Biomedical subjects

Peter Spurgeon

Publications and source records attributed to Peter Spurgeon.

5 recordsLinked to original sources

PubMed2006

Admissions processes for five year medical courses at English schools: review.

OBJECTIVE: To describe the current methods used by English medical schools to identify prospective medical students for admission to the five year degree course. DESIGN: Review study including documentary analysis and interviews with admissions tutors. SETTING: All schools (n = 22) participating in the national expansion of medical schools programme in England. RESULTS: Though there is some commonality across schools with regard to the criteria used to select future students (academic ability coupled with a "well rounded" personality demonstrated by motivation for medicine, extracurricular interests, and experience of team working and leadership skills) the processes used vary substantially. Some schools do not interview; some shortlist for interview only on predicted academic performance while those that shortlist on a wider range of non-academic criteria use various techniques and tools to do so. Some schools use information presented in the candidate's personal statement and referee's report while others ignore this because of concerns over bias. A few schools seek additional information from supplementary questionnaires filled in by the candidates. Once students are shortlisted, interviews vary in terms of length, panel composition, structure, content, and scoring methods. CONCLUSION: The stated criteria for admission to medical school show commonality. Universities differ greatly, however, in how they apply these criteria and in the methods used to select students. Different approaches to admissions should be developed and tested.

Education, Medical, Undergraduate↗

PubMed2005

The new GMS contract: impact and implications for managing the changes.

BACKGROUND: In February 2003, a new General Practitioner (GP) contract was agreed between the profession's leaders and the government, which was later accepted following a national ballot of GPs. However, the ballot simply required respondents to vote for or against the proposal; it did not provide any opportunity to identify which aspects of the new contract were more or less acceptable. Since the proposed changes were far reaching, the implications of implementing and managing these were considerable. Consequently, some information about how GPs viewed various components of the new contract would enable a more targeted and effective management strategy to be developed that would facilitate the introduction of all aspects of the contract. OBJECTIVES: To survey GPs working within the West Midlands region regarding their opinions on each of the key features of the new contract. METHOD: A postal survey of 360 GPs was undertaken, using a specially devised questionnaire. RESULTS: Four factors emerged as the most acceptable aspects of the contract: option to opt out of out-of-hours work, flexibility in the services provided, prediction of future income levels and linking practice to performance targets. Least acceptable were: performance monitoring systems, the new financial formula for calculating income, greater patient involvement in service development and 24/48 hour access. With regard to potential outcomes of the contract, the most positive were considered to be increased proportion of salaried GPs, increased salaries, appropriate quality standards for care, earlier retirement; the factors least likely to be of potential benefit were: reduction in occupational stress, simplification of the regulatory framework, improved equity of workload and improved staff retention. Further analysis of the results using inferential statistics revealed a range of subgroup differences in reaction to the contract. CONCLUSION: Overall, those aspects of the new contract that are perceived to reduce workload and enhance salary were supported, while those that increase targets and bureaucracy were not. Generally, there was only moderate support for the changes, which could be explained by a general scepticism about any top-down modifications, the practicality and power of the changes to impact upon practice and/or a genuine belief that the modifications are unacceptable. Taken together, these results provide an indicative focus for managing the implementation of the new contract, especially with regard to its least acceptable components and the emerging differences between subgroups of GPs.

Attitude of Health Personnel↗

PubMed2003

Changing Childbirth: a pilot project.

OBJECTIVE: To compare the outcomes of an adapted pilot Changing Childbirth initiative providing continuity of care by a group of known midwives with traditional maternity care. DESIGN: Between-groups trial to compare levels of satisfaction and clinical outcomes for two groups of women, cared for either under this Changing Childbirth scheme or the traditional model of care. METHOD: Of the 200 women who agreed to participate in the project, 100 were randomly allocated to the pilot scheme and 100 to the traditional care package. During the postpartum period, information was collected via a questionnaire about participants' levels of satisfaction with a variety of aspects of care provided during the antenatal, delivery and postpartum periods. Data about clinical outcomes for the two groups were also obtained. RESULTS: Women in the pilot group had significantly more continuity of care throughout each of the three periods, were generally more satisfied with their care, felt that they had more choice over a variety of aspects of care and experienced no compromise in clinical outcomes (P = 0.05 or less in each case). IMPLICATIONS FOR PRACTICE: Many previous attempts to introduce the Changing Childbirth initiative have revealed significant problems, particularly with regard to the continuity of carer requirement. Taking account of local health care needs and existing provision, the present study adapted this concept to continuity of care. This did not apparently affect any of the guiding principles contained in the original document, and yet enhanced satisfaction. It would appear that the Changing Childbirth agenda can be adapted and integrated with local health care situations without sacrificing any of the overarching principles.

Adolescent↗

PubMed2003

The tendering process: flaws and all.

The tendering process has become the dominant and now traditional approach to the allocation of research and consultancy projects. This is largely built around the notion that it ensures accountability and probity within the allocative procedure, and that high quality of work and 'value for money' are the outcomes. It appears to have become an institutionalized and unchallengeable process. Yet it is rarely costed in terms of the true resource implications for all the organizations involved, nor is quality assessed in terms of alternative processes that might be employed. This paper explores the tendering process in terms of factors that may suggest that the quality of work produced via the tendering process is not always as good as it might be. Also in a hypothetical example involving the university sector and the National Health Service, data are presented indicating that the overall cost to the public sector is often actually greater than the value of the contract being allocated. An alternative preferred provider relationship-based allocative process is advocated as an improvement to the current established tendering procedure.

Consultants↗

PubMed2002

Staff attitude surveys. The morale majority.

Since April 2000, it has been mandatory for all NHS organisations to conduct annual surveys of staff morale. Analysis of staff attitude surveys in 18 trusts and 20 health authorities in 2001 showed that most staff groups were not happy with their pay or the recognition they received. Managers were happy with all aspects of their jobs. Doctors and nurses were concerned about their safety. All employing organisations must act on these results to improve employment practice and help to develop motivation.

Attitude of Health Personnel↗