Management for Child Health Services JOIN US ON THE INTERNET VIA WWW, GOPHER, FTP OR EMAIL: WWW: http://www.thomson.com GOPHER: gopher.thomson.com !T\® A service of 1\.!JP FTP: ftp.thomson.com EMAIL: [email protected] Management for Child Health Services Edited by Michael Rigby Centre for Health Planning and Management Keele University Staffordshire UK Euan M. Ross King's College School of Medicine and Dentistry, London Mary Sheridan Centre for Child Health London UK and Norman T. Begg PHLS Communicable Disease Surveillance Centre London UK ~~nl Springer-Science+Business Media, B.V. Published by Chapman & Hall, 2-6 Boundary Row, London SEI SHN, UK First edition 1998 ©Springer Science+Business Media Dordrecht 1998 Originally published by Chapman & Hall in 1998. Softcover reprint of the hardcover 1st edition 1998 Typeset in 10/12 Palatino by Keyset Composition, Colchester ISBN 978-0-412-59660-5 ISBN 978-1-4899-3144-3 (eBook) DOI 10.1007/978-1-4899-3144-3 Apart from any fair dealing for the purposes of research or private study, or criticism or review, as permitted under the UK Copyright Designs and Patents Act, 1988, this publication may not be reproduced, stored, or transmitted, in any form or by any means, without the prior permission in writing of the publishers, or in the case of reprographic reproduction only in accordance with the terms of licences issued by the Copyright Licensing Agency in the UK, or in accordance with the terms of licences issued by the appropriate Reproduction Rights Organization outside the UK. Enquiries concerning reproduction outside the terms stated here should be sent to the publishers at the London address printed on this page. The publisher makes no representation, express or implied, with regard to the accuracy of the information contained in this book and cannot accept any legal responsibility or liability for any errors or omissions that may be made. A catalogue record for this book is available from the British Library Library of Congress Catalog Card Number: 97-68391 Dedication The editors dedicate this book to their own children, who by their positive and cheerful drives to put the maximum value into life's opportunities have given their parents a continuous reminder of the incalculable importance of ensuring the optimum health and development for each and every young person. This book is for you, as the representatives of your peers. Contents Contributors ix Foreword xvii Introduction xix 1 The development of British child health services 1 Euan M. Ross, Michael Rigby and Alison While 2 Management skills in the new NHS 26 John Owens 3 Working with parents 41 Kate Saffin 4 Consumer orientation and service quality 56 Michael Rigby 5 Rights, values and ethical issues in child health 76 Peter de Cruz 6 Analysing and promoting the health of children 99 Eva Alberman 7 Information in child health management 122 Michael Rigby 8 Running a clinical service: a case study 142 Harry Baumer 9 Health service finance 164 Nicholas Jennett and Andrew Wainwright viii Contents 10 Developing personnel skills in management 181 John Edmonstone 11 Analysing and controlling risk 194 Malcolm Lowe-Lauri 12 Working with other agencies 209 Brent Taylor and Euan M. Ross 13 The law relating to child health 223 Jane Fortin 14 Project management 247 Colin Nolder Appendix A Wales 259 Joyce Thomas Appendix B Scotland 278 Alison Allen, Anne Maree Wallace and Helen Zealley Appendix C Northern Ireland 299 Adrian Mairs and Leslie Boydell Index 317 Contributors Eva Alberman FFPHM, FRCP, FRCOG Professor of Clinical Epidemiology (London University - Emeritus) Research Director, National Down Syndrome Cytogenetic Register Department of Environmental and Preventive Medicine, Wolfson Institute of Preventive Medicine, Medical College of St Bartholomew's Hospital, Charterhouse Square, London EC1M 6BQ Initially appointed a Research Fellow in 1960 in the Paediatric Research Unit of Guys Hospital, where she remained until 1978, Eva Alberman worked on studies of cerebral palsy and Down's syndrome, and on the initial and follow up activities of the National Perinatal Mortality Survey. Additionally, in 1972 she was appointed Senior Lecturer, and then Reader, in Social Medicine at the London School of Hygiene and Tropical Medicine, where she worked on outcome studies of low birthweight. In 1979 she was appointed Professor of Clinical Epidemiology at the London Hospital Medical College, a post held for 10 years in which she continued her earlier studies. From 1979 to 1996 she was Deputy Chairman of the Medical Advisory Committee of the Office of Population Censuses and Surveys. Alison Allen BA Formerly Clinical Audit Coordinator, Lothian Clinical Audit Depart­ ment Mrs Allen's experience in child health has included three years as coordinator of the Oxford Growth Study, looking at the effectiveness of screening for short stature in preschool children. Also, between 1992 and 1994, she was coordinator of a Scottish national audit on preschool child health surveillance looking at the availability of data and quality standards for auditing preschool surveillance programmes. x Contributors Harry Baumer MB chs, FRCP Consultant Paediatrician Department of Child Health, Level 12, Derriford Hospital, Plymouth PL6 SOH Dr Baumer has been a Consultant Paediatrician in Plymouth for 14 years, and was the Clinical Director of the combined child health directorate from 1989 to 1994. He is presently South West Regional Council Representative of the Royal College of Paediatrics and Child Health and Regional Adviser in Paediatrics. His research interests include neonatology, diabetes, asthma and informatics, and he is currently coordinating a multicentre controlled trial of two forms of neonatal ventilation. Norman T. Begg MB chs, FFPHM, DTM&H Consultant Epidemiologist, Public Health Laboratory Service, Com­ municable Disease Surveillance Centre PHLS Communicable Disease Surveillance Centre, 61 Colindale Avenue, London NW9 SEQ Dr Norman T. Begg qualified in 1976 from Edinburgh University. He worked in general practice and community child health both overseas and in the UK before entering training in public health medicine in 1981. He joined the PHLS Communicable Disease Surveillance Centre (CDSC) as a senior registrar in 1984, and was appointed to the post of Consultant Epidemiologist in 1987 with responsibilities for the surveillance of the national immunisation programme in England and Wales and clinical trials of new vaccines and vaccine schedules. From October 1993 to 1996 he was Deputy Director of CDSC. He chaired the Child Health System Consortium from 1990 to 1994. Leslie Boydell MB chB, BAO, DRCOG, MRCGP, MFPHM Consultant in Public Health Medicine South & East Belfast Trust, Trust Headquarters, Knockbracken Healthcare Park, Saintfield Road, Belfast BT8 8BH Dr Boydell has held a Consultant Post in Public Health Medicine since 1990, both with the Eastern Health and Social Services Board in Belfast and South and East Belfast Health and Social Services Trust. Previously within the Eastern Health and Social Services Board, she had responsibility for child health and subsequently has held responsibility for health promotion within South and East Belfast Trust. She has been involved in the management of several European Health Telematics Projects within the field of primary and community health and social care. Contributors xi Peter de Cruz LLB, LLM, rho Professor of Law Law School, Staffordshire University, Leek Road, Stoke-on-Trent, Staf­ fordshire ST4 2DF Peter de Cruz, formerly Senior Lecturer in Law at Keele University, is currently Professor of Law at Staffordshire University and has written widely on Child Law. He has been Director of the MA in Child Care Law and Practice at Keele University, where he taught Family Law for eleven years. He is Editor of the Practitioners' Child Law Bulletin and his book, Child Abuse (co-written with Professor Christina Lyon) is now in its second edition. John Edmonstone MSC Senior Research Fellow Centre for Health Planning and Management, Darwin Building, Keele University, Keele, Staffordshire STS SBG John Edmonstone is an experienced practitioner within the Human Resources field, having held a number of senior positions within the UK National Health Service. He combines an academic role at Keele University, contributing to a number of Masters and Diploma pro­ grammes, with consultancy and advice within the public sector. Mr Edmonstone is a regular contributor to publications within the manage­ ment and organisation development sphere. Jane Fortin LLB Solicitor and Senior Lecturer in Law School of Law, King's College, Strand, London WC2R 2LS Jane Fortin is a solicitor and Senior Lecturer in law at King's College, London. She writes widely on child law topics and is joint-editor of the legal journal Child and Family Law Quarterly. For many years she was joint director of a specialised postgraduate course on child protection for a wide range of practitioners involved in this field of work. Nicholas Jennett BA, MSC, MBA Director, Moores Rowland Consulting Moores Rowland Consulting, Tameway Tower, PO Box 30, Bridge Street, Walsall WSl lQX Nick Jennett is Director of Moores Rowland Consulting's Health Economics team. After an early career lecturing in microeconomics, he joined the Department of Health as an Economic Adviser, where he worked on the Prime Minister's Review of the NHS which culminated in the publication of Working for Patients. In recent years he has worked as a xii Contributors management consultant within the NHS, with a particular interest in the application of economic techniques to issues faced by both purchasers and providers relating to the management of resources. Malcolm Lowe-Lauri BA, MHSM, oip HSM Chief Executive Officer, Peterborough Hospitals NHS Trust Peterborough Hospitals NHS Trust, Edith Cavell Hospital, Bretton Gate, Peterborough PE3 9GZ Malcolm Lowe-Lauri is an honours graduate in modern history from Oxford University. He has a 'pedigree' background in NHS management, having held a range of senior posts at StGeorge's Hospital, Tooting, and King's Healthcare NHS Trust, both being major London teaching hospitals.