The following is a glossary of terms used to describe different kinds of hospital, departments and treatments.
See also our Jargon buster for terms used on this website and in the Healthier Together programme
A&E – An accident and emergency department is open 24 hours a day, seven days a week. It provides acute care for patients who arrive without prior appointment either by their own means or by ambulance and who have medical or surgical conditions that are likely to need hospital admission.
Acute Care – Urgent short term treatment - usually in a hospital - for patients with a new injury or illness or for patients with an existing condition that is worsening.
Acute Trust – NHS acute trusts manage hospitals. Some are regional or national centres for particular specialisms. Others are attached to universities and help to train clinicians. Some may also provide community services. There are five acute trusts in the South East Midlands – Bedford Hospital NHS Trust, Kettering General Hospital NHS Foundation Trust, Luton & Dunstable Hospital NHS Foundation Trust, Milton Keynes NHS Foundation Trust and Northampton General Hospital NHS Trust.
Antenatal Care – Care of women during pregnancy up to their going into labour by professionals in order to detect, predict, prevent and manage problems with the women or their unborn babies. This care also includes education, advice and support.
Audit – originally applied to assessment of the accuracy and probity of financial accounting. A clinical audit covers the assessment of treatment processes to ensure they are of the best possible standard.
Birth Centres – Small maternity units, staffed and in most cases run by midwives. They offer a homely rather than a clinical environment. They are good at supporting women who want a birth with no or few medical interventions. Birth centres tend to follow the same rules about care during labour and birth as hospital maternity units.
Benchmarking – comparison of practice or performance with that of others, with the purpose of identifying and emulating best practice.
Birthrate Plus – is a framework for workforce planning and strategic decision making in maternity services.
Black and Minority Ethnic (BME) – People from black and minority ethnic backgrounds – a group identified as vulnerable in health terms. Local health improvement programmes may include strategies to deal with the health needs of minority ethnic groups.
Bundle – A combination of relevant care services for a patient. For example, a bundle for a patient with diabetes may include podiatry, dietetics, diabetes nursing and ophthalmology.
CAMHS – Child and Adolescent Mental Health Services – these care for children and adolescents usually until school-leaving age.
The services include:
Cardiothoracic – the field of medicine involved in treatment of diseases affecting organs inside the thorax (chest) - usually surgical treatment of heart disease and 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 in a community setting. This could be a patient’s home or community health centre.
Care Quality Commission (CQC) – this is an organisation funded by the Government to check all hospitals, GP surgeries, care homes and other facilities in England to make sure they are meeting government standards and to share their findings with the public.
Clinical audit – evaluation and measurement by health professionals of how far they are meeting standards that have been set for their service. Standards may be set by health professionals themselves or others. (See Audit above)
Clinical Commissioning Group (CCG) – these are the health commissioning organisations replacing 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 become responsible for commissioning healthcare services in both community and hospital settings from April 2013 onwards. There are five CCGs in the South East Midlands – Nene, Corby, Milton Keynes, Bedford and Luton.
Clinical governance – a “framework through which NHS organisations are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will flourish”
Clinical pathway – a clinical pathway is a template or blueprint for a plan of care. It is a guide to best practice treatment patterns, but does not compromise the need for clinical judgement in meeting an individual’s needs.
Clinical protocol – the detailed outline of the steps to be followed in the treatment of a patient with a particular condition.
Clinical Working Group (CWG) – a group that provides a multi-disciplinary clinical forum to review evidence and best practice and to make recommendations for future delivery of health services. There are six clinical working groups in the Healthier Together programme covering cancer, long term conditions, maternity, children, planned care and emergency care.
Community Hospitals – these hospitals are typically small providing non-emergency services close to home. In some cases, the services include in-patient care.
Community services – wide range of non-emergency services provided closer to home at community facilities including local health centres and GP practices. Some may be provided by social care services.
Complex elective medicine or surgery – a planned operation or medical care where the patient may need to be in a critical care unit – either because the operation is complex or because they have other health problems. This includes some surgery for cancer and treatment of many heart conditions.
COPD – chronic obstructive pulmonary disease. COPD is a lung disease that causes difficulty and/or discomfort in breathing (including asthma and chronic bronchitis).
Critical care unit (CCU) – generic term for a unit covering both intensive care and high dependency care.
Deliberative event – an event where participants are selected to consider relevant information, discuss the issues and options relating to that information and develop their thinking before making a decision. The NHS often uses deliberative events to gain public, staff and stakeholder views on important issues.
District General Hospital – typically the major health care facility in its locality with services including maternity, A&E, acute medicine, surgery and a range of outpatients care. It may also provide some specialist facilities for care such as plastic surgery or specialist surgery but does not cover all specialist services.
Elective Hospital – this is where patients go if they need an operation or treatment which is not an emergency and so can be planned. (Also see Planned Care Centre)
Elective Surgery – elective surgery or an elective procedure is surgery that can be planned in advance because it does not involve a medical emergency. Semi-elective surgery is surgery that must be done more quickly but does not need to be performed immediately.
Emergency care – treatment for medical and surgical emergencies that may 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 must be performed without delay. The patient has no choice other than immediate surgery if they do not want to risk permanent disability or death.
Engagement – engagement is a measureable degree of a stakeholder or patient’s positive or negative involvement the NHS, which influences their willingness to take part in NHS issues.
Equality Impact Assessment (EqIA) – EqIAs provide an evidence-based assessment of the likely impact of service changes on priority groups and are a statutory requirement.
Evidence based practice – practices and disciplines in clinical fields based upon the best available evidence of what works. Practices should include asking the most apposite question for a particular patient, searching for evidence to answer the question, critically appraising the evidence to make sure that it applies to the patient in question, applying it and auditing success.
European Working Time Directive (EWTD) – implemented in August 2009, this legislation limits doctors in training to a maximum 48 hour working week calculated by average working hours over a six months period.
Forceps delivery – delivery of a baby using specially designed instruments which cradle the baby’s head during the birth.
Foundation trusts – NHS foundation trusts (FTs) are not-for-profit corporations. They are part of the NHS yet have greater freedom to decide their own plans and the way local services are run. Foundation trusts have members and a council of governors. The Government’s aim is that, all NHS trusts will be FTs by December 2014. Currently there are three foundation trusts in the South East Midlands - Luton & Dunstable, Kettering and Milton Keynes.
GP network or cluster – a smaller group of GPs working within a CCG area (see CCG)
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 by April 2013.
Health Impact Assessment – an HIA is a process that ensures decision making at all levels considers the potential, or actual, impacts of decisions on health and health inequalities. It identifies actions that can enhance positive effects and reduce or eliminate negative effects.
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 to 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 Care Quality Commission (see above).
High Dependency Unit (HDU) – HDUs are wards for people who need more intensive observation, treatment and nursing care than is possible in a general ward but slightly less than that given in intensive care. The ratio of nurses to patients may be slightly lower than in intensive care but higher than in most general wards. HDUs treat conditions that need intensive nursing support, such as people who are ill with pneumonia or who have had major surgery.
Hub – a setting for care outside hospital where patients are brought together for treatment also serving as a base for 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.
Hyper-acute stroke unit (HASU) – hospital wards that specialise in treating people who are having a stroke. A dedicated unit that gives all stroke patients access to the most up-to-date treatments and latest research breakthroughs during the first 72 hours after a stroke: swift action can reduce levels of disability and, in some cases, may even eradicate symptoms completely.
Induction of labour – the process of artificially bringing on labour using drugs or surgical interventions with a view to achieving vaginal delivery.
Instrumental delivery – vaginal delivery of a baby using forceps or vacuum extraction.
Interdependencies – where some clinical services need other clinical services to be based on the same site for particular types of care to be successfully and safely delivered
Intensive Care Units (ICUs) – cater for patients with the most serious injuries and illnesses, most of which are life-threatening and need constant, close monitoring and support from specialist equipment and medication in order to maintain normal bodily functions. They are staffed by highly trained doctors and critical care nurses who specialise in caring for the most severely ill patients.
Patients may be transferred to an Intensive Care Unit from a ward if they require constant monitoring or immediately after surgery if the patient is at risk of complications.
Interventional radiology (IR) – interventional radiology uses X-rays and scans to diagnose and treat patients without recourse to surgery.
Key Performance Indicator (KPI) – targets agreed between health service providers and health service commissioners against which performance can be tracked.
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. In 2013, they will be replaced by HealthWatch (see above).
Midwifery – the profession which leads on normal pregnancy and birth and provides expert care to mother and baby during pregnancy, childbirth and the postnatal period within a family centred environment.
Midwife-led Unit (MLU) – these are units run by midwives that can either be run alongside a main hospital maternity unit or completely separate from hospital (freestanding). MLUs are ideal for handling births with no complications. Women facing complications may be advised to give birth at a consultant-led maternity unit.
Minor Injuries Unit (MIU) – these are walk-in units that can treat:
Nurses usually lead MIUs and an appointment is not necessary.
Multidisciplinary team – a group of people from different disciplines (both healthcare and non-healthcare) who work together to provide care for patients with a particular condition. The composition of multidisciplinary teams will vary according to many factors, these can include the specific condition; the scale of the service being provided; and geographical / socio-economic factors in the local area.
National Institute for Health and Clinical Excellence (NICE) – a special health authority producing guidance for the NHS and patients on medicines, medical equipment and clinical procedures.
National Service Framework (NSF) – guidelines for the health service on how to manage and treat specific types of disease and illness.
Neo Natal Unit (NNU) – a unit of a hospital that provides care and treatment of new-born babies who are too sick to be cared for by their mothers.
Networked A&E – these partner with an A&E department from a neighbouring hospital. The hospitals work along joint clinical protocols. Staff – including emergency specialist nurses and consultants – rotate between sites.
It is estimated that networked A&Es are able to deal with at least 80 per cent of patients coming through their door. Only the most serious emergency cases would need to go to an A&E department for treatment.
Networked A&Es are staffed by specialist nurses trained in emergency care and GPs who have undertaken additional emergency care training. They are supported by specialist consultants on site for some of the time and available for telephone advice all of the time.
Nurse Practitioner (NP) – an Advanced Practice Registered Nurse who has completed graduate-level education (either a Master of Nursing or Doctor of Nursing Practice degree). Nurse Practitioners treat both physical and mental conditions independently including prescription of select medications.
NPs can serve as a patient's primary health care provider, and see patients of all ages depending on their specialty (family, pediatrics, care for the elderly etc.) or may work in hospitals.
Obstetrics – the medical speciality dealing with the care of pregnant women and their babies during pregnancy, childbirth and the postnatal period.
Obstetrician – a doctor specialising in pregnancy and childbirth.
Overview and Scrutiny Committee (OSC), Health Overview and Scrutiny Committee (HOSC) and Joint Health Overview and Scrutiny Committee (JHOSC) – the committee of the relevant local authority, of group of local authorities, made up of local councillors who are responsible for monitoring, and if necessary challenging, programmes such as Healthier Together. Parts of the consultation – including the timing of the consultation period – have to be agreed by them.
Paediatrician – a doctor who specialises in medicine specifically related to children normally up to age 16.
Patient and public advisory group (PPAG) – representsthe interests of patients and the public in the Healthier Together programme. Members include representatives of local LINks, hospital patient groups, voluntary organisation representatives and carers.
Planned Care Centre – a centre for elective surgery kept separate from emergency surgery where specialist teams deliver procedures on a frequent basis, increasing their expertise and improving their performance. Additional patient benefits include a decrease in cancelled appointments.
Primary percutaneous coronary intervention (PPCI) – more commonly known as coronary angioplasty or angioplasty – this is a technique for inserting a balloon to open a narrowing or blocked blood vessel. PPCI is usually performed by an interventional cardiologist.
POSCU – Paediatric Oncology Shared Care Unit – this type of unit provides most of the care for children and young people who have been diagnosed with cancer.
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 each pound spent is used to bring maximum benefit and quality of care to patients.
Referral – the process whereby a patient is transferred from one professional to another, usually for specialist advice and/or treatment.
RSCN – Registered Sick Children’s Nurse
Resuscitation – cardio pulmonary resuscitation is a life-saving procedure that is performed when a person’s breathing or heartbeat has stopped.
Royal colleges – the Royal colleges are professional organisations for doctors, nurses and allied health professionals. In general, they have a vision of improving, maintaining and promoting standards of care within the specialist area which they cover. They work jointly to develop policy on some issues and work closely with other organisations and associations that have similar objectives. They promote education and research in their respective field.
The list of royal colleges who evidence and information has been used in the development of the the reports from the clinical working groups of the Healthier Together programme, is as follows:
Safeguarding Children and vulnerable adults – the process of protecting children and vulnerable adults from abuse or neglect, preventing impairment of their health and development, ensuring that children are growing up in circumstances consistent with the provision of safe and effective care that enables children to have the best chances in life and enter adulthood successfully.
Secondary care – specialist health care usually provided in hospital after a referral from a GP or other health professional.
Short-Stay Paediatric Assessment Unit (SSPAU) also Short-Stay Assessment Unit (SSAU) – a facility within which children with acute illnesses, injuries or other urgent referrals (from GPs, community nursing teams, walk-in centres, NHS Direct and emergency departments) can be assessed, investigated, observed for a short period of time and treated without recourse to in-patient areas. May be co-located with A&E.
South East Midlands – the area covered by the Healthier Together review of services. It includes the counties of Bedfordshire and Northamptonshire with Luton and Milton Keynes.
Special Care Baby Unit (SCBU) – an intensive care hospital unit specialising in the treatment of ill or premature new-born infants.
Treatment Centre – providing routine diagnostic and surgery procedures to day cases and short-stay patients. Patients benefit because there is a much reduced risk of appointments being cancelled and because the surgical teams treating them improve their performance by performing the same procedures regularly.
UCC – Urgent Care Centre – Urgent care centres provide treatment to patients who need immediate care but who are not serious enough to need a visit to A&E. The services they offer can vary from area to area but include treatment for infections, allergic reactions and rashes; minor cuts, bruises and burns; vomiting and diarrhoea; insect and animal bites; emergency contraception and advice.
Vascular surgery – A speciality of surgery in which diseases of the blood system are managed by medical therapy, minimally-invasive catheter (flexible tube insertion) procedures and surgery.
Ventouse delivery – delivery of a baby using a vacuum extractor or a suction cup. It consists of a round cup which is placed on the baby’s head and a handle which is held by the person doing the delivery.
Walk in Centres – offer convenient access to a range of treatments for minor illnesses and injuries without prior appointment. They are usually led by GPs supplying a range of treatments for conditions including, for example infections, allergic reactions and rashes; minor burns, cuts and bruises; vomiting and diarrhoea; insect and animal bites.
No hospitals will close. Northampton, Kettering, Milton Keynes, Luton & Dunstable and Bedford will all continue to provide most local services
All five hospitals will have an A&E and maternity service
Our first priority is safe, sustainable, high quality services
Our recommendations will be based on clinical evidence and local need
No decisions without full public consultation
Healthier Together Programme Office
NHS Milton Keynes
Bletchley MK3 6RT
T. 01908 278735