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

AMBULANCE STAFF 'FEARED REVEALING FIDDLED 999 DATA'

J. Carvel

The Guardian, Oct. 15th 2002, p. 11

Paramedics and junior staff at the Dorest Ambulance Service were cowed by managers and did not dare voice suspicions that the organisation was fiddling the figures on ambulance response times, according to the Health Inspectorate.

CITIZENS' PANELS POINT THE WAY TO EFFECTIVE PUBLIC CONSULTATION

A. Coleman and A. Holcroft

Primary Care Report, vol. 4, no. 16, Sept. 25th 2002, p. 24-25

Authors believe that by consulting the public in combination with other stakeholders, primary care organisations can tap into an invaluable pool of knowledge.

CONSULTANTS' CONTRACT WILL ADD TO PCTs' COST PRESSURE

S. Brown

Primary Care Report, vol. 4, no. 15, Sept. 11th 2002, p. 8-11

The historically lucrative consultants' contract has received a further cash boost in its recent revision and it is primary care trusts (PCTs), the author suggests, that will foot some of the bill as their budgets are sucked into secondary care .

DRIVING SEAT OR BACK SEAT? GPS' VIEWS ON AND INVOLVEMENT IN PRIMARY CARE GROUPS AND TRUSTS

E. Regen

Birmingham: Health Services Management Centre, University of Birmingham, 2002

Survey showed that GPs' involvement with primary care organisations was likely to be limited to commenting on policy proposals. Only 20-30% attended subgroup meetings or awaydays. This lack of grassroots involvement was attributed to lack of time and scepticism about the effectiveness of Primary Care Groups and Trusts. Goes on to make recommendations on how levels of participation might be raised.

ELECTRONIC BOOKING HERALDS NEW DAWN FOR GP REFERRALS

G. Fleming

Primary Care report, vol. 4, no. 15, Sept. 11th 2002, p. 27-29

Electronic booking will revolutionise the way GPs arrange hospital appointments for patients. Article reports on how the system is being piloted and progress being made.

HARD TO SWALLOW

J. Jesson and others

Health Service Journal, vol. 112, Oct. 10th 2002, p. 28-29

The Department of Health has invited applications from Primary Care Trusts wishing to become pathfinder sites for repeat dispensing schemes. These allow patients to be issued with several prescriptions which are then stored by the pharmacist. Research suggests that repeat dispensing is popular with patients but does not save large amounts of money.

HEALTH ACTION ZONES: "CREATING ALLIANCES TO ACHIEVE CHANGE"

E. Matka, M. Barnes and H. Sullivan

Policy Studies, vol. 23, 2002, p. 97-106

The New Labour government stresses partnership working and community involvement as fundamental to achieving change. Article argues that the Health Action Zone programme provides important lessons on how such new ways of working can be developed. Evaluation of Health Action Zones shows that community and voluntary sector organisations initially lacked resources and capacity to act as equal partners. Health Action Zones have piloted successful local strategies for engaging partners and involving communities; however, without the extra funding they have provided these resource intensive approaches may lose out to main stream and national agendas seeking quick results.

MARGIN OF ERROR

P. Dinsdale

Health Service Journal, vol. 112, Oct. 17th 2002, p. 10-11

Results of a survey show that lead nurses in primary care trusts are feeling marginalised in the decision-making process and pressured by their heavy workloads.

MODEL BEHAVIOUR

S. Moore

Health Service Journal, vol. 112, Oct. 17th 2002, p. 26-27

A statistical model in use at Plymouth Primary Care Trust enables the prediction of acute admissions to hospital over a two-year period. Results show that the rise in emergency medical admissions threatens the local hospital's capacity to meet waiting time targets for planned work. The research also shows that the establishment of a local diagnostic and treatment centre would reduce levels of bed occupancy in the hospital to a level that could threaten its survival.

NHS DENTISTRY: ARE PCTS BITING OFF MORE THAN THEY CAN CHEW?

S. Prestwood

Primary Care Report, vol. 4, no. 17, Oct. 9th 2002, p. 7-8

Primary Care Trusts (PCTs) have assumed responsibility for commissioning NHS dental services. There is concern that the PCTs will lack time and resources to give commissioning dental services the priority it needs. However, under the proposals contained in "NHS Dentistry: Options for Change", a pilot scheme to commission dental services and fund them locally through PCTs will be trailed at 10 sites.

NO CASH HANDOUTS FOR OVERSPENT PCTS

S. Crowe

Primary Care Report, vol. 4, no. 16, Sept. 25th 2002, p. 1

PCTs will not receive Treasury handouts should prescribing pressures and inherited health authority deficits leave them with overspends at the end of this financial year.

OVERSEAS TREATMENT: HOW HARD WILL IT HIT THE POCKETS OF PCTS?

S. Crowe

Primary Care Report, vol. 4 no. 15, Sept. 11th 2002, p. 16-17

Although the first overseas commissioning pilots have been judged a success, the cost impact of sending patients abroad is starting to raise serious concerns.

PCT STAFFING CRISIS SPARKS RATINGS ALARM

S. Prestwood and N. Bostock

Primary Care Report, vol. 4, no. 15, Sept. 11th 2002, p. 1, 4-6

Staff shortages could damage PCTs' ability to do well on performance assessments, further disadvantaging overstretched staff. The extent of the recruitment crisis is revealed in a Primary Care Report Survey which found 77 per cent of PCTs had recruitment difficulties.

PROFESSIONAL EXECUTIVE COMMITTEES: DOES YOUR'S STAND DIVIDED?

J. Huntingdon

Primary Care Report, vol. 4, no. 16, Sept. 25th 2002, p. 26-27

As primary care trusts have grown in size and scope, many GPs have grown alienated by what they perceive as their bureaucratic nature. Author also believes Professional Executive Committees are not as effective as they could be due to confusion over their nature and function.

PUBLIC SERVICE RESPONSIVENESS TO USERS' DEMANDS AND NEEDS: THEORY, PRACTICE AND PRIMARY HEALTH CARE IN ENGLAND

R. Sheaff, S. Pickard, and K. Smith

Public Administration, vol. 80, 2002, p. 435-452

Study of English primary care groups explores problems they face in practical demand management. This received low priority in terms of incentives and intellectual resources applied to it. Needs assessment had higher priority but was regarded as a branch of evidence-based professional practice, controlled by professionals rather than responsive to users. This separation tended to defeat the purposes of needs-based public services. "Needs" were defined for the purposes of the paper as "rational" demands, with rational meaning "consistent and evidence based", and "demands" as "desires" rather than "effective (ie economic) demand.

REDESIGN STAFF ROLES TO STRENGTHEN YOUR WORKFORCE

M. Land and D. Sanderson

Primary Care Report, vol. 4, no. 17, Oct. 9th 2002, p. 28-29

Discusses ways of improving job opportunities and satisfaction in primary care through the creation of specialist nursing posts and by encouraging GPs to develop a special interest in a clinical area such as dermatology.

REFOCUSING COMMISSIONING FOR PRIMARY CARE TRUSTS

C. James, M. Dixon and M. Sobanja

Retford: NHS Alliance, 2002

Government policy is to promote consumer choice in the NHS by changing funding flows to "move resources with patients". This could undermine commissioning by Primary Care Trusts (PCTs) which will find it impossible to predict who the patient's preferred provider will be. A PCT could make a firm financial commitment with local providers which would put it at risk if patients wanted to be treated elsewhere. Alternatively it could purchase care on a case-by-case basis, with providers losing any long-term security. Providers could respond by adopting marketing techniques and advertising services direct to patients.

URL: www.nhsalliance.org

STUCK BETWEEN FLAWS

P. Smith

Health Service Journal, vol. 112, Oct. 17th 2002, p. 10-11

Discusses errors made by the Department of Health in the calculation of performance indicators for primary care trusts in 2002. If repeated, these could undermine the credibility of the system.

SUM OF THE PARTS

A. Frater and M. Gill

Health Service Journal, vol. 112, Oct. 17th 2002, p. 24-25

A simulation exercise intended to ease the introduction of clinical networks revealed that primary care trusts were eager to co-operate with one another. Acute trusts emerged as the most confident "players" and were perceived as a "provider cabal" by PCTs. The regulator role of strategic health authorities proved crucial to the development of the network.

WHY FALLING JUNIOR DOCTOR HOURS FUEL PCT COSTS

S. Brown

Primary Care Report, vol. 4, no. 16 Sept. 25 2002, p. 16-19

Author believes that reducing junior doctors' hours in line with European law is increasing financial pressure on commissioning organisations.

WILL STRATEGIC HEALTH AUTHORITIES BE TARRED WITH THE SAME BRUSH?

M. Pownall

Primary Care Report, vol. 4, no. 17, Oct 9th 2002, p. 16-19

Discusses the roles of, and relationships between, primary care trusts and regional health and social care directorates on the one hand and strategic health authorities on the other. Strategic health authorities will performance manage primary care trusts without becoming involved in their day to day operations.

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