience in care received and the effectiveness of that care. Best practice will be widely promoted, with a central role for the National Institute for Health and Clinical Excellence (NICE) in expanding national standards. This will bring clarity to the high standards expected and quality performance will be measured and published. The review outlines the need to put frontline staff in control of this drive for quality (chapter 5), with greater freedom to use their expertise and skill and decision-making to find innovative ways to improve care for patients. Clinical and managerial leadership skills at the local level need further development, and all levels of staff will receive support through education and training (chapter 6). The review recommends the introduction of an NHS Constitution (chapter 7). The final chapter sets out the means of implementation.

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.

This guidance is directed to all NHS services, including primary and community care, e.g. NHS dentistry services as well as district nursing and health visitor services, and hospital inpatient and outpatient care. The guidance is directed to all staff involved in providing NHS services. Many interactions are with clinically trained staff but interaction with non-clinical staff can have a profound effect on patient experience of care. As the guidance is generic in nature we have concentrated on core areas such as staff-patient interaction. There are inevitably a large number of areas not covered and are important for patient experience. Most frameworks of patient experience include the physical environment and access but to enable us to develop guidance in the time available it was agreed with NICE that we would not look at these. There are many groups of patients who have needs beyond those that generic guidance can cover. Patient experience issues specific to particular topics will be covered as usual in topic specific guidance and quality standards. Many of the recommendations in this guidance overlap with recommendations from policy documents and codes of professional organisations. The inclusion of these items in quality standards will allow the NHS to be held to account for the delivery of these key areas for patient experience.

Revealing the British coalition government's plans, this examination demonstrates how a small "policy community" inside and outside the department of health have schemed for 10 years to replace the National Health Service (NHS) with a U.S.-style health care market without informing parliament or the public. While ex-ministers, officials, and the like profit from lucrative positions in private health companies, the population must cope with the increasing health care costs and the diminishing quality of care. With accounts from NHS patients and doctors, the key strategies of implementation are uncovered and the companies involved--their lobby, their businesses, their fortunes, and, in some cases, their crimes--exposed.

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.