This thesis seeks to understand the role of audit in managing the performance of the NHS in Scotland and the impact which the relationship between performance and audit has upon key actors, including NHS organisations and national audit bodies. It is informed by Michael Power’s Audit Society (1999) and associated works, which present audit as a collection of ideas which shape how society defines control, accountability and transparency. The premise of this doctoral research is that the age of performance assessment in the NHS is evidence of Power’s Audit Society in action. A longitudinal analysis of annual Overview Reports produced by Audit Scotland, which symbolise the national audit body’s identity relative to the NHS, explores the impact which the performance assessment regime had upon the evolution of the national audit body and demonstrates the capacity of a national audit body to forge its own role in performance assessment and in doing so shift its identity from traditional external auditor to authoritative commentator on performance. A recent performance crisis in a Scottish NHS board is the subject of a case study which explores the role of audit when significant gaming is uncovered in a previously high-trust system. This case demonstrates how the ritual appeal of audit can be mobilised by the government to restore public confidence in reported improvements in performance across the whole NHS. The organisational impact of audit on performance management is explored through an observation-based case study set in a Scottish NHS board, which traces interactions between the main actors in audit and performance networks. These analyses show how audit can permeate the performance assessment of NHS bodies, at both the national and organisational level, even where it is not given a formal role in the assessment framework.

Distributive justice in the health sector in the context of the rationalization of health care This paper should briefly introduce the major principle of health service in the Czech Republic but also practised in most developed countries. Distributive justice is a system of accumulating and redistributing wealth in order to seek balance in society. In health sector it is most commonly associated with rationing i.e. distribution of limited and costly medical sources among those who are in need of medical care in a justifiable way. Not to be mistaken distributive justice with social justice even though there is a fine line between the two. The thesis is divided into fifteen chapters each describing certain aspect of distributive justice in the health sector or a related issue. Opening chapters are dedicated to theoretical, historical and philosophical overview; following part contains single elements of distributive justice both in general and in context of health care. Issues of medical standards and regulatory charges are discussed in subsequent chapters with regard to recent case law of the Constitutional court. In conclusion the problem of distributive justice in health care can be approached from two different points - communitarian and liberal. These issues are also political, philosophical and...

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The Diploma thesis describes telecommunication market in Czech Republic and the most important telecommunication companies in Czech Republic and in the world. Also provides the marketing application of new technologies. The goal of diploma thesis is the proposal of product eHealth care from the health industry for T --Mobile company. This product will use technology with high added value could help T -- Mobile to get product with high added value to get to goal to prevent falling revenues.

The National Response Plan (NRP) was developed to provide support during national disasters. The U.S. Public Health Service (USPHS) Corps is 1 of the 7 uniform services and contributes to the mission of the (NRP). The USPHS Commissioned Corps (CC) Officers may be deployed for national disasters at any time and they must be ready to deploy. The purpose of this phenomenological qualitative study was to explore the lived experiences of USPHS CC Nurse Officers who have deployed in response to disasters in the United States. This study addressed the gap in literature related to the deployment perception of USPHS Nurse Officers and may lead to an increase in deployment readiness. The lifeworld theory was used to guide the study that addressed the question of how nurse officers of the USPHS CC described their clinical nursing experience while deployed. Selection criteria used to recruit the 10 participants included USPHS Nurse Officers in non-clinical billets that have deployed in support of hurricane responses in 2017. In-depth interviews were conducted, and data were organized and analyzed using NVivo analysis software. The themes that emerged from the data included characteristics of nurse officers, clinical preparedness, training needs, challenges, and lessons learned. USPHS Nurse Officers perceived other nurse officers as resourceful, skillful educators, felt comfortable and prepared during the deployment, recommended additional training to benefit future Corps deployments, and identified physical and emotional challenges they experienced. These findings may assist in promoting positive social change within nursing practice of the USPHS Nurse Officers as it may enhance and improve readiness training, and USPHS policies for deployment readiness.

The history of the care of the mentally ill in Britain, which has been broadly reflected in Western Australia since 1826, can be conveniently, if simplistically divided into a number of epochs. Each epoch is characterised by a particular focus or paradigm of clinical management, which prevails over a period of time but is then followed by a comparatively short period of rapid change to a new paradigm. Such changes are shaped by a number of forces, but three categories can be readily identified. These are: concepts of mental illness; reactions of administrative systems and the attitudes of medical practitioners. As the concept of the nature of mental illness has changed, succeeding epochs have evolved to a more humane and enlightened approach to the mentally ill. Nevertheless, each management paradigm has failed to deliver the expected 'cures' and the consequent reduction in the burden of illness. Each has been replaced by a new and radically different paradigm, often at enormous cost, but there has been no progressive evolution towards a system that incorporates measures that have proven value. In recent years 'Community Care', has failed in such a manner that there have been strong arguments that it should be abandoned. At the same time there is evidence that a new paradigm 'Primary Care Psychiatry' is emerging as government policy. The challenge is to preserve the best elements of community care and integrate Primary Care Psychiatry into the broader framework. The best chance of achieving this is to develop a gradual, evolutionary process, built on consensus between psychiatrists, general practitioners and administrators. / The purposes of the present research are threefold: to develop a conceptual model for an optimal community based mental health service. Then by examining the views of general practitioners, psychiatrists and administrators, determine the degree of congruence of these views. This is achieved by a qualitative study comprising extended interviews with 24 GPs, 15 psychiatrists and 11 administrators. This approach is chosen over a more broadly based, structured questionnaire approach for two reasons. Firstly, the views expressed in informal face to face interviews are more likely to be true expressions of opinion, especially when these are critical. Secondly, by using a comparatively unstructured approach, the stakeholders are able to express views on issues that they consider important. Finally, the areas of consensus and disagreement are analysed and recommendations made on strategies to develop a plan for a practical, viable service in a local area.

The aim of the current study was to develop and test a methodology that could be applied to the evaluation of the complaints processes of regulatory bodies of health professionals in Australia including mental health regulatory bodies such as the board that the Council of Australian Governments (COAG) are planning to set up to regulate the psychology profession. The methodology was applied to the evaluation of the complaints process at the Office of the Health Services Commissioner of Victoria (HSC). There were four main research questions. The first research question related to the extent to which the methodology was able to determine how well the HSC was performing in their role of resolving health complaints. The second research question explored the implications of the findings of the evaluation of the HSC complaints process for the management of health complaints in general. The third research question related to the strengths and limitations of the methodology when applied in a practical setting and the final research question related to further improvement of the methodology for future applications. Questionnaires and telephone interviews were used to examine the experiences of 133 providers and 150 complainants whose complaints had been reviewed and closed in one year. The methodology proved successful in assessing the performance of the complaints process at the HSC. The findings of the evaluation indicated that complainants and providers were generally satisfied with the process by which their complaints were managed. However, they were in general less satisfied with the outcome. In particular the evaluation highlighted the unintended negative consequences that complaints processes can have on the complainants and respondents. It was concluded that these maladaptive behavioural responses to complaints most probably have their origins in the negative emotional overlay attached to health complaints which has the potential to lead to unrealistic expectations of the process and outcomes on the part of complainants, and maladaptive post-complaint practices for health service providers. The findings highlight the importance of providing advocacy and support for the parties involved in health complaints as a means of minimising these maladaptive responses. Finally, it is acknowledged that these findings are specific to Australian health regulatory systems.

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