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Biomedical subjects

Chris Ham

Publications and source records attributed to Chris Ham.

23 records · Page 2Linked to original sources
PubMed2002

Hospital bookings. Sticking points.

The proportion of patients with booked appointments for hospital admissions and day-case treatment will have to more than double by 2005 to meet the NHS plan targets. Most patients with a booked appointment liked the system. Implementing a booking system requires considerable commitment from health professionals. The booking targets of the NHS plan will not be achieved without an increase in capacity.

Ambulatory Care↗
PubMed2000

Five cases, four actors and a moral: lessons from studies of contested treatment decisions.

The case of Jaymee Bowen (child B) illustrated the conflict that may arise over treatment decisions in the National Health Service (NHS). This article reviews four further cases involving disagreement between patients and families on the one hand, and health authorities on the other, and a fifth case in which a health authority questioned the treatment decision of a medical specialist. The cases illustrate the rise of consumerism in health care and the challenge for health authorities in weighing the claims of individual patients against the needs of communities. They also demonstrate the increasing role of lawyers and the courts in resolving disputes over treatment decisions. Clinicians were closely involved in all cases, both in recommending treatment options and in serving as independent advisers when disputes arose. The findings presented here indicate that there is a need to strengthen the process of decision-making in cases of this kind and to make greater use of evidence in informing decisions. In future, decision-making needs to be characterized by openness, reason giving, an appeals procedure and regulation of the process to ensure that these conditions are met. The funders of health care also need to consider each individual in his or her own right while also using their resources for the benefit of the population as a whole.

Journal Article↗
PubMed1999

The role of doctors, patients and managers in priority setting decisions: lessons from the 'Child B' case.

The difficulties in treating patients with life threatening illnesses were highlighted by the case of Jaymee Bowen, a 10-year-old girl with leukaemia who was refused funding for a second bone marrow transplant in 1995. Jaymee's case was widely reported at the time and came to epitomize the dilemmas of rationing in the United Kingdom's National Health Service. In reality, the paediatricians who had cared for Jaymee based their decision on clinical rather than financial considerations, and the media reporting of the case failed to reflect the complexities of the issues involved. The case also demonstrated the difficulties of determining the best interests of children and of obtaining their consent to treatment. There were disagreements between Jaymee's father and the paediatricians who had treated her about how her best interests could be served and this led to a breakdown of trust and the search for further opinions. This highlighted the rise of consumerism in health care and the challenge to doctors and managers to justify their decisions and to give reasons for these decisions. The common theme in Jaymee's story is the need for greater openness in decisions on priority setting and stronger safeguards for patients.

Journal Article↗