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Welfare Reform on the Web (July 2001): National Health Service - Community and Primary Care Services

CRISIS IN CARE : A GP DOSSIER

British Medical Association

London : 2001

Study of more than 100 family doctors shows morale to be at an all-time low, with many considering leaving the profession. GPs say they do not have enough time with patients, have to deal with mountains of paperworks, and face intolerable pressures on resources. There is serious dissatisfaction with the state of the NHS, and especially with long waits for elective surgery such as hip replacements.

DOES GENERAL PRACTITIONER INVOLVEMENT IN COMMISSIONING MATERNITY CARE MAKE A DIFFERENCE?

S. Wyke et al

Journal of Health Services Research and Policy, vol. 6, 2001 p. 99-104

Study evaluated the impact of GPs' commissioning of maternity services on women's experiences of care and on resource use, and considered the implications for primary care commissioning. Results of the survey showed that there were no significant differences in women's experience of care or their resource use between commissioning and non-commissioning practices . Authors conclude that hopes that giving primary care organisations responsibility for commissioning care will result in improved patient experiences of care or better use of resources should be treated with caution. The presence of strong national policy may be equally important. Models of service organisation are not proxies for quality of care.

GPS STAGE MAY DAY PROTEST AT RISING WORKLOAD.

J. Laurance

Independent, May 2nd 2001, p.9

Reports that 68 of 11,000 GP surgeries in the UK took part in a May Day protest against rising workloads and burgeoning paperwork. The day of action was organised by the Doctor magazine, but was not supported by the British Medical Association or the Royal College of General Practitioners.

(See also Guardian May 2nd 2001, p. 10)

GP'S THREATEN TO QUIT OVER WORKLOAD

N. Hawkes

Times, Apr 20th 2001, p1

Doctors are threatening a mass resignation because they feel government initiatives have increased their workload to such an extent that they can no longer care properly for patients. 'GPs are not happy about pay, but what they really want is a way of controlling the workload.' There is agreement that a new contract between GPs and the health service is needed. The NHS plan commits to this, but it is the timing that is the issue. There is a second issue and that is over the repesentation of GPs who take up a contract called Personal Medical Services (PMS) which is designed to encourage them to work in inner city areas or large estates that find it hard to attract doctors . The BMA is worried that the government will try and 'divide and rule' the two sets of doctor

(See also Independent, Apr. 20th 2001, p. 1)

GP'S TO VOTE ON QUITTING NHS

C. Hall

Daily Telegraph, Apr. 20th 2001, p. 1+2

The GPs committee of the British Medical Association has voted to ballot doctors as to whether they would quit the NHS if a new contract cannot be agreed by the government within a year. Manpower shortages, heavier workloads, and patients raised expectations and lack of progress with new contract have led to the current situation. Doctors are not against the NHS but patient safety and their ability to deliver safe and competent care to a high standard must be a first priority

(See also Guardian, Apr. 20th 2001, p. 2)

GROUP DYNAMICS

T. Milena and S. Harrison

Health Service Journal, vol. 111, Apr. 26th 2001, p. 32-33.

A telephone survey of primary care groups and trusts has revealed that visits to community groups are the most favoured form of public involvement. There was some evidence of plans having been changed in response to public involvement, but it is too early to say whether PCGs and PCTs will be more successful in involving the public in planning care than health authorities.

PASS THE SMELLING SALTS

P. Stephenson

Health Service Journal, vol. 111, May 3rd 2001, p. 12-13

Morale among GPs has collapsed due to the pace and volume of change imposed by the government. Problems could be resolved by a new GP contract, but there is a real danger of the professional standing of GPs being undermined.

THE PRIMARY CARE TREATMENT OF USERS: IS SHARED CARE REALLY THE BEST APPROACH?

I. Ryrie and C. Ford

Journal of Substance Use, vol. 6, 2001, p. 3-6

Recent guidelines on the clinical management of drug misuse emphasize a central role for primary care staff, and advocate shared care as the mechanism by which this role may be fulfilled. To date and in spite of such policy initiatives, the involvement of GPs has been described as "patchy and slow". Paper suggests that specialist - led models of "shared care" may militate against GP involvement and examines alternative approaches to the primary care management of drug misuse. "Primary care facilitation" is presented as one such alternative, and its critical features are elaborated.

WHY ANGRY GPS ARE RUNNING OUT OF PATIENCE

S. Boseley

Guardian, Apr. 26th 2001, p. 9

Reports that general practitioners are in full revolt against the government due to

  • increasing paperwork;
  • increased public expectations;
  • shortages of both qualified doctors and nurses which makes it difficult to recruit more staff.

WILL GPs SWALLOW LABOUR'S LATEST PILL?

S. Ward

Public Finance, May 4th-10th 2001, p. 12-13

With a debate on their workloads raging in the background, the British Medical Association and the department of Health are negotiating a new contract for GPs. The government wants to change the way that GPs' pay is calculated. Under the proposed new scheme, this would be based on outcomes rather than numbers of patients registered or seen. The BMA wants to ensure this does not reduce GPs' incomes. The union also wants to prevent pay being linked to achievement of locally negotiated targets.