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Welfare Reform on the Web (August 2002): National Health Service - Primary and Community Care

ARE PCTs DISENGAGING THEMSELVES FROM THEIR BEST ASSETS?

M Pownall

Primary Care Report, vol. 4, no.10, June 2002, p.7-9

Reports on tensions between Primary Care Trust chief executives, board chairs and Professional Executive Committee chairs. There may also be feelings of disengagement amongst GPs, who have lost the central role they had in the former primary care groups.

THE BUCK STOPS HERE

D Austin

Health Service Journal, vol. 112, June 20th 2002, p.32-33

Primary Care Trusts (PCTs) need to develop strategies for rationing treatments and train key staff in handling patients' adverse reactions when funding is refused. PCTs need to develop a mindset that rationing is a legitimate activity and support those involved.

CAN THE PROPOSED GP CONTRACT BE ALL THINGS TO ALL PCOs?

M Pownall

Primary Care Report, vol. 4, no.9, May 22nd 2002, p.4-7

Presents comments on the proposed new contract from general practitioners in Northern Ireland, Wales and Scotland.

EQUITABLE LIFE

A Issott

Health Service Journal, vol. 112, June 13th 2002, p.26-27

A primary care group has weighted the formula for allocating prescribing budgets to take account of chronic disease. The new system is sensitive to local factors such as the siting of a home for children with physical and learning difficulties. Monitoring of the system suggests that some practices are under-prescribing. Successful use of the formula is dependent on practices having accurate disease registers.

GOVERNANCE MODEL KEEPS PCOs IN CHECK

S Brown

Primary Care Report, vol. 4, no.9, May 2002, p.14-18

The Department of Health has published a corporate governance framework for Primary Care Trusts to help them establish sound management and control systems. This framework contains standing orders and standing financial instruments which PCTs are required to adopt. It covers tendering and contracting procedures, acceptance of gifts and hospitality, audit requirements, etc.

GPs TIME WASTED BY EARLY SICK NOTES

J Meikle

The Guardian, June 24th 2002, p.6

Family doctors are being forced to waste time as employers make staff collect sick notes from GPs within seven days of falling ill. According to the Cabinet Office team responsible for cutting doctor's workload, doctors have complained they are still under pressure to sign people off sick despite the 20 year old self-certification scheme.

HOW TO STOP ACUTE CARE PASSING THE BUCK IN PRESCRIBING

A Legge

Primary Care Report, vol. 9, no.4, May 2002, p.25-28

Primary Care Trusts are developing mechanisms for medicines management to prevent hospital consultants from starting patients on expensive drugs and then transferring the cost to GPs budgets.

LEADING LIGHTS

R Thornham and R Nicholson

Health Service Journal, vol. 112, June 7th 2002, p.26-27

Involving clinicians, lay members and managers on the boards of primary care trusts has great potential for producing innovative services. The involvement of clinicians means decisions are more likely to be acceptable to frontline staff. It is important that strategic health authorities foster innovations and do not seek to become controlling of PCTs. It is vital that a culture of performance management does not hamper PCTs development.

LPS OFFERS A LOCAL CURE FOR COMMUNITY PHARMACIES' ILLS

R Lewis

Primary Care Report, vol. 4, no.9, May 2002, p.17-18

Local Pharmaceutical Services (LPS) pilots will enable primary care trusts to commission general community pharmacy services for the first time. This should pave the way for more patient centred services and reduce the emphasis on use of volume of prescriptions dispensed as a performance measure.

MAKE CHILD HEALTH DATA THE CORNERSTONE FOR LIFELONG PATIENT RECORDS

B Taylor

Primary Care Report, vol. 4, no. 10, June 2002, p.27-30

Primary Care Trusts are assuming responsibility for the maintenance of child health information systems. This information is vital for child protection, for caring for children with special needs, for research and for performance measurement of PCTs.

ONE OF THESE DAYS

A Moore

Health Service Journal, vol. 112, June 13th 2002, p.22-25

Government figures suggest that about 75% of general practices are now able to offer patients an appointment within 48 hours. However the methods of gathering the data on which this statistic is based are suspect. Article goes on to investigate innovative measures being used by some practices to meet the 48 hour target, including more use of telephone consultations and delegating work to nurses.

PCTs CAN GAUGE PROGRESS WITH A TRIP TO CYBERSPACE

B Hakin

Primary Care Report, vol. 4, no.9, May 2002, p.31-32

An online performance framework set up by the National and Primary Care Trust Development Programme, will enable PCTs to compare and develop their skills and structures in 9 key areas.

REVISED CONTRACT LETS GPs CALL THE SHOTS, BUT CAN PCTs COPE

B Bates

Primary Care Report, vol. 4, no.9, May 2002, p.22-23

The new GP contract absolves family doctors of many mandatory responsibilities, which will then rest with Primary Care Trusts. A PCT could have a different contract with each practice in its area, and will have to provide for the services not being offered. Author proposes that complex enhanced services should be delivered in local primary care centres by GP-led specialist teams employed by the PCT.

STREET-LEVEL BUREAUCRATS ? HEART DISEASE, HEALTH ECONOMICS AND POLICY IN A PRIMARY CARE GROUP

R McDonald

Health & Social Care in the Community, vol. 10, 2002, p.129-135

Paper reports on a study of local decision-making in a Primary Care Group which focused on the process of service planning and healthcare commissioning in relation to coronary heart disease (CHD). It examines the process, analyses the influence of the various stakeholders and assesses the extent to which health economics input was influential in the decisions taken.

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