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

Advanced paramedics deliver on the frontline

L . Brown and others

Health Service Journal, Mar. 24th 2011, p. 24-26

This article explores the advanced paramedic role introduced by the North West Ambulance Service. Advanced paramedic practitioners provide clinical leadership to improve patient care delivery. They provide strategic support to teams and units by attending incidents where an ambulance is inappropriate, giving phone advice to teams, and acting as bronze commander at large incidents, focusing on medical management. The practitioners are also putting new procedures into place to avoid unnecessary hospital admissions.

Critical issues in practice development: localism and public health reforms

P. Regan

Community Practitioner, vol.84, Mar. 2011, p. 32-33

The White Paper Healthy Lives, Healthy People offers a radical new approach to public health in the UK, with the concepts of localism, devolved funding and devolved decision-making at its heart. This article explores the role of practice development in the context of the reforms, referring to the continuing work of the Warrington Community Services Practice Development Unit in effectively encouraging local change and innovation. Two issues of significance to the promotion of innovation in nursing practice and to the effectiveness of localism are the application of evidence to practice and the motivation of staff worn down by the pressure of unrelenting reforms.

Drawing new life from the 'well'

R. Hussey and J. Stansfield

Health Service Journal, Mar. 3rd 2011, p. 20-22

This article describes the development of a new 'wellness' approach to public health in the North West of England. This broader focus on wellbeing requires services that offer a holistic assessment at the point of access and generic interventions that address the psycho-social determinants of health. These would focus on enhancing a sense of control, coherence, self-efficacy, motivation and social skills, enabling individuals to start making healthy lifestyle choices. Wellness services require an integrated approach across local authorities, commissioning consortia, NHS trusts, voluntary and independent providers and local communities and could be coordinated by the proposed new health and wellbeing boards.

Foucault's progeny: Jamie Oliver and the art of governing obesity

M. Warin

Social Theory and Health, vol. 9, 2011, p. 24-40

This article explores how reality TV is being used as an instrument for health promotion and social change through a case study of celebrity chef Jamie Oliver's latest series, Ministry of Food. In this TV series , the population of Rotherham is targeted as representative of poor eating habits and unhealthy lifestyles in Britain. Through the use of selective Rotherham cases, Oliver argues for urgent intervention, and then uses various techniques and strategies of empowerment to propel the citizens of Rotherham into healthy eating regimes.

Healthy lives equal healthy communities: the social impact of self-management

Expert Patients Programme Community Interest Company

2011

This study looked at the wider benefits of self-management courses for patients within communities in the North of England using social return on investment methodology. Results showed that the direct outcomes of attending a self-management course included an improved diet, meeting new people, gaining better control of emotions and having increased self-worth, as well as changes in service use. The main result of these direct outcomes was a general increase in confidence. Increased confidence led to other positive outcomes such as decreased anxiety, better sleep, the ability to try new things and increased motivation. Using social return on investment calculations this equated to a return on investment of 6.00 for every 1.00 spent.

Improving the quality of care in general practice

N. Goodwin and others

The King's Fund, 2011

General practice is often regarded as the bedrock of the English health care system. Surveys consistently report high levels of trust in GPs and good levels of patient satisfaction with the services they receive in general practice. However, other than data available through the Quality Outcomes Framework and the GP Patient Survey, very little information is published on the quality of care in general practice. It was for this reason that The King's Fund set up, in April 2009, an independent inquiry into the quality of general practice in England. The aim of the inquiry, which was conducted by an independent panel of experts and chaired by Sir Ian Kennedy, was to help to support the work of general practice and to provide a guide to ensure that quality is at the heart of the service that it offers to patients. Improving the Quality of Care in General Practice is the report of the inquiry; it represents the most extensive review of quality across general practice carried out in recent years. Its work was informed by specially commissioned research and analysis of routinely available data across a range of aspects of general practice including: core elements of day-to-day practice - for example, diagnosis, referral and prescribing; non-clinical aspects of quality - for example, access to care and patient engagement; and areas where the role is shared with others - for example, maternity and end-of-life care.

URL: http://www.kingsfund.org.uk/publications/gp_inquiry_report.html

PCTs diverge on consortium handover

D. West

Health Service Journal, Mar. 17th 2011, p. 4-5

An analysis based on information from 114 primary care trusts (PCTs) reveals that 30 have already delegated significant commissioning budgets to emerging shadow GP consortia, or are ready to do so from April 2011. A further 48 PCTs said they were developing plans to delegate budgets but were unlikely to do so by April 2011. The remaining 36 said they had no clear plans to delegate.

Who will be the heroes?

J. Redman and L. Kenyon

Community Practitioner, vol. 84, Mar. 2011, p. 42-43

In its White Paper Healthy Lives, Healthy People the Coalition government proposes returning responsibility for public health to local authorities, where it resided until 1974. Looking back over the history of public health, the authors suggest that tensions within local authorities - together with social, economic and political forces outside them - have in the past limited the effectiveness of their public health departments, and may do so again.

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