R Gandy

Undergraduate regional migration in the UK: perspectives on local markets and trends for gender and international student groups

This article presents an analysis of degree course acceptances for UK undergraduate students in 2002 and 2008. It examines student mobility between the UK regions, and the trends in their movement within local markets. Data shows a growing trend for students to study within local regions, especially women. Increases in acceptances of over 10% are observed for students in Wales, a saturated local market is observed for Scotland, whilst in other regions there are increased student acceptances of up to 9%. Data shows the government target for 50% participation in higher education by 2010 was broadly achieved in 2008. The changing landscape in higher education is considered for its student migration and strategic income implications. Caps on student numbers are considered against balancing finances through international student numbers, highlighting implications for capacity planning and changing competition strategies. Findings highlight a need for possible strategic alliances in order to maintain positive regional developments.

Using care profiles to commission end-of-life services.

AIMnIn early 2010, Liverpool Primary Care Trust (PCT) undertook a project to establish whether a care profiles methodology could be used to commission end-of-life (EoL) services. The Department of Health (DH) originally used them for a variety of services in the 1990s. The project sought to adapt the original care profiles structure for commissioning purposes, and produce a series of care profiles that would cover the full EoL care pathway.nnnBACKGROUNDnThe DH required PCTs in England to undertake local reviews of EoL services ahead of its publication of the National EoL Strategy in 2008. Related cross-sector work in Liverpool highlighted the need for a means of specifically commissioning EoL services. It was contended that care profiles offered the opportunity to set service requirements in respect of skill mix, delivery, quality and outcomes for each stage of the EoL pathway, which could be costed subsequently.nnnMETHODSnAn iterative approach was adopted involving workshops and consensus, based on action learning events, which incorporated and adapted past approaches for developing care profiles. Four half-day workshops were held, each targeting one EoL stage, with the outputs evaluated by an external reference group. A full cross-section of commissioning, provider and service user interests were involved.nnnFINDINGSnThe project was successful, with its recommendations subsequently used to commission EoL services across Liverpool. It was concluded that the basic service requirements for EoL care are the same, irrespective of the related disease. The strength of care profiles is their simplicity and flexibility. They complement and augment integrated care pathways, and by requiring the recording of outcomes throughout the care process, they aid quality and audit processes. They should be transferable to other conditions, with benchmarking enabling improved efficiency. They represent the type of clinically relevant and detailed vehicle essential for clinical commissioning groups.

Using care profiles as a catalyst for improving end of life commissioning, involvement and service delivery.

Objectives In 2010, Liverpool Primary Care Trust successfully pioneered a care profiles approach to commissioning End of Life (EoL) services. They established service requirements for each stage of the EoL pathway, and set out skill mix, delivery, quality and outcomes. This feature sets out how the approach can also support local work relating to Advance Care Planning, palliative care funding tariffs and patient and public involvement. Situation Local EoL services vary, reflecting geography, history, service models and resources. Few commissioners know in detail how all EoL services and resources systematically inter-relate, particularly those involving non-specialist services. Also, anecdotal evidence indicates that information provided by healthcare professionals to patients and carers is not necessarily consistent or complete. Finances The planned introduction of per patient tariffs for palliative care in 2015 means commissioners must be clear about what EoL services are and what are not covered by the tariffs, and how this might impact on service delivery and contracts. Information A multi-disciplinary workshop established that by clarifying what services are commissioned locally, EoL care profiles can provide detailed information to ensure patients and carers receive comprehensive, consistent, quality information to support their Advanced Care Planning. They can address gaps in EoL information prescriptions and enable transparent information for patient and public involvement. Conclusions EoL care profiles enable local services to be commissioned in detail, which is a catalyst and essential precursor for an inclusive and explicit approach to planning and resourcing services for individual patients and the population as a whole.

Measuring and performance‐managing aseptic dispensing in the National Health Service

Objectivesu2002 This paper provides an overview of a research programme, undertaken by the author over a number of years, to determine how aseptic dispensing production and usage in the National Health Service should be quantified, and performance measured. The purpose was to enable hospitals to maximise the usage of aseptic products and optimise the performance of aseptic dispensing units, in order to reduce medication errors and consequently improve hospital performance, patient safety and patient outcomes.