Clinical management. Unknown quantities

Poor performance on cancer waiting-time targets has been partly blamed on the government only recently pushing it to the top of the agenda. The first priority is to improve data collection. A number of trusts have made good progress, through streamlining services and encourging whole-trust ownership of the problem.     

Long-term care. No grey areas

The government policy on the future of long-term care is unclear. The debate has been narrowly focused on home closures and users' interests have been marginalised. The government's U-turn on care standards in July sent out worrying messages about whose interests are being protected. The NHS may have a role in providing capital investment for new developments. Experience in Scandinavia suggests more intense home support could lessen reliance on residential services.     

Long-term care. Theme and variations

Health authorities' eligibility criteria for long-term care vary in scope. This small study suggests that while differences in access remain, they may be lessening. There is little evidence of radical changes in investment.     

Long-term care. The best of both worlds

An NHS/housing association venture has produced good accommodation for 30 elderly people in need of long-term care. The housing organisation takes responsibility for support services such as laundry, cleaning, security and catering. The unit remains part of the NHS. Patients appreciate the environment and staff turnover is low.     

Long-term care in Canada

Problems associated with long-term care in Canada include the growing number of elderly citizens, inconsistencies in social policy and legislative initiatives among provinces, effective quality assurance, and cost containment. Deinstitutionalization and independent living have shifted the focus to community participation.