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5 questions to ask before you do anything:
1. Who is the leader?
2. Who is the supervisor?
3. Who is the manager?
4. Who is the planner?
5. Who is Accountable?
Until you are crystal clear about each one anything you do will be futile and costly!!
A guide to common abbreviations, acronyms, complex terminology, buzzwords and gobbledegook
Initials and Acronyms (words formed from the initial letters of other words)
A&E: Accident and Emergency
Accountability: Comprises one of three foundations of public service. All actions of NHS staff must be able to stand the test of parliamentary scrutiny, public judgements on propriety and professional codes of conduct.
ACE Inhibitors: Angiotensin Converting Enzyme Inhibitors
ACE: Achieving Clinical Excellence
ACHCEW: Association of Community Health Councils for England and Wales
ACoP: Approved Code of Practice
ACPC: Area Child Protection Committee
Activity: The amount of work conducted in a certain time, such as the number of patients seen.
Acute Coronary Events: Heart Attacks
Acute Hospitals: Hospitals providing urgent or planned treatments or operations and out-patient appointments.
Acute: Services at general hospitals which treat patients for a certain condition for a short time.
ADHD/ADD: Attention Deficit Hyperactivity Disorder/ Attention Deficit Disorder. An inability to control behaviour, developmentally inappropriate inattention, and/or impulsivity and hyperactivity. It is most common in males and begins in childhood, but usually diminishes in adolescence.
Advocacy: When an advocate (such as a pharmacist, doctor, voluntary worker, or carer) acts on behalf of a patient or carer.
Aetiology: The cause of a disease
Age Standardised Mortality Rates: Death rates to take into account the age profile of the population, which change overtime.
Agenda 21: A document agreed by the participating nations at the United Nations Conference on the Environment and Development in Rio de Janeiro in 1992. It aims to identity a global action plan, part of it requesting all local authorities to develop a strategy for sustainable development in their area (Local Agenda 21).
Allocation: The amount of Government money received locally to buy healthcare.
ALS: Advanced Life Support
Ambulatory Care Centre: A centre with services designed around patients’ needs where they can be admitted and discharged within a day, including out-patients, x-ray, day surgery and medical diagnostic services.
AMHP: Approved Mental Health Professional
AMI: Acute Myocardial Infarction (heart attack)
Angina, angina pectoris: Literally, pain in the chest. Usually gripping or crushing in nature in the chest and/or left arm and jaw felt when there is insufficient blood supply to the heart muscle. Stable Angina: is the term used for angina which is relatively predictable and the intensity and frequency of which remains similar over long periods. Unstable Angina: is severe and unpredictable and which threatens to progress to an acute myocardial infarction (heart attack)
Angiogram: A procedure in which a fine catheter is inserted via a blood vessel to inject x-ray opaque dye into the coronary arteries to obtain an x-ray image of the anatomy of the coronary arteries.
Angioplasty: A procedure in which a small balloon on the end of a catheter is inserted into an artery (in CHD, the coronary arteries) and inflated to widen a narrowed artery.
Anti-emetic: A drug administered to relieve nausea and vomiting.
Anti-thrombotics: Drugs administered to reduce blood clotting, e.g. aspirin, heparin
AO: Assertive Outreach
Area Child Protection Committee (ACPC): Each county or authority has an ACPC comprised of members from all statutory agencies working with children and an independent chair. The ACPC ensures that children in their area are protected from significant harm. This includes taking responsibility for forming good local policies and practices, ensuring they are adhered to.
areas have local strategies)
Around (as in ‘to work around’, ‘issues around’): On, to do with.
Arrest Referral Team: Where ones’ crimes are caused by their drug or alcohol use and are referred for treatment, but can still be charged for their offences.
Arrhythmia: An abnormal rhythm of the heart
Artery: A blood vessel that carries blood away from the heart.
As of the date of: From, since
Asperger’s: A form of Autism where the person may have normal intelligence but has difficulties with social interaction and communication, found in autistic spectrum disorders.
Assertive Outreach Services: Services for those with severe and persistent mental illness who may be difficult to engage in treatment. Involves social care, practical help and psychiatric treatment, usually 24 hours a day, seven days a week.
Assertive Outreach: Ensures those in need of specialist mental health care stay in touch with services.
Atheroma: Deposits of fatty material and cholesterol inside the walls of arteries.
Atherosclerosis: Narrowing and thickening of arteries due to the development of fibrous tissue in the wall and sometimes calcium deposits. Usually associated with atheroma.
Atrial fibrillation: Irregular electrical activity in the atria (the receiving chambers of the heart) leading to irregular contraction of the heart muscle.
Atypical Anti-Psychotic Medication: A range of new drugs to treat psychosis, usually schizophrenia.
Audit: To conduct a thorough examination of health care performance.
Autism/Autistic Spectrum Disorder: A disability affecting verbal and non-verbal communication, social interaction and imagination. It encompasses wide-ranging degrees of severity and each affected person has a triad of impairment.
AVR: Aortic Valve Replacement
BA: Benefits Agency
BACR: British Association of Cardiac Rehabilitation
BCS: British Cardiac Society
Benchmarking: A process to identify best performers and to examine how results are met.
Best Value: Sets a standard of services to be delivered, covering cost and quality, by the most cost-effective means.
Beta-blocker: A class of drugs used to treat raised blood pressure and slow the heart rate.
BHF: British Heart Foundation
Bilateral: Of both sides, for e.g. nasal bilateral obstruction means obstruction of both sides.
Blue sky thinking: Approaching a problem or issue as though we lived in an ideal world and anything was possible. (For example: ‘if we had unlimited money, what would we do to improve services?’).
BMI: Body Mass Index
BP: Blood Pressure
Bradycardia: A heart rate of 50 beats per minute or lower.
Bridging the Gap: Social Exclusion Unit discussion paper.
BSVP: Better Services for Vulnerable People. A Department of Health initiative that requires health authorities and social services to work together to agree local joint investment plans (JIPs) for community care services.
Bulimia: An eating disorder involving vomiting after self-induced eating.
C&D: Crime and Disorder (P – Partnerships - in all District Council
CAB: Citizens’ Advice Bureau
CABG: Coronary Artery Bypass Graft
Caldicott: Review led by Dame Fiona Caldicott into the use of patient-identifiable information for non-clinical purposes with recommendations on appropriate safeguards to govern access to and storage of such information.
Calman Report (manpower): Chief Medical Officer report that changed the structure of post-graduate medical training.
Calman-Hine Cancer Report: The report ‘A Policy Framework for Commissioning Cancer Services’, commissioned in response to concerns about variations in treatment. It recommended cancer services be organised at 3 levels: primary care – cancer units in local hospitals with multi-disciplinary teams to treat common cancers; cancer centres in bigger hospitals to treat less-common cancers; and support cancer units with services like radiotherapy, not available in smaller hospitals.
CAMHS: Child and Adolescent Mental Health Service
Capacity building: Working with local organisations and individuals to maximise their potential by increasing their skills and effectiveness. Empowering community members.
Capacity: Total amount of patients that local healthcare providers can safely see within a given time.
Capital: Capital expenditure on land and premises, and on the renewal, adaptation, replacement or demolition of buildings or equipment where it exceeds £5000.
CARATS: Counselling, Assessment, Rehabilitation and Through-care
Cardiac arrest: Complete cessation of the heart beat.
Cardiac Catheter: A long, narrow tube which, when passed through the veins or arteries into the heart cavities, is used for measuring pressures or injecting x-ray opaque dye for outlining the heart and blood vessels.
Cardiology: Study of the heart
Cardio-pulmonary resuscitation: The techniques for treating cardiac arrest by artificial respiration and cardiac compression.
Cardiothoracic: Of the heart and chest contents, e.g. oesophagus and lungs
Cardioversion: The application of electric shock or drugs to attempt restoration of a normal heart rhythm in a patient with cardiac arrhythmia.
Care in the Community: Policy whereby patients with continuing medical and social care needs are cared for in a community or domestic, rather than institutional setting. It is part of a government agenda to give patients the right of choice.
Care Trust: New level of PCT to include social services commissioning on delegated authority from local government.
Carotid Endarterectomy: Surgical procedure to reduce thickening in the ceratoid artery.
CCAD: Central Cardiac Audit Database
CCI: Comprehensive Community-based Initiative
CCU: Coronary Care Unit
CDSC: Communicable Disease Surveillance Centre. Undertakes surveillance of communicable diseases and provides assistance in the investigation and infection control in England and Wales.
CDT: Community Drug Team
CER: Community Empowerment Fund
CGDP: Clinical Governance Development Plan
CHAI: Commission for Healthcare Audit and Inspection. New CHAI to replace CHI (Commission for Health Improvement), will be independent of the government and the NHS and will inspect and review NHS and private healthcare. It will produce an annual report to parliament.
Challenging Behaviour: Violent, aggressive or difficult behaviour, making social interaction difficult.
CHC: Community Health Council: A statutory body independent of the health authority, representing the health interests of local people and assisting them make complaints. They have the power to visit hospitals and make reports. Councils are funded by, but operate independently of the NHS. CHCs will be abolished on 1/9/03 and will soon after be replaced by Patient and Public Involvement (PPI) bodies.
CHD: Coronary Heart Disease
CHDGP: Collecting Health Data from General Practice
Cherry pick (e.g. ‘let’s cherry pick the survey results’): Only use the good or best parts of something and ignore the rest.
CHI: Commission for Health Improvement
Child Protection Register: Each county or local authority by law keeps a register of children considered to be at risk of significant harm and is therefore in need of protection.
Cholesterol: A substance found in many foods and in all cells. Most of the cholesterol in the body is manufactured in the liver. An important constituent of atheroma.
Chronic Disease: long-term illness or condition.
Circulatory Disease: Any disease affecting the heart or blood vessels.
CJD: Creutzfeldt-jakob Disease. The Human form of Bovine Spongiform Encephalopathy (mad cow disease).
Clinical Audit: A cyclical evaluation and measurement by healthcare professionals of clinical standards achieved.
Clinical Governance: NHS organisational framework accountable for ensuring and improving patient safety and high care standards. It can include personal and organisational development, patient partnership, dealing with poor staff performance, quality improvement systems, learning from experience and risk
Clinical Indicators: Statistics used to assess clinical care that may raise issues for further investigation.
Clinical Intervention: Any examination, procedure or therapy used to benefit patients.
Clinical: Of or for the treatment of patients.
Clinician: Someone who is medically trained to deal with patients, including doctors, dentists, nurses, midwives, health visitors, pharmacist, opticians, orthoptists, chiropodists, radiographers, physiotheropists, dieticians, occupational therapists, medical laboratory scientific officers, orthotists and prosthetists, speech and language therapists, and all other healthcare professionals.
CLPDG: Central Lancashire Pharmacy Development Group
CMHT: Community Mental Health Team
CNA: Carers’ National Association
Cochlear Implants: A surgical procedure where a mechanical device is implanted to restore hearing.
Colorectal: Affecting the lower bowel.
Commissioning: Identifying health needs of local people and planning and purchasing health services to respond to their needs.
Community Minimum Data Set (MDS): A developing information standard to record healthcare activity in the community.
Community Nurses: Includes practice nurses, district nurses, health visitors and school nurses.
Community Planning: A new duty under the Local Government Bill 2000, for all local authorities to prepare a community strategy and promote economic, social and environmental wellbeing.
Community Safety: A responsibility under the Crime and Disorder Act for local authorities to organise local partnerships to address issues around personal safety and crime.
Consultant: a senior doctor who specialises in a particular area of medicine.
Continuing Care: Health care provided over a long period of time for those with long-term needs.
CPA: Community Psychiatric Assessment/Care Programme Approach/Care Management, of individuals’ needs leading to appropriate care.
CPD: Continuing Professional Development
CPN: Community Psychiatric Nurse. A nurse who works in the community seeing patients with psychiatric problems, at home and in clinics.
CPPIH: Commission for Patient and Public Involvement in Health. This organisation is to assist PALs and Patients’ Forums to involve patients in making the NHS more responsive to their needs.
CPR: Cardio Pulmonary Resuscitation
CRES: Cost Reducing Efficiency Spending Programme
CSR: Comprehensive Spending Review
CSSD: Central Sterile Supplies Department
CTALD: Community Teams for Adults with Learning Disabilities. A team of staff from different backgrounds such as psychiatry, psychology and nursing, who provide specialist healthcare for learning disabled people.
CVD: Cardio Vascular Disease
CVS: Cardio Vascular System
Cystic Fibrosis: A disorder a person is usually born with, affecting the lungs.
DAARS: Drug & Alcohol Arrest Referral Team. A scheme employing specialist drug workers to assess offenders and refer them to treatment services if appropriate.
DAT: Drug Action Team
Data Accreditation Process: A systematic methodology developed in the NHS for conducting internal reviews of the quality of data management and data outputs against clear criteria, incorporating NHS standards and recognised good practice. The achievement of standards can then be compared by external audit.
Day Case: A surgical procedure not requiring over night hospital stay.
Deliberate Self-Harm: A way of releasing/relieving emotional pain, or a suicide attempt - which may be a cry for help, rather than a serious attempt at suicide.
Demographic: Statistics showing certain populations, e.g. it may refer to age, gender, health or a combination.
Dermatology: Refers to skin conditions and diseases.
Designated Doctor: A community paediatrician with expertise in child protection appointed by the health authority to sit on the ACPC to advise and co-ordinate child protection matters across agencies.
Designated Nurse: A community nurse with expertise in child protection appointed by the health authority to sit on the ACPC, to advise and co-ordinate nursing input, relating to child protection.
Determinants of Health: Life style and social factors contributing to the population’s health and well being, such as good quality housing, nutrition and education.
DETR: Department of Environment, Transport and the Regions
DfEE: Department for Education and Employment
DGH: District General Hospital
DH: Department of Health
Diabetes: A condition whereby the body’s control of sugar level in the blood and tissues is poor due to lack of sufficient insulin.
Dialysis: Artificial mechanical support for patients with kidney disease, which mimics the function of the kidneys.
Diana Community Nurses Team: A team of nurses, therapists and others providing care at home for children with life-threatening illnesses. Funded by the Diana Memorial Fund.
Direct Access: Where GP’s can make use of hospital based facilities, such as x-rays, physiotherapy, without reference.
Disability Registers: A register of all the people with a significant disability.
Disinvestment: The process of removing or reducing funds.
DPAS: Drug Prevention Advisory Service. Part of the Home Office Action Against Drugs Unit, it advises Government and local Drug Action Teams on good practice across all four themes of National Drug Strategy.
DPH: Director of Public Health
DRG: Drug Reference Group
DSPO: Dangerous Severe Personality Disorder
DTC: Diagnostic and Treatment Centre
DTTO: Drug Treatment and Testing Orders. Under the Crime and Disorder Act they enable courts to sentence individuals, with their consent, to an intensive treatment and rehabilitation programme.
Dual-diagnosis: Refers to people with more than one diagnosis, most commonly to people with mental illness and drug/alcohol problems, and also to people with both mental illness and learning disabilities.
Early Intervention Service: Within mental health, this refers to services offering prompt intervention to young people experiencing psychiatric illness to promote a good outcome.
EC: European Community
ECDL: European Computer Driving Licence
ECG: Electrocardiogram: A recording of the heart’s electrical activity obtained from electrodes positioned on the chest wall and limbs. An exercise (stress) ECG is taken before and during exercise (usually using a treadmill or stationary bicycle) to obtain objective and quantitative recording of myocardial ischaemia on exertion.
Echocardiogram: An image and measurement of the heart obtained using ultrasound.
ECR: Extra Contractual Referral – now OAT
EDT: Education, Training and Development
Effectiveness: The extent to which a treatment, procedure or service works.
EFL: External Financing Limit
EHR: Electronic Health Records. Longitudinal records of patients’ health and healthcare throughout life.
EL: Executive Letter (NHS Executive)
Elective: Planned care and treatment.
Eligibility Criteria: The requirements a person needs to meet to receive treatment/service.
Embolism: The migration through the bloodstream of a blood clot from one part of the body to another where is causes an blockage
Emergency Activity: Difficulties faced by the NHS Trusts in accommodating increasing numbers of patients requiring emergency hospital admission.
EMI: Elderly Mentally-Ill Patients
ENT: Ear, Nose and Throat
Epidemiology: The study of diseases in the population.
EPR: Electronic Patient Records. Records containing patients’ personal details (name, date of birth, etc), their diagnosis of condition, and details about the treatment/assessments undertaken, clinician etc. Typically covers the episodic care provided mainly by one institution.
EQUIP: Enabling Quality in Practice
ERG: External Reference Group
ESF: European Social Fund. A major fund to which all the partner states in the European Union contribute, against which bids can be made for a wide range of projects to tackle deprivation and social problems.
Evidenced-Based Practice/Medicine: Concerns the development of clinical practice guidelines, which are based on a thorough review of all available research.
FACS: Fair Access to Care Services
FBC: Full or Final Business Case
FCE: Finished Consultant Episode
Femur: The thigh bones. Statistics for ‘broken neck or femur’ relate to hip replacements.
FHSA: Family Health Services Authority
Fit for purpose: Suitable
Forensic Services: Specialist health services for offenders with mental health problems.
Formulary: A directory providing information on drugs available for treating illness and disease.
Four-Tier Model: A system developed in CAMH services based on four tiers of provision from level 1 at primary care level to level 4 covering highly specialised regional services.
GDP: General Dental Practitioner
GDS: General Dental Service
Generic: Not specific.
GIDA: Government Intervention in Deprived Areas
GMC: General Medical Council
GMS: General Medical Services. Services provided by GPs and their staff. Also GPs main source of payment.
GP: General Practitioner. A doctor who, often with colleagues in partnership, works from a local surgery providing medical advice and treatment to patients who are registered with them, usually supported by practice nurses. GPs are not usually employed by the NHS, but provide services to patients through a contract with the Health Service.
GPwSI (pronounced “gypsy”): General Practitioner with Special Interests
Gynaecology: Clinical speciality concerned with women’s diseases and illnesses, particularly those of the reproductive system.
H&SC Act: Health and Social Care Act
HA: Health Authority. Abolished in April 2002, their functions handed to PCTs.
HAS: Health Advisory Service
HAZ: Health Action Zone. These represent a partnership between the NHS, local authorities, community groups and the voluntary sector, to pioneer new approaches in rejuvenating services, responding to social exclusion, addressing health inequalities and to develop services that are more responsive.
HBG: Health Benefit Groups. A method of linking health needs with service delivery and expected health benefit to assist in health needs assessment and planning service delivery.
HC: Health Circular (Department of Health)
HCHS: Hospital and Community Health Services
HDA: Health Development Agency
HDL: High Density Lipoprotein: A complex of fat and protein that may serve to remove cholesterol from the tissues. Sometimes described as a “good” form of cholesterol
HEA: Health Education Authority
Health Gain: The improvement in the populations’ health status. Health Improvement Programme: An action programme to improve health and healthcare locally, led by the Health Authority. It will involve NHS Trusts, Primary Care Groups and other primary care professionals, working in partnership with the local authority and engaging in other local interests.
Health Inequalities: Poorer health experience is referred to as ‘health inequalities’. They are a shared problem for people in local government and the NHS. They arise because some people are more likely to become ill and /or less likely to have access to health services. They exist between different age groups, genders, ethnic groups, social classes etc. The Aim is for everyone to have the opportunity to attain high levels of health and not to be disadvantaged.
Health Informatics: The effective use of information management and information and communications technology for recording and sharing information, and decision making to improve the planning and delivery of healthcare. Health informatics is the theory and practice of using information responsibly in the context of healthcare.
Health Promotion: Giving communities the resources and information they need to make informed choices about their health, such as measures to help people stop smoking.
Healthy Living Centres: Community-based initiatives providing additional health improvement, such as exercise classes.
Heart Failure: A condition in which the pumping action of the heart is inadequate. It can result in the accumulation of fluid in the body and/or congestion of the lungs.
Hepatitis B: A virus causing infection of and damage to the liver, which is potentially infectious to others.
HES: Hospital Eye Services
HFA: Health For All (world organisation)
HIA: Health Impact Assessment. A combination of procedures, methods and tools by which a policy, programme or project may be judged as to its potential effects on the health of a population and the distribution of those effects within the population.