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

BMA warns against rewarding GPS for saving money

C. Smyth

The Times, June 27th 2011, p. 8

Patients will begin to lose trust in their doctors if government plans to reward GPs for saving money are implemented, as they will suspect they are not being properly treated if doctors are paid extra for financial efficiency rather than for providing care

GP senators usher in a new era of commissioning

Anon

Health Service Journal, June 9th 2011, p. 20-21

One of the challenges facing all primary care trusts is the provision of co-ordinated and effective leadership during the transition to GP commissioning in 2013. NHS Cambridgeshire responded to the challenge by setting up a GP commissioning senate in March 2011. The senate will provide clinical leadership and achieve a smooth transition to GP commissioning by beginning to build key elements of the new system in advance.

A high definition telehealth vision

J. Oldham

Health Service Journal, June 2nd 2011, p. 22-23

Telehealth is often presented as key to modernising care and maximising efficiency, but many projects fail to realise their full potential. Often the installation of electronic equipment adds to but does not substitute for existing services. This article presents principles and actions that need to be in place for telehealth to have a chance to produce efficiency savings. These include buy-in from local clinicians, making changes to care pathways and protocols to embed telehealth, ensuring that personnel who monitor data can also give advice to patients on how to manage their conditions, use of multi-disciplinary neighbourhood care teams, and risk profiling of patients being considered for telehealth.

Ten million cannot get to see GP in two days

S. Adams

Daily Telegraph, June 17th 2011, p. 4

The proportion of patients who say they cannot get an appointment with a GP within two working days has risen from 15 to 20 per cent since early 2009, according to the annual GP Patient Survey. The Labour government brought in the two working day target to try to ensure that patients could see their GPs promptly. But last June Andrew Lansley, the current health secretary, pledged to scrap that target, saying it would reduce bureaucracy. It ceased being a target earlier this year.

Transforming NHS ambulance services

National Audit Office

London: TSO, 2011 (House of Commons papers, session 2010/12; HC 1086)

The Department of Health has until recently been focusing on speed of response as a measure of performance of the ambulance service, rather than on clinical outcomes for patients. The ambulance service achieves high levels of public satisfaction but there are wide variations in ambulance trusts' efficiency. The 8-minute response target, intended for the most seriously ill patients, is one of the most demanding in the world. However, its application has skewed ambulance trusts' approach to performance measurement and management. The target is also applied to a much wider group of patients than intended. The report identifies various inefficiencies in the system, with cost per incident varying between 176 and 251. There is scope across the urgent and emergency care system to make more of different ways of responding to patients, such as clinical advice to callers over the phone and taking patients to minor injuries units rather than Accident and Emergency (A&E) departments. The new clinical quality indicators introduced from April offer the potential for a fuller measurement of performance based on outcomes.

What stops doctors doing annual health checks?

J. Walmsley

Learning Disability Today, June 2011, p.30-33

From 2009, GPs have been paid to carry out annual health checks for people with learning disabilities. Even though GPs are paid to carry out these checks, fewer than 50% of eligible adults had one in 2009/10. This research looked at what was happening in Oxfordshire where only 26% of eligible people had a check that year. One of the main reasons was that ensuring that people with learning disabilities receive better healthcare was not a priority for GPs, who need better training in this field.

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