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Welfare Reform on the Web (June 1999): National Health Service - Community and Primary Care Services

DEVELOPING THE MENTAL HEALTH AGENDA FOR PRIMARY CARE GROUPS

E. Peck and A. Greatley
Managing Community Care, vol. 7, 1999, p. 3-6.

Paper reports on a project carried out by the King's Fund and the Centre for Mental Health Services Development on primary care and mental health. Primary Care Groups offer great opportunities for primary care and secondary care to address areas of mutual concern. There are, however, long standing resentments between GPs and community mental health teams which will have to be overcome if the parties are to work together for maximum benefit.

DON'T LEAVE ME THIS WAY

B. Noakes and N. Johnson
Health Service Journal, vol. 109, March 11th 1999, p. 20-22.

Primary care has an ageing workforce. Results of a survey covering Oxfordshire, Berkshire, Buckinghamshire and Northamptonshire showed a quarter of GP principals, half of single-handed doctors and 44% of practice managers to be over 50. The data suggest that 166 new staff will have to be recruited for each primary care group in the study area over the next five years. Individual practices and PCGs need to be made aware of the need for workforce planning. PCGs will have to address the issue of ensuring that practice staff have equity with those in other parts of the NHS.

EMPTY POCKET

K. McIntosh
Health Service Journal, vol. 109, Feb. 18th 1999, p. 14.

This article is one of an occasional series following Primary Care Groups in Enfield and Haringey. Reports that Enfield and Haringey Health Authority has proposed management resourcing of £3 per head for its new Primary Care Groups. Board members are unhappy with a figure based on the former fundholding management allowance rather than the needs of the new groups and point out that it will limit what they can achieve. There is also concern about shadow boards which have only met a few times being asked to draw up Primary Care Investment Plans (PCIPs) for the next three years in a very short time.

FINDING POLL POSITION

N. Starey and M. Marchment
Health Service Journal, vol. 109, March 11th 1999, p. 24-25.

There are major governance issues for primary care trusts that need to be addressed now. Greater accountability to the community is needed. There should be clear and rapid moves towards a democratic model. Electing a third of board members every year for three years, with participation by the local population, would improve democratic accountability.

GUIDING LIGHT

K. McIntosh
Health Service Journal, vol. 109, March 4th 1999, p. 9-10.

Reports that GPs and managers are alarmed by the lack of detail in Department of Health guidance on Primary Care Trusts (PCTs). The proposed management structure attempts to balance the roles of clinicians and managers with overall supervision by a lay majority board and a trust executive with a majority of primary care professionals.

HEALTHY NEIGHBOURHOODS

N. Gowman
London: King's Fund, 1999.

Argues that the healthy neighbourhood concept first proposed in the green paper Our Healthier Nation should be developed to form a central component of the government's public health strategy. It could provide a new way for a range of organisations, including local and health authorities, voluntary organisations, businesses and local people, to work together at a community level to improve health.

(See also Community Care, no. 1261, 1999, p. 20-21)

LOCAL HEROES GET STUCK IN

A. Coote
Health Service Journal, vol. 109, Feb 25 1999, p. 16-17.

Presents a critique of community initiatives for health improvement. Local action is messy, unpredictable and hard to control from the centre. A community may build up its social capital and then use it for anti-social purposes such as stopping a social housing scheme. Community projects are often fragile, and may fizzle out before attaining their goals. Current hopes are invested in the social entrepreneur as community leader, but these at worst may be erratic, obsessive egoists who concentrate power in their own hands. Even success produces problems. Successful community action makes people healthier, better off and more socially mobile. They are then likely to head off for greener pastures, making it difficult to sustain the well-being of communities left behind.

MODERNISING THE MENTAL HEALTH SERVICES: THE RIGHT ACT FOR THE WRONG REASON?

J. A. McFadyen
British Journal of Health Care Management, vol. 5, 1999, p. 28-34.

Article explores the various options outlined in the government's recently launched mental health strategy. Argues that we need to set aside false arguments about civil liberty and get on with the job of making community care as safe and supportive as possible. Mental health professionals must accept responsibility for delivering care and protection, and for taking control when necessary in respect of people with severe mental illness.

PLACING POVERTY ON THE AGENDA OF A PRIMARY HEALTH CARE TEAM: AN EVALUATION OF AN ACTION RESEARCH PROJECT

M. Bond
Health and Social Care in the Community, vol. 7, 1999, p. 9-16.

In 1994 the Audit Commission pointed to the potential contribution which proactive and well co-ordinated health and welfare services could make to meeting the needs of vulnerable families, and suggested setting up local demonstration projects. Paper discusses a two-year initiative (the SPIDA Project) based in an inner city primary health care team in Nottingham, which adopted an action research and team learning approach to develop collaborative strategies to alleviate the effects of poverty.

PRIMARY HEALTH CARE AND SOCIAL CARE: WORKING ACROSS PROFESSIONAL BOUNDARIES. PART 1, THE CHANGING CONTEXT OF INTER-PROFESSIONAL RELATIONSHIPS.

B. Hudson
Managing Community Care, vol. 7, 1999, p. 15-22.

Traces of growing recognition of the value of teamworking in primary care, and looks at barriers to progress.

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