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Welfare Reform on the Web (January 2010): National Health Service - primary and community care

Continuing health care: the plot thickens...

J. Dow

Journal of Integrated Care, vol.17, Dec. 2009, p. 20-22

This article explores the roles of the NHS and local authority services in the provision of continuing care at home for adults and children.

Health inequalities

Health Service Journal, Nov. 19th 2009, supplement, 17p

This special supplement looks at the impact of government policies to tackle health inequalities, including use of targets to incentivise NHS staff and bodies to engage with disadvantaged communities; the role of the infant mortality national support team in helping disadvantaged areas to hit the target of reducing infant death rates by 10% by 2010; approaches to reducing death rates from heart disease, cancer and stroke in poor areas; encouraging engagement with hard-to-reach groups; use of health trainers to help people improve their well-being; maximising the role of local government in health improvement initiatives; and improving data and intelligence on population health to support decision-making.

Health visiting: the end of a UK wide service?

R.A.J. Hoskins

Health Policy, vol.93, 2009, p. 93-101

The nationwide health visiting service which evolved in the UK in the late nineteenth and twentieth centuries was built on the three pillars of child health surveillance, maternal support and advice and public health promotion. However the tensions between the social (community/population) and the medical (family/individual) focuses of the health visiting role were subject to fierce debate throughout this period. This paper argues that this fault line in the health visiting role has been reactivated by a recent seismic shift towards devolved policy making structures in Scotland, Wales and Northern Ireland and recent regulatory changes which impact on health visiting throughout the UK. These factors have combined to compromise the existence of a strategic public health role and the provision of a UK wide health visiting service.

Preliminary results from a medical telecare pilot in Wrexham

K. Cooper and K. Doughty

Journal of Assistive Technologies, vol. 3, Sept. 2009, p. 36-41

A pilot project was initiated in Wrexham, North Wales with two groups of patients suffering from chronic obstructive pulmonary disease (COPD). One group was provided with a commercial telehealth system, while the other received a medical telecare service involving standalone vital signs peripherals and a phone call from a respiratory nurse who collected data and entered them into a spreadsheet. After four months of monitoring, the outcomes were analysed for both groups and found to be largely similar in terms of perceived quality of life benefits for the patients. This kind of telecare may greatly increase the independence of people with a chronic disease.

Safeguarding adults: perspectives from primary care trusts in Kent and Medway

T. Draper, S. Roots and H. Carter

Journal of Adult Protection, vol.11, Aug. 2009, p.6-11

Until recently, adult protection has have been seen as an add-on to other jobs within health organisations. However, statutory health bodies have now begun to integrate their adult protection activities more effectively with social services and the police. This paper reviews the journey undertaken by the three primary care trusts in Kent and Medway in developing adult protection expertise and sharing practice with both social services and the police.

Still puzzling: patient and public involvement in commissioning

A. Coleman, K. Checkland and S. Harrison

Journal of Integrated Care, vol.17, Dec. 2009, p. 23-30

Patient and public involvement (PPI) is currently being given a high priority by the Department of Health in respect of commissioning generally and practice-based commissioning in particular. However, evidence from a three-year research project at Manchester University which investigated the development of practice-based commissioning nationally shows that there is widespread disagreement over what PPI means in practice. There is a danger that, faced with performance targets and top-down directives, primary care trusts and practice-based commissioning groups may opt for a tokenistic 'tick box' approach.

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