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

Abortion clinic protests raise fears over doctors' safety

D. Campbell and B. Quinn

The Guardian, May 28th 2012, p. 5

Doctors who helped women end unwanted pregnancies were growing concerned for their own safety as anti-abortion groups stepped up protests outside clinics, a specialist in women's health warned. Tony Falconer, president of the Royal College of Obstetricians and Gynaecologists, described the American-style protests outside abortion clinics as distressing and humiliating for those preparing to have a termination. Falconer called the rising use of vigils and human chains at clinics an unwelcome and worrying development that could also deter younger doctors from opting to perform abortions. Falconer said colleagues were very anxious and worried about the provision of the service. "It doesn't help to have a sort of clamour [against] individual people who are trying to provide a difficult service for women in a period of their lives when they are in great difficulty."

CCGs rock boat by hosting in-house support

D. Williams

Health Service Journal, May 17th 2012, p. 4-5

Clinical commissioning groups are opting to host support functions in-house rather than outsource to 'unproven' clinical support services. The trend threatens to undermine the government's plan to create a market for 'standalone' support services.

Discuss resuscitation orders with families, care home GPs are told

J. Meikle

The Guardian, May 7th 2012, p. 7

The NHS warned GPs treating thousands of patients in care homes to follow the law and good practice on issuing "do not resuscitate" forms after apologising for not discussing the issue with a patient or his family. The "reminder" followed investigations into a complaint by the daughter of a 77-year-old man after she found out by chance that he had such a form in his medical notes. The GP and staff at the home for people with physical disabilities and long-term medical conditions in south London where he was staying did not consider the man to have the capacity to be involved in the decision - a verdict the family strongly disputed. Officials investigating the case said staff were "extremely sorry that they did not make more strenuous attempts" to speak to his daughter, who is next of kin and lives in Las Vegas. The GP was also sorry that she "became aware of this decision in such a blunt manner".

Formula aims to settle CCG disputes

D. Williams Health Service Journal, May 3rd 2012, p. 6

Guidance from the NHS Commissioning Board has set out new principles for "firming up" clinical commissioning group (CCG) boundaries, and an elaborate formula for resolving disputed areas. However, even if applied everywhere, the formula still leaves around 8% of the population living in areas not assigned to a CCG, with large gaps in the North of England and the West Midlands. Although CCGs are made up of groups of GP practices, they will also be responsible for a defined geographical area. The precise boundaries have proved difficult to agree as practice catchment areas often overlap.

From healthcare to self care

D. Kyne

Health Service Journal, Apr. 26th 2012, p. 32-33

This article describes how investing in service redesign at Smethwick Medical Centre enabled the practice to make cost savings and improve patient health. The population was risk stratified and new services introduced, including educational events, a triage callback service to reduce face to face appointments, a telephone support and advice service and group consultations to help patients manage long-term conditions.

GPs 'punished' as late opening proves a flop with patients

S. Adams

Daily Telegraph, May 3rd 2012, p. 6

When he was prime minister, Gordon Brown pushed GPs to offer extended opening hours, arguing that working people found it hard to take time off for appointments. Doctors said that there was no demand for late opening, with only one third of late appointment slots being filled at some surgeries. However, some primary care trusts are withholding payments for the service unless doctors fill a set proportion of appointments, typically 70%.

Lethal errors in 2m prescriptions

R. Smith

Daily Telegraph, May 2nd 2012, p. 1

Research by the General Medical Council found that GPs were giving out almost two million prescriptions a year containing potentially life threatening errors. One in five patients was receiving prescriptions with mistakes including wrong dosage, incorrect instructions or inadequate monitoring. Older people and children were twice as likely to be given a prescription with an error. The study also found evidence that GPs were signing prescriptions without seeing patients, issuing repeat prescriptions without questions, and failing to adjust drug dosages following new tests.

(See also Guardian, May 2nd 2012, p. 9)

Frontline First: Congress 2012 update

Royal College of Nursing, 2012

Government plans to move care from acute hospitals to community settings were branded a "façade" by the Royal College of Nursing , as a survey of community nurses showed that many were facing cutbacks and spending less time with patients. While the shift from acute hospitals to community care had been given as a justification for NHS posts being lost from hospitals in the past, RCN survey demonstrated that community services were overburdened, underinvested and at risk from cutbacks. The RCN released data from its 'Frontline First' campaign that showed that more than 61,000 NHS posts were at risk of being cut. The RCN called on the Government and employers to take these figures seriously.


Primary care: today and tomorrow: improving general practice by working differently

Deloitte Centre for Health Solutions

London: The Centre, 2012

The number of GP appointments is steadily growing, while the number of general practitioners retiring is at a ten year high. By 2035, GPs would be undertaking 433m appointments a year, up from 300m in 2008, the report predicts, leaving surgeries struggling to cope with demand. Most of the rise in demand would be from the over-65s, doubling from about 90m appointments in 2012 to an estimated 180m by 2035. It is concluded that the growing numbers of elderly people mean that the GP service is unlikely to be sustainable.

Social marketing as an appropriate strategy to reduce oral health inequalities

P.R. Brocklehurst, P. Morris and M. Tickle

International Journal of Health Promotion and Education, vol.50, 2012, p. 81-91

Social marketing has been shown to be effective across a wide range of public health settings, yet remains underused. It uses the principles of marketing to understand health-related behaviour and tailor appropriate interventions to population subgroups. Whilst commercial marketing capitalises on current demand for a tangible benefit, social marketing relies on stimulating behavioural change for future health gain. This means that the benefit (i.e. improvement in future health) must be attractive enough to stimulate behaviour change. In contrast many public health interventions rely on 'top-down' diffusion of health information. As a result, the relevance of the message conveyed is often limited and does not produce behaviour change. This paper reviews the theory of social marketing and uses data from the UK to explore its potential to reduce inequalities in oral health and access to care.

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