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1
Inskip, Hazel. "The Mortality of Royal Naval Submariners 1960–1989." Journal of The Royal Naval Medical Service 83, no. 1 (March 1997): 19–25. http://dx.doi.org/10.1136/jrnms-83-19.
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AbstractThe mortality pattern of 15,318 Royal Naval submariners has been examined to assess the long term effects on health of serving in submarines. The main outcome measures used were standardised mortality ratios (SMRs) which present the submariners’ mortality rates as a percentage of those for men in England and Wales. The SMR for all causes of death combined was low at 86, this being comparable to findings in other studies of Armed Forces personnel. Cancer mortality was particularly low with an SMR of 69 and there was no particular cancer site which showed an excess. Raised mortality from digestive diseases was seen; the excess was attributable to cirrhosis of the liver which gave rise to an SMR of 221 based on 12 deaths, alcohol being a contributory factor in eight. This excess mortality from cirrhosis was concentrated in the period 1970-79 and occurred in men who had left the Royal Navy. Deaths from accidents and violence were also higher than expected with an SMR of 115, but this was due to high levels of accidents occurring after discharge from the Navy.
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Гаврилов, С. Н. "«YOU MAKE NO MEN OF US, BUT BEASTS» SAILORS OF THE ENGLISH ROYAL NAVY AT THE END OF THE XVI CENTURY." Британские исследования, no. VII(VII) (June 1, 2022): 60–88. http://dx.doi.org/10.21267/aquilo.2022.vii.vii.011.
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Эпоха правления династии Тюдор в Англии — время рождения военного флота, его превращения из средневекового «события» в постоянно действующий институт. Не удивительно, что военно-морские силы этого периода традиционно привлекают внимание исследователей. В ходе развития науки менялись научные подходы и направления в исследовании истории королевского флота: от героической истории, объектом которой становились прославленные флотоводцы и победы, до институциональной истории, фокусировавшейся на исследовании повседневных механизмов функционирования военно-морских сил. Вне поля зрения ученых долгое время оставалась история простых моряков, без которых были бы невозможны как победы на море, так и само существование «морских стен Англии». Данная статья посвящена изучению положения английских моряков конца тюдоровской эпохи, ознаменовавшейся не только успешной защитой независимости страны, но и началом ее превращения в будущую Британскую империю. The epoch of the Tudor dynasty in England is the time of the emergence of the navy, its transformation from a medieval “event” into a permanent institution. It is not surprising that the naval forces of this period traditionally attract the attention of researchers. In the course of the development of science, scientific approaches and directions in the study of the history of the Royal Navy changed: from heroic history, the object of which became famous naval commanders and victories, to institutional history, focusing on the study of everyday mechanisms of the functioning of naval forces. For a long time, the history of ordinary sailors remained out of sight of scientists. But without sailors both victories at sea and the very existence of the “sea walls of England” would have been impossible. This article is devoted to the study of the history of sailors at the end of the Tudor epoch, which was marked not only by the successful defense of the independence of England, but also by the beginning of transformation this country into the future British Empire
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Battesti, Michèle. "Les aléas de la stratégie de Napoléon sur mer." Revue Historique des Armées 241, no. 4 (2005): 68–79. http://dx.doi.org/10.3406/rharm.2005.5764.
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The risks of Napoleon's maritime strategy ; Evaluating Napoleon’s relations with his navy and his maritiume strategy is like trying to shine light into a black hole. Only the defeats have gone down into history - Aboukir, Trafalgar - the underside, as it were, of the glories of the Napoleonic era. Yet in exile on St. Helena Napoleon, with some justification, declared himself satisfied with his record at sea. This article seeks to explain this apparent paradox. On assuming power, Napoleon inherited a French navy crippled by six years of war and blockade. He got to grips with making improvements quite effectively, but realised that he would need ten years of peace to fashion a fleet capable of challenging Britain’s Royal Navy with any prospect of suc¬ cess. The ending of the Peace of Amiens (1803) left France virtually disarmed at sea, certainly compared with the protection afforded Britain by its insular position and the ‘wooden walls’ of her fleet. To escape this strategic impasse, Napoleon decided to attempt an invasion of Britain. He based his plan on the assembly of a large fleet of shallow-draught barges to project the Grand Army, 150,000 soldiers, across the Channel. But the plan became delayed. And the more time passed, the greater the complications that emerged, and the clearer became the need for an accompanying sea-going fleet. In 1805 Napoleon attempted a large-scale manoeuvre aimed at concentrating the squadrons of the French fleet in the rear of the British - in the West Indies - before bringing them unexpectedly and suddenly back into Channel waters to cover the passage of the Grand Army to England. The plan failed, but it resulted in the Battle of Trafalgar, which ought never to have taken place. Napoleon, who at first sought to deny the scale of that defeat, did not give up on the French navy. On the contrary, he had it rebuilt once again and raised to the level of the fleet in 1789. He hoped that Britain would lower its guard, to enable him at some point to deliver her a mortal blow. Thus, contrary to what is often argued, Napoleon did understand the mysteries of naval strategy. He realised that a full-scale naval recovery could not be achieved in wartime, whilst Britain retained its mastery of the waves. Yet, and to his credit, he persevered.
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Langton, John. "Royal and non-royal forests and chases in England and Wales." Historical Research 88, no. 241 (May 5, 2015): 381–401. http://dx.doi.org/10.1111/1468-2281.12098.
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Miller, Benjamin T., and Don K. Nakayama. "In Close Combat: Vice-Admiral Lord Horatio Nelson's Injuries in the Napoleonic Wars." American Surgeon 85, no. 11 (November 2019): 1304–7. http://dx.doi.org/10.1177/000313481908501141.
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Born in Norfolk, England, on September 29, 1758, Horatio Nelson was the sixth of eleven children in a working-class family. With the help of his uncle, Maurice Suckling, a captain in the Royal Navy, Nelson began his naval career as a 13-year-old midshipman on the British battleship Raisonnable. His courage and leadership in the battle marked him for promotion, and he rose quickly from midshipman to admiral, serving in the West Indies, East Indies, North America, Europe, and even the Arctic. As his rank ascended, Nelson's consistent strategy was close engagement, an approach that led to success in combat but placed him in direct danger. Thus, Britain's greatest warrior was also her most famous patient: Nelson suffered more injuries and underwent more operations than any other flag officer in Royal Navy history. His career reached a climax off Cape Trafalgar, where he not only led the Royal Navy to victory over the combined French and Spanish fleets but also met his own death.
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Neufeld, Matthew. "The Biopolitics of Manning the Royal Navy in Late Stuart England." Journal of British Studies 56, no. 3 (July 2017): 506–31. http://dx.doi.org/10.1017/jbr.2017.61.
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AbstractThis article examines the Royal Navy's implementation between 1690 and 1710 of new and publicly controversial policies, grounded in quantitative technologies, to manage the multitude of English seamen. These policies and their promotion can be profitably interpreted using the Foucauldian concept of biopolitics. Naval biopolitics meant mobilizing and promoting political arithmetic in the service of the fiscal-naval state. Thus, naval biopolitics was both a new model of statecraft and a form of state publicity, that is, a genre of works that strove to influence government policy and public opinion by promoting projects that a polemicist argued the state could and should undertake to better govern its subjects. The directives, legislation, and pamphlet literature of naval biopolitics projected a fiscal-naval state capable of counting, tracking, and mobilizing the national stock of seamen onto its ships in a predictable, salubrious, and, most crucially, orderly fashion. However, English naval biopolitics endured much longer as a genre of state propaganda than as a method of mobilizing the population of seamen onto ships.
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Campbell, Ewan, and Alan Lane. "Llangorse: a 10th-century royal crannog in Wales." Antiquity 63, no. 241 (December 1989): 675–81. http://dx.doi.org/10.1017/s0003598x0007681x.
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Crannogs, artificial island settlements built of stone and timber in lakes, are a feature of Scotland and Ireland from later prehistoric times to the medieval period. They have been absent from England and Wales until the recognition that is reported here of the Llangorse site–known and puzzling for a century–as a first Welsh crannog, and a special one.
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Carroll, Alan. "Obituary." Polar Record 43, no. 3 (July 2007): 287–88. http://dx.doi.org/10.1017/s0032247407006390.
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Victor Aloysius Jean-Baptiste Marchesi was born in London on 25 January 1914 and was educated at St. Joseph's in Norwood before joining the Merchant Navy. He later served fifteen months as fourth mate on RRS Discovery in 1936–7. He returned to a country preparing for the possibility of war, and joined the Royal Navy as a Sub-Lieutenant specialising in hydrographic survey. While serving as First Lieutenant on HMS Franklin surveying waters off southeast England in 1943, he received a signal requesting him to report to Lieutenant Commander Jimmy Marr at the Admiralty.
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Doe, Norman. "The Church in Wales and the State: A Juridical Perspective." Journal of Anglican Studies 2, no. 1 (June 2004): 99–124. http://dx.doi.org/10.1177/174035530400200110.
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ABSTRACTIn 1536 Wales (Cymru) and England were formally united by an Act of Union of the English Parliament. At the English Reformation, the established Church of England possessed four dioceses in Wales, part of the Canterbury Province. In 1920 Parliament disestablished the Church of England in Wales. The Welsh Church Act 1914 terminated the royal supremacy and appointment of bishops, the coercive jurisdiction of the church courts, and pre-1920 ecclesiastical law, applicable to the Church of England, ceased to exist as part of public law in Wales. The statute freed the Church in Wales (Yr Eglwys yng Nghymru) to establish its own domestic system of government and law, the latter located in its Constitution, pre-1920 ecclesiastical law (which still applies to the church unless altered by it), elements of the 1603 Canons Ecclesiastical and even pre-Reformation Roman canon law. The Church in Wales is also subject to State law, including that of the National Assembly for Wales. Indeed, civil laws on marriage and burial apply to the church, surviving as vestiges of establishment. Under civil law, the domestic law of the church, a voluntary association, binds its members as a matter of contract enforceable, in prescribed circumstances, in State courts.
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Andoh, Benjamin. "The Informal Patient in England and Wales." Medicine, Science and the Law 40, no. 2 (April 2000): 147–55. http://dx.doi.org/10.1177/002580240004000211.
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The informal status of a patient is a very important topic because the vast majority of mental patients in hospital are informal. The origins of the status are traced to the Royal Commissions of 1924–6 and 1954–7 which recommended voluntary admissions and informal admissions, respectively. It is pointed out, inter alia, that it is only generally true to say the informal patient has consented to admission and cannot be treated without his or her consent because exceptionally he or she can be given such treatment, e.g. on the grounds of necessity, as held by the House of Lords in R v Bournewood Community and Mental Health Trust (1998) and that today there are two types of informal patients: those who can, and do, consent to admission, and those who cannot consent to admission, but do not show willingness to leave hospital. It is argued that there is only a power under the Mental Health Act 1983 to admit patients informally. Finally, the informal patient's consent to admission, consent to treatment, other rights, leaving hospital, and how his or her position can be improved are looked at.
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Reed, E. "England and Wales: Charities Act 2006--receives Royal Assent and becomes law." Trusts & Trustees 13, no. 2 (March 8, 2007): 34–36. http://dx.doi.org/10.1093/tandt/ttl023.
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Squatriti, Paolo. "Patrons, Landscape, and Potlatch: Early Medieval Linear Earthworks in Britain and Bulgaria." Offa's Dyke Journal 3 (October 17, 2021): 17. http://dx.doi.org/10.23914/odj.v3i0.315.
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Often seen as exceptional monuments, comparative analyses of linear earthworks are rare. Exploring Offa’s Dyke (Wales and England) and the Erkesiya (Bulgaria) as comparable expressions of authority in the early medieval landscape. This article is a revised and updated republication of an early study (Squatriti 2001), arguing that both linear monuments represent strategies to not only reflect, but actively create, royal power.
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Sarafidou, Katerina, and Robert Greatorex. "Surgical Workforce: Planning Today for the Workforce of the Future." Bulletin of the Royal College of Surgeons of England 93, no. 2 (February 1, 2011): 48–49. http://dx.doi.org/10.1308/147363511x552575.
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The Royal College of Surgeons in collaboration with the surgical specialty associations has just published the results of the first comprehensive survey of the surgical workforce in England, Wales and Northern Ireland. As part of our commitment to maintain the highest standards of surgical practice and patient care, we aim to support a dynamic workforce planning process for delivering the best possible care for the population.
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Tahir, Tayyeb A., Adam Watkins, Philip Slack, Phil Chick, William Lee, and Andrea Gray. "Liaison psychiatry services in Wales." BJPsych Bulletin 43, no. 1 (September 7, 2018): 17–20. http://dx.doi.org/10.1192/bjb.2018.63.
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Aims and methodRecent funding from Welsh Government for mental health has helped to develop liaison psychiatry services in Wales. Systematic data collection was undertaken to map the liaison psychiatry services in Wales in collaboration with the Royal College of Psychiatrists in Wales and Public Health Wales 1000 Lives Improvement. A questionnaire was designed and circulated to all the health boards in Wales to gather information to map liaison psychiatry services in Wales. Up-to-date information was confirmed in January 2018, via email.ResultsOver the past 2 years, liaison psychiatry services have been set up in six out of seven health boards in Wales. Staffing levels have increased and the remit of services has broadened.Clinical implicationsMapping has highlighted that liaison psychiatry services in Wales continue to evolve. It will be important to continue to monitor these developments and their effects. Comparison with services in England will provide a useful comparison of service provision. A particular challenge will be to establish and monitor liaison psychiatry standards in Wales.Declaration of interestNone.
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Wilkinson, Greg. "Mental Health Services Planning." Bulletin of the Royal College of Psychiatrists 9, no. 7 (July 1985): 138. http://dx.doi.org/10.1192/s0140078900022161.
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A timely conference on Mental Health Services Planning, organized jointly by the Royal College of Psychiatrists and the Department of Health and Social Security, took place in London in March 1985. The conference concentrated on difficulties associated with the implementation of government policies for mental health service planning in England and Wales. Particular emphasis was given to the problems of transition from hospital-based services to community-based services.
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Penn-Barwell, Jowan G. "Sir Gilbert Blane FRS: the man and his legacy." Journal of The Royal Naval Medical Service 102, no. 1 (June 2016): 61–66. http://dx.doi.org/10.1136/jrnms-102-61.
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Sir Gilbert Blane (1749-1834) was a Medical Officer in the Royal Navy who saw action against both the French and Spanish fleets, and later served as a Commissioner on the Sick and Wounded Board of the Admiralty. His work to improve the living conditions and health of sailors, and the significant reductions in sickness rates this achieved, brought him national recognition and honoursIn 1830, Sir Gilbert Blane established a legacy with the Royal College of Surgeons of England for the award of a Gold Medal in his name to be awarded to medical officers ‘who have brought about an advancement….or improvement in any matter affecting the health or living conditions of Naval personnel’. The first two Gilbert Blane medals were awarded in 1832, and the eponymous award continues to this day, 182 years after his death.
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Hu, Jiazhu. "The Cinque Ports and Great Yarmouth in dispute in 1316: Maritime violence, royal mediation and political language." International Journal of Maritime History 32, no. 3 (August 2020): 666–80. http://dx.doi.org/10.1177/0843871420944650.
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Before the Tudors, England had no standing navy, and relied heavily on its urban corporations for shipping and coastal defence. Despite their significant naval contribution to medieval England, eminent maritime communities such as the Cinque Ports were notorious for indiscriminate piratical activities, especially at a time when the sea was largely a lawless area, and crime could hardly be differentiated from reprisals and private wars. In the late thirteenth and early fourteenth centuries, Admiralty jurisdiction was not yet established, and royal intervention into domestic maritime disputes was limited and only resulted in short-term peace. While local factors in royal mediation have largely been ignored in the historiography, this article argues that the result of arbitration depended significantly on local cooperation. It focuses on the recurring royal mediation in the perennial conflict between the Cinque Ports (Kent and Sussex) and Great Yarmouth (Norfolk), and especially on a notably hostile episode in 1316. Two opposing petitions from the Cinque Ports and Great Yarmouth, produced and submitted for the purpose of arbitration, show how the two communities presented maritime disputes and voiced their grievances before royal authority. By contextualising and comparing these petitions, the article explores the political language used by the two communites and the political awareness behind it, which led to their different reactions to the royal proclamation of peace in the following months. The dispute between the Cinque Ports and Great Yarmouth in 1316 also illustrates the nature of political interaction between England’s maritime communities and royal authority in the early fourteenth century, a period when the English Crown’s interest in keeping maritime peace was growing.
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Knight, Frances. "Anglican Worship in Late Nineteenth-Century Wales: a Montgomeryshire Case Study." Studies in Church History 35 (1999): 408–18. http://dx.doi.org/10.1017/s0424208400014170.
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In 1910, the Royal Commission on the Church of England and the Other Religious Bodies in Wales and Monmouth revealed that the Church of England was the largest religious body in Wales, and attracted over a quarter of all worshippers. This indicated a significant improvement in the Church’s fortunes in the previous half century, and a different picture from that which had emerged from the 1851 Census of Religious Worship, which had suggested that the established Church had the support of only twenty per cent of Welsh worshippers. The purpose of this paper is to shed some light upon the Church’s improving fortunes between 1851 and 1910 by exploring the liturgical patterns which were evolving in a particular Welsh county, Montgomeryshire, in the late nineteenth century. Montgomeryshire is part of the large rural heart of mid-Wales, bordered by Radnor to the south, Cardigan and Merioneth to the west, Denbigh to the north, and Shropshire to the east. The paper considers the annual, monthly, and weekly liturgical cycles which were developing in the county, and how the co-existence of the Welsh and English languages was expressed in different styles of church music and worship.
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Giliker, Paula. "ANALYSING INSTITUTIONAL LIABILITY FOR CHILD SEXUAL ABUSE IN ENGLAND AND WALES AND AUSTRALIA: VICARIOUS LIABILITY, NON-DELEGABLE DUTIES AND STATUTORY INTERVENTION." Cambridge Law Journal 77, no. 3 (September 24, 2018): 506–35. http://dx.doi.org/10.1017/s0008197318000685.
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AbstractThis paper will argue that, in the light of recent case law in the UK and Australia, a new approach is needed when dealing with claims for vicarious liability and non-delegable duties in the law of tort. It will submit that lessons can be learnt from a comparative study of these jurisdictions, notably by reflecting on the courts’ treatment of claims of institutional liability for child sexual abuse. In parallel to decisions of their highest courts, public enquiries in Australia and England and Wales, established to report on historic child sexual abuse and how to engage in best practice, are now reporting their findings which include proposals for victim reparation: see Royal Commission into Institutional Responses to Child Sexual Abuse (Australia, 2017) including its Redress and Civil Litigation Report (2015); Independent Inquiry into Child Sexual Abuse (Interim report, England and Wales, 2018). The Australian reports suggest reforms not only to state practice, but also to private law. This article will critically examine the operation of vicarious liability and non-delegable duties in England and Wales and Australia and proposals for statutory intervention. It will submit that a more cautious incremental approach is needed to control the ever-expanding doctrine of vicarious liability in UK law and to develop more fully its more restrictive Australian counterpart.
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Janjua, S. S., H. F. Boardman, A. Sami, N. K. Tanna, L. S. Toh, and M. K. Javaid. "Supporting Fracture Liaison Services in England and Wales: A role for pharmacists?" International Journal of Pharmacy Practice 31, Supplement_2 (November 30, 2023): ii25—ii26. http://dx.doi.org/10.1093/ijpp/riad074.031.
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Abstract Introduction Fracture Liaison Service (FLS) deliver secondary fracture prevention to adults aged 50 years and over. Performance is measured against ten benchmarks [B1-10]: cases identified [B1], spine fractures [B2], assessment within 90 days [B3], dual x-ray absorptiometry (DXA) within 90 days [B4], falls risk assessment [B5], bone treatment recommended [B6], strength and balance by 16 weeks [B7], 16-week follow-up [B8], treatment by first follow-up [B9] and 1-year drug adherence check [B10]. Each indicator has standards for meeting >80% of target (green), 50-79% (amber) and <50% (red). For Spine fractures [B2], >20% identified denotes green, amber for 11-19% and red for <10%. For bone treatment recommended [B6], green denotes >50% and red <50%. Audit data is uploaded to the Fracture Liaison Service Database (FLS-DB).1 Aim To establish whether FLSs meet performance targets and identify how pharmacists could support the service. Methods This work was done as part of a PhD project at the University of Nottingham looking at how pharmacists could improve osteoporosis medication adherence. Therefore, an existing service which encounters people with osteoporosis (FLS) was investigated to see if it required support. Approval reference: 017-2021. National averages for benchmarks were analysed to see if targets were being met over a 5-year period (2016-2020).1 The Royal Osteoporosis Society (ROS) Clinical Standards for FLSs2 were reviewed to identify areas where pharmacists could support the service. Findings were reviewed by two authors of the Clinical Standards for FLSs. Results Less than half (49%) of FLSs’ in England and Wales submitted data consistently between 2016-2020. Of those who submitted, only recommendations to initiate bone treatment [B6] met the required target (>50% of patients) in 2018 (53%), 2019 (52.4%) and 2020 (52.9%). However, B9: Treatment by 1st follow-up targets were not met. Possibly due to the lack of data for pharmacy support, the ROS Clinical Standards for FLSs do not mention pharmacists. Staffing data shows no pharmacists employed at FLSs. However, the research team identified eleven areas where implementation of referral pathways between community pharmacy (CP) and FLSs could support patient management. These were related to identification of people aged over 50 years with a fragility fracture (1.1), investigations of fragility fracture risk within 12 weeks of a fracture diagnosis (2.1, 2.2), provision of information to patients and healthcare professionals (3.1, 3.2, 3.3, 3.4), interventions such as drug treatment initiation, reviews, referrals to falls prevention services (4.1, 4.2, 4.3) and integration of the wider healthcare system to ensure long term management of osteoporosis (5.1). Multi-disciplinary working and incorporating primary and secondary fracture prevention and medicines review outcomes,3 would help inform transfer of care on this pathway. Discussion/Conclusion FLSs’ needs support to ensure benchmark targets are met especially related to anti-osteoporosis medication initiation and adherence. Due to their expertise, pharmacists could support the FLS, particularly with treatment initiation and adherence related monitoring. Implementation of a two-way referral pathway between FLSs’ and community pharmacy could help improve patient outcomes. Limitation: There is missing data as not all FLSs upload to the FLS-DB. References 1. Royal College of Physicians. Fracture Liaison Service Database, https://www.fffap.org.uk/fls/flsweb.nsf/ 2. Royal Osteoporosis Society. Effective Secondary Prevention of Fragility Fractures: Clinical Standards for Fracture Liaison Services, August 2019. https://theros.org.uk/media/1eubz33w/ros-clinical-standards-for-fracture-liaison-services-august-2019.pdf 3. Tanna, N., Tatla, T., Winn, T., Chita, S., Ramdoo, K., Batten, C. and Pitkin, J. (2016) Clinical Medication Review and Falls in Older People—What Is the Evidence Base? Pharm. Pharmacol., 7, 89-96. http://dx.doi.org/10.4236/pp.2016.72012
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Livermore, David M. "Globalisation of antibiotic resistance." Microbiology Australia 37, no. 4 (2016): 198. http://dx.doi.org/10.1071/ma16065.
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Travel always spreads disease. Bubonic plague reached Turkey in 1347 via the Silk Road, following an outbreak in 1330s China. By 1348, it raged in Italy, shadowing the gaiety of Boccaccio’s Decameron. By 1351, half of Europe lay in plague pits. One hundred and fifty years later, the conquistadors took smallpox to the Americas, decimating local populations. They returned – many believe – with syphilis, which ‘enjoyed’ its first European outbreak in 1495 among Charles VIII’s army, then besieging Naples. The French called it the ‘Neapolitan disease’ and carried it home. In England, it became the ‘French pox’ and in Tahiti, the ‘British disease’, imported by the Royal Navy.
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Jenkins, Rachel, and Jan Scott. "Medical staffing crisis in psychiatry." Psychiatric Bulletin 22, no. 4 (April 1998): 239–41. http://dx.doi.org/10.1192/pb.22.4.239.
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This article summarises the findings of a National Health Service Executive, Royal College of Psychiatrists', National Association of Health Authorities and Trusts, and Trust Federation working group on medical staffing in mental health, which reported to ministers in summer 1996 and was launched at a conference in November 1996 jointly with the College. Although primarily focused on England and Wales, it is clear that similar problems exist in other parts of the United Kingdom and the Republic of Ireland.
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Manning, Catherine, Andrew Molodynski, Jorun Rugkåsa, John Dawson, and Tom Burns. "Community treatment orders in England and Wales: national survey of clinicians' views and use." Psychiatrist 35, no. 9 (September 2011): 328–33. http://dx.doi.org/10.1192/pb.bp.110.032631.
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Aims and methodTo ascertain the views and experiences of psychiatrists in England and Wales regarding community treatment orders (CTOs). We mailed 1928 questionnaires to members of the Royal College of Psychiatrists.ResultsIn total, 566 usable surveys were returned, providing a 29% response rate. Respondents were generally positive about the introduction of the new powers, more so than in previous UK studies. They reported that their decision-making regarding compulsion was based largely on clinical grounds.Clinical implicationsIn the absence of research evidence or a professional consensus about the use of CTOs, multidisciplinary input in decision-making is essential. Further research and training are urgently needed.
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Of Bradford, Lord Patel, and Chris Heginbotham. "Race equality, human rights and mental health legislation: Recent developments in England and Wales." South African Journal of Psychiatry 13, no. 3 (August 1, 2007): 3. http://dx.doi.org/10.4102/sajpsychiatry.v13i3.17.
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<p>England now has revised mental health legislation following the passage of a mental health Bill through both Houses of Parliament following protracted discussions over seven years. The Mental Health Bill 2006, amending the Mental Health Act 1983, eventually received Royal Assent on 19 July 2007. There is much that could be said about the new Act, which makes a number of important changes to the present legislation. These changes include a new single definition of mental disorder; the abolition of the so-called ‘treatability test’; and the extension of compulsion into the community through a supervised community treatment order.</p>
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Goodburn, Damian, Frank Meddens, Stuart Holden, and Chris Phillpotts. "Linking Land and Navy: archaeological investigations at the site of the Woolwich Royal Dockyard, south-eastern England." International Journal of Nautical Archaeology 40, no. 2 (April 4, 2011): 306–27. http://dx.doi.org/10.1111/j.1095-9270.2011.00316.x.
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Mcdonald, L. "Developing a Systematic Training Programme in Women’s Mental Health." European Psychiatry 65, S1 (June 2022): S51. http://dx.doi.org/10.1192/j.eurpsy.2022.171.
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This presentataion outlines the development of a post-membership masterclass programme in Perinatal Psychiatry, funded by Health Education England and delivered through the Royal College of Psychiatrists. The masterclass programme renges from 5-15 days and there are separate programmes for consultants, SAS doctors and senior trainees in psychiatry. The course is delivered by experts in the area and contains a mix of didactic teaching and small group work. The programme was developed to meet the workforce needs of rapidly expanding perinatal mental services throughout England. The programme also helps facilitate the needs of perinatal psychiatrists from Ireland and from the devolved nations of the UK (Scotland, Wales and Northern Ireland). Disclosure No significant relationships.
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FLEMING, D. M., and A. J. ELLIOT. "Lessons from 40 years' surveillance of influenza in England and Wales." Epidemiology and Infection 136, no. 7 (November 30, 2007): 866–75. http://dx.doi.org/10.1017/s0950268807009910.
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SUMMARYThe influenza virus continues to pose a significant threat to public health throughout the world. Current avian influenza outbreaks in humans have heightened the need for improved surveillance and planning. Despite recent advances in the development of vaccines and antiviral drugs, seasonal epidemics of influenza continue to contribute significantly to general practitioner workloads, emergency hospital admissions, and deaths. In this paper we review data produced by the Royal College of General Practitioners Weekly Returns Service, a sentinel general practice surveillance network that has been in operation for over 40 years in England and Wales. We show a gradually decreasing trend in the incidence of respiratory illness associated with influenza virus infection (influenza-like illness; ILI) over the 40 years and speculate that there are limits to how far an existing virus can drift and yet produce substantial new epidemics. The burden of disease caused by influenza presented to general practitioners varies considerably by age in each winter. In the pandemic winter of 1969/70 persons of working age were most severely affected; in the serious influenza epidemic of 1989/90 children were particularly affected; in the millennium winter (in which the NHS was severely stretched) ILI was almost confined to adults, especially the elderly. Serious confounders from infections due to respiratory syncytial virus are discussed, especially in relation to assessing influenza vaccine effectiveness. Increasing pressure on hospitals during epidemic periods are shown and are attributed to changing patterns of health-care delivery.
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MURPHY, ELAINE. "ATROCITIES AT SEA AND THE TREATMENT OF PRISONERS OF WAR BY THE PARLIAMENTARY NAVY IN IRELAND, 1641–1649." Historical Journal 53, no. 1 (January 29, 2010): 21–37. http://dx.doi.org/10.1017/s0018246x09990501.
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ABSTRACTIn 1643, Robert Rich, the second earl of Warwick, the parliamentary lord high admiral, issued directions for naval officers in the Irish squadron to execute any soldiers seized whilst crossing from Ireland to join royalist armies in England and Wales. An ordinance was duly promulgated by parliament in October 1644 which authorized the killing of Irishmen captured at sea or in England. Thereafter, although a number of captains implemented this policy and put to death mariners, soldiers, and passengers detained on vessels going to and from confederate and royalist ports in Ireland, the killing of maritime captives never became the norm in the war at sea. This article provides a detailed analysis of the atrocities that occurred and the treatment of prisoners taken in the seas around Ireland during the war of the three kingdoms. In particular, this article examines the effect exerted by the threat of retaliatory executions of English seamen held in towns such as Wexford and Waterford on forcing parliament and its naval commanders to moderate their actions.
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Yakeley, Jessica, Richard Taylor, and Angus Cameron. "MAPPA and mental health — 10 years of controversy." Psychiatrist 36, no. 6 (June 2012): 201–4. http://dx.doi.org/10.1192/pb.bp.111.037960.
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SummaryMultiagency public protection arrangements (MAPPAs) were established in England and Wales 10 years ago to oversee statutory arrangements for public protection by the identification, assessment and management of high-risk offenders. This article reviews MAPPAs' relationship with mental health services over the past decade. Despite areas of progress in the management of mentally ill offenders, inconsistent practice persists regarding issues of confidentiality and information-sharing between agencies, which calls for clearer and more consistent guidance from the Royal College of Psychiatrists, the Ministry of Justice and the Department of Health.
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Sokol, Mary. "Jeremy Bentham and the Real Property Commission of 1828." Utilitas 4, no. 2 (November 1992): 225–45. http://dx.doi.org/10.1017/s0953820800004520.
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In February 1828 a Royal Commission was appointed to examine the law of Real Property of England and Wales. The Commission sat for four years and examined a vast amount of material, recommended certain changes in the law, and drafted several bills for consideration by parliament. Four massive reports were eventually presented to parliament in May 1829, June 1830, May 1832, and lastly in April 1833. As a result parliament enacted a limited number of piecemeal (although important) reforms, but did not attempt a major revision of the law.
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Cranmer, Frank. "June–September 2019." Ecclesiastical Law Journal 22, no. 1 (December 31, 2019): 70–75. http://dx.doi.org/10.1017/s0956618x19001698.
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On 9 September, the European Union (Withdrawal) (No 2) Act 2019 received Royal Assent and Parliament was prorogued until 14 October. The prorogation was challenged in the courts both in England and Wales and in Scotland, and a strong Divisional Court of Queen's Bench and the Inner House of the Court of Session came to opposite conclusions as to its legality. The judgments were appealed to the Supreme Court, and on 24 September an eleven-judge bench handed down a unanimous judgment in the conjoined cases of Miller and Cherry.
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Rix, Keith J. B. "The psychiatrist as expert witness. Part 2: criminal cases and the Royal College of Psychiatrists' guidance." Advances in Psychiatric Treatment 14, no. 2 (March 2008): 109–14. http://dx.doi.org/10.1192/apt.bp.107.004416.
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Psychiatrists reporting in criminal cases in England and Wales are now governed by the Criminal Procedure Rules on expert evidence and these will require changes to the format and content of psychiatrists' reports in criminal proceedings. This article sets out the new rules and also draws attention to additional requirements made by the Court of Appeal and, when instructed by the police or the Crown Prosecution Service, by the Crown Prosecution Service. It also draws attention to the report of the Scoping Group on Court Work of the Royal College of Psychiatrists.
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Black, John. "The College at the party conferences." Bulletin of the Royal College of Surgeons of England 91, no. 9 (October 1, 2009): 294–95. http://dx.doi.org/10.1308/147363509x474296.
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The Royal College of Surgeons is a professional body dedicated to setting the highest possible standards for surgery. It is a charity, not a political organisation, but in furtherance of its charitable aims, namely advancing surgical standards, it can enter the political arena and I think that it is vitally important that it does. Our membership survey tells me that you approve of the College entering the national political debate and putting forward to ministers and opposition parties the views of working surgeons in England, Wales and Northern Ireland.
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Duffet, Richard, and Paul Lelliott. "Auditing electroconvulsive therapy." British Journal of Psychiatry 172, no. 5 (May 1998): 401–5. http://dx.doi.org/10.1192/bjp.172.5.401.
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BackgroundThis is the third large-scale audit in the past 20 years and compares the practice of electroconvulsive therapy (ECT) in England and Wales with the standards derived from the Royal College of Psychiatrists' 2nd ECT handbook.MethodFacilities, equipment, practice, personnel and training were systematically evaluated during visits to all ECT clinics in the former North East Thames and East Anglia regions and Wales. All other English ECT clinics were surveyed with a postal questionnaire. Information was obtained for 184 (84%) of the 220 ECT clinics identified.ResultsAlthough some aspects of ECT administration had improved since the last audit in 1991, overall only one-third of clinics were rated as meeting College standards. Only 16% of responsible consultants attended their ECT clinic weekly and only 6% had sessional time for ECT duties. Fifty-nine per cent of all clinics had machines of the type recommended by the College and 7% were still using machines considered outdated in 1989. Only about one-third of clinics had clear policies to help guide junior doctors to administer ECT effectively.ConclusionsTwenty years of activity by the Royal College of Psychiatrists and three large-scale audits have been associated with only modest improvement in local practice.
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Hargest, Rachel, and Robert Mansel. "The National Collaborating Centre for Cancer: A Report From RCS Representatives." Bulletin of the Royal College of Surgeons of England 93, no. 5 (May 1, 2011): 1–3. http://dx.doi.org/10.1308/147363511x568235.
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The National Institute for Health and Clinical Excellence (NICE) now plays a major part in determining the management of patients with a wide range of surgical conditions. The Royal College of Surgeons of England has representation at various levels within NICE. For several years we have represented the RCS on the management board of the National Collaborating Centre for Cancer (NCC-C). The NCC-C is funded and commissioned by NICE to develop evidence-based clinical guidelines for the NHS in England, Wales and Northern Ireland on treating and caring for people with cancer. As there is no formal mechanism for feedback to the College on the activities of this organisation, we felt that we should write this article for the Bulletin in order to keep fellows informed.
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Cranmer, Frank. "February–May 2019." Ecclesiastical Law Journal 21, no. 3 (September 2019): 359–63. http://dx.doi.org/10.1017/s0956618x19000656.
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The Civil Partnerships, Marriages and Deaths (Registration Etc.) Bill, originally introduced by Tim Loughton MP as a private Member's bill in the Commons, received Royal Assent on 26 March and came into force two months after it was passed. Section 1 empowers the Secretary of State to amend by regulations the Marriage Act 1949 to provide for a central register of marriages in England and Wales ‘which is accessible in electronic form’. Section 2 requires the Secretary of State to amend the Civil Partnership Act 2004 so that opposite-sex couples become eligible to form a civil partnership in England and Wales – and the amending regulations must be in force no later than 31 December 2019. Section 3 requires the Secretary of State to report on whether the law should be changed to allow the registration of pregnancy losses which cannot be registered as stillbirths under the Births and Deaths Registration Act 1953 and section 4 requires the Secretary of State to make arrangements for the preparation of a report on whether, and if so how, the law should be changed to enable or require coroners to investigate stillbirths.
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Bolwell, JS. "The licensing of surgeons by RCS England and its predecessors (extended online version)." Bulletin of the Royal College of Surgeons of England 103, no. 3 (May 2021): E17—E24. http://dx.doi.org/10.1308/rcsbull.2021.55.
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This article appeared in the print version of this issue in a shortened form, which can be found in Bulletin May 2021, Volume 103, Issue 3, pp144-148. DOI: 10.1308/rcsbull.2021.60. Preserved records suggest that the first licences to practise surgery in England and Wales were issued by craft guilds from the 14th century and probably earlier. A brief chronicle is presented of the training, examining, qualifying and licensing of surgeons by The Royal College of Surgeons of England and its direct predecessors, now a part of history. The context in which these organisations were founded and evolved is outlined along a timeline of almost 700 years. The landmark Medical Acts of 1858 and 1886 are briefly reviewed. Mention is also made of the abolition of the two non-university qualifying examinations that were still being offered in England at the end of the 20th century and of the sale of both jointly owned Examination Halls.
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Bolwell, JS. "The licensing of surgeons by RCS England and its predecessors." Bulletin of the Royal College of Surgeons of England 103, no. 3 (May 2021): 144–48. http://dx.doi.org/10.1308/rcsbull.2021.60.
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This article originally appeared in the print version of this issue. An online-only extended version can be found at https://publishing.rcseng.ac.uk/doi/full/10.1308/rcsbull.2021.55 . Preserved records suggest that the first licences to practise surgery in England and Wales were issued by craft guilds from the 14th century and probably earlier. A brief chronicle is presented of the training, examining, qualifying and licensing of surgeons by The Royal College of Surgeons of England and its direct predecessors, now a part of history. The context in which these organisations were founded and evolved is outlined along a timeline of almost 700 years. The landmark Medical Acts of 1858 and 1886 are briefly reviewed. Mention is also made of the abolition of the two non-university qualifying examinations that were still being offered in England at the end of the 20th century and of the sale of both jointly owned Examination Halls.
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Taylor, Denise A., Gina M. Nicholls, and Andrea D. J. Taylor. "Perceptions of Pharmacy Involvement in Social Prescribing Pathways in England, Scotland and Wales." Pharmacy 7, no. 1 (March 4, 2019): 24. http://dx.doi.org/10.3390/pharmacy7010024.
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Social prescribing is increasingly viewed as a non-pharmacological option to address psychosocial consequences of social isolation, loneliness and bereavement; key contributors to poor mental health and wellbeing. Our study explored experiences and attitudes of pharmacists and pharmacy technicians to social prescribing in England, Scotland, and Wales, using an on-line survey. (Ethical approval, University of Bath, November 2017). The electronic survey was distributed to pharmacists registered with Royal Pharmaceutical Society local practice forum network groups in England, Scotland, and Wales, and pharmacy technicians via social media platforms. Data were analysed using descriptive statistics and free text by thematic analysis. One hundred and twenty respondents took part in the survey; (94.6% pharmacists and 5.4% pharmacy technicians). Responses indicated a lack of knowledge and experience with social prescribing; however, there was enthusiasm for pharmacists and the wider pharmacy team to be involved in local social prescribing pathways. Respondents believed they were well positioned within the community and consequently able to be involved in identifying individuals that may benefit. Barriers to involvement, included time, funding and training while enablers were pharmacist skills and the need within the community for social prescribing. There is a willingness in pharmacy, to be involved in social prescribing, however further research is required to enable pharmacy to be full participants in social prescribing pathways.
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Wragg, Richard. "A Naval Wife: The Letters of Susannah Middleton." Bulletin of the John Rylands Library 90, no. 2 (September 2014): 111–26. http://dx.doi.org/10.7227/bjrl.90.2.7.
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In 1805 Susannah Middleton travelled with her husband, Captain Robert Middleton, to Gibraltar where he was to run the naval dockyard. Abroad for the first time, Susannah maintained a regular correspondence with her sister in England. Casting light on a collection of letters yet to be fully published, the paper gives an account of Susannah‘s experiences as described to her sister. Consideration is given to Susannah‘s position as the wife of a naval officer and her own view of the role she had to play in her husband‘s success. Written at a time when an officers wife could greatly improve his hopes for advancement through the judicious use of social skills, the Middleton letters provide evidence of an often overlooked aspect of the workings of the Royal Navy.
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Rogstad, K. E. "Medical Workforce Speciality Review for Genitourinary Medicine 2001/2002—England, Wales, Northern Ireland and Scotland." International Journal of STD & AIDS 13, no. 7 (July 1, 2002): 495–98. http://dx.doi.org/10.1258/09564620260079662.
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This document addresses medical workforce needs for the speciality of Genitourinary Medicine (GUM) for the next 10 years. Data on current consultant numbers, working patterns and retirement are based on information from the Royal College of Physicians (RCP) Workforce Unit annual census undertaken on 30 September 2000. Information on specialist registrars is from the JCHMT. Senior house officers (SHO) data are from the RCP's General Professional Training department. Data on Non-Consultant Career Grade Doctors is from the Association of Genitourinary Medicine Survey. Data on incidence of Sexually Transmitted Infections (STIs) are from KC60 returns on STIs collected from GUM clinics by CDSC. There is considerable movement of doctors in GUM between countries in the UK both during progression from SpR to consultant and at consultant level. Data are therefore presented as amalgamated UK data and also by country. It is essential that workforce planning takes this lateral movement into consideration when undertaking calculations for future workforce requirements.
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Wrigley, E. A. "THE DIVERGENCE OF ENGLAND: THE GROWTH OF THE ENGLISH ECONOMY IN THE SEVENTEENTH AND EIGHTEENTH CENTURIES." Transactions of the Royal Historical Society 10 (December 2000): 117–41. http://dx.doi.org/10.1017/s0080440100000062.
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AbstractTHAT something remarkable was happening in England in the quarter millennium separating the late sixteenth century from the early nineteenth is plain. In Elizabeth I's reign the Spanish Armada was perceived as a grave threat: the English ships were scarcely a match for the Spanish, and the weather played a major part in the deliverance of the nation. By the later eighteenth century the Royal Navy was unchallenged by the naval forces of any other single country, and during the generation of war which followed the French revolution, it proved capable of controlling the seas in the face of the combined naval forces mustered by Napoleon in an attempt to break the British oceanic stranglehold. Growing naval dominance was a symbol of a far more pervasive phenomenon. In the later sixteenth century England was not a leading European power and could exercise little influence over events at a distance from its shores. The Napoleonic wars showed that, even when faced by a coalition of countries occupying the bulk of Europe west of Russia and led by one of the greatest of military commanders, Britain possessed the depth of resources to weather a very long war, enabling her to outlast her challenger and secure a victory. The combination of a large and assertive Navy and dominant financial and commercial strength meant that, in the early decades of the nineteenth century, Britain was able to impose her will over large tracts of every continent. But her dominance did not grow out of the barrel of a gun. It derived chiefly from exceptional economic success: it grew out of the corn sack, the cotton mill, and the coal mine.
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Browne, J., TJ Coats, DA Lloyd, PA Oakley, T. Pigott, KJ Willett, and DW Yates. "High Quality Acute Care for the Severely Injured is not Consistently Available in England, Wales and Northern Ireland: Report of a Survey by the Trauma Committee, The Royal College of Surgeons of England." Annals of The Royal College of Surgeons of England 88, no. 2 (March 2006): 103–7. http://dx.doi.org/10.1308/003588406x94850.
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INTRODUCTION A survey was undertaken to determine the extent to which acute hospitals in England, Wales and Northern Ireland were meeting the acute trauma management standards published in 2000 by The Royal College of Surgeons of England and the British Orthopaedic Association. METHODS A questionnaire comprising 72 questions in 16 categories of management was distributed in July 2003 to all eligible hospitals via the link network of the British Orthopaedic Association. Data were collected over a 3-month period. RESULTS Of 213 eligible hospitals, 161 (76%) responded. In every category of acute care, failure to meet the standards was reported. Only 34 (21%) hospitals met all the 13 indicative standards that were considered pivotal to good trauma care, but all hospitals met at least 7 of these standards. Failures were usually in the organisation of services rather than a lack of resources, with the exception of the inadequate capacity for admission to specialist neurosurgery units. A minority of hospitals reported an inability to provide emergency airway control or insertion of chest tube. The data have not been verified and deficiencies in reporting cannot be excluded. CONCLUSIONS The findings of this survey suggest that high quality care for the severely injured is not available consistently across England, Wales and Northern Ireland, and appear to justify concerns about the ability of the NHS to deal effectively with the current trauma workload and the consequences of a major incident.
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Wallace, Louise M., Peter Spurgeon, Jonathan Benn, Maria Koutantji, and Charles Vincent. "Improving patient safety incident reporting systems by focusing upon feedback – lessons from English and Welsh trusts." Health Services Management Research 22, no. 3 (August 2009): 129–35. http://dx.doi.org/10.1258/hsmr.2008.008019.
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This paper describes practical implications and learning from a multi-method study of feedback from patient safety incident reporting systems. The study was performed using the Safety Action and Information Feedback from Incident Reporting model, a model of the requirements of the feedback element of a patient safety incident reporting and learning system, derived from a scoping review of research and expert advice from world leaders in safety in high-risk industries. We present the key findings of the studies conducted in the National Health Services (NHS) trusts in England and Wales in 2006. These were a survey completed by risk managers for 351 trusts in England and Wales, three case studies including interviews with staff concerning an example of good practice feedback and an audit of 90 trusts clinical risk staff newsletters. We draw on an Expert Workshop that included 71 experts from the NHS, from regulatory bodies in health care, Royal Colleges, Health and Safety Executive and safety agencies in health care and high-risk industries (commercial aviation, rail and maritime industries). We draw recommendations of enduring relevance to the UK NHS that can be used by trust staff to improve their systems. The recommendations will be of relevance in general terms to health services worldwide.
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Osman, E. Z., M. K. Aneeshkumar, and R. W. Clarke. "Paediatric otolaryngology services in the UK: a postal questionnaire survey of ENT consultants." Journal of Laryngology & Otology 119, no. 4 (April 2005): 259–63. http://dx.doi.org/10.1258/0022215054020331.
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Approximately half a million children in England and Wales receive in-patient or day-case surgical treatment annually. Otolaryngology is the surgical specialty that provides the greatest number of episodes of such care. As 30–50 per cent of our total volume of work is paediatric, we feel it is important to assess current attitudes to paediatric otolaryngological practice. In its year 2000 document Children’s Surgery: a First Class Service, The Royal College of Surgeons (RCS) of England sets out recommendations on how children’s surgical services should be delivered in the UK. A postal questionnaire was sent to all UK-based ENT consultant members of the British Association of Otorhinolaryngologists-Head and Neck Surgeons (BAO-HNS). The questionnaire was designed to assess the current practice of paediatric otolaryngology in the UK with an emphasis on the RCS recommendations. Wide variations were found, and they are discussed with reference to the recommendations.
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Ferris, John. "The Royal Navy and German Naval Disarmament, 1942-1947, by Chris Madsen.The Royal Navy and German Naval Disarmament, 1942-1947, by Chris Madsen. London, England, Frank Cass, distributed by I.S.B.S., 1998. xx, 277 pp. $55.00 U.S." Canadian Journal of History 35, no. 2 (August 2000): 372–73. http://dx.doi.org/10.3138/cjh.35.2.372.
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Smith, H., and S. Taylor. "Hephaestion and Alexander: Lord Hervey, Frederick, Prince of Wales, and the Royal Favourite in England in the 1730s." English Historical Review CXXIV, no. 507 (April 1, 2009): 283–312. http://dx.doi.org/10.1093/ehr/cep003.
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Marston, Geoffrey. "The Personality of the Foreign State in English Law." Cambridge Law Journal 56, no. 2 (July 1997): 374–417. http://dx.doi.org/10.1017/s000819730008137x.
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The Daily Cause Lists at the Royal Courts of Justice disclose that from time to time foreign sovereign States appear as parties to civil litigation in the courts of England and Wales, mostly as plaintiffs but also, in cases often better known because of the issues of immunity to which they give rise, as defendants. In his judgment in the House of Lords in Arab Monetary Fund v. Hashim (No. 3), Lord Templeman, eferring to the case concerning the financial collapse of the International Tin Council decided the previous year by the same tribunal,1 observed:2 “The Tin Council case reaffirmed that the English courts can only identify and allow actions by individuals, sovereign states and corporate bodies.”
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Price, Cathy, Amanda C. de C Williams, Blair H. Smith, and Alex Bottle. "The National Pain Audit for specialist pain services in England and Wales 2010–2014." British Journal of Pain 13, no. 3 (December 7, 2018): 185–93. http://dx.doi.org/10.1177/2049463718814277.
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Introduction: Numerous reports highlight variations in pain clinic provision between services, particularly in the provision of multidisciplinary services and length of waiting times. A National Audit aims to identify and quantify these variations, to facilitate raising standards of care in identified areas of need. This article describes a Quality Improvement Programme cycle covering England and Wales that used such an approach to remedy the paucity of data on the current state of UK pain clinics. Methods: Clinics were audited over a 4-year period using standards developed by the Faculty of Pain Medicine of The Royal College of Anaesthetists. Reporting was according to guidance from a recent systematic review of national surveys of pain clinics. A range of quality improvement measures was introduced via a series of roadshows led by the British Pain Society. Results: 94% of clinics responded to the first audit and 83% responded to the second. Per annum, 0.4% of the total national population was estimated to attend a specialist pain service. A significant improvement in multidisciplinary staffing was found (35–56%, p < 0.001) over the 4-year audit programme, although this still requires improvement. Very few clinics achieved recommended evidence-based waiting times, although only 2.5% fell outside government targets; this did not improve. Safety standards were generally met. Clinicians often failed to code diagnoses. Conclusion: A National Audit found that while generally safe many specialist pain services in England and Wales fell below recommended standards of care. Waiting times and staffing require improvement if patients are to get effective and timely care. Diagnostic coding also requires improvement.
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Durkin, Natalie, and Mark Davenport. "Centralization of Pediatric Surgical Procedures in the United Kingdom." European Journal of Pediatric Surgery 27, no. 05 (September 25, 2017): 416–21. http://dx.doi.org/10.1055/s-0037-1607058.
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AbstractThe NHS provides more than 98% of all surgical procedures in infants and children in the United Kingdom through a comprehensive network of secondary (typically for the general surgery of childhood) and tertiary (specialist neonatal and specialist pediatric surgery) centers [n = 22]), typically located within large conurbations. It was originally envisaged that these specialized centers would be able to provide the full range of surgical interventions (aside from organ transplantation). However, there has been a trend toward centralization of some key procedures, previously thought to be within general neonatal surgery.The architype for centralization is the management of biliary atresia (BA). Since 1999, within England and Wales, this has been exclusively managed in three centers (King's College Hospital, London; Birmingham Children's Hospital and Leeds General Infirmary). All of these provide facilities for the diagnosis of BA, primary surgical management (Kasai portoenterostomy), and liver transplantation if required. The case for centralization was made by rigorous national outcome analysis during the 1990s showing marked disparity based on case volume and driven by parents' organizations and national media. Following centralization, national outcome data showed improvement and provided a benchmark for others to follow.The management of bladder exstrophy was later centralized in England and Wales, albeit not based on strict outcome data, to two centers (Great Ormond Street, London and Royal Manchester Children's Hospital).