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Report cover showing doctor and boy

Darent Valley Hospital: The PFI contract in action

“My 50th PFI/PPP report continues our current strategy of reporting on how PFI projects are working out. I am pleased to be able to report on the successful delivery of the Darent Valley PFI hospital but this early PFI deal highlights that there are important issues to manage once the operational phase is under way. In particular, although refinancing may offer attractive benefits to the public sector it may also present new risks which authorities need to fully assess before agreeing to the refinancing.”

10 Feb 2005
Cover of Patient Choice report

Patient Choice at the Point of GP Referral

“Enabling patients who are referred by their GPs for hospital treatment to choose where they want to be treated promises to bring benefits to the patients themselves and to the wider NHS. Providing such choice will not be simple, however. The Department of Health must take urgent and effective action to inform and engage with GPs about the new arrangements. GPs’ support may be hard to secure and indeed choice will be hard to deliver successfully by the end of 2005 if the electronic booking system is not largely up and running by then.”

19 Jan 2005
Report cover showing attendance record

Managing Attendance in the Department for Work and Pensions

“Achieving better staff attendance at the Department for Work and Pensions, the largest government department, would be an important step towards improving central government efficiency. The Department’s absence rate is high and has not yet been reduced by the introduction of a new policy. There are no easy solutions, particularly at a time when the Department is undergoing a heavy programme of change, but the Department needs to do more to ensure that the good attendance management procedures it has introduced are adopted by all staff and managers across the organisation.”

8 Dec 2004
Report cover showing dentist examining a child's teeth

Reforming NHS Dentistry: ensuring effective management of risks

“The Department of Health is pursuing an ambitious programme to reform NHS dentistry. There are good reasons to modernise the system but it is vital that the Department gets it right. I have identified significant risks that will need to be carefully managed.

“In the light of concerns by dentists and the NHS, the Department’s decision to postpone the introduction of the new arrangements to October of next year is welcome. It now needs to be more transparent about its plans and its timetable for managing the change process to achieve the new date – and ensure that these are conveyed to dentists and their patients.”

25 Nov 2004
Cover of report showing picture of ambulances

Department of Health: Improving Emergency Care in England

“I welcome the fact that patients in accident and emergency departments are experiencing fewer delays. This is against a background of a continuing high demand for A&E services. There is scope, however, in those trusts which are behind the best for further reductions in the time patients spend in A&E.

“The Department of Health should continue to pursue more effective joint working: on the one hand, between A&E departments and other parts of their hospitals; and, on the other, between all the providers of emergency care. Emergency care networks are a promising way of taking this forward.”

13 Oct 2004
Report cover showing painting of Florence Nightingale

Improving patient care by reducing the risk of hospital acquired infection: a progress report

“The Department of Health has made important progress in raising the profile in NHS trusts of the control of hospital-acquired infection, culminating in its key publication Winning Ways. However, I am concerned that, four years on from my original report, the NHS still does not have a proper grasp of the extent and cost of hospital-acquired infection in trusts.

“The war against hospital-acquired infection must be pursued on many different fronts: ranging from tackling the factors which inhibit good practice, including a more robust approach to antibiotic prescribing and hospital hygiene, though instituting a system of mandatory surveillance, to persuading all NHS staff to take responsibility for, and contribute towards, effective infection control.”

14 Jul 2004
Report cover showing AIDS awareness ribbon

International Development: Responding to HIV AIDS

“The HIV/AIDS epidemic has a devastating effect on the lives of poor people in developing countries. The Department for International Development has a clear commitment to respond to HIV/AIDS. The Department should put in place management systems sufficiently robust to ensure that people affected by HIV/AIDS gain the greatest possible benefit from the increasing resources allocated to the epidemic.”

18 Jun 2004
Cover of report showing prison officer with keys

The Management of Sickness Absence in the Prison Service

“The Prison Service has made good progress in tightening up its procedures for recording sickness absence and now has a better grip on the performance of establishments. The average sickness rate remains high, however. Any reduction in working days lost would free resources which could be used, for instance, to improve regimes for reducing re-offending rates or to deal with the increased number of prisoners being held in custody.

“Further reductions in the average rate of sickness absence among Prison Service staff depend on governors working more closely with staff to improve morale and to overcome a culture of absenteeism prevalent in some prisons.”

19 May 2004
Report cover image

NHS (England) Summarised Accounts 2002-2003

“Although, overall, the NHS successfully met its financial targets in 2002-2003, I am concerned by the variation in financial performance and the large deficits incurred by some NHS bodies. Such deficits may put at risk the achievement of overall financial balance of the National Health Service if they are not matched by surpluses elsewhere in the NHS.

“The Department of Health has delegated detailed monitoring of NHS Trusts and Primary Care Trusts to Strategic Health Authorities. They must ensure that deficits of the scale of the £44.6 million incurred by North Bristol NHS Trust do not happen again”.

28 Apr 2004
Cover of Drug Treatment and Testing order

The Drug Treatment and Testing Order: early lessons

“Probation areas made rapid progress in establishing the Drug Treatment and Testing Order, meeting the target for commencements by April 2003. The Order can help some offenders turn their lives around and reduce their use of drugs. However, the high drop out rate and evidence from pilots of the Order of a high rate of reconviction need to be addressed.

“The Home Office should now shift its emphasis from achieving commencements towards improving the effectiveness of the Order in delivering positive outcomes. More needs to be done to build and sustain the motivation of those on the Order to address their problems and to recognise that the chaotic lives of many such users mean support and treatment may be needed beyond the period of the sentence.”

26 Mar 2004