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

Delivering NHS health checks to all

H. Martin

British Journal of Healthcare Management, vol. 17, 2011, p. 250-255 The NHS Health Check programme is an ambitious initiative that will offer preventative checks to men and women aged 40-74 years to assess their risk of vascular disease. In order to implement the programme by 2012, primary care trusts face a number of challenges, including how to reach certain vulnerable populations. NHS Hastings and Rother is seeking to implement health checks for hard-to-reach individuals through a mobile outreach service or bus.

Establishing social enterprises under the Right to Request Programme

National Audit Office

London: TSO, 2011 (House of Commons papers, session 2010/12; HC 1088)

As part of its agenda for transforming community services, the Department of Health (the Department) has supported Primary Care Trust (PCT) staff joining together and leaving the NHS ('spinning out') to form social enterprises. These have become independent bodies delivering services, previously delivered in-house, under contract to the PCT. At this early stage of the 'Right to Request Programme', it is too early to assess its costs and benefits. Only 20 social enterprises are operational, most having been launched as recently as April 2011. But the Department has not set measurable objectives specifically for the Right to Request Programme against which to evaluate its success. PCTs expected social enterprises to deliver more benefits than other providers, but did not generally contract for them to deliver savings or any other additional benefits. The report points out that many risks and liabilities still reside with the PCTs and will need to be managed if value for money is to be achieved. In the last resort, the trust or its successors will be responsible for ensuring that essential services continue to operate. At least for a time, social enterprises will be highly dependent on work and cash flow from their respective PCTs. They will also be operating in an increasingly competitive market owing to changes in health legislation currently going through Parliament. PCTs or their successors will need to have a clear idea of how they will react if enterprises run into financial difficulty or fail.

Protecting the almost adult

S. Cox and J. Holden

Health Service Journal, July 21st 2011, p. 21-23

When teenagers aged 16 or 17 attend their GP surgeries alone they are managed as adults. However, any safeguarding investigation following an allegation of inappropriate behaviour by the GP will regard the patient as a vulnerable child. The authors present a case study of a safeguarding investigation following allegations by a 16-year-old girl and consider its wider implications.

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