BACKGROUND There is a need to increase flu vaccination rates in England particularly among those under 65 years of age and at risk because of other conditions and treatments. Patients in at risk groups are eligible for free vaccination on the National Health Service (NHS) in England, but despite this, some choose to pay privately. This paper explores how prevalent this is and why people choose ...

The multi-billion NHS Connecting for Health programme in England has completely reconfigured the relationships between the Department of Health, the National Health Service (NHS), primary care computing suppliers and healthcare professionals (including general practitioners). The implications of this reconfiguration are now becoming apparent and have potentially significant effects on the deliv...

Acute Kidney Injury (AKI), an abrupt deterioration in kidney function, is defined by changes in urine output or serum creatinine. AKI is common (affecting up to 20% of acute hospital admissions in the United Kingdom), associated with significant morbidity and mortality, and expensive (excess costs to the National Health Service in England alone may exceed £1 billion per year). NHS England has m...

Reducing undiagnosed and late diagnosed HIV infection in the population remains a public health priority. By the end of 2012, of the estimated 98 400 people living with HIV in the UK, approximately 1 in 3 (31 700) were women of whom about 1 in 4 (7700) were unaware of their infection. There were 842 200 conceptions for women aged 15–44 years in England in 2012; of these, 1 in 5 (21%) resulted i...

BACKGROUND Pay and pay systems are a critical element in any health sector human resource strategy. Changing a pay system can be one strategy to achieve or sustain organizational change. This paper reports on the design and implementation of a completely new pay system in the National Health Service (NHS) in England. 'Agenda for Change' constituted the largest-ever attempt to introduce a new pa...

What prevents the delivery of effective, high quality and safe health care in the National Health Service (NHS) in England? This paper presents 760 challenges which 330 NHS staff reported as preventing the delivery of effective, high quality and safe care. Some problems have been known for over 25 years (staff shortages, finance and patient complexity) but other challenges raise questions about...

OBJECTIVES In modern society, people expect to be actively informed and engaged in decisions about their own health care. Developments in health informatics for patients are increasingly enabling digital solutions to supporting a culture of shared decision making between patients and clinicians. In England, the national patient portal NHS Choices has pioneered patient access to information, wit...

Competing interests Jim Cox is Medical Director of Cumbria Ambulance Service NHS Trust, a role which involves some direct patient care. He is a former GP and member of RCGP Council. REFERENCES 1. WONCA Europe. The European definition of general practice/family medicine. WONCA Europe, 2002. 2. Department of Health. The NHS Plan. A plan for investment, a plan for reform. London: Department of Hea...

BACKGROUND The management of epilepsy incurs significant costs to the United Kingdom (UK) National Health Service (NHS). Making a diagnosis of epilepsy can, however, be difficult and misdiagnosis frequently occurs when patients are seen by non-specialists. This study estimates the financial costs of epilepsy misdiagnosis in the NHS in England and Wales. METHODS Standard costing methods were a...