Downsizing of acute inpatient beds associated with private finance initiative: Scotland's case study

OBJECTIVES: To evaluate whether the projected 24% reduction in acute bed numbers in Lothian hospitals, which formed part of the private finance initiative (PFI) plans for the replacement Royal Infirmary of Edinburgh, is being compensated for by improvements in efficiency and greater use of community facilities, and to ascertain whether there is an independent PFI effect by comparing clinical activity and performance in acute specialties in Lothian hospitals with other NHS hospitals in Scotland. DESIGN: Comparison of projected and actual trends in acute bed capacity and inpatient and day case admissions in the first five years (1995-6 to 2000-1) of Lothian Health Board's integrated healthcare plan. Population study of trends in bed rate, hospital activity, length of stay, and throughput in Lothian hospitals compared with the rest of Scotland from 1990-1 to 2000-1. MAIN OUTCOME MEASURES: Staffed bed rates, admission rates, mean lengths of stay, occupancy, and throughput in four adult acute specialty groups in 1990-1, 1995-6, and 2000-1. RESULTS: By 2000-1, rates for inpatient admission in all acute, medical, surgical, and intensive therapy specialties in Lothian hospitals were respectively 20%, 6%, 28%, and 38% below those in the rest of Scotland. Day case rates in all acute and acute surgical specialties were 13% and 33% lower. The proportion of delayed discharges in staffed acute and post-acute NHS beds in Lothian hospitals exceeded the Scottish average (15% and 12% respectively; P<0.001). CONCLUSION: The planning targets and increase in clinical activity in acute specialties in Lothian hospitals associated with PFI had not been achieved by 2000-1. The effect on clinical activity has been a steeper decline in the number of acute beds and rates of admission in Lothian hospitals compared with the rest of Scotland between 1995-6 and 2000-1

Tomographically reconstructed master equations for any open quantum dynamics

Memory effects in open quantum dynamics are often incorporated in the equation of motion through a superoperator known as the memory kernel, which encodes how past states affect future dynamics. However, the usual prescription for determining the memory kernel requires information about the underlying system-environment dynamics. Here, by deriving the transfer tensor method from first principles, we show how a memory kernel master equation, for any quantum process, can be entirely expressed in terms of a family of completely positive dynamical maps. These can be reconstructed through quantum process tomography on the system alone, either experimentally or numerically, and the resulting equation of motion is equivalent to a generalised Nakajima-Zwanzig equation. For experimental settings, we give a full prescription for the reconstruction procedure, rendering the memory kernel operational. When simulation of an open system is the goal, we show how our procedure yields a considerable advantage for numerically calculating dynamics, even when the system is arbitrarily periodically (or transiently) driven or initially correlated with its environment. Namely, we show that the long time dynamics can be efficiently obtained from a set of reconstructed maps over a much shorter time.Comment: 10+4 pages, 5 figure

Dismantling the signposts to public health? NHS data under the Health and Social Care Act 2012

The Health and Social Care Act 2012 will replace the administrative structure of the NHS in England, currently based on the resident populations of defined geographical areas, with one that relates instead to the shifting populations of individuals registered with specific general practices at given points in time.1 This will radically change the longstanding basis for collecting data routinely about the health needs of local populations, making it difficult to monitor the effect of new legislation on the health of the population locally or nationally.2 3 We discuss some of the implications of the act for existing routine data systems and the production of routine statistics that underpin essential NHS functions, including monitoring healthcare provision and ensuring equity of access, allocation of resources, and measurement of outcomes

An introduction to operational quantum dynamics

In the summer of 2016, physicists gathered in Torun, Poland for the 48th annual Symposium on Mathematical Physics. This Symposium was special; it celebrated the 40th anniversary of the discovery of the Gorini-Kossakowski-Sudarshan-Lindblad master equation, which is widely used in quantum physics and quantum chemistry. This article forms part of a Special Volume of the journal Open Systems & Information Dynamics arising from that conference; and it aims to celebrate a related discovery -- also by Sudarshan -- that of Quantum Maps (which had their 55th anniversary in the same year). Nowadays, much like the master equation, quantum maps are ubiquitous in physics and chemistry. Their importance in quantum information and related fields cannot be overstated. In this manuscript, we motivate quantum maps from a tomographic perspective, and derive their well-known representations. We then dive into the murky world beyond these maps, where recent research has yielded their generalisation to non-Markovian quantum processes.Comment: Submitted to Special OSID volume "40 years of GKLS

Non-Markovian memory in IBMQX4

We measure and quantify non-Markovian effects in IBM's Quantum Experience. Specifically, we analyze the temporal correlations in a sequence of gates by characterizing the performance of a gate conditioned on the gate that preceded it. With this method, we estimate (i) the size of fluctuations in the performance of a gate, i.e., errors due to non-Markovianity; (ii) the length of the memory; and (iii) the total size of the memory. Our results strongly indicate the presence of non-trivial non-Markovian effects in almost all gates in the universal set. However, based on our findings, we discuss the potential for cleaner computation by adequately accounting the non-Markovian nature of the machine.Comment: 8 page

Tight, robust, and feasible quantum speed limits for open dynamics

Starting from a geometric perspective, we derive a quantum speed limit for arbitrary open quantum evolution, which could be Markovian or non-Markovian, providing a fundamental bound on the time taken for the most general quantum dynamics. Our methods rely on measuring angles and distances between (mixed) states represented as generalized Bloch vectors. We study the properties of our bound and present its form for closed and open evolution, with the latter in both Lindblad form and in terms of a memory kernel. Our speed limit is provably robust under composition and mixing, features that largely improve the effectiveness of quantum speed limits for open evolution of mixed states. We also demonstrate that our bound is easier to compute and measure than other quantum speed limits for open evolution, and that it is tighter than the previous bounds for almost all open processes. Finally, we discuss the usefulness of quantum speed limits and their impact in current research.Comment: Main: 11 pages, 3 figures. Appendix: 2 pages, 1 figur