Enforceability of leasehold covenants and the landlord and tenant (Covenants) Act 1995

Describes the impact of the English Landlord and Tenant (Covenants) Act 1995, reforming liability in the context of new leases, extending the 'touching and concerning' requirement so all covenants 'run with the land' (with some exceptions), and abolishing the enduring liability of the original tenants and landlords. Explains that landlords will have more freedom to prescribe in advance the circumstances in which they consent to an assignment, referring also to changes in default notices requiring an 'early warning' to defaulters, and overriding leases, with a remedy for former tenants. Expects future leases to be shorter as landlords realize they cannot hold original tenants liable any more.

Patient anxiety and experiences associated with an outpatient "one-stop" "see and treat" hysteroscopy clinic

BACKGROUND: "One-stop" outpatient hysteroscopy clinics have become well established for the investigation and treatment of women with abnormal uterine bleeding. However, the advantages of these clinics may be offset by patient factors such as anxiety, pain, and dissatisfaction. This study aimed to establish patients' views and experiences of outpatient service delivery in the context of a one-stop diagnostic and therapeutic hysteroscopy clinic, to determine the amount of anxiety experienced by these women and compare this with other settings, and to determine any predictors for patient preferences. METHODS: The 20-item State-Trait Anxiety Inventory was given to 240 women attending a one-stop hysteroscopy clinic: to 73 consecutive women before their appointment in a general gynecology clinic and to 36 consecutive women attending a chronic pelvic pain clinic. The results were compared with published data for the normal female population, for women awaiting major surgery, and for women awaiting a colposcopy clinic appointment. In addition, a questionnaire designed to ascertain patients' views and experiences was used. Logistic regression analysis was used to delineate the predictive values of diagnostic or therapeutic hysteroscopy, and to determine their effect on the preference of patients to have the procedure performed under general anesthesia in the future. RESULTS: Women attending the hysteroscopy clinic in this study reported significantly higher levels of anxiety than those attending the general gynecology clinic (median, 45 vs 39; p = 0.004), but the levels of anxiety were comparable with those of women attending the chronic pelvic pain clinic (median, 45 vs 46; p = 0.8). As compared with the data from the normal female population (mean, 35.7) and those reported for women awaiting major surgery (mean, 41.2), the levels of anxiety experienced before outpatient hysteroscopy clinic treatment were found to be higher (mean, 45.7). Only women awaiting colposcopy (6-item mean score, 51.1 +/- 13.3) experienced significantly higher anxiety scores than the women awaiting outpatient hysteroscopy (6-item mean score, 47.3 +/- 13.9; p = 0.002). Despite their anxiety, most women are satisfied with the outpatient hysteroscopy "see and treat" service. High levels of anxiety, particularly concerning pain but not operative intervention, were significant predictors of patients desiring a future procedure to be performed under general anesthesia. CONCLUSIONS: Outpatient hysteroscopy is associated with significant anxiety, which increases the likelihood of intolerance for the outpatient procedure. However, among those undergoing operative therapeutic procedures, dissatisfaction was not associated with the outpatient setting.

Enterprise and Regulatory Reform Act 2013

This factsheet was last updated in August 2013. Background to the Act The Enterprise and Regulatory Reform Bill was introduced to Parliament in May 2012 and, following various amendments, received Royal Assent on 25 April 2013. In early June 2013, the Government issued an indicative timetable of commencement dates for the various sections of the Act. While some of the changes have come into force or had definite implementation dates announced, for other there is no definite date. The Act is broad ranging. Although this factsheet focuses specifically on employment related issues it is important to note that the Act also makes other provisions: Login or register for a free account to continue reading this factsheet and to learn about: •Background to the Act •Employment provisions of the Act •Action points for employers •CIPD viewpoint •Useful contacts •References •Further reading

Orally active antitumour agents, patient compliance and clinical trails

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Impacts of flood hazards on small and medium companies:strategies for property level protection and business continuity

Worldwide floods have become one of the costliest weather-related hazards, causing large-scale human, economic, and environmental damage during the recent past. Recent years have seen a large number of such flood events around the globe, with Europe and the United Kingdom being no exception. Currently, about one in six properties in England is at risk of flooding (EA, 2009), and the risk is expected to further increase in the future (Evans et al., 2004). Although public spending on community-level flood protection has increased and some properties are protected by such protection schemes, many properties at risk of flooding may still be left without adequate protection. As far as businesses are concerned, this has led to an increased need for implementing strategies for property-level flood protection and business continuity, in order to improve their capacity to survive a flood hazard. Small and medium-sized enterprises (SMEs) constitute a significant portion of the UK business community. In the United Kingdom, more than 99% of private sector enterprises fall within the category of SMEs (BERR, 2008). They account for more than half of employment creation (59%) and turnover generation (52%) (BERR, 2008), and are thus considered the backbone of the UK economy. However, they are often affected disproportionately by natural hazards when compared with their larger counterparts (Tierney and Dahlhamer, 1996; Webb, Tierney, and Dahlhamer, 2000; Alesch et al., 2001) due to their increased vulnerability. Previous research reveals that small businesses are not adequately prepared to cope with the risk of natural hazards and to recover following such events (Tierney and Dahlhamer, 1996; Alesch et al., 2001; Yoshida and Deyle, 2005; Crichton, 2006; Dlugolecki, 2008). For instance, 90% of small businesses do not have adequate insurance coverage for their property (AXA Insurance UK, 2008) and only about 30% have a business continuity plan (Woodman, 2008). Not being adequately protected by community-level flood protection measures as well as property- and business-level protection measures threatens the survival of SMEs, especially those located in flood risk areas. This chapter discusses the potential effects of flood hazards on SMEs and the coping strategies that the SMEs can undertake to ensure the continuity of their business activities amid flood events. It contextualizes this discussion within a survey conducted under the Engineering and Physical Sciences Research Council (EPSRC) funded research project entitled “Community Resilience to Extreme Weather — CREW”.

Logics of marginalisation in health and social care reform:integration, choice, and provider-blind provision

The period 2010–2013 was a time of far-reaching structural reforms of the National Health Service in England. Of particular interest in this paper is the way in which radical critiques of the reform process were marginalised by pragmatic concerns about how to maintain the market-competition thrust of the reforms while avoiding potential fragmentation. We draw on the Essex school of political discourse theory and develop a ‘nodal’ analytical framework to argue that widespread and repeated appeals to a narrative of choice-based integrated care served to take the fragmentation ‘sting’ out of radical critiques of the pro-competition reform process. This served to marginalise alternative visions of health and social care, and to pre-empt the contestation of a key norm in the provision of health care that is closely associated with the notions of ‘any willing provider’ and ‘any qualified provider’: provider-blind provision.