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


Health Committee

London: TSO, 2010 (House of Commons papers, session 2009/10; HC 151)

This report calls for a radical change in the Government's approach to the health and social problems caused by the rising consumption of alcohol in England and Wales. Consumption per head has nearly tripled since 1947, and 31% of men and 21% of women are drinking hazardously (more than 21 units per week) or harmfully (more than 50 units per week). It is estimated alcohol abuse in England and Wales kills 30-40,000 people a year and costs the economy 55bn. Excessive consumption also leads to serious accidents, disorder, violence and crime. The report: considers the impact of alcohol on health, the NHS and society as a whole, including the costs of crime and loss of work. The report:

  • analyses the Government's alcohol strategy.
  • considers the NHS policies on prevention and treatment.
  • looks at education and information policies and examines the marketing of alcohol.
  • considers pubs and licensing, off-licence , and supermarkets sales
  • looks at the key issue of the price of alcohol.

The Committee calls for minimum pricing for units of alcohol and puts forward a new alcohol strategy. Evidence shows that a rise in the price of alcohol is the most effective way to reduce consumption. It would affect most of all those who drink cheap alcohol, save up to 3000 lives a year with a price of 50 pence per unit, would benefit traditional pubs and encourage a switch to weaker wines and spirits. Alcohol duty should continue to rise year on year, but unlike in recent years duty increases should predominantly be on stronger alcoholic drinks, notably on spirits.

Arabic-speaking students' primary care experiences in Scotland

A.I. Amed and others

Community Practitioner, vol. 83, Feb. 2010, p. 23-26

There is limited knowledge about the burden of poor health and healthcare utilisation among minority ethnic groups in higher education in the UK. Scottish health policy is directed toward proactive care delivered within primary care settings. The community of one university in Scotland was chosen to explore the acceptability of primary care among one minority group, namely Arabic speakers. The majority of participants were satisfied with the availability of a healthcare professional of their preferred gender, the attitudes of healthcare professionals, and healthcare information provided.

Case management for long-term conditions: implementation and processes

S. Reilly, J. Hughes and D. Challis

Ageing and Society, vol. 30, 2010, p. 125-155

This paper presents a review of the literature on comprehensive case management by nurses for adults with long-term conditions living in the community. On the basis of the reviewed evidence, three issues were identified as key to the coherent and sustainable implementation of case management for people with long-term conditions: fidelity to the core elements of case management; size of caseload; and case-management practice, incorporating matters relating to continuity of care, the intensity and breadth of involvement and control over resources.

General practice out-of-hours services: project to consider and assess current arrangements

D. Colin-Thome and S. Field

Department of Health, 2010

This review has found widespread failings in system of out-of-hours care, although it claims that services have improved since primary care trusts took over responsibility for them from GPs in 2004. It is claimed that primary care trusts failed to review contractors' performance consistently. They also used standard contracts instead of taking into account local needs. Foreign doctors coming in to work for out-of-hours providers did not have their language skills checked thoroughly and did not receive adequate induction training.

Lansley points to joint powers in public health

R. Evans

Health Service Journal, Feb. 11th 2010, p. 12-13

Under a Conservative administration, public health would remain a central government responsibility. The public health budget would be administered by primary care trusts, although local authorities would have a greater say in how the money was spent. Primary care trusts would continue to contract dentistry and pharmacy services and tender for services where there could be a potential conflict of interest between GPs as commissioners and providers. In addition, they would be local representatives of the NHS Board, assisting in the performance management of the contractual relationship with GPs as commissioners.

One-to-one cancer care at home 'is just a bribe for voters'

R. Smith

Daily Telegraph, Feb. 8th 2010, p. 14

A Labour plan for every cancer patient to have one-to-one care at home by a specialist nurse has been called into question by opposition parties on the grounds that the government has failed to explain how it would be funded at a time of financial stringency. The Department of Health will be investing 20m in 2011/12 to provide more specialist nurses in partnership with Macmillan Cancer Support.

Quality in practice

R. Godson

Community Practitioner, vol. 83, Feb. 2010, p. 32-33

Lord Darzi in his report on the future of the NHS developed a vision that quality would be the organising principle for everything and would result in services becoming more efficient and staff more innovative. The report heralded the Transforming Community Services programme which aims to deliver real improvements in quality, innovation and productivity. This article explores what the continued emphasis on quality means for health visitors, school nurses and community nurses.

Plan to switch medicines for cheaper versions will harm patients, say experts

S. Lister

The Times, Feb. 24th 2010, p.12

Ministers plan to push for generic versions of drugs to be automatically used as substitutes for the more expensive brands in patient prescriptions. 17 doctors and health care professionals have written to The Times in response, suggesting that this kind of automatic substitution could be dangerous to patients. A consultation on Automatic Generic Substitution (AGS) is due to finish at the end of next month.

'Scandal' of just one out-of-hours doctor on call for 650,000 people

R. Smith, H. Blake and A. Jamieson

Daily Telegraph, Feb. 1st 2010, p. 10

An investigation by the newspaper has revealed huge regional variations in the number of doctors on call outside of normal business hours. In Barnet and Enfield in North London, just one doctor covered 650,000 people over night during the last weekend in January 2010, while the same number of patients in Shropshire had eight doctors.

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