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

Christian chemists fear sack if they take stand on morning-after pill

S. Caldwell and T. Ross

Daily Telegraph, Aug. 9th 2011, p. 12

Some chemists and lawyers say that new guidance issued by the General Pharmaceutical Council effectively strips them of their right to refuse to hand out emergency contraception (the morning-after pill) on religious grounds. For the first time under the guidelines, pharmacists are told that their right to object on grounds of conscience is secondary to the contractual demands of employers. Many Christian, Jewish and Muslim pharmacists have conscientious objections to dispensing emergency contraception because the drugs work by preventing the fertilised egg from implanting in the womb.

Community empowerment for health visiting and other public health nursing

S.M. Piper

Community Practitioner, vol.84, Aug. 2011, p. 28-31

This paper discusses a community empowerment approach to health promotion for health visitors and other public health nurses that is consistent with the developing public health agenda and the Big Society. It emphasises that this proposed model of practice is concerned with process as much as outcome. It involves the use of enabling strategies for community development, social capital growth and capacity building based on community assets and a subjective agenda. The practice model is thus about the nature and quality of the relationship between public health nurses and the community, and the relationships between community members, for social health gain rather than top-down, objective and professionally-led disease prevention interventions and associated health-related behaviour of individual clients.

GPs’ attitudes to practice based commissioning

S. Astles and C. Jones

British Journal of Healthcare Management, vol. 17, 2011, p. 276-283

Practice based commissioning was launched in 2004. Uptake among GPs has been slow despite central government support and investment. Using a sample of 85 GPs, this study aimed to gain a deeper understanding of their attitudes to commissioning based on data gathered through a survey and a focus group. Results showed that GPs were worried about having to make decisions influenced by financial considerations as well as clinical need and about their capacity to take on commissioning responsibilities. They were also concerned about the effects of constant organisational change.

Healthy lives, healthy people: update and way forward

Department of Health

London: TSO, 2011 (Cm 8134) This policy statement sets out the progress the government has made in developing the new public health system. It sets out how the government expects the reformed public health system to work including:

  • clarifying the role of local authorities and the Director of Public Health in health improvement, health protection and population healthcare
  • proposals for who is responsible for commissioning the different public health services
  • the mandatory services local authorities will be required to provide
  • the grant conditions expected to be placed on the local authority public health grant
  • establishing Public Health England as an Executive Agency to provide greater operational independence within a structure that is clearly accountable to the Secretary of State for Health
  • clear principles for emergency preparedness, resilience and response.

Hospitals 'failing to act on mandatory safety alerts'

S. Boseley and R. Ramesh

The Guardian, Aug. 17th 2011, p. 10

Patients are being left at risk of harm in hospital and under GP care because NHS trusts are failing to act on mandatory NHS safety alerts, some of them urgent. Alerts are sent out by the National Patient Safety Agency (NPSA) after mistakes have come to light around the country. Some of them are very serious, such as the injection of a toxic chemotherapy drug called vincristine into the spine rather than a vein. That mistake led to the death of 18-year-old Wayne Jowett in 2001. The NPSA alerts trusts to the safety precautions that must be taken so that errors are not repeated. But the patient support organisation Action against Medical Accidents is warning that compliance with the alerts is partial – and no trust has taken all the action required by the NPSA in the last year.

One in seven CCGs too small for authorisation

S. Lewis and D. West

Health Service Journal, Aug. 18th 2011, p. 4-5

A population of 50,000 is likely to be seen as the minimum for clinical commissioning groups (CCGs). However, 47 emerging CCGs are made up of GP practices with less than 50,000 patients; some have as few as 5,000. CCGs will be allocated running costs budgets based on the number of patients they cover, prompting fears that those with small populations may not be financially viable.

Performance measurement and the UK emergency ambulance service: unintended consequences of the ambulance response time targets

P. Wankhade

International Journal of Public Sector Management, vol. 24, 2011, p. 384-402

Response time performance based on 999 call prioritisation has been used as the main indicator of emergency ambulance service quality since 1974. A literature review and an in-depth case study of a large ambulance trust in the North of England revealed that the targets have distorted the actual functioning of ambulance trusts in England. More importantly, the continued focus on response time targets has the potential to adversely affect the future modernisation agenda of developing clinical performance indicators and delivering clinical education to staff.

Pharmacy assisted patient self care of minor ailments: a chronological review of UK health policy documents and key events 1997-2010

V. Paudyal and others

Health Policy, vol. 101, 2011, p. 253-259

This chronological review of UK health policy documents from before and after devolution demonstrates the evolution of policies relevant to support of enhanced self care of minor ailments by community pharmacists. Key drivers for this policy were: the need to reduce the burden on GPs of treating minor ailments, improving patient access to services and aiding pharmacists’ professional development. Two key interventions aimed at shifting care from GPs to pharmacists were: introduction of free minor ailments schemes in community pharmacies and reclassification of medicines so that more could be prescribed by pharmacists.

‘Pro-life’ MPs refuse to back down over bid to change abortion advice

O. Wright

The Independent, Aug. 30th 2011, p. 10

Conservative MP Nadine Dorries is proposing an amendment to the Health Bill designed to cut the number of pregnancies terminated each year in the UK. The amendment would strip abortion charities and doctors of their exclusive responsibility to counsel women seeking to terminate an unwanted pregnancy. Under her proposal, the responsibility would go to specially trained independent counsellors. Critics say the proposal would add another layer of bureaucracy which would cause distress.

Why all’s ending well in Wells

A. Moore

Health Service Journal, Aug. 18th 2011, p. 19-21

Wells Community Hospital in North Norfolk had been a mainstay of the local area for nearly a hundred years when the NHS decided to close its inpatient beds in the mid-2000s. With few services remaining, its future was in doubt. After a long campaign to raise funds and support, ownership has passed into the hands of a charitable trust, which has ambitious plans to develop more health and social care services on the site.

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