Derek Feeley, Chief Executive at NHS Scotland, gives an overview of health care in Scotland, including the economic, demographic and population health challenges.
Improving the Quality of Care in General PracticeThe King's Fund
Dr Nick Goodwin, Project Director and Senior Fellow at The King's Fund, talks about the main findings from the independent Inquiry into the Quality of General Practice in England.
Simon Cunningham: How the Safer Births Programme has made a difference to qua...The King's Fund
Simon Cunningham, Consultant at Mid Cheshire Hospitals NHS Foundation Trust, explains how his team have improved teamworking, communication and governance arrangements in their maternity services.
Giles Wilmore: How will the NHS Information Strategy support the new NHS?The King's Fund
Giles Wilmore, Director of Quality Framework and QIPP, Department of Health, discusses the NHS Information Strategy at The King's Fund's NHS Information Revolution conference.
Lynda Bull: Providing joint services across the public sectorThe King's Fund
Lynda Bull, Corporate Director, Community Wellbeing for Milton Keynes Council talks about providing joint services across the public sector at The King's Fund Annual Conference 2010.
Frances Patterson: Creating a new framework for delivering adult social careThe King's Fund
Frances Patterson QC, Public Law Commissioner at the Law Commission, outlines the recommendations set out in the new legal framework for adult social care.
Belinda Phipps: Why choice matters - Improving the experience of maternity careThe King's Fund
Belinda Phipps, Chief Executive of the National Childbirth Trust, looks at what maternity service choices are available and why having choice is important for mothers.
Improving the Quality of Care in General PracticeThe King's Fund
Dr Nick Goodwin, Project Director and Senior Fellow at The King's Fund, talks about the main findings from the independent Inquiry into the Quality of General Practice in England.
Simon Cunningham: How the Safer Births Programme has made a difference to qua...The King's Fund
Simon Cunningham, Consultant at Mid Cheshire Hospitals NHS Foundation Trust, explains how his team have improved teamworking, communication and governance arrangements in their maternity services.
Giles Wilmore: How will the NHS Information Strategy support the new NHS?The King's Fund
Giles Wilmore, Director of Quality Framework and QIPP, Department of Health, discusses the NHS Information Strategy at The King's Fund's NHS Information Revolution conference.
Lynda Bull: Providing joint services across the public sectorThe King's Fund
Lynda Bull, Corporate Director, Community Wellbeing for Milton Keynes Council talks about providing joint services across the public sector at The King's Fund Annual Conference 2010.
Frances Patterson: Creating a new framework for delivering adult social careThe King's Fund
Frances Patterson QC, Public Law Commissioner at the Law Commission, outlines the recommendations set out in the new legal framework for adult social care.
Belinda Phipps: Why choice matters - Improving the experience of maternity careThe King's Fund
Belinda Phipps, Chief Executive of the National Childbirth Trust, looks at what maternity service choices are available and why having choice is important for mothers.
Hugh Reeve: How is the NHS in Cumbria adapting to lessons from the Alternativ...The King's Fund
Hugh Reeve draws on the lessons that can be learnt from the Alternative Quality Contract and shares how Cumbria Clinical Commissioning Group have started to put those lessons into practice.
Dr Robert Petzel at The King's Fund Annual ConferenceThe King's Fund
Dr Robert Petzel, Under Secretary for health, Veterans Health Administration talking at The King's Fund Annual Conference 2010 on transforming health services.
Paul Zollinger-Read: Understanding the big pictureThe King's Fund
Paul Zollinger-Read, GP and Medical Adviser and Clinical Lead on Primary Care, The King's Fund speaks on 'Understanding the big picture: how consortia can grasp early opportunities and take ownership of reforms'
Our infographics highlight some key facts and figures around leadership vacancies in the NHS and some of the difficulties NHS organisations face in recruiting and retaining people for executive positions.
Chris Ham: capitated budgets - a flexible way to enable new models of careThe King's Fund
Chris Ham, Chief Executive at The King’s Fund, looks at how high performing integrated systems are using capitated budgets and shares examples of eight PCTs who are commissioning integrated care in an innovative way.
More Powers: What Powers? - David Bell, University of Stirlingfutureukscotland
What next for Scotland? Future of UK and Scotland & Scottish Centre on Constitutional Change event at Dynamic Earth on Monday 6 October 2014
http://www.futureukandscotland.ac.uk/events/what-next-scotland
The referendum result has raised questions for both the immediate and longer term future of Scotland and the rest of the UK. At this event, experts from the Scottish Centre on Constitutional Change offered some answers, looking at what happened on 18 September and what might happen in the weeks, months, and years ahead. As the nations of the UK enter what looks to be an unprecedented period of constitutional reconfiguration, this public event highlighted the most recent research by some of the UK's most respected academics, providing a framework for understanding the process and proposals put forth by the parties.
Conference Call/Webcast
October 29th, 2012
» QUARTER HIGHLIGHTS
» Net Income of R$5,567 million and EBITDA of R$14,375 million
» Oil production in Brazil of 1,904 kboed (-3% vs. 2Q12) and natural gas of 377 kboed (+4% vs. 2Q12)
» Start up of FPSO Cidade de Anchieta in September 10th
» Current production: 42 kbpd with 3 wells
» Production peak (100 kbpd): March/2013
» Discoveries: Grana Padano (Espirito Santo), Pecém (Ceará), Barra and Moita Bonita (Sergipe Alagoas)
» Record refinery output (2,026 kbpd in 3Q12 vs. 1,886 kbpd in 3Q11)
» Start up of REPAR’s Coking unit
» 7th consecutive year in the Dow Jones Sustainability Index
Understanding NHS financial pressures: visual resourcesThe King's Fund
This slideset contains key visual elements from our report, Understanding NHS financial pressures: how are they affecting patient care? Please feel free to share and re-use these graphics with credit to The King's Fund.
Nine characteristics of good-quality care in district nursing taken from interviews with patients, carers and staff.
We hope this framework and these slides will be a useful resource for you – please feel free to use them in your work, in documents and presentations.
As part of a joint learning network on integrated housing, care and health, The King's Fund and the National Housing Federation have produced a set of slides illustrating the connections between housing, social care, health and wellbeing.
We hope they will be a useful resource for you – please feel free to use them in your office, in documents or presentations.
District councils’ contribution to public healthThe King's Fund
Our health is primarily determined by factors beyond just
health care. These slides illustrate the ways in which district
councils influence the health of local people through their key
functions and in their wider role supporting communities and
influencing other bodies.
The King’s Fund Events organise more than 20 health and social care events each year. Our highly-regarded conferences attract leading speakers from the government, the NHS, local authorities and the independent and voluntary sectors.
Jos de Blok set up Buurtzorg – which means ‘neighbourhood care’ in Dutch – with a team of four nurses. Today there are nearly 8,000 Buurtzorg nurses in 630 independent teams, caring for 60,000 patients a year. Nurses in Sweden, Norway, Japan and the United States are adopting the Buurtzorg model.
Sharing leadership with patients and users: a roundtable discussionThe King's Fund
‘What more is possible when patients, service users and those delivering services share the leadership task in health and social care?’
We held a roundtable discussion with patient leaders and organisational leads to discuss this question. Our slidepack summaries the conversations, including the opportunities and challenges for patient leaders, and where and how to start shared leadership working.
Making the case for public health interventionsThe King's Fund
In partnership with the Local Government Association, we have produced a set of infographics that describe key facts about the public health system and the return on investment for some public health interventions.
We hope they will be a useful resource for you – please feel free to use them in your office, in documents or presentations.
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
How STIs Influence the Development of Pelvic Inflammatory Disease.pptx
Derek Feeley: Scotland - why quality is the best response to the financial challenge
1. The King’s Fund
2012 Annual Conference
Derek Feeley
Director General Health and Social Care
and Chief Executive of NHS Scotland
2. NHS Scotland
• c. 5.1 million population
• Devolved (since 1999)
• 14 Regional Boards
• Integrated system ( e.g. no
purchaser/ provider split)
• Integration of health and
social care underway
• Tax funded/ cash limited
• Equal access on basis of
need
• Free at the point of care
3. Health Budget Real Terms Summary
overall Overall
00-01 01-02 02-03 03-04 04-05 05-06 06-07 07-08 08-09 09-10 10-11 11-12 12-13 13-14 14-15 Increase Increase
£m £m £m £m £m £m £bn £bn £bn £bn £bn £bn £bn £bn £bn £bn %
Health Budget (Cash) 5.521 6.162 6.474 7.227 8.048 8.790 9.531 10.215 10.642 11.058 11.182 11.369 11.583 11.803 11.946 6.425 116.4%
Health Budget
(Real at 2000-01 prices) 5.521 6.047 6.198 6.769 7.322 7.818 8.255 8.632 8.754 8.962 8.812 8.751 8.682 8.631 8.522 3.001 54.4%
Health Budget Cash and Real Terms Summary 2000-01 to 2014-15
12
11
10
Budget 9 Cash
£bn
Real
8
7
6
5
'00- '01- '02- '03- '04- '05- '06- '07- '08- '09- '10- '11- '12- '13- '14-
01 02 03 04 05 06 07 08 09 10 11 12 13 14 15
Financial Year
Note: This presentation provides a high level position based on
published budget figures. It should be noted that budgets between
years are not directly comparable due to transfers between portfolios
and other budgetary and accounting adjustments (e.g. HM Treasury
cost of capital removal)
4. Health spend – 4 nations
Identifiable Expenditure per capita on Health, UK and countries, £
2,500
2,000
England
1,500 Scotland
Wales
Northern
Ireland
1,000
UK identifiable
expenditure
500
0
2007-08 2008-09 2009-10 2010-11 2011-12
Source: HM Treasury Oct 2012
5. Health spend – Scotland and
English regions
Identifiable spend per capita on health, Scotland and English Regions, £ Identifiable Expenditure per head
2,500 on health, £ 2011-12
North East
London 2,102
North West
North East 2,095
2,000
Yorkshire and
North West 2,029
the Humber
East Midlands
Yorkshire and the Humber 1,905
1,500 West Midlands
West Midlands 1,865
East
South West 1,771
London
East Midlands 1,728
1,000 South East
East 1,711
South West
South East 1,702
Scotland
England 1,874, Scotland 2,091,
500
Source: HM Treasury, Oct 2012
0
2007-08 2008-09 2009-10 2010-11 2011-12
Source: HM Treasury Oct 2012
6. 4 key challenges
• Economic
• Demographic
• Population health
• Changing expectations
7. Triple Aim
The triple aim
Health of the
Population
Integration
Experience of Best Value
Care for Money
8.
9. 3 quality ambitions
• Mutually beneficial partnerships between patients, their families
and those delivering healthcare services. Partnerships which
respect individual needs and values and which demonstrate
compassion, continuity, clear communication and shared
decision-making.
• No avoidable injury or harm from the healthcare they receive,
and that they are cared for in an appropriate, clean and safe
environment at all times.
• The most appropriate treatments, interventions, support and
services will be provided at the right time to everyone who will
benefit, with no wasteful or harmful variation.
10. HSMR
Ja
n-
M
ar
0.80
0.85
0.90
0.95
1.00
1.05
A 20
pr
-J 0
un 8
Ju 2
l-S 00
ep 8
O 2
ct 1.03
-D 008
ec
Ja
n- 200
M 8
ar
A 20
pr
-J 0
un 9
Ju 2
l-S 00
ep 9
O 20
ct
-D 0
ec 9
Ja
n- 200
M 9
ar
A 20
pr
1
10.6%
-J
un 0
Ju 2
l-S 01
ep 0
O 2
ct
redu
-D 010
c
ec
Ja
n- 201
M 0
ar
A 20
tion
pr
HSMR: Scotland
-J 1
un 1
Ju 2
Jan. ’08 Mar. ‘12
l-S 01
ep 1
O 2
ct
6640 less than expected deaths
-D 011
Ja ec
n- 20
M 11
ar
20
12
p
0.89
12. Implications for costs – what do we
know?
• Poor quality is costly
• Costs and benefits are
spread over time and
between stakeholders
• The context matters
• Better data would help
13. Quality and cost - it’s
complicated….
Too bad all the people who know how to run
the country are busy driving cabs and
cutting hair.
-- George Burns
14. Why quality?
• Waste, harm and variation
• Poor quality costs more
• Clinical engagement
• Thrive or survive?
• Route to longer term sustainability
• What is the alternative?
17. Ja
0
1
2
0.5
1.5
2.5
n-
08
Ap
r- 0
8
Ju
l-0
8
O
1.15
ct
-0
8
Ja
n-
09
Ap
r- 0
9
Ju
l-0
9
O
ct
-0
9
Ja
n-
10
Ap
r- 1
0
Ju
l-1
0
O
ct
-1
0
(per thousand patient days)
Ja
n-
11
Ap
r- 1
1
90% reduction
Ju
l-1
1
O
ct
-1
1
0.12
Harm - General ward C.Difficile rate
23. Improving quality and reducing costs
Our choice
Surviving – the 3%
Thriving – the 97%
24. The future - getting to the third curve
Co-production
& assets
Performance
Improvement
Performance
Time
25. "Quality is never an accident; it is
always the result of high intention,
sincere effort, intelligent direction
and skillful execution; it represents
the wise choice of many
alternatives.”
1941, William A. Foster
Editor's Notes
Quality Strategy launched May 2010 Quality Alliance Board to challenge and ensure implementation to achieve aim of being a world leader Commitment to prioritise, align and ensure a coherent programme of local and national work underpinning Quality Strategy Ambitions Quality Outcomes and related measures, with national targets embedded Quality Strategy launched May 2010 Quality Alliance Board to challenge and ensure implementation to achieve aim of being a world leader Commitment to prioritise, align and ensure a coherent programme of local and national work underpinning Quality Strategy Ambitions Quality Outcomes and related measures, with national targets embedded Quality Strategy launched May 2010 Quality Alliance Board to challenge and ensure implementation to achieve aim of being a world leader Commitment to prioritise, align and ensure a coherent programme of local and national work underpinning Quality Strategy Ambitions Quality Outcomes and related measures, with national targets embedded
Smoothed the seasonal effect . Fit regression line: shows a marked acceleration over the most recent two year period. Why is this ? We cant say for certain – but one explanation is the cumulative additive effect of the many many small changes and improvements made across a nation. Made by you and the people you work with The so called aggregation of marginal gains The sum is greater than the whole- there is probably a synergistic effect beyond the simple addition or cumulation- achieving a critical mass. Fits with our thinking- focus on processes – and outcomes will follow – often after a delay or lag