BMJ analysis: NICE’s end of life decision making scheme: impact on population health

Reference: BMJ 2013;346:f1363, published 21st March 2013

Date published: 22/03/2013 16:56

Summary

by: Devika Sennik

The authors of this article estimate the effect of the end of life criteria on the NHS in England and Wales since they were introduced in 2009.  They quantify the impact of raising the cost effectiveness threshold for end of life drugs and find that the effect on other NHS services could be substantial.

BMJ: Impact of managed clinical networks on NHS specialist neonatal services in England: population based study

Impact of managed clinical networks on NHS specialist neonatal services in England: population based study: BMJ 2012;344:e2105 doi: 10.1136/bmj.e2105

Objective:  To assess the impact of reorganisation of neonatal specialist care services in England after a UK Department of Health report in 2003. (This study includes Ignatius Losa, Macclesfield District General Hospital)

Design: A population-wide observational comparison of outcomes over two epochs, before and after the establishment of managed clinical neonatal networks.

Setting: Epoch one: 294 maternity and neonatal units in England, Wales, and Northern Ireland, 1 September 1998 to 31 August 2000, as reported by the Confidential Enquiry into Stillbirths and Sudden Deaths in Infancy

Project 27/28 Epoch two: 146 neonatal units in England contributing data to the National Neonatal Research Database at the Neonatal Data Analysis Unit, 1 January 2009 to 31 December 2010.

Participants: Babies born at a gestational age of 27+0-28+6 (weeks+days): 3522 live births in epoch one; 2919 babies admitted to a neonatal unit within 28 days of birth in epoch two.

Intervention: The national reorganisation of neonatal services into managed clinical networks.

Full open access article