If you are reading this document, it is likely to be because you have an interest in how we can improve health care commissioning in the NHS and an appetite to use international comparisons to help us to do so. Our rationale for asking Chris Ham to produce this high level paper was based on a conviction that management decision making should be as much as is practicable evidence based (acknowle...

Recent health policy in England has demanded greater involvement of patients and the public in the commissioning of health and social care services. Public involvement is seen as a means of driving up service quality, reducing health inequalities and achieving value in commissioning decisions. This paper presents a summary and analysis of the forms that public involvement in commissioning are t...

OBJECTIVE To explore the relational challenges for general practitioner (GP) leaders setting up new network-centric commissioning organisations in the recent health policy reform in England, we use innovation network theory to identify key network leadership practices that facilitate healthcare innovation. DESIGN Mixed-method, multisite and case study research. SETTING Six clinical commissi...

BACKGROUND Addressing health inequalities remains a prominent policy objective of the current UK government, but current NHS reforms involve a significant shift in roles and responsibilities. Clinicians are now placed at the heart of healthcare commissioning through which significant inequalities in access, uptake and impact of healthcare services must be addressed. Questions arise as to whethe...

Introduction: Very low, Low and Medium X-ray machines are used extensively for Superficial Radiation Therapy mostly used for Basal Cell, Squamous Cell Carcinoma, and Melanoma skin cancers. In most of cases, Superficial X-ray Therapy (SXRT) is preferred to Electron beams generated using a linear accelerator. SXRT tube characteristics may vary with the use of the machine for a lo...

The ISAC II superconducting linac is presently in the beam commissioning phase. The linac lattice consists of modules of four quarter wave cavities and one superconducting solenoid. At the moment five cryomodules (indicated as medium beta section) are installed. Beam steerers between cryomodules compensate for steering effects due to misalignments in the solenoids. Beam dynamics aspects of lina...

Methods and results for commissioning of the complete VMAT delivery chain are presented for the combination of Nucletron's Oncentra MasterPlan® v3.3 with Elekta's Mosaiq® v1.6 and SynergyS® linac. VMAT specific linac commissioning included determination of the size of the minimal dynamic leaf gap. Dosimetric validation of the complete treatment chain was performed using a 2D-ionization-chamber-...

BACKGROUND The direction of health service policy in England is for more diversification in the design, commissioning and provision of health care services. The case study which is the subject of this paper was selected specifically because of the partnering with a private sector organisation to manage whole system redesign of primary care and to support the commissioning of services for people...

The new superconducting RF system consisting of four single-cell cavity modules is an important part of the CESR Luminosity Upgrade. We describe the commissioning of the first three accelerating modules. This includes in situ testing and conditioning, pulsed power and beam processing of RF windows, commissioning of various cryogenic feedback loops, measuring cavity spacing and phasing with beam...