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Welfare Reform on the Web (February 2012): National Health Service - primary and community care

An asset-based approach: an alternative health promotion strategy?

L. Whiting, S. Kendall and W. Wills

Community Practitioner, vol. 85, Jan. 2012, p. 25-28

Recent local and national UK policy documents have supported an assets-based approach to health promotion, so that more emphasis is placed on the maintenance and creation of health and wellbeing. This paper considers the application of an asset-based health promotion approach to a community context. A practice-based scenario is provided as an illustration of the application of an asset-focused health promotion strategy.

Best practice guidelines for monitoring socioeconomic inequalities in health status: lessons from Scotland

J. Frank and S. Haw

Milbank Quarterly, vol. 89, 2011, p. 658-693

This research analyses, using a novel list of critical appraisal criteria, the strengths and weaknesses of three high quality reports from Scotland that monitor recent trends in routinely collected population health outcomes, including their inequalities by socioeconomic position (SEP). It is concluded that even state-of-the-art reports on health inequalities by SEP have limited usefulness for most health and social policymakers because they focus on routinely collected outcomes that are not amenable to intervention. It is argued that more 'upstream' outcome measures are required, which occur earlier in the life course, can be changed within five years by feasible programmes and policies, accurately reflect individuals' future life chances and health status, and are strongly patterned by SEP.

The learning orientation of primary healthcare teams in the English national health service: is this a myth that should be perpetuated?

J. Wallis and L. Kemp

International Journal of Public Administration, vol.34, 2011, p. 869-878

It is postulated that in a learning-oriented team, members are committed not to the goals set by the leader but to a collaborative process of creative learning in which all engage together. Such commitment is reflected in a willingness to cross the professional and organisational barriers that separate team members in order to work together. Interviews and observations conducted at four general practice sites in England show that the present reality of the primary health care teams studied may fall short of the ideal of a learning-oriented team characterised by broad engagement in the collaborative process. This makes it relatively easy to dismiss the ideal as a myth, as did the coalition government's health white paper which insisted that primary health care teams should be led and coordinated by doctors. This article considers whether perpetuating the myth of the ideal learning-oriented primary healthcare team can serve any useful purpose.

Overweight patients will be banned from routine operations, say GPs

R. Smith

Daily Telegraph, Jan. 19th 2012, p. 8

Overweight patients in Hertfordshire in need of routine elective surgery such as hip replacements were told by local GPs to lose weight and give up smoking before they were put on the waiting list. The move was criticised as rationing, but new clinical commissioning groups set up under the coalition government's health reforms claimed the policy was introduced to mitigate the risks of surgery in obese patients.

Patient access to healthcare services and optimisation of self-management for ethnic minority populations living with diabetes: a systematic review

C. Wilson and others

Health and Social Care in the Community, vol. 20, 2012, p. 1-9

This review aimed to synthesise and evaluate evidence relating to barriers and facilitators in accessing healthcare services and optimising self-management by ethnic minority groups living with diabetes in the UK. The results point to persistent barriers in patient access and self-management of diabetes, particularly for ethnic minority groups with low literacy. Self-management practices are in need of targeted intervention in terms of patients' knowledge and understanding of their illness, inadequacy of information and language and communication difficulties arising from cultural differences. Access to healthcare is similarly hindered by a lack of cultural sensitivity in service provision and under use of clinic-based interpreters and community-based services.

A problem shared

C. Clayton

Health Service Journal, Jan. 19th 2012, p. 26-27

A pilot scheme in Blackburn with Darwen integrates all out-of-hours health and social care services, giving the public a single point of access through a partnership between the local council, the independent sector and care trust plus. The long term ambition is to create an integrated network of professional teams focused on improving the health and wellbeing of families in the borough. This approach could integrate health and social care commissioning and manage the transition of public health into local government.

Risk to patients left with no GPs out of hours


Daily Telegraph, Jan. 18th 2012, p. 6

An investigation by Pulse magazine showed that out-of-hours medical services providers were leaving gaps in rotas. It was alleged that pay for covering an out-of-hours shift, which ranged from 50.00 to 120.00, was insufficient to entice GPs to work evenings and weekends.

'Suspended animation' risk of restructure

D. West and J. Clayton

Health Service Journal, Jan. 5th 2012, p. 4-5

Clinical commissioning is behind schedule in many areas with the transfer of staff from primary care trusts stalled just over a year before NHS restructuring is due to be completed in April 2013. An analysis of progress in half of primary care trusts showed 33% had not formally delegated any budget to emerging clinical commissioning groups. It appeared that many primary care trusts had been unable to delegate budgets because they had not confirmed the structure of their clinical commissioning groups.

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