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四部分还是一个整体:权力下放后的国民医疗服务体系(NHS)。

Four parts or one whole: The National Health Service (NHS) post-devolution.

作者信息

Maslin-Prothero Sian E, Masterson Abigail, Jones Kerry

机构信息

School of Nursing and Midwifery, Keele University Hospital Campus, Clinical Education Centre, University Hospital of North Staffordshire NHS Trust, Stoke on Trent, UK.

出版信息

J Nurs Manag. 2008 Sep;16(6):662-72. doi: 10.1111/j.1365-2834.2008.00909.x.

Abstract

AIM(S): There is a need for nurse and midwifery managers to have an understanding of devolution and its implications for them and their colleagues. This paper will explain devolution, consider some health and social care policy including similarities and differences, and assess the impact of devolution on the nursing workforce and the regulation of nursing across the four countries of the United Kingdom (UK).

BACKGROUND

If managers are to manage effectively it is critical that they remain aware of emerging policy development and outcomes across the UK. It is now more important than ever that nurses maintain a keen eye on the impact divergent policy is having on practice as well as the UK nursing workforce.

EVALUATION

The impact of devolution across the UK will be explored using convergence and divergence as a framework; commencing by providing an overview of devolution and health, moving on to examine health policy in action across the four countries.

KEY ISSUES

Healthcare is highly political in nature. Devolution has implications for all, and adds to the complexity of health and social care provision. If managers are to manage effectively it is critical that they remain aware of emerging policy development and outcomes across the UK.

CONCLUSION

It is equally important that nurses, and nurse managers, develop and draw upon their political leadership skills, actively engaging in policy debates to ensure that when policies are translated into practice their outcomes are optimal in terms of quality, efficiency and sustainability. Implications for nursing management There is a need for nurse and midwifery managers to have an understanding of post-devolution structures and how they operate in order to work effectively, as well as to learn from the experiences of other parts of the UK.

摘要

目的

护士和助产士管理人员需要了解权力下放及其对他们自己和同事的影响。本文将解释权力下放,探讨一些卫生和社会护理政策,包括异同之处,并评估权力下放对英国四个国家护理人员队伍以及护理监管的影响。

背景

如果管理人员想要有效管理,至关重要的是他们要时刻关注英国各地新出现的政策发展和成果。现在,护士比以往任何时候都更需要密切关注不同政策对实践以及英国护理人员队伍的影响。

评估

将以趋同和差异为框架探讨权力下放在英国各地的影响;首先概述权力下放与卫生情况,接着考察四个国家实际实施的卫生政策。

关键问题

医疗保健本质上具有高度政治性。权力下放对所有人都有影响,并增加了卫生和社会护理提供的复杂性。如果管理人员想要有效管理,至关重要的是他们要时刻关注英国各地新出现的政策发展和成果。

结论

护士和护士长培养并运用其政治领导技能,积极参与政策辩论,以确保政策转化为实践时,其在质量、效率和可持续性方面的成果达到最优,这同样重要。对护理管理的启示护士和助产士管理人员需要了解权力下放后的结构及其运作方式,以便有效开展工作,同时借鉴英国其他地区的经验。

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