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

The choice is theirs

R. McGough

Health Service Journal, Oct. 20th 2011, p. 28-29

Under the any qualified provider strategy to be implemented in 2012, private sector firms will be able to provide some community-based services under contract to the NHS. This article explores five crucial questions about how the new system will work: 1) possible fragmentation of services; 2) handling NHS staff redundancies; 3) setting fixed tariff prices to ensure that there is no price competition; 4) how contracts will be awarded without competitive tendering as planned; and 5) impact on providers who will only be paid for the work that they do - there will be no block contracts.

Get everybody in on the action

D. Stout

Health Service Journal, Oct. 27th 2011, p. 26-27

The NHS Act 2006 places a statutory duty on all NHS organisations to involve patients and their representatives in decisions about services. Under the Health Bill proposals, all new commissioners are expected to have an approach to engagement in place before achieving authorisation by the NHS Commissioning Board. With the bill putting heavy emphasis on the need to involve more clinicians and patients in decisions about care planning, it is essential that clinical commissioning groups plan from an early stage how they intend to engage with their local communities.

Health checks flagging as GP funding dries up

C. Santry

Health Service Journal, Oct. 13th 2011, p. 9

The NHS health check programme, aimed at reducing health inequalities, is flagging as GPs dismiss it as charity work that mostly benefits the worried well. Between April and June 2011, only 2.7% of eligible patients received a health check, designed to assess people aged between 40 and 74 for signs of heart disease, stroke, kidney disease and diabetes every five years. This is well below the target of 18% of eligible patients set out in the 2011/12 operating framework.

Health visitor national growth plan stalls

L. Higgs

Children and Young People Now, Oct. 4th-17th 2011, p. 8-9

The Coalition Government's Health Visitor Implementation Plan published in February 2011 promised to recruit an extra 4,200 health visitors to add to the 8,092 that were practising in England in May 2010. However by October 2011 official statistics showed that the number of health visitors had dropped by 213 to 7,879.

Join hands for a unifying purpose

C. Alessi

Health Service Journal, Oct. 27th 2011, p. 16-17

This comment piece advocates integration of healthcare services provided by Clinical Commissioning Groups (CCGs) and foundation trusts with social care provided by local authorities. CCGs, foundation trusts and local authorities share the unifying purpose of optimal delivery of health and social care to a population. This approach would also give a boost to the drive towards prevention of ill health to deliver cost savings.

Keogh warns commissioners not to ration care

S. Lewis and D. West

Health Service Journal, Oct. 13th 2011, p. 4-5

A letter from NHS medical director Sir Bruce Keogh sent in October 2011 warned primary care trusts against referral restriction policies, particularly bans on procedures of allegedly marginal or limited clinical effectiveness. The Department of Health was also understood to be considering a tougher regime for checking whether commissioners were following clinical guidance.

NHS reform risks 'wrecking patient-GP relationship'

D. Campbell and R. Ramesh

The Guardian, Oct. 20th 2011, p. 5

The NHS shakeup risks wrecking GPs' relationship with their patients, turning them into rationers of care who deny the sick the treatment they need, the leader of Britain's family doctors warned. GPs could be "compromised" by having to decide whether to provide sick patients with the best treatment or meet financial targets, according to Dr Clare Gerada, the chair of the Royal College of GPs. Giving GPs control of health budgets - the cornerstone of Andrew Lansley's restructuring of the NHS in England - could diminish the trust between patients and family doctors.

Pilot buckles up for turbulent times

S. Ford

Health Service Journal, Oct. 20th 2011, p. 20-21

The planned transfer of responsibility for public health from primary care trusts to local authorities has been widely welcomed. However, there has been rising frustration in the sector because no detailed implementation plans have been produced. Dr Ruth Hussey, interim director at Public Health England, promises that detailed plans will be published this Autumn.

Primary care

Health Service Journal, Oct. 13th 2011, supplement, p.23-28

This supplement includes articles on the impact of Care Quality Commission registration on GP practices, options for managing referrals to cut costs, the future of branch surgeries, and the role of GPs in reducing the NHS's carbon footprint.

Thousands of patients struck off by their GPs

J. Laurance

The Independent, Oct. 18th 2011, p. 1

A new report by the NHS Ombudsman, Ann Abraham, has revealed that many GP practices are adopting a zero-tolerance approach and striking patients off their lists following minor perceived misbehaviour. GPs have the right to strike patients off, but only after violent or abusive behaviour. The report has found that the draconian measure is often adopted for minor incidents, not all of them involving violence or abuse, and that often the appropriate procedures are not being followed by GP practices.

Transforming NHS ambulance services

Committee of Public Accounts

London: TSO, 2011 (House of Commons papers, session 2010/12; HC1353)

Ambulance services are expected to make 4% efficiency savings year on year at a time when public demand for services continues to rise. Until April 2011performance was measured against three response time targets, but the incentive to meet these targets led to some inefficiency, such as when more than one team was sent to incidents. The Committee welcomes the decision to introduce a wider suite of health quality indicators to create a broader performance regime in which response times remain one indicator. There is wide variation in the cost of responding to an incident across the services, and there is a need for more consistent performance data in order to benchmark and share best practice. There is need for greater clarity on the roles and responsibilities of the Department of Health, commissioners and ambulance trusts with appropriate structures for accountability. Other parts of the health service affect ambulance services and a more integrated emergency care system is needed to ensure that ambulances are utilised in the most efficient manner.

Vision for commissioning support revealed

D. Williams

Health Service Journal, Oct. 20th 2011, p. 4-5

The Department of Health has produced draft guidance on the organisation of commissioning support services following the abolition of primary care trusts. There will be 25-35 'end-to-end' commissioning support organisations from which clinical commissioning groups can buy services. Most of these organisations will initially be hosted by the NHS Commissioning Board, before becoming independent enterprises in 2016. Additionally, ten regional business units will provide some business intelligence. Back office functions, major clinical procurement, business intelligence and communications could be run nationally with local outposts, as a national network, or with a range of suppliers working to national standards.

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