National Clinical Assessment Service: From 1 Different Sources
(NCAS) see Practitioner Performance Advice.
A controlled research study of the safety and effectiveness of drugs, devices or techniques that occurs in four phases, starting with the enrolment of a small number of people, to the later stages in which thousands of people are involved prior to approval by the licensing authorities (for example, the Food and Drug Administration).... clinical trial
A framework through which health organizations are accountable for continuously improving the quality of their services and safeguarding high standards of care.... clinical governance
See “geriatric assessment”.... assessment
A MEDICAL AUDIT carried out by health professionals.... clinical audit
See DENTAL SURGEON.... general dental services
This is a structured, multi-disciplinary process for assessing and improving the health consequences of projects and policies in the non-health sector. It combines a range of qualitative and quantitative evidence in preparing conclusions. Applications of the assessments include appraisal of national policies, local urban planning, and the progress of transport, water and agricultural projects.... health impact assessment
A systematic procedure for determining the nature and extent of problems experienced by a specified population that affect their health, either directly or indirectly. Needs assessment makes use of epidemiological, sociodemographic and qualitative methods to describe health problems and their environmental, social, economic and behavioural determinants. See also “geriatric assessment”.... health needs assessment
The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences.... risk assessment
Services provided by government to improve the social welfare of those who need them.... social services
Multidisciplinary team of health professionals that is responsible for comprehensive assessments of the needs of older persons, including their suitability for hospital, home or institutional care.... aged care assessment team
Support service provided in conjunction with medical or hospital care. Such services include laboratory, radiology, physical therapy and inhalation therapy, among others.... ancillary service
A process that allows a person who has been assessed to dispute the assessment, and which provides for the assessment to be changed.... assessment appeal process
A structured process developed to ensure that assessment is relevant, consistent, fair and valid. The system requires rules of operation, a regular review process and competent assessors.... assessment system
A network of health units providing essential health care to a population. Basic health services include communicable disease control, environmental sanitation, maintenance of records for statistical purposes, health education of the public, public health nursing and medical care.... basic health service
Help with chores, such as home repairs, gardening and heavy house cleaning.... chore service
Clinical means literally ‘belonging to a bed’, but the word is used to denote anything associated with the practical study or observation of sick people – as in clinical medicine, clinical thermometers.... clinical
Professional specialized or therapeutic care that requires ongoing assessment, planning, intervention and evaluation by health care professionals.... clinical care
A diagnosis (e.g. myocardial infarct) or a patient state that may be associated with more than one diagnosis (such as paraplegia) or that may be as yet undiagnosed (such as low back pain).... clinical condition
Services provided to patients (history-taking, physical examination, preventive care, tests, procedures, drugs, advice) or information on clinical condition or on patient state used as a patient outcome.... clinical event
Systematically developed statements which assist clinicians and patients to decide on appropriate treatments for speci?c conditions. The guidelines are attractive to health managers and patients because they are potentially able to reduce variation in clinical practice. This helps to ensure that patients receive the right treatment of an acceptable standard. In England and Wales, the NATIONAL INSTITUTE FOR CLINICAL EXCELLENCE (NICE) is developing national guidelines with advice from health-care professionals and patients to improve clinical e?ectiveness of NHS care. Some doctors have reservations about guidelines because (1) health-care managers might use them primarily to contain costs; (2) in?exibility would discourage clinical innovations; (3) they could encourage litigation by patients. (See also HEALTH CARE COMMISSION; MEDICAL LITIGATION.)... clinical guidelines
An information system that collects, stores and transmits information that is used to support clinical applications (e.g. transmission of laboratory test results, radiology results, prescription drug orders). Electronic medical records are one method by which clinical information systems can be created.... clinical information system
Clinical information, excluding information about treatment and intervention. Clinical information that does not record an intervention is by nature a clinical observation. The observer may be the patient or related person (information about symptoms, family history, occupation or lifestyle) or a health care professional (information about physical signs, measurements, properties observed or diagnoses). While information about the nature of a planned or performed treatment is excluded by the definition, clinical observations may be recorded on the results of a treatment, on progress during the course of a treatment, or on the result of a treatment.... clinical observation
A multidisciplinary set of daily prescriptions and outcome targets for managing the overall care of a specific type of patient, e.g. from pre-admission to post-discharge for patients receiving inpatient care. Clinical pathways are often intended to maintain or improve quality of care and decrease costs for patients in particular diagnosis-related groups.... clinical pathway
An instrument that estimates the extent to which a health care provider delivers clinical services that are appropriate for each patient’s condition; provides them safely, competently and in an appropriate time-frame; and achieves desired outcomes in terms of those aspects of patient health and patient satisfaction that can be affected by clinical services.... clinical performance measure
A systematically developed statement to assist practitioner and patient decisions about appropriate health care for one or more specific clinical circumstances.... clinical practice guideline
A conclusion that an intervention has an effect that is of practical meaning to older persons and health care providers. Even though an intervention is found to have a statistically significant effect, this effect may not be clinically significant. In a trial with a large number of participants, a small difference between treatment and control groups may be statistically significant, but clinically unimportant. In a trial with few participants, an important clinical difference may be observed that does not achieve statistical significance. (A larger trial may be needed to confirm that this is a statistically significant difference).... clinical significance
Initially driven by anxiety about the possibility of medical negligence cases, clinical risk management has evolved into the study of IATROGENIC DISEASE. The ?rst priority of risk managers is to ensure that all therapies in medicine are as safe as possible. Allied to this is a recognition that errors may occur even when error-prevention strategies are in place. Lastly, any accidents that occur are analysed, allowing a broader understanding of their cause. Risk management is generally centred on single adverse events. The threat of litigation is taken as an opportunity to expose unsafe conditions of practice and to put pressure on those with the authority to implement change. These might include senior clinicians, hospital management, the purchasing authorities, and even the Secretary of State for Health. Attention is focused on organisational factors rather than on the individuals involved in a speci?c case.... clinical risk management
The physical manifestations of an illness elicited by a doctor when examining a patient – for example, a rash, lump, swelling, fever or altered physical function such as re?exes.... clinical signs
The experiences of a patient as communicated to a doctor, for example, pain, weakness, cough. They may or may not be accompanied by con?rmatory CLINICAL SIGNS.... clinical symptoms
The ongoing process of evaluating the health needs of a community. Usually facilitates prioritization of needs and a strategy to address them.... community health needs assessment
Usually managed by NHS trusts, these are a complex variety of services provided to people outside hospital settings. The key parts are the services delivered by district nurses, health visitors and therapists – for example, physiotherapists and speech therapists.... community health services
The blend of health and social services provided to an individual or family in his/her place of residence for the purpose of promoting, maintaining or restoring health or minimizing the effects of illness and disability. These services are usually designed to help older people remain independent and in their own homes. They can include senior centres, transportation, delivered meals or congregate meals sites, visiting nurses or home health aides, adult day care and homemaker services.... community-based care / community-based services / programmes
A process which includes a multidimensional assessment of a person with increasing dependency, including medical, physical, cognitive, social and spiritual components. Can also include the use of standardized assessment instruments and an interdisciplinary team to support the process.... comprehensive geriatric assessment (cga)
Willingness and/or ability to seek, use and, in some settings, pay for services. Sometimes further subdivided into expressed demand (equated with use) and potential demand or need.... demand (for health services)
Service provided in response to the perceived individual need for immediate treatment or care.... emergency service
Transportation for older adults to services and appointments. May use buses, taxis, volunteer drivers, or van services that can accommodate wheelchairs and persons with other special needs.... escort services
Method of billing for health services under which a medical practitioner or other practitioner charges separately for each patient encounter or service rendered. Under a fee-for-service payment system, expenditures increase if the fees themselves increase, if more units of service are provided, or if more expensive services are substituted for less expensive ones. This system contrasts with salary, per capita, or other prepayment systems, where the payment to the medical practitioner is not changed according to the number of services actually used.... fee for service (ffs)
(See EVIDENCE-BASED MEDICINE.) Clinical trials aim to evaluate the relative effects of di?erent health-care interventions. They are based on the idea that there must a fair comparison of the alternatives in order to know which is better. Threats to a fair comparison include the play of chance and bias, both of which can cause people to draw the wrong conclusions about how e?ective a treatment or procedure is.
An appreciation of the need to account for chance and bias has led to development of methods where new treatments are compared to either a PLACEBO or to the standard treatment (or both) in a controlled, randomised clinical trial. ‘Controlled’ means that there is a comparison group of patients not receiving the test intervention, and ‘randomised’ implies that patients have been assigned to one or other treatment group entirely by chance and not because of their doctor’s preference. If possible, trials are ‘double-blind’ – that is, neither the patient nor the investigator knows who is receiving which intervention until after the trial is over. All such trials must follow proper ethical standards with the procedure fully explained to patients and their consent obtained.
The conduct, e?ectiveness and duplication of clinical trials have long been subjects of debate. Apart from occasional discoveries of deliberately fraudulent research (see RESEARCH FRAUD AND MISCONDUCT), the structure of some trials are unsatisfactory, statistical analyses are sometimes disputed and major problems have been the – usually unwitting – duplication of trials and non-publication of some trials, restricting access to their ?ndings. Duplication occurs because no formal international mechanism exists to enable research workers to discover whether a clinical trial they are planning is already underway elsewhere or has been completed but never published, perhaps because the results were negative, or no journal was willing to publish it, or the authors or funding authorities decided not to submit it for publication.
In the mid 1980s a proposal was made for an international register of clinical trials. In 1991 the NHS launched a research and development initiative and, liaising with the COCHRANE COLLABORATION, set out to collect systematically data from published randomised clinical trials. In 1994 the NHS set up a Centre for Reviews and Dissemination which, among other responsibilities, maintains a database of research reviews to provide NHS sta? with relevant information.
These e?orts are hampered by availability of information about trials in progress and unpublished completed trials. With a view to improving accessibility of relevant information, the publishers of Current Science, in 1998, launched an online metaregister of ongoing randomised controlled trials.
Subsequently, in October 1999, the editors of the British Medical Journal and the Lancet argued that the case for an international register of all clinical trials prior to their launch was unanswerable. ‘The public’, they said, ‘has the right to know what research is being funded. Researchers and research funders don’t want to waste resources repeating trials already underway.’ Given the widening recognition of the importance to patients and doctors of the practice of EVIDENCE-BASED MEDICINE, the easy availability of information on planned, ongoing and completed clinical trials is vital. The register was ?nally set up in 2005.... clinical trials
Multidimensional, interdisciplinary, diagnostic process used to quantify an older individual’s medical, psychosocial and functional capabilities and problems, with the intention of arriving at a comprehensive plan for therapy and long-term follow-up.... geriatric assessment
See “aged care assessment team”.... geriatric assessment team
The systematic evaluation of properties, effects and/or impacts of health care technology. It may address the direct, intended consequences of technologies as well as their indirect, unintended consequences.... health care technology assessment (hcta)
Service performed by health care professionals, or by others under their direction, for the purpose of promoting, maintaining or restoring health.... health service
A geographic area designated on the basis of such factors as geography, political boundaries, population and health resources, for the effective planning and development of health services.... health service area
An o?cial, responsible to the United Kingdom’s parliament, appointed to protect the interests of National Health Service patients in matters concerning the administration of the health service and the delivery of health care (excluding clinical judgements). Known colloquially as the health ombudsman, the Commissioner presents regular reports on the complaints dealt with.... health service commissioner
The multidisciplinary field of scientific investigation that studies how social factors, financing systems, organizational structures and processes, health technologies, and personal behaviours affect access to health care, the quality and cost of health care, and ultimately health and well-being. Its research domains are individuals, families, organizations, institutions, communities and populations.... health services research
The systematic evaluation of the properties, effects or other impacts of health care technology. HTA is intended to inform decision-makers about health technologies and may measure the direct or indirect consequences of a given technology or treatment.... health technology assessment (hta)
The administrative machinery for planning, delivering and monitoring health care provided by health professionals and their supporting sta?. This may range from running a small primary-care centre to organising a large hospital or being responsible for meeting the health needs of a region or a nation. Whether the overall structure for proving care is state-funded, insurance-based, private-practice or a mixture of these, health-service management is essential in an era of rapidly evolving and expensive scienti?c medicine. Health-service managers are administrators with special training and skills in managing health care; sometimes they are doctors, nurses or other health professionals, but many have been trained in management in commercial, civil service or industrial environments.... health-service management
See “community-based care”.... home and community-based services; home and community care programme
A home help service for meal preparation, shopping, light housekeeping, money management, personal hygiene and grooming, and laundry.... homemaker service
A service provided in the home by a home health agency or a residential services agency. It may be provided by personal care attendants or home health aides hired privately and informally, or through staff agencies or registries.... in home health service
A designated site or contact for locating needed services or care for older adults.... information and referral service
Health services delivered on an inpatient basis in hospitals, nursing homes or other inpatient institutions. The term may also refer to services delivered on an outpatient basis by departments or other organizational units of such institutions, or sponsored by them.... institutional (care) health services
A network of organizations, usually including hospitals and medical practitioner groups, that provides or arranges to provide a coordinated continuum of services to a defined population and is held both clinically and financially accountable for the outcomes in the populations served.... integrated delivery system / integrated services network (isn)
The provision of assistance with laundry tasks for someone in his or her own home, either through a central facility or by a home help in the home.... laundry services
Comprehensive mental health services, as generally defined under some national (or state) laws and statutes, include: inpatient care, outpatient care, day care and other partial hospitalization and emergency services; specialized services for the mental health of the elderly; consultation and education services and specialized programmes for the prevention, treatment and rehabilitation of alcohol and drug abusers. They generally include a variety of services provided to people of all ages, including counselling, psychotherapy, psychiatric services, crisis intervention and support groups. Issues addressed include depression, grief, anxiety and stress, as well as severe mental illnesses.... mental health services
An assessment of people with health and social care needs by two or more professionals from different disciplines.... multidisciplinary assessment
A service delivery model that consists of a comprehensive range of services meeting the aged and health care needs of a community. Multipurpose centres could bring together existing health services and develop additional services from a single base.... multipurpose service
This body manages regional TRANSFUSION centres. Among its aims are the maintenance and promotion of blood and blood products based on a system of voluntary donors; implementing a cost-e?ective national strategy for ensuring adequate supplies of blood and its products to meet national needs; and ensuring high standards of safety and quality.... national blood authority
This was set up under the CARE STANDARDS ACT 2000 as an independent regulator in respect of homes for the elderly, the disabled and children in the state and private sectors in the UK.... national care standards commission
This National Health Service initiative went online in November 2000. It aims to provide health professionals with easy and fast access to best current knowledge from medical journals, professional group guidelines, etc. Unbiased data can be accessed by both clinicians and the public.... national electronic library for health
Information, usually in the form of indicators, a country may collect on its health expenditures. Indicators may include total health expenditure, public expenditure, private expenditure, out-of-pocket expenditure, tax-funded and other public expenditure, and social security expenditure.... national health accounts
See “health policy”.... national health policy
The United Kingdom’s National Health Service was created by Act of Parliament and inaugurated on 5 July 1948. Its original aim was to provide a comprehensive system of health care to everyone, free at the point of delivery. Scotland had its own, similar legislation, as did Northern Ireland. The service is funded by National Insurance contributions and from general taxation, with a small amount from patient charges. The structure, functioning and ?nancing of the NHS have been – and still are – undergoing substantial changes.... national health service (nhs)
A National Health Service body intended to combat the increasing threat from infectious diseases and biological, chemical and radiological hazards. Covering England, the agency includes the Public Health Laboratory Service, the National Radiological Protection Board, the Centre for Applied Microbiology and Research, and the National Focus Group for Chemical Incidents.... national infection control and health protection agency
National Listening Library is a charity which produces recorded books for handicapped people who cannot read, with the exception of the blind who have their own separate organisation, the Royal National Institute for the Blind. (See also CALIBRE.)... national listening library
A broad intersectoral master plan for attaining national health goals through implementation of a strategy. It indicates what has to be done, who has to do it, during what time-frame, and with what resources. It is a framework leading to more detailed programming, budgeting, implementation and evaluation. It specifies, in operational terms, the steps to be taken in accordance with the strategy, keeping in mind the various objectives and targets to be attained and the programmes for attaining them.... national plan of action
Based on national health policy, a set of decisions that includes the broad lines of action required in all sectors involved to give effect to the national health policy and indicates the problems and ways of dealing with them.... national strategy
See “geriatric assessment”.... needs assessment
A service that enables a caregiver night rest (e.g. where night disturbances of the older person receiving care are frequent).... night-sitting service
Health services concerned with the physical, mental and social well-being of an individual in relation to his/her working environment and with the adjustment of individuals to their work. The term applies to more than the safety of the workplace and includes health and job satisfaction.... occupational health services
This is an executive agency of the UK government formed by an amalgamation in 1990 of the Central Statistical O?ce and the O?ce of Population Censuses and Surveys (OPCS). The ONS compiles and publishes statistics on national and local populations, including their social and economic situation and contributions to the country’s economy. It also records the demographic patterns of births, marriages and deaths, including the medical cause of death. The former OPCS organised a national ten-yearly census and ONS is carrying on this activity. The census is based on the actual presence of individuals in a house or institutions on a given night. The ?gures provide government departments and local authorities with information for planning services.... office for national statistics (ons)
See “ambulatory care”.... outpatient services
Standardized tools to determine patient characteristics and abilities, what assistance they need and how they may be helped to improve or regain abilities. Patient assessment forms are completed using information gathered from medical records, interviews with the patient, other informants (e.g. family members) and direct observation.... patient assessment (resident)
Health services targeted at populations with specific diseases or disorders.... population-based services
Health services re-orientation is characterized by a more explicit concern for the achievement of population health outcomes in the ways in which the health system is organized and funded.... re-orienting health services
A service designed to improve function and/or prevent deterioration of functioning. Such services may include physical therapy, occupational therapy, and/or speech therapy. They may be provided at home, in a hospital or in a long-term care facility.... rehabilitation service
Accommodation and support for people who can no longer live at home.... residential care services
QAPI establishes strategies for promoting high quality health care. First, each organization must meet certain required levels of performance when providing specific health care and related services. Second, organizations must conduct performance improvement projects that are outcome-oriented and that achieve demonstrable and sustained improvement in care and services. It is expected that an organization will continuously monitor its own performance on a variety of dimensions of care and services, identify its own areas for potential improvement, carry out individual projects to undertake system interventions to improve care, and monitor the effectiveness of those interventions.... quality assessment and performance improvement programme (qapi)
A result of a provider’s actions aimed at meeting the needs of a consumer.... service
See “care package”.... service package
See “care plan”.... service plan
The coordinated, or otherwise explicitly agreed upon, sharing of responsibility for provision of medical or nonmedical services on the part of two or more otherwise independent hospitals or health programmes.... shared services
The process whereby a person is assessed for care needs using one form/mechanism so that agencies do not duplicate each other’s assessment.... single assessment process
A service which involves a worker or volunteer going into an older person’s home to provide care whilst the carer takes a break for up to six hours.... sitting service
Assistance with the activities of daily life (personal care, domestic maintenance, self-direction) delivered by a personal care helper, home helper or social worker and aimed at supporting older people who experience disabilities in functioning.... social care service
See “assisted living facility”.... supported residential service
A comprehensive form of policy research that examines the technical, economic and social consequences of technological applications.... technology assessment
In the UK, this NHS authority (UKTSSA) provides a 24-hour service for matching, allocating and distributing organs. It is also responsible for keeping the records of all patients awaiting transplants. Established in 1991, the authority allocates donor organs without favour, following protocols set by advisory groups. It also administers the Human Organ Transplant Act on behalf of the Department of Health. (See TRANSPLANTATION.)... transplant support services authority
A system operated to transfer a patient or client to or from a health care facility and place of residence.... transportation service
Through volunteers or community workers, a service providing companionship and support for older people who may be lonely and isolated.... visiting service / visitor programme
A type of social care service supported through public funding. Eligibility criteria vary from universal coverage to specialized requirements. See “social care service”.... welfare service
Environmental medicine. Treatment of allergies by natural medicines. The science that endeavours to bridge physics and chemistry; including such disciplines as homoeopathy, acupuncture, herbalism, etc. ... clinical ecology
A test on human volunteers of the effectiveness and safety of a drug. A trial can also involve systematic comparison of alternative forms of medical or surgical treatment for a particular disorder. Patients involved in clinical trials have to give their consent, and the trials are approved and supervised by an ethics committee.... trial, clinical
(BNF) a reference source published by the Royal Pharmaceutical Society of Great Britain and the British Medical Journal (BMJ) Group twice a year (in March and September). It contains comprehensive information on medications from various sources, including the manufacturer as well as regulatory and professional bodies, resulting in information that is relevant to practice and takes into account national guidelines.... british national formulary
Est. 1864. The oldest and only body of professional medical herbalists, now known as phytotherapists, in Europe. Membership by examination after completion of course of training. A stipulated period of clinical practice must be completed before the final examination is taken.
Members are directly involved with patient-care, carrying full responsibility for their recommendations, prescribing medication suitable to the individual biological requirements of each patient. Their role includes patient-counselling, health education and research.
Official recognition of the Institute, indicating its growing importance in the field of medicine came with the historic Grant of Arms by Her Majesty’s College of Heralds. Members regard this as evidence that the Royal Charter of King Henry VIII still stands and that there is no monopoly in healing the sick. See: HENRY VIII, HERBALISTS’ CHARTER.
The Institute played a major role in winning vital concessions for the survival of the herbalist in the passage through Parliament of the Medicine’s Bill. See: MEDICINE’S ACT, 1968.
In connection with the NIMH degree courses in herbal medicine are available at a London University, and Exeter University.
The Institute provides professional indemnity cover for its members, and is engaged in a series of clinical trials to evaluate traditional remedies.
All members are required to adhere to a strict professional Code of Ethics and are entitled to carry after their names the letters of qualification: MNIMH or FNIMH.
Members have a key role in preventative medicine and health promotion in their contribution to improvement of the nation’s health.
Address: 56 Longbrook Street, Exeter EX4 6AH, from which a list of members is obtainable. ... national institute of medical herbalists
(CCGs) self-governing bodies set up by the Health and Social Care Act 2012, following the abolition of *primary care trusts and *strategic health authorities, to commission most NHS services in England. CCGs are formed of all GP practices within a given geographical area, and all GP practices must belong to a clinical commissioning group. All CCGs have their own constitution and governing body, which (in addition to GPs) must include at least one registered nurse and at least one secondary care specialist doctor. There are currently 195 CCGs in England.... clinical commissioning groups
consideration of the moral issues attendant upon, and questions arising from, clinical practice, as distinct from research. In North America, it is common for hospitals to employ a clinical ethicist or provide a formal clinical ethics consultation service. In the UK, clinical *ethics committees are increasingly common in the NHS.... clinical ethics
(CGI) rating scales commonly used by clinicians to measure symptom severity and treatment response in treatment studies of patients with psychiatric illnesses. Many researchers consider them to be a good tool to measure the clinical utility or relevance of a given treatment. The Clinical Global Impression–Severity scale (CGI-S) is used to rate the severity of the patient’s symptoms relative to the clinician’s past experience with patients who have the same diagnosis. Scores range from 1 (normal) to 7 (extremely ill). The Clinical Global Impression–Improvement scale (CGI-I) measures change in the patient’s presentation from baseline. Scores range from 1 (very much improved) to 7 (very much worse). A score of 4 indicates no change.... clinical global impression
see community health.... clinical medical officer
the branch of medicine dealing with the study of actual patients and the diagnosis and treatment of disease at the bedside, as opposed to the study of disease by *pathology or other laboratory work.... clinical medicine
see domiciliary services.... community services
(HHS) the major US government agency providing health care. The department was created in 1953 and assumed its current name in 1980. HHS administers more than 300 health and health-related programmes and services, including *Medicare and *Medicaid. Other activities include research, immunization services, and providing financial assistance for low-income families. Almost a quarter of federal spending occurs through HHS.... department of health and human services
(in Britain) health and social services that are available in the home and are distinguished from hospital-based services. They include the services of such personnel as community nurses employed by care trusts (see district nurse; community midwife; health visitor) and social workers and care assistants employed by social service departments of local authorities. The term community services is applied to these services.... domiciliary services
an administrator with special training and skills in management who is concerned with the planning and provision of health services and with managing performance. Some managers enter the profession via the NHS Graduate Management Training Scheme; for others the basic training is in disciplines other than health; however, doctors, nurses, and others may fill such posts, sometimes combining them with professional appointments. See also National Health Service.... health service manager
balancing the health and health-care needs of a community, assessed by such indices as mortality, morbidity, and disability, with the resources available to meet these needs in terms of human resources (including ensuring the numbers in training grades meet future requirements) and technical resources, such as hospitals (capital planning), equipment, and medicines. See also clinical audit.... health service planning
see HEMS.... helicopter-based emergency medical services
see census; Office for National Statistics.... national census
see NICE.... national institute for health and care excellence
(in Britain) a compulsory scheme of insurance under the terms of which employers and employees make joint contributions so that those who have contributed for a qualifying period may claim national insurance benefits in times of sickness, injury, maternity leave, unemployment, and retirement; self-employed persons pay all their own contributions. Those who do not qualify under the terms of this insurance scheme may also receive financial payments in times of need, but only subject to a means test.... national insurance
(NPSA) formerly, a special health authority that led and coordinated work to improve all aspects of patient safety in England. The NPSA comprised three divisions: the National Reporting and Learning Service, the National Research Ethics Service, and the National Clinical Assessment Service. It closed in 2012, with its key functions transferred to *NHS England. In 2016 the same functions were transferred from NHS England to the newly formed *NHS Improvement.... national patient safety agency
(NSFs) formerly, national standards of care published for a variety of conditions and patient groups (the first were for coronary heart disease and mental health). NSFs were ten-year programmes designed to improve, and reduce variations in, the quality of care by defining long-term strategies for delivery of the standards and by setting specific goals. The NSFs were dropped in the reform of the NHS after 2010 and subsequent establishment of *NHS England.... national service frameworks
an electronic referral system administered by *NHS Digital. Since 2015 it has been used by NHS England to support referrals from GPs to secondary care. Replacing the earlier choose and book system, it enables patients to choose which hospital they are referred to and then to book a convenient date and time for the appointment.... nhs e-referral service
(NHSPSA) see NHS Business Services Authority.... nhs prescription services authority
(NS-SEC) an occupational classification of the national population that was developed to replace older systems based on social classes and socio-economic groups. The groupings are intended to stratify the population according to different forms of employment: households are classified according to the occupation of the household reference person (the person renting, owning, or otherwise responsible for accommodation). The NS-SEC is used for official surveys and statistics, including the *census. The analytic version of the classification has eight classes and is the version used for most analyses.... national statistics socio-economic classification
(OSCE) a type of examination used increasingly in the health sciences (medicine, dentistry, nursing, physiotherapy, pharmacy) to assess clinical skills in examination, communication, medical procedures, and interpretation of results. The examination usually takes the form of a circuit of stations around which each candidate moves after a specified time interval (5–10 minutes) at each station. Stations are a mixture of interactive and noninteractive tasks. Some have an examiner and a simulated patient, either an actor for assessment of communication or history-taking skills or a manikin of a specific part of the body (e.g. to demonstrate how to use an auriscope). Other stations have investigation results with a list of questions that are to be completed on computer-marked examination papers. Each station has a different examiner and the stations are standardized with specific marking criteria, thus enabling fairer comparison with peers.... objective structured clinical examination
(OHS) a scheme by which employers provide a mainly preventive health service for employees. Specially trained doctors and nurses advise management on hazardous situations at work. Advice is also given to management to ensure that people with ill health or disability are not prevented from taking up employment and on the potential for rehabilitating employees with prolonged or repeated sickness absence. Instruction may be given to the workforce on simple first aid procedures, and *health promotion programmes may be offered in relation to nutrition, physical activity, and stress. With the approval of the *Health and Safety Executive, the OHS may conduct routine tests on employees working with potentially hazardous substances, such as lead. See also coshh.... occupational health service
(in England) an official responsible to Parliament and appointed to protect the interests of patients in relation to administration of and provision of health care by the *National Health Service. He or she can investigate complaints about the NHS when they cannot be resolved locally. In Scotland, and in Wales, this role is undertaken by a Public Services Ombudsman.... parliamentary and health service ombudsman
(PALS) (in England) a confidential service provided by each NHS trust to support patients, their families, and carers by giving advice and information in response to questions and concerns about local NHS services. See also advocacy.... patient advice and liaison service
an interviewing technique that combines psychiatric history taking with elements of problem solving in *psychotherapy: after a psychiatric history has been elicited, the interviewer summarizes the patient’s difficulties and offers potential solutions. It is often used in patients who have presented with *deliberate self-harm, and research suggests that it offers the possibility of reducing repetition rates in such patients.... psychosocial assessment
(PHS) the oldest and one of the largest US federal health agencies. Founded in 1798 as a system of hospitals for sailors, the PHS is now the major health service operating division of the *Department of Health and Human Services and administers eleven agencies, including the *Food and Drug Administration, the National Institutes of Health, and the Substance Abuse and Mental Health Services Administration. The agency employs tens of thousands of people with a total annual budget well into the billions.... public health service
see Parliamentary and Health Service Ombudsman.... public services ombudsman
(in Britain) a service concerned with promotion of health and wellbeing in schoolchildren, including the early detection of health and social problems and their subsequent treatment and surveillance.... school health service
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