The market forces, governance shortfalls, and a crisis of values that have led to the global financial collapse in 2009 have a frighteningly similar pattern to the collapse of hospital quality that has led to a crisis in patient care. We have stated that you cannot defy the business laws of gravityVthat quality, cost, value, speed, and trust are intrinsically interlocked and tightly coupled. Pe...

Trust is central to the relationship between doctor and patient. An important skill in psychiatry therefore is the ability to relate to and effectively treat patients in whom the capacity for trust is diminished as a consequence of psychopathology. The focus of this article is paranoid personality disorder, a condition in which mistrust of other people is the cardinal feature. It is not an un c...

Sharing electronic patient records without compromising individual’s privacy and confidentiality is a key challenge in adoption of distributed, electronic healthcare systems. To address this issue, it is necessary to ensure that a sender can trust the receiver and its environment to correctly implement its policy and vice versa, while sharing electronic patient records. This paper proposes an a...

OBJECTIVE In 2010, the National Institute for Health and Care Excellence (NICE) in the UK published Clinical Guideline 95 (CG95) advocating risk stratification of patients using 'CADScore' to guide appropriate cardiac investigations for chest pain of recent onset. Implementation of the guideline in the University College London Hospitals NHS Foundation Trust was evaluated to see if it led to a ...

BACKGROUND The objective of this study was to compare differences in cost estimates for paediatric HIV hospital service provision based on hospital prices with cost estimates obtained through a research-based service-specific costing exercise. METHODS Activity data on the use of hospital services of children by stage of HIV infection were collected from case-notes for 118 HIV antibody positiv...