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

Better care, better lives

Department of Health

London: 2008

Aims to improve the outcomes and services for children with life limiting illnesses or severe disabilities, as well as delivery to them of universal services such as mainstream and specialist education, social care, transport, home help and short breaks. It also aims to provide a high-quality and integrated healthcare service, including palliative care delivered by community nursing teams.

(For comment see Community Practitioner, vol. 81, Sept. 2008, p. 16-17)

End of life care strategy: promoting high quality care for all adults at the end of life

Department of Health

London: 2008

The strategy aims to help more people die in the setting they choose, mainly at home surrounded by loved ones. Areas it will focus on include:

  • Improved community services, ensuring that rapid response home nursing services are available in all areas
  • workforce training and development
  • development of specialist palliative care outreach services
  • setting up a national end of life research initiative
  • development of quality standards for end of life care against which providers can be assessed.

(For comment see National Health Executive, vol. 2, July/Aug. 2008, p. 25-26; Community Practitioner, vol. 81, Sept. 2008, p. 16-17)

Holding back the years

E. Dent

Health Service Journal, Sept. 25th 2008, p. 25-26

As people with HIV/AIDS live longer, services must adapt to meet their needs. HIV can now be treated as a controllable long term condition, but clinical inertia may be delaying much needed changes to services. Experts are divided over whether they should be shifted into the community, but patients clearly want services that are designed to fit round their lives.

Making sense of Darzi

C. Adams

Community Practitioner, vol. 81, Sept. 2008, p. 38-39

This article explains the implications of Lord Darzi's review of the NHS for community practitioners. The review identifies the need for nurses and midwives to take on leadership roles and to be at the forefront of improving the quality of care, pledging rewarding career opportunities in return. The quality of education and training available to the workforce will be improved by bringing education providers together with service providers and industry, and offering rewards for high-quality outcomes.

Midwives' warning over risky 'freebirths'

K. Devlin

Daily Telegraph, Sept. 11th 2008, p. 7

The Royal College of Midwives is concerned that more women are opting for risky 'freebirths', with no doctors or midwives in attendance. It is argued that this dangerous trend has arisen because government has failed to deliver on pledges to give all pregnant women the choice of having their babies in hospital, at home or in a centre led by midwives.

Open all hours

K. McIntosh

Health Service Journal, Sept 11th 2008, p. 23-24

Complaints about out-of-hours services have soared since GPs were allowed to opt out of providing them in 2004. Huge variations in their cost and quality across England have been revealed by a benchmarking exercise carried out by the Primary Care Foundation for the Department of Health. However, services, call handling methods and software all vary so much that comparisons are difficult.

Polyclinics to have more nurses than GPs

K. Devlin

Daily Telegraph, Sept 10th 2008, p.2

Documents released under the Freedom of Information Act by the Department of Health show that the planned new polyclinics will be staffed by up to three times as many nurses as GPs, leading to accusations that they will offer second rate care to patients on the cheap.

Silent witness

M. Gould

Health Service Journal, Sept. 18th 2008, p. 22-24

General practice sees 95% of NHS activity but records only 0.4% of patient safety incidents. Some GPs say they have never heard of the National Patient Safety Agency, to which incidents should be reported. GPs may be keeping quiet to protect their businesses, and patients may be reluctant to complain because of their long term relationship with their GP.

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