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Welfare Reform on the Web (February 2011): National Health Service - primary and community care

Co-operative commissioning

M. Dixon

NHS Executive, Nov/Dec. 2010, p. 26

The 2010 NHS White Paper proposes the transfer of responsibility for commissioning health services to GP consortia. There are concerns that GPs are now essentially businessmen who will put profit before patient care. In order to guard against this temptation, the author proposes that GP consortia should be set up as a form or social enterprise or co-operative.

Dentists routinely failing children with serious tooth decay

D. Campbell

The Guardian, Jan. 10th 2011, p. 14

Serious tooth decay in children as young as two is being either ignored or badly treated as a result of a system of 'poor care' and 'supervised neglect', a leading dental expert has warned.

The four challenges facing consortia

S. Hill, B. Richardson and N. Manson

Health Service Journal, Jan. 20th 2011, p. 18-20

In the first of two articles on the challenges facing GP commissioning consortia, two questions are discussed: 1) how GPs can add value to commissioning and 2) controlling management cost.

Government to take flu vaccine orders out of GP hands

S. Boseley

The Guardian, Jan. 21st 2011, p. 11

Flu vaccines are likely to be bought by central government in the future, after some GPs failed to order sufficient stock for Winter 2010/11. Taking the job of ordering the vaccines away from family doctors goes against the grain of the NHS reform announced in Parliament.

Groups of GPs are already signing up for the NHS revolution, says Cameron

R. Smith

Daily Telegraph, Jan. 17th 2011, p. 4

So far, there are 141 GP consortia set up in shadow form ready to take responsibility for healthcare commissioning in 2013. However, NHS managers have criticised the Coalition Government's NHS reforms as 'extraordinarily risky', while the Royal College of General Practitioners has said that they could put vulnerable children at risk.

(For doubts about the actual engagement of pathfinder consortia, see Health Service Journal, Jan. 20th 2011, p. 6-7)

How to deliver high quality, patient-centred, cost-effective care: consensus solutions from the voluntary sector

Age UK and others

King's Fund, 2010

This report presents a set of evidenced examples showing how the voluntary sector can provide interventions that are effective in terms of cost and quality. The case studies demonstrate that the voluntary sector can deliver coordinated care, patients engaged in decisions about their care, supported self-management, prevention and early diagnosis, and support for those with chronic or acute illness.


It's time to let the right ones in

N. Churchill

Health Service Journal, Jan. 20th 2011, p. 14-15

Exception reporting allows GP practices to exclude certain patients from their quality and outcomes framework assessments. There are concerns that exception reporting allows practices to exclude patients in order to cover up poor management of chronic conditions and maximise income. Exception reporting should now be abolished.

Ministers face court challenge over 'ludicrous' abortion rule

S. Boseley

The Guardian, Jan. 13th 2011, p. 19

The Department of Health is accused of putting political considerations ahead of the wellbeing of women who need an abortion in early pregnancy, by refusing to allow them to take the necessary pills in the comfort of their own home. Britain's leading charitable abortion provider, the British Pregnancy Advisory Service (BPAS) will challenge the government in the high court this month, arguing that the UK is out of line with most other countries.

New GP cancer tests will save 5,000 lives a year, says Lansley

N. Watt

The Guardian, Jan. 12th 2011, p. 12

An extra 5,000 lives a year will be saved within the next five years as GPs are given greater direct access to diagnostic tests for patients suffering from a range of cancers, the health secretary Andrew Lansley will announce.

NHS chief admits country short of 4,500 midwives

The Press Association

The Guardian, Jan 19th 2011, p. 12

The planning of midwifery services has not been 'quite as it should have been' with the country still short of 4,500 midwives, the head of the NHS David Nicholson has admitted, adding that the organisation remains unsure as to how to recruit and retain more midwives.

NHS commissioning: a better way forward

J. Gubb

NHS Executive, Nov/Dec. 2010, p. 24-25

The 2010 NHS White Paper proposed abolishing primary care trusts and transferring responsibility for commissioning healthcare to consortia of GPs. This article proposes an alternative reform, focused on strengthening primary care trusts and increasing the statutory influence of GPs over them.

One in five GP practices are underperforming

D. West

Health Service Journal, Jan. 13th 2011, p. 4-5

An HSJ analysis of primary care trusts' own GP performance scorecards shows that nearly one in five practices are underperforming across a significant number of quality and performance measures. Trusts use different indicators depending on their priorities. They also use different thresholds to define a 'red' rating, so direct comparisons cannot be made between areas and practices. The findings have sparked concerns about the confused arrangements for monitoring and improving primary care under the coalition government's commissioning reform proposals.

Should GPs make or buy?

C. Ham, C. Imison and R. Ashton

Health Service Journal, Jan. 6th 2011, p. 12-13

As the main primary medical care providers, GPs and their teams are in a unique position to use commissioning to develop new models of care in the community. Many GPs who are in the vanguard of commissioning are keen to provide more care in the community through general practices and have begun to set up new provider organisations to offer it. However, there is a risk that GPs will use the new freedoms to line their own pockets. This article discusses the options for regulatory regimes that can protect patients while giving GPs freedom to innovate.

Sizing up the issues of financial security

B. Richardson, N. Manson and S. Hill

Health Service Journal, Jan. 27th 2011, p. 19-21

There are four challenges which every GP commissioning consortium will have to face. In this second of two articles, the authors consider financial risk and how to manage the performance of GP practices within the consortium.

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