Glossary of terms

A

A&E

Accident & Emergency is a service available 24 hours a day, seven days a week where people receive treatment for medical and surgical emergencies that are likely to need admission to hospital. This includes severe pneumonia, diabetic  coma, bleeding from the gut, complicated fractures that need surgery, and other serious illnesses.

Acute care

Acute care refers to short–term treatment, usually in a hospital, for patients with any kind of illness or injury.

Acute trust

NHS acute trusts manage hospitals.  Some are regional or national centres for specialist care, others are attached to universities and help to train health professionals.  Some acute trusts also provide community services.

Ambulatory care

Ambulatory care is a patient focused service where some conditions may be treated without the need for an overnight stay in hospital. You will receive the same medical treatment you would previously have received as an inpatient. The aim of this service is to provide you with the care required to treat your condition during scheduled ambulatory care opening hours. You will be able to return home and if further treatment is required you will be asked to return to the unit to receive this.

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B

Bundle

A combination of relevant ‘packages of care’ for a patient.  For example a bundle for a patient with diabetes could include podiatry, dietetics, diabetes nursing and ophthalmology.

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C

Cardiothoracic

The field of medicine involved in surgical treatment of diseases affecting organs inside the thorax (the chest)—generally treatment of conditions of the heart (heart disease) and lungs (lung disease).

Cardiovascular

This refers to the heart and blood vessels. Cardiovascular diseases affect the function of the cardiovascular system which carries nutrients and oxygen to the tissues of the body while removing carbon dioxide and other wastes from them.

Care outside hospital

Care that takes place outside of hospital, in a community setting. This could be a patient's home, community bed or community health centre.

CCG Clinical Commissioning Group

These are the health commissioning organisations which will replace primary care trusts (PCTs) in April 2013. CCGs are led by GPs and represent a group of GP practices in a certain area. They are currently shadowing the PCTs and will be responsible for commissioning healthcare services in both community and hospital settings from April 2013 onwards.

Centralise

A principle of the 'Shaping a healthier future' programme, which is about bringing more services together on a number of specific sites to create a greater level of expertise.

Complex elective medicine or surgery

A planned operation or medical care where the patient may need to be in a high-dependency unit while recovering from the operation, either because the operation is complex or because they have other health problems.

Complex elective surgery

Including cancer operations, operations for heart disease, bariatric surgery and hip replacements

Continuity of care

An integrated care project that has been launched in Hammersmith and Fulham. The project aims to improve outcomes for patients at minimal costs and reduce treatment of stays in hospital.

COPD

Chronic obstructive pulmonary disease. COPD is a lung disease which causes difficulty or discomfort in breathing.

Co-production

“Co-production means designing and delivering public services in an equal and reciprocal relationship between professionals, people using services, their families and their neighbour. Where activities are co-produced in this way, both services and neighbourhoods become far more                 effective agents of change." NESTA (2009) The Challenge of Co-production.

CQC - Care Quality Commission

This is an organisation funded by the Government to check all hospitals in England to make sure they are meeting government standards and to share their findings with the public.

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D

Deficit

When expenditure is greater than income.

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E

Elective Hospital

This is where patients go if they need an operation which is not urgent and so can be planned.

Emergency care

Treatment for medical and surgical emergencies that are likely to need admission to hospital. This includes severe pneumonia, diabetic  coma, bleeding from the gut, complicated fractures that need surgery, and other serious illnesses.

Emergency surgery

Surgery that is not planned and which is needed for urgent conditions.  This includes surgery for appendicitis, perforated or obstructed bowel and gallbladder infections.  It is also known as non-elective surgery. 

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F

Financial Surplus

When income is greater than spending.

Foundation trust

NHS foundation trusts are not-for-profit corporations.  They are part of the NHS yet they have greater freedom to decide their own plans and the way services are run.  Foundation trusts have members and a council of governors.  The aim is that eventually all NHS trusts will be FTs.

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G

GP network or cluster

A smaller group of GP practices within a borough or CCG area (see CCG above).

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H

Health and well-being board (HWB)

Part of the NHS restructure, the aim of these boards is to encourage joint working between the NHS and local authorities across health and social care. HWBs are expected to be up and running in April 2013.

Health Centre or 'hub'

A setting for care outside hospital which will be adapted from existing community sites to provide other services locally, serving as a support 'hub' to local  healthcare teams.  The services offered will vary depending on local needs and will range from bases for multidisciplinary teams to 'one-stop' centres for GP services, diagnostic and outpatient appointments.

HealthWatch

These are new organisations which will replace LINks (see below) as part of the restructure of the NHS.  Their role is to make sure patients are involved in developing and changing NHS services and provide support to local people.  There will be a national HealthWatch to oversee the local HealthWatch and provide advice as an independent part of the CQC (see above).

Heart attack centre

A centre which treats people who have had a heart attack.

High dependency unit

Treats conditions that need intensive nursing support, such as people who are ill with pneumonia or who have had major surgery.

Hyper-acute stroke unit (HASU)

Hospital wards that specialise in treating people who are having a stroke.

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I

Inpatient

A patient who is admitted to a hospital, usually for 24 hours for treatment or an operation.

Inpatient paediatrics

These units treat sick children who require a stay in hospital.

Integrate

A principle of this programme which refers to creating more co-ordinated care for the patient, making sure all parts of the NHS and social services work more closely and effectively together.

Integrated care pilot (ICP)

A joint venture led by commissioners and providers of primary, community, acute, social and mental health care for people aged 75 and over with diabetes.  The aim is to offer integrated care to improve the outcome for patients and reduce unnecessary stays in hospital.

Intensive care

These units provide support for patients after complex surgery, or patients needing multiple organ support such as ventilation and dialysis.

Interdependency

Where some clinical services need other clinical services to be based on the same site for particular types of care to be successfully and fully delivered together.

Interventional radiology

Uses minimally invasive image-guided procedures to diagnose and treat diseases in nearly every organ system.

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K

Key performance indicator (KPI)

Targets that are agreed between the provider and commissioner of each service, which performance can be tracked against.

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L

Level 3, as in level 3 intensive care unit

ICUs are sections within a hospital that look after patients whose conditions are life-threatening and need constant, close monitoring and support from equipment and medication to keep normal body functions going.  Level 3 ICU is for patients who need advanced respiratory support alone or basic respiratory support  with the support of at least two organ systems.  This level includes all patients with complex needs who need support for multi-organ failure.

LINks - local involvement networks

LINks are made up of individuals and community groups whose goal is to improve health and social care services.  They are funded by local councils, although they are independent of the Government. In 2012 they will be replaced by HealthWatch (see above).

Local hospital

A type of hospital proposed in the changes.  Local hospitals will include urgent care centres which provide the services that three-quarters of people go to hospital for - such as everyday illnesses, minor injuries and long-term conditions such as diabetes or asthma. You can find out more about local hospitals in our factsheet.

Localise

A principle of this programme which is to deliver as much care as possible in the most convenient locations making sure people have earlier and easier access to treatment.

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M

Major hospital

A type of hospital proposed in the changes. A major hospital will include full A&E, paediatrics and maternity services.

Maternal deaths

Death of a woman while pregnant or within 42 days of end of pregnancy, from any cause related to the pregnancy.

Maternity

Relating to pregnancy, childbirth and immediately following childbirth.

Multi-disciplinary group (MDG)

Sometimes referred to as a multidisciplinary team. These are groups of professionals from primary, community, social care and mental-health services who work together to plan a patient's care.

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N

Neonatal

Relating to newborn infants.

Non elective medicine

Treatment for illnesses that is not planned, including severe pneumonia, flare-ups of inflammatory bowel disease, severe asthma attacks and worsening of COPD, needing admission to hospital.

Non-complex elective surgery or medicine (or both)

This includes hernia repairs, knee replacements and planned gallbladder operations, usually as day cases.

Non-elective surgery

See emergency surgery.

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O

Obstetric

The care associated with giving birth.

Obstetrics and maternity unit

Where babies are delivered and women with complex pregnancies, such as expectant mothers with diabetes or heart disease or who are pregnant with triplets, are monitored.

Outpatient

A patient who attends an appointment to receive treatment without actually needing to be actually admitted to hospital unlike an inpatient.  Outpatient care can be provided by hospitals GPs and community providers and is often used to follow up after treatment or to assess for further treatment.

Outpatients and diagnostics

For people who need specialist advice or investigation in hospital.  This includes support for insulin-dependent diabetics or neurological conditions such as multiple sclerosis.  It also includes minor surgery, ECGs, x-rays, ultrasounds, CT and MRI scans.

Overview and Scrutiny Committee (OSC)/Health Overview and Scrutiny Committee (HOSC) and Joint Heath (JHOSC)

The committee of the relevant local authority, or group of local authorities, made up of local councillors who are responsible for monitoring, and if necessary challenging, programmes such as the 'Shaping a healthier future' programme.  Parts of consultation such as the length of a consultation period, have to be agreed by them.

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P

Package of care

A term used to describe a combination of services put together to meet a person's assessed healthcare needs.  It outlines the care, services and equipment a person needs to live their life in a dignified way.

Paediatric services

This refers to healthcare services for babies, children and adolescents

Patient and public advisory group (PPAG)

There is a London-wide PPAG as well as a PPAG in NW London.  Their role is to make sure the interests of patients and the public are represented in the NHS.  Members usually include representatives of local LINks, hospital patient groups, local clinical commissioning groups, the London PPAG and NHS staff.

Patient pathway or journey

This is the term used to describe the care a patient receives from start to finish of a set timescale, in different stages.  There can be integrated care pathways which include multi-disciplinary services for patient care (see MDG above).  

Primary care

Services which are the main or first point of contact for the patient, provided by GPs community providers and so on.

Primary care trust (PCT)

PCTs commission primary, community and secondary care from providers.  To be replaced by CCGs (see above) in April 2013.

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Q

Quality, innovation, productivity and prevention (QIPP)

The Department of Health QIPP agenda aims to achieve up to £20 billion of efficiency savings by 2015 by making sure that each pound spent is used to bring maximum benefit and quality of care to patients.

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S

Secondary Care

Hospital or specialist care that a patient is referred to by their GP or other primary care provider.

Specialist hospital

A hospital which provides specialist care for particular conditions for example cancer or lung disease.

Stroke

A stroke is the sudden death of brain cells in a particular area due to inadequate blood flow.

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T

Trauma, as in major trauma centre or trauma centre

These centres treat major trauma patients who have complex injuries - either one very serious injury or a number of injuries -which make managing these these patients very challenging.  They need expert care from a large number of different specialities to give them the best chance of survival and recovery.

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U

Urgent care centre (UCC)

A centre that is open 24 hours a day, seven days a week.  These centres will treat most illnesses and injuries that people have which are not likely to need treatment in a hospital.  This includes chest infections, asthma attacks, simple fractures, abdominal pain and infections of the ear, nose and throat.

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V

Value for money (VFM)

A term often used to demonstrate the quality of a healthcare service balanced against the cost of delivering that service.

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