Year: 2011
Type: editorial
Abstract: This edition of the Journal of Research in Nursing offers a timely focus on quality, safety and innovation.Threads running through these papers include acknowledgement of the significance of organisational culture and the complex range of knowledge and skills required to innovate in health care, transfer research informed evidence into practice and keep patients safe.At the time of writing (March 2011) health services in England are being consulted on unprecedented proposals to reform workforce planning processes and the commissioning of education (Department of Health, 2010b).These proposals arrive in the wake of far-reaching health care reforms, progressed by the UK Conservative: Liberal-Democratic coalition government, which aspire to 'put patients at the heart of everything the NHS does; focus on continuously improving those things that really matter to patientsthe outcome of their healthcare; and empower and liberate clinicians to innovate, with the freedom to focus on improving healthcare services' (Department of Health, 2010a: http:// www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_117353).Ideologically driven, these reforms are based on the assumption that competition is a primary lever for improving quality and localism is a key means of both enabling the public, the consumers of health care, to exercise choice and empowering professionals to participate in decision-making.Born in part, perhaps, through frustration with the previous Labour administration's centralising tendencies (Wilson, 2003) and nationally-set targets (Barber, 2007), which were seen to lead to gaming (Gulland, 2003), to deliver unintended, negative consequences (Young and Heymann, 2003) and to have the capacity to stifle innovation (McMahon, 2008).The pendulum has most certainly swung towards the rhetoric of localism.Whilst localism undoubtedly has its merits, a swinging pendulum, without effective balances and checks in place, may undermine the benefits of centralism.For example, readers will be familiar with the arguments against the so called 'post-code lottery' where service provision is dependent upon where you live and what your local health care services will provide.Equity in the provision of in vitro fertilisation (IVF) is a highly emotive and oftcited case in point (Wilson, 2007).Such a scenario appears to be the antithesis of the core values and principles of the NHS -a comprehensive service, available to all, free at the point of use, based on need, not ability to pay.Principles upon which the UK NHS was founded (Great Britain Parliament, 1946), and upon which serial NHS reforms, including the most
Source: Journal of research in nursing
Author: Ann McMahon
Language: English
Subfield: General Health Professions
Field: Health Professions
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4234693592