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

Behavioural science in public health policy

R. Cheung and A. Ardolino

British Journal of Healthcare Management, vol. 17, 2011, p. 140-144

Traditional methods used by government to influence public behaviour range from information provision and education to taxation and regulatory restrictions. There is good evidence that standard mass marketing and information campaigns are inefficient and, by and large, ineffective, while regulation is unpopular and subject to moral and ethical criticisms. The current coalition government is exploring an alternative approach. The publication of the Public Health White Paper signals the government's intention to apply insights from social psychology and behavioural economics to influence the public to choose healthy lifestyles. This article warns that behavioural science has its limitations and should be seen as an additional, rather than a replacement, policy tool to improve the health of the population.

Care closer to home: aspirations and delivery

L. Nazarko

British Journal of Healthcare Management, vol.17, 2011, p. 145-151

The NHS has a limited number of acute beds and demand for them is increasing, as are cost pressures. Intermediate care delivered in a person's own home or in an intermediate care bed is more appropriate for patients, is cost effective and reduces pressure on acute beds. This article analyses why intermediate care services are not being fully utilised and sets out the case for increased investment.

Governance for health and wellbeing in the English NHS

L. Marks and others

Journal of Health Services Research and Policy, vol. 16, 2011, Supplement 1, p. 14-21

Shifting the focus of health services towards prevention has proved difficult to achieve. Governance structures are complex, incentives may conflict, and there are many competing priorities. This article focuses on how the underlying principle of promoting health and wellbeing is reflected in the commissioning cycle, including incentive schemes; in performance management regimes; and in the attention paid to partnership governance and public involvement. It then explores a number of paradoxes which emerge. It is concluded that, as the NHS in England undergoes further reorganisation, it is important to ensure that a systematic, strategic and population-based approach to commissioning is not lost. Governance and incentive arrangements should be critically assessed for their impact on population health and wellbeing.

GPs criticise NHS decision to deny MS patients cannabis-based drug

D. Campbell

The Guardian, May 31st 2011, p. 2

Multiple sclerosis specialists claim primary care trusts (PCTs) are exacerbating patients' pain and suffering by refusing to let them use Sativex, a drug derived from cannabis that the regulators have approved to help relieve pain.

GPs who fail financial tests will be denied new NHS powers - Treasury

P. Wintour, N. Watt and D. Campbell

The Guardian, May 10th 2011, p. 2

The Treasury will only support GP-led consortia if the new bodies have passed rigorous clinical and financial tests, the chancellor's deputy Danny Alexander has warned, adding that the reforms will be implemented in a variable pattern.

Health Mela: a novel way of health promotion

R. Gupta and others

British Journal of Healthcare Management, vol. 17, 2011, p. 165-167

South Asians living in the UK have higher prevalence of cardiovascular and metabolic disease, but their access to the NHS is poor. The Health Mela is an innovative way of addressing this issue by providing health information and check-ups at their community centres. Undergraduate medical students take an active role in delivering the service, which they value for improving their communication skills and awareness of various cultures and health beliefs.

Implementation of case management in long-term conditions in England: survey and case studies

D. Challis and others

Journal of Health Services Research and Policy, vol. 16, 2011, Supplement 1, p.8-13

In England, case management is targeted predominantly on older people who are very high intensity users of unplanned secondary care and is led by community matrons. This article aims to describe the current provision of case management arrangements in primary care and identify the extent and nature of self-care support services within it, based on a cross-sectional survey of primary care trusts and four case studies. It is concluded that case management in the NHS is at an early stage of development. More effective links with a range of local services are required if care plans are going to be comprehensive.

More pathways into health visiting

K. Ly

Community Practitioner, vol.84, Apr. 2011, p. 14-15

Alternative routes and training pathways into health visiting are being explored to meet the target of 4,200 additional health visitors by 2015. Unite/CPHVA supports the use of flexible training, but has raised concerns over routes that could be unclear or unsafe.

Physician assistants in English general practice: a qualitative study of employers' viewpoints

V. Drennan and others Journal of Health Services Research and Policy, vol.16, 2011, p. 75-80

In the USA, physician assistants graduate from a two year programme plus an internship year and are licensed to practice medicine in interdependent roles with physicians. They undertake physical examinations, diagnosis, treatment and prescribing within their scope of practice as agreed with their supervising physician. There has been interest in introducing the role into the UK. This study explored the perceptions and views of GPs who have chosen independently to employ US-trained physician assistants, and their perception of the value and challenges involved.

Plot better care with a good map

C. Cohen and B. Duper

Health Service Journal, May 19th 2011, p. 22-24

A crucial element of the NHS approach to improving knowledge management is the Map of Medicine, which delivers evidence-based clinical knowledge from authoritative sources displayed as pathways reflecting the patient journey. It allows national pathways to be not only assimilated but also adapted to reflect local health needs and facilities. This article presents a case study of the use of the Map of Medicine by NHS Tameside and Glossop to develop five local customised care pathways and subsequent moves to encourage its use by GPs.

Rise in children at A&E with minor ailments

D. Campbell

The Guardian, May 24th 2011, p. 10

Doctors are calling for better NHS out of hours care after a new report published in the Emergency Medical Journal revealed a big rise in children turning up at accidents and emergency units with common illnesses such as a cough or diarrhoea.

Tackling men's health: implementation of a male health service in a rugby stadium setting

K. Witty and A. White

Community Practitioner, vol.84, Apr. 2011, p. 29-32

The setting in which a health intervention is delivered has a considerable effect on its ability to engage the target group. Sports stadia have until recently been overlooked as settings for delivering health promotion interventions aimed at men. This paper presents a critical account of the delivery of a male targeted health intervention to men attending rugby league matches at a large UK sports stadium. The main aim is to report key barriers and facilitators associated with the implementation of the intervention. The report highlights the value of a skilled and adaptable delivery team, strong knowledge of the stadium and collaborative working.

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