Spending Review Research Articles

Кольпоскопічно-цитологічні паралелі у вагітних з великим інтергенетичним інтервалом

Relevance of the study of cervical pathology in pregnant women due not only to high frequency, the development of socially active women age and the ability to transition to the malignant form, but ineffective existing methods of diagnosis and treatment The objective: To investigate cytological, colposcopic features of cervical cancer in pregnant women with great interhenetyc interval. Patients and methods. We examined 81 women 40 women with great intergenetichnim intervals in the course of pregnancy, childbirth and the postpartum period – Group 1; 27 pregnant women who gave birth for the first time at the age of 30 years, 2-nd group, 14 pregnant women who have a break between the first and subsequent births was 3-5 years old – Group 3. The study of the cervix uteri of pregnant women with large intergenetic intervals in later stages performed by colposcopic and cytological methods. Statistical processing osuschstvlyali standard methods. Results. The data show elevated levels of precancerous cervical pathology in pregnant women with great interhenetyc intervals and in the age of pregnant women compared to young pregnant women in which the interval between births is small – 3–5 years. A small percentage difference precancerous lesions of the cervix, 22.5% – women in group 1 and 22.2% – women in group 2, but said that with increasing age probability themselves elimination papillomavirus is reduced accordingly increases the risk of precancer and cervical cancer. Conclusion. 1. The study showed that the problem of the status of the cervix in women with large intergenetic interval remains relevant and not studied until the end. 2. Pregnant women for the first time after 35 years and with more multiparous intergenetichnim interval must always be at the first visit to the antenatal clinic in addition to taking a Pap smear colposcopic spending review. 3. In case of LSIL and HSIL in this category of women – colposcopic and cytological control 1 every 3 months during pregnancy with mandatory HPV PCR WRC. Key words: cervical pathology, pregnancy, colposcopy, cytology.

Performance budgeting practices and procedures

This article examines performance budgeting practices and reforms in five OECD member countries: Canada, Ireland, the Netherlands, the United Kingdom and the United States. In each case, three dimensions of performance budgeting are analysed: performance information and monitoring, evaluation, and spending review. Reflecting upon the common experiences in each country, generalised analytical considerations are presented for practitioners planning and implementing current and future performance budgeting reforms. JEL classification: H50, H60, H61 Keywords: performance budgeting, performance-based budgeting, PBB, budget reform, performance information, Canada, Ireland, the Netherlands, the United Kingdom, the United States

Budgeting in Italy

Italy is in the process of making significant reforms to its budgeting process. This report provides a comprehensive overview of the Italian budgeting system and the envisaged reforms. It also offers a number of specific recommendations for further consideration as Italy advances its reform agenda. The report has been peer reviewed by OECD Senior Budget Officials. JEL Classification: H50, H61, H83, O52 Keywords: Italy, Stability Law, spending reviews, medium-term expenditure frameworks

Address of the President, Sir Paul Nurse, given at the Anniversary meeting on 30 November 2015.

Address of the President, Sir Paul Nurse, given at the Anniversary meeting on 30 November 2015.

A IHE-Like Approach Method for Quantitative Analysis of PACS Usage.

Today, many hospitals have a running enterprise picture archiving and communication system (PACS) and their administrators should have the tools to measure the system activity and, in particular, how much it is used. The information would be valuable for decision-makers to address asset management and the development of policies for its correct utilization and eventually start training initiatives to get the best in resource utilization and operators' satisfaction. On the economic side, a quantitative method to measure the usage of the workstations would be desirable to better redistribute existing resources and plan the purchase of new ones. The paper exploits in an unconventional way the potential of the IHE Audit Trail and Node Authentication (ATNA) profile: it uses the data generated in order to safeguard the security of patient data and to retrieve information about the workload of each PACS workstation. The method uses the traces recorded, according to the profile, for each access to image data and to calculate how much each station is used. The results, constituted by measures of the frequency of PACS station usage suitably classified and presented according to a convenient format for decision-makers, are encouraging. In the time of the spending review, the careful management of available resources is the top priority for a healthcare organization. Thanks to our work, a common medium such as the ATNA profile appears a very useful resource for purposes other than those for which it was born. This avoids additional investments in management tools and allows optimization of resources at no cost.

Entrepreneurial universities in the region: the force awakens?

Purpose – The growth in popularity of the regional innovation system approach has, in part, been driven by the need for economies to respond to the after shocks of the global financial crisis. At the same time, the author sees the term anchor institutions are used increasingly to describe organisations that have an important presence in the local community and make some strategic contribution to the local economy. The purpose of this paper is to consider the needs of the micro and small business (MSB) ecosystem through the lens of the entrepreneurial university as a regional anchor institution. Design/methodology/approach – Asheim et al. (2011) refers to regional innovation systems as, an emphasis on economic and social interaction between agents, spanning the public and private sectors to engender and diffuse innovation within regions embedded in wider national and global systems. According to Doloreux and Parto (2005) three dimensions underpin the use of the regional innovation systems concept, namely: the interactions between different actors in the innovation process, the role of institutions and the use of regional systems analysis to inform policy decisions. The author has drawn on contemporary literature on the entrepreneurial university, regional systems of innovation and institutions to explore some key qualities and problems around anchor Institutions, networks and national and local policy. Findings – Following the Chancellor’s Comprehensive Spending Review in November 2015 and post the changes in the Department of Business Innovation and Skills remit the author wants to highlight the way universities can take a lead role as an anchor institution within their region. The author argues that this role should include providing a wider range of formal and informal support, knowledge and resource for MSBs, alongside the usual SME suspects (Hart and Anyadike-Danes, 2014; Witty, 2013; Wilson, 2012). Based on my analysis and involvement in the the work of the eight Entrepreneurial Universities of the Year Award winners – during the author’s time as President of ISBE – He suggested four different ways in which collaboration might be enhanced to ensure MSBs make maximum use of the advice and support on offer from universities playing this anchor role. Originality/value – The results emerging from this work suggest a need for regional policy makers to embrace a innovation-supportive culture, which actually enables firms and systems to evolve over time would be far more effective than those proposed in the latest Comprehensive Spending Review. The outcomes of which will see some of the most robustly evaluated programmes, designed to support small firm growth, closed down and replaced by a commitment (by government) to secure a strong, growing economy, cutting of more red tape and extending small business rate relief for an extra year (Mole, 2015).

Perspectives: Nursing Student Funding Debate

On a dark and damp London evening on 6 January 2016, leading healthcare academics, students, union representatives and other concerned parties gathered together at London South Bank University’s (LSBU’s) Keyworth Events Theatre with one thing on their minds, the ending of NHS student bursaries. Announced in the Spending Review (HM Treasury, 2015), the Treasury has decided that nursing, midwifery and allied health professional students can no longer benefit from ‘free’ qualifications and must pay a contribution as other graduates do, through a 9% marginal rate income tax for 30 years or until the £50,000 or greater loan plus interest is fully repaid (Student Loans Company, 2015). The headline question for the evening’s debate was ‘Will removing the restrictions on nursing student places and NHS funded nursing bursaries and fees increase the supply of registered nurses in the UK?’ Although the present proposal only directly affects England, later in the debate it was suggested that there may be consequences for devolved territories that would need separate conversations. Further, balancing cost-effectiveness, quality and security of supply of nurses is a concern with global reach. Speaking in support of the changes was Elisabeth Jelfs, Director of the Council of Deans of Health, seconded by nurse Charlotte Johnston. Speaking against the changes was nurse Rob Waterson, seconded by student nurse Serena Ruffoni. Chairing, in her first day of a new job no less, was Becky Malby, Professor of Health Systems Innovation at LSBU, with co-hosting provided online by @WeNurses under their #WeNurses hashtag. Live polling of the present audience was facilitated before and after the debate by Dr Elaine Maxwell, with the results as fascinating as ever, revealing some shifting from moderate towards stronger opinions, with the broadest consensus being that loans would make studying less attractive and discourage mature students. The debates hosted by Elaine and her colleagues are always excellently provocative and enlightening, but as a student (albeit currently on deferment for family reasons) I felt this one was especially personal, making it hard to approach with a dispassionate objectivity. Elisabeth (Lizzie) Jelfs spoke first and immediately shattered any entrenched preconceptions I held by being disarmingly reasonable and comprehensively informed. She carefully explained how the >20% increase in commissioned places since 2012 described by Health Education England (2015a) could not be sustained in the current

Are you ready, willing and able to influence health policy?

Journal of Health VisitingVol. 4, No. 2 EditorialAre you ready, willing and able to influence health policy?Rita NewlandRita NewlandSearch for more papers by this authorRita NewlandPublished Online:17 Feb 2016https://doi.org/10.12968/johv.2016.4.2.65AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Council for the Education and Training of Health Visitors (1977) An Investigation into the Principles of Health Visiting. London, CETHV Google ScholarHM Treasury (2015) Spending Review and Autumn Statement 2015. London, TSO Google ScholarLocal Government Association (2015) A new home for public health services for children aged 0–5. A resource for local authorities. London, LGA Google ScholarNuffield Trust (2015) The Spending Review: What does it mean for health and social care? London, Nuffield Trust Google ScholarNHS England (2014) The Five Year Forward View. London, NHSE Google Scholar FiguresReferencesRelatedDetails 2 February 2016Volume 4Issue 2ISSN (print): 2050-8719ISSN (online): 2052-2908 Metrics History Published online 17 February 2016 Published in print 2 February 2016 Information© MA Healthcare LimitedPDF download

Every penny must reach providers

£300 million of additional funding was announced in the Spending Review, and the new hourly rate paid to local authorities will be increased, but scratch the surface and the pennies start to be eroded.

Sector responds to spending review funding commitment

Sector responds to spending review funding commitment

The development and evaluation of an online intervention, ‘MePlusMe’, supporting mood, wellbeing, study skills, and everyday functioning in students in higher education

The development and evaluation of an online intervention, ‘MePlusMe’, supporting mood, wellbeing, study skills, and everyday functioning in students in higher education

THE PROPOSED TEACHING EXCELLENCE FRAMEWORK (TEF) FOR UK UNIVERSITIES

The role of universities within society has been the subject of constant discussion and conjecture amongst politicians, the public, as well as within the Higher Education (HE) sector itself. However, this issue has come ever more to the forefront of people?s minds in recent times due to the comprehensive spending review (CSR), related concerns regarding student fees and public debt, and governmental demands for the increased accountability of Universities in terms of student satisfaction and perceived ?value for money?. The Research Excellence Framework (REF), which replaced the Research Assessment Exercise (RAE), is accepted as a reasonably effective means by which universities, and their researchers, may be assessed periodically and subsequently allocated Quality Research (QR) funding in recognition, as well as to reinforce, research excellence in the HE sector. However, the results of any exercise will be interpreted in a number of ways and, inevitably, has led to claims that the ?teaching? function of universities has become the poor relation to the sector's research agenda. There have been a number of initiatives which have sought to address this perceived imbalance, and to regulate, monitor or even promote the educational function of universities. Amongst these have been Teaching Quality Assessments, Centres of Excellence in Teaching and Learning (CETLs), and the most recent initiative in the form of the Teaching Excellence Framework (TEF). In many respects, it is hard to challenge the principle that universities should be assessed in the same way for their teaching function as they are for their research activities and outputs. Indeed, the incorporation of 'impact' into the REF offers a seductive promise of similar connections that may be made with teaching in the form of progression, achievement and employability statistics. After all, this is the era of analytics and Big Data, why shouldn't it be used as part of a new system if it is readily available across the HE sector? The authors don't, in principle, disagree with this direction of travel. However, as with any new initiative, time and thought should not only be given to the precise objective of this exercise, but also to the potential pitfalls that may result from making a less than perfect choice. In this respect, the consultation surrounding the current green paper '...' may be likened to the following passage from Lewis Carrol?s ?Alice?s Adventures in Wonderland: Would you tell me, please, which way I ought to go from here?

Does the 30-hour funding stack up?

Nursery WorldVol. 2015, No. 25 In this issueDoes the 30-hour funding stack up?Jo VerrillJo VerrillSearch for more papers by this authorJo VerrillPublished Online:24 Dec 2015https://doi.org/10.12968/nuwa.2015.25.12AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View articleAbstractFollowing the announcements made in the Chancellor's Autumn Spending Review, Dr Jo Verrill, managing director of research agency Ceeda, examines how providers will be affected financially

Osborne announces student bursaries will be replaced by loans

BURSARIES FOR nursing students are to be replaced by loans, chancellor George Osborne announced in his spending review and autumn statement.

What to expect after the spending review

no bad thing. Some of the saving will come from ending bursaries for student nurses, eventually providing £1.2 billion a year. That, the government argues, will allow the cap on student nurse numbers to be lifted, and there is a logic with the way the rest of higher education is treated in substituting loans for bursaries for student nurses. It remains to be seen, however, what effect the switch in fact has on those choosing to become nurses. Some of the money will come from public health spending, which has already undergone a £200 million reduction since the election. If you believe the public health money is being spent well, then the implications of further cuts are larger demands on the NHS down the line from the very issues—obesity, smoking and alcohol— that the Five Year Forward View said had to be tackled. There is some capital to revenue transfer involved, when, presumably, more capital rather than less will be needed to deliver some of the new models of care—and when it is certainly needed for IT to provide the long promised, way overdue, electronic health record. While the spending review was strong on the rhetoric of integrating health and social care, it was anything but strong on integrating the funding. There is some more money for the Better Care Fund later in the Parliament, but any other additional cash for social care will come only if councils take advantage of their new ability to raise council tax by 2%, ring-fenced for social care. This is yet another example of the last government and this one shovelling difficult national issues—the social fund, council tax benefit and others— down to local government to resolve, often with a cut included. In this case, a form of the inverse care law will come into play—more deprived councils, who are likely to have higher social care costs, will raise least from the levy, if they choose to use it. As all the health think tanks have pointed out, average spending on the NHS over the next five years will be almost identical to that in the last Parliament—around 0.9% a year. The NHS managed that without the roof falling in over the past five years, although the strains are becoming almost daily more evident. Quite how it will manage another five years is highly questionable. Assuming the economy prospers—and in the end everything depends on that—the later years of this spending review will have to be revisited. BJHCM Nick Timmins, senior fellow at the Institute for Government and the King’s Fund, looks at the implications for health and social care following the spending review What to expect after the spending review

Offline: The (higher) responsibilities of science and medicine

Offline: The (higher) responsibilities of science and medicine

Autumn Statement Briefing 2015

Government spending: The government’s Spending Review will be far from comprehensive. With the triple-lock for state pension increases and NHS, per-pupil funding for schools, international aid and the defence budget all protected, the overwhelming majority of government spending has been ring-fenced from cuts. Rather than salami-slicing remaining departmental budgets to hit arbitrary savings targets, the government should rethink its functions from first principles. The spending review should take account of changing demand patterns and relative prices in certain sectors and should not maintain arbitrary targets for spending as a percentage of national income in others. It should take into account the long-term effects of ageing on health and pensions spending. Capital spending decisions should prioritise projects with the highest economic return. The tax credits fiasco: The government’s proposed tax credit changes should be abandoned. They significantly increase marginal tax rates for the low-paid. Delaying implementation or other minor changes to the reforms will not change this. Instead, the government should overhaul the system. It should replace tax credits with a negative income tax based on household income with the amount of tax-free income based on tax allowances which would be transferable within households. This would end the discrimination against family formation inherent within the current system. Consideration should be given to increasing the conditionality of benefits with more stringent work requirements. The tax system: The Autumn Statement should make plans to simplify the tax system and make it more economically rational. The government should not put forward changes to the system of pension tax relief except that the tax-free lump sum should be abolished or severely restricted. Property taxation should be completely overhauled, with the long-term aim of abolishing council tax, business rates and stamp duty, and replacing them with a Land Value Tax on commercial land and a tax on imputed rent for residential property. Personal tax thresholds should rise by the higher of inflation or earnings growth in the coming years after a number of years of under-indexation. Further increases in tax thresholds at the lower end should focus on raising the starting threshold for national insurance contributions. The withdrawal of the personal allowance above £100,000 should be abolished as should the higher rate of income tax. The VAT base should be broadened to include VAT at the full rate on domestic energy consumption. Other extensions of the VAT base should be implemented in the long run. This change and the restricting of the tax-free lump sum for pensions would facilitate all the tax reductions above plus a number of measures that would considerably simplify the tax system. Decentralisation: The government should be ambitious in its fiscal decentralisation agenda. But rather than ad-hoc City Deals powers for spending, revenue raising and regulation should be devolved to all local authorities.

Upcoming spending review has UK scientists concerned over funding future

Upcoming spending review has UK scientists concerned over funding future

The NHS in 1991: Parallels with today

of ministers and NHS leaders. It took quite a while to work out what was happening. The parallel with today is the result of the Five Year Forward View. By stating, virtually for the first time in the history of the NHS, that the structural arrangements no longer have to be the same everywhere, a clutch of different ways of doing things—the new models of care—are being tried and permitted. From apparently total devolution of the health and care budget in Manchester and Cornwall; to GPs and the hospital in Northumbria seeking to turn the latter into an accountable care organisation; to multispeciality community providers in Kent and Birmingham; to other ways of trying to bring the primary and acute systems together elsewhere. In other words, the really interesting stuff, the work that may shape the way the NHS functions in future, is out there on the ground. In 1991, the centre was distinctly nervous about how the new freedoms would be used, and in some cases— notably London—rapidly pulled the new freedoms back for fear of the effect they would have. This time round the various bits of the centre that Lansley’s legislation created, are struggling to work out just how far they can— statutorily or otherwise—let go to let the new models of care emerge. And there, probably, the parallel ends. One huge difference is that in 1991 the reforms were lubricated by cash to make sure the purchaserprovider split did not crash and burn on day one. This time around, providers are projecting big deficits and a mere £200 million has been allocated so far to a transformation fund to help the innovators get there. Huge amounts depend on the outcome of the spending review now underway—how much at what speed does the NHS get? How much does social care? Will the double counting of shifting NHS cash into the Better Care Fund continue? Or, despite the political commitment to eliminating the deficit primarily through spending cuts, will there be sufficient cash to allow a tolerable settlement for each? Do these new models of care signal— if not necessarily the complete end of the purchaser-provider split—a pretty radical reshaping of it, as Sir David Nicholson suggested in his formal lecture for NHS Providers last month? The answer to that lies in the diversity being attempted locally, as well as in the decisions that will be made centrally over the coming months. BJHCM Nick Timmins, senior fellow at the Institute for Government and the King’s Fund, compares the NHS reforms of 1991 to those ongoing today The NHS in 1991: Parallels with today

Spending Review will force children's services to rethink how they deliver

In less than three months' time the government will publish its Spending Review, setting out department budgets for the four years from 2016/17 to 2019/20, with the impact on children's services likely to be profound