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Welfare Reform on the Web (January 2008): National Health Service - primary and community care

Can they do the double?

J. Taylor

Health Service Journal, vol. 117, Dec. 6th 2007, p. 24-26

Chris Bull has been appointed chief executive of Herefordshire public service trust - the countryís first partnership between a primary care trust and a county council. The organisations will, however, remain distinct legal entities. One of Mr Bullís first tasks is to look at the management structure.

Community matrons: a conduit for integrated working?

H. Lyndon

Journal of Integrated Care, vol. 15, Dec. 2007, p. 6-13

The Cornwall health and social care community has sought to improve the management of patients with long-term conditions through the use of community matrons who actively case manage the most vulnerable patients at risk of repeated emergency hospital admission. Community matrons work collaboratively with the patientís GP and other members of the health and social care team in the identification, assessment, planning and delivery of services to patients with chronic illnesses. This article demonstrates the effectiveness of the service in terms of savings for the health and social care community, and presents a case study to show how integrated working can be used to facilitate improved outcomes for patients.

A funding model for health visiting (part 2): impact and implementation

S. Cowley

Community Practitioner, vol. 80, Dec. 2007, p. 24-31

This is the second of two papers prepared to assist in planning and commissioning generic health visiting services. The first paper gave the basic requirements, while this one identifies and explains the separate components of the service, along with issues of scope and skill mix. The funding model aims to allow a service that succeeds mainly through universal prevention, using this as a mechanism for identifying health needs that require additional support, and which simultaneously meets those needs.

Itís time to manage great expectations

J. Allen

Health Service Journal, vol.117, Dec. 13th 2007, p. 20-21

Public expectations of the NHS are rising constantly, and there is little understanding or acceptance of the need to ration finite resources. The situation is made worse by national politicians intervening to overturn local rationing decisions in response to public and media pressure. The author proposes that, in order to increase local accountability for decision-making, primary care trusts should develop as mutually owned organisations. Local people could become trust members and sit on a governing board. This approach should increase community involvement in NHS decision-making at the local level and stave off inappropriate central control and intervention.

Making change happen in land that time forgot

C. Harris

Community Practitioner, vol. 80, Dec. 2007, p. 21-22

Report of an interview with James Quinn, managing director of Meridian Productivity, on their work in analysing staff activity and time utilisation in NHS trusts. The aim is to give frontline managers the tools assess patient need, to create teams of the right size, and to assign tasks to the most appropriate people with the most appropriate skill mix. The result should be more efficient use of staff time, and a maximisation of the time that professionals spend in direct contact with patients.

Standards for CNNs


Community Practitioner, vol. 80, Dec. 2007, p. 16-17

Summarises new professional guidelines for community nursery nurses working in primary care and community settings, covering educational standards, professional development, clinical governance, confidentiality and supervision.

Ticking boxes and changing the social world: data collection and the new UK General Practice contract

K. Checkland, R. McDonald and S. Harrison

Social Policy and Administration, Vol. 41, 2007, p. 693-710

The new General Medical Services contract introduced in the NHS in 2004 links the earnings of general practice to performance to a far greater extent than before. Accurate and retrievable medical records are necessary to maximise practice income as well as to enable good patient care. As a result electronic data collection has become an increasingly important fact of life in general practice. This article reports findings from an ethnographic study of the effects of the demands of the new contract for complete and accurate data collection. The use of electronic medical records in the context of government targets has generated pressure on practices to move away from a model that treats patients as individuals towards one that privileges hard biomedical information that can be easily recorded on a computer. Routine care was delegated to staff with less training and the need to collect data led to the introduction of systems that reduced patient choice in such matters as whether or when to attend the practice.

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