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

Data shortfalls hinder efforts for world class strategy plans

H. Crump

Health Service Journal, July 17th 2008, p. 4-5

Primary care trust managers have warned that poor data is preventing them from making progress on world class commissioning. The PCT Network has warned that only a handful of trusts are likely to score above levels one or two out of four on most world class commissioning competencies in their initial assessment, due at the end of 2008.

Decision on cervical cancer vaccine is false economy, say health groups

S. Boseley

The Guardian, July 18th 2008, p. 15

Charities involved in sexual health are protesting against the government's decision to buy a cervical cancer drug which does not also protect against genital warts. A paper published in the British Medical Journal claims that the Department of Health's decision to use Cervarix for its mass vaccination of 12- to 13-year-old girls set to start in September 2008, was based on minimising costs instead of maximising health benefits.

Dental services

Health Committee

London: TSO, 2008 (House of Commons papers, session 2007/08; HC289)

The Committee's investigation into the impact of the new dental contract found that it had failed to improve services. Two years after its introduction in 2006, 900,000 fewer patients are being treated by an NHS dentist than under the old system. As a result of the changes, dentists no longer have any financial incentive to carry out complex treatments. In fact, the volume of complex work such as crowns, bridges and dentures has fallen by 57% since the new contract was introduced. Instead, dentists have a financial incentive to persuade patients to have a decayed tooth extracted. Patients also have a financial incentive to put off treatment, as they now pay the same for one filling as for three.

Do not prescribe antibiotics for colds, GPs told

R. Smith

The Daily Telegraph, July 23rd 2008, p. 1

Patients are to be refused antibiotics for coughs, colds and ear infections under strict new guidelines for family doctors issued by the NHS drugs rationing body, the National Institute for Health and Clinical Excellence. The new guidance says that patients should be reassured that antibiotics are not needed immediately as they will make little difference to symptoms and may have side-effects.

Ministers will force family doctors to take new patients

C. Brown

The Independent, July 4th 2008, p. 19

Family doctors are to be forced to open their lists to new patients under radical reforms to allow people to shop around for the best GP practices. Patients will be given the right to choose their GP practice with more information on how to switch, including an NHS website with details of the services offered by local surgeries.

(See also The Guardian, July 8th 2008, p. 13)

Patients' experience of a community pharmacy-led medicines management service

P. Bissell and others

Health and Social Care in the Community, vol. 16, 2008, p. 363-369

Medicines management services offer a discussion between a health professional, such as a pharmacist, and a patient about their medicines and a review of the appropriateness of the treatment, including both pharmacological elements and lifestyle factors. Based on this interview, the pharmacist advises the patient and makes recommendations to the prescriber about any changes to medication or lifestyle that might be beneficial. As well as benefiting the patient, these services may also offer a way of addressing the historic under-utilisation of pharmacists' skills and expertise. This paper reports on patients views about a community-pharmacist-led medicines management service for people with coronary heart disease delivered in England. Findings suggest that while patients cautiously welcomed the opportunity to consult with a pharmacist about their medicines, they had reservations about their making recommendations about treatment.

Power to the patients

R. Lewis

Public Finance, June 20th-26th 2008, p. 24-25

There is a growing political consensus that primary care trusts (PCTs) should be made more democratically accountable, but considerable disagreement about how this can be achieved. Alternative approaches include bringing PCTs completely under local authority control, giving local councillors places on PCT boards, or instituting direct elections of board members. On the other hand, more could be done to involve local people in decision making through consultation, without overhauling governance systems.

Scotland rules out private NHS moves

N. Timmins

Financial Times, July 9th 2008, p. 2

Scotland is to legislate to prevent commercial companies being able to run family doctor services, the Scottish Health Secretary has announced. The move creates a sharp contrast with England where primary care trusts have been told that, if they introduce new services or make significant changes to existing ones, there is a presumption that the service should be put out to tender.

A shot in the arm for community health services

I. Torjesen

Health Service Journal, July 24th 2008, p. 10-11

Primary care trusts are required under the NHS operating framework to separate their commissioning and provision functions by the end of 2008. Services may be delivered by an arms-length body still linked to the PCT or by a community foundation trust or contracted out to social enterprises formed by NHS staff.

Strategy will knit up the ravelled sleeve of care

R. Lewis and D. Colin-Thomé

Health Service Journal, July 10th 2008, p. 16-17

The primary and community care strategy published as part of Lord Darzi's review of the NHS highlights the need for more integrated care. A number of different models of integration are to be tested at carefully evaluated pilot sites. The integration that these pilots promote could be vertical, between primary and specialist care, or horizontal, combining primary, community and social care. They should be clinically led and could involve a wide range of disciplines, including consultants and primary, community and social care professionals. They will be held to account by primary care trusts.

Taking a lead in change

V. Bennett

Community Practitioner, vol. 81, July 2008, p. 36-37

The Primary and Community Care Strategy is a key component of Lord Darzi's NHS Next Stage Review. It recognises that most health care is delivered in the community and that people wish to receive as much as possible of their care close to home. It is generally agreed that the NHS needs to move from diagnosing and treating illness to proactively predicting and preventing it. This paper considers the role of community nurses in realising this vision.

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