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Welfare Reform on the Web (December 2009): National Health Service - primary and community care

Bringing genetics into primary care: findings from a national evaluation of pilots in England

G. Martin, G. Currie and R. Finn

Journal of Health Services Research and Policy, vol. 14, 2009, p. 204-211

In common with a number of developed countries, the UK has sought to increase the role of primary care in delivering clinical genetics services. However, efforts to reconfigure service delivery face multiple challenges associated with divergent policy objectives, organisational boundaries and professional cultures. This paper presents findings from an evaluation of an English pilot programme to embed clinical genetics into mainstream NHS services in primary and secondary care. Results showed that lack of interest in clinical genetics among primary care staff was compounded by national targets that focused their attention elsewhere and by service structures that rendered genetics a peripheral concern demanding minimal engagement. Established divisions between the commissioning of mainstream and specialist services, along with the pressures of shorter-term targets, impeded ongoing funding.

Equity in the distribution of community pharmacies in England: impact of regulatory reform

A. Wagner and others

Journal of Health Services Research and Policy, vol.14, 2009, p.243-248

In April 2005, recommendations by the UK Office of Fair Trading prompted legislation revising control of entry regulations for community pharmacies in England. Subsequently, the new NHS community pharmacy contract in England and Wales generated significant reorganisation of community pharmacy patient care, with the aim of increasing pharmacists' contribution to primary care provision. This research explored whether relaxation of control of entry regulations for community pharmacy contracts in England affected the distribution of community pharmacies relative to population need indicators. Deregulation was found to be associated with more community pharmacies per capita and a small increase in geographic equity of community pharmacy distribution at PCT level.

Management of infertility in primary care

S. Wilkes

British Journal of Healthcare Management, vol. 15, 2009, p. 543-548

Each GP will see an average of only two infertile couples per year and will therefore be unable to develop the skills needed to manage them efficiently. Open access hysterosalpingography (HSG) is a recent innovation that allows full initial investigation of infertile couples in primary care. Initial investigation of infertile couples is in fact straightforward, comprising follicle stimulating hormone, mid-luteal progesterone, semen analysis, and open access HSG. A full initial assessment in primary care is essential for the cost effective management of infertile couples. It is concluded that there is an urgent need for commissioners to reappraise fertility treatment pathways.

Motivations for training as an SCPHN in Northern Ireland

B. Poulton and others

Community Practitioner, vol. 82, Nov. 2009, p. 28-32

Several policy consultations addressing post-registration nursing careers have followed the creation of the specialist community public health nurse (SPCHN) role, part of the Nursing and Midwifery Council register for health visitors, school nurses and occupational health nurses. This study surveyed a cohort of students starting a SCPHN programme to explore what factors influenced their decision to train for this part of the register, and whether these differed according to previous experience. The most highly rated factors were an interest in health promotion, a desire to work in community settings, and more involvement in the social aspects of health. These factors were closely linked with aspirations of career progression.

NHS missed target on sex disease tests - watchdog

D. Campbell

The Guardian, Nov. 12th 2009, p, 4

A National Audit Office (NAO) report has accused the NHS of failure, wasting money and missing targets in its 150m campaign to curb the spread of chlamydia through the national chlamydia screening programme (NCSP), meaning that the total number of under-25s tested for the infection is significantly below target. Only half of England's 152 primary care trusts manage to screen 26% of the younger men and women in their areas for the disease.

Plan is unveiled to boost health visiting profession

N. Puffett

Children and Young People Now, Oct. 22nd-28th 2009, p. 11

Introduces the Action on Health Visiting Programme which represents the government's attempt to address the chronic staff shortages and low morale among the profession. However, no extra funding is being provided for primary care trusts to implement the programme, there are no specified sanctions for those which do not invest in the profession, and no specified targets for numerical increases in staff.

Self-directed support in health: developing the concepts

R. Brewis

Journal of Integrated Care, vol. 17, Aug. 2009, p. 16-21

This article outlines work being done by In Control with a range of innovative primary care trusts and local authorities, to explore how the concept of personalisation may be applied in healthcare to the management of long-term conditions. The programme has been called Staying in Control, to reflect the need for integration of health and social care, so that a person does not lose control when their health deteriorates and different funding streams and services come into play.

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