Welfare Reform on the Web (April 2003): National Health Service - Primary and Community Care
ALL IN A DAY'S WORK
G Buckle and D Gallen
Health Service Journal, vol. 113, February 27th 2003, p.28-29
Establishing a first contact team of two practice nurses and a GP has enabled an Oxford general practice to offer same day access for any patient who wants it. The team provides morning and afternoon sessions five days a week, seeing an average of 45 patients a session. The service has freed up GPs to spend more time with patients who have booked an appointment, allowing them to give each patient a minimum of ten minutes. The first contact service has been welcomed by patients.
CLINICAL GOVERNANCE: HOW PCTs ARE KEEPING BIG BROTHER IN CHECK
S Crowe
Primary Care Report, vol. 5, February 19th 2003, p.34-36
Primary Care Trusts are making good progress in implementing clinical governance structures and are beginning to address quality issues in a supportive manner.
COMMUNITY PRACTITIONERS: THE CINDERELLAS OF IT?
G Wilson
Community Practitioner, vol. 76, 2003, p.49-52
Argues that nurses are suffering from restricted or denied access to information technologies such as the Internet and e-mail. Asserts that unless this issue is addressed, and the IM&T training needs of nurses are met, the planned expansion of their role will not be delivered. The ability of nurses to expand their role by embracing IM&T to develop new ways of working in order to deliver the modernisation agenda will be seriously compromised.
DEVELOPMENT AND USE OF INTEGRATED ELECTRONIC RECORDS
K Darroch and B Ellis
Community Practitioner, vol. 76, 2003, p.53-55
Paper discusses the experience of an integrated primary health care team in establishing a shared electronic patient record. All members of the primary health care team record clinical activity on a single system supplemented by an electronic appointment system, pathology messaging and the scanning in of all incoming mail.
IS RESPIRATORY DISEASE ABOUT TO COME IN FROM THE COLD?
M Pownall
Primary Care Report, vol. 5, February 5th 2003, p.40-42
As there is no national service framework for respiratory disease, the Respiratory Alliance has produced its own guidelines aimed at giving PCTs advice on addressing the lung conditions that present in primary care.
IT TAKES TWO
A Altoft and D Raven
Health Service Journal, vol. 113, February 6th 2003, p.28-29
Chiltern and South Bucks PCT launched an intermediate care scheme in April 2000 which offers older people nursing care, physiotherapy and occupational therapy at home. Patients receive an assessment within two hours of referral and care within four hours. Patients can refer themselves to the scheme, as can ambulance crews, preventing hospital admissions.
LIBERATING THE TALENTS: HELPING PRIMARY CARE TRUSTS AND NURSES DELIVERY THE NHS PLAN
Department of Health
London: 2002
In the government's eyes, community nurses and health visitors now have three core functions:
- first contact/acute assessment, diagnosis, care, treatment and referral;
- continuing care, rehabilitation, chronic disease management and delivering National Service Frameworks;
- public health/health protection and promotion.
It is suggested that staff should be adaptable enough to take on any element of these three roles. The emphasis is on flexibility and joint posts across the hospital/community divide. Nurses should have more opportunities to provide secondary care in community settings, to extend nursing roles, and to deliver 24 hour first contact care across a range of settings.
MORE TRAINING IS KEY TO HELPING GPs AND POLICE IMPROVE CHILD PROTECTION
C Jerrom
Community Care, February 6th-12th 2003, p.20-21
The Laming report attributes the failure of the police to help Victoria Climbié to the low priority given to child protection. Police child protection teams were poorly trained and under-resourced. Report also calls for better training for GPs in identification of deliberate harm to children, and more detailed record keeping in primary care.
PRIMARY IGNITION
P Stephenson
Health Service Journal, vol. 113, February 27th 2003, p.15
Discusses steps primary care trusts will need to take to implement the new GP contract. This includes provision of out-of-hours cover for those practices which opt out of offering it, as they can under the new contract. They will also need to ensure that the IT infrastructure is in place to support necessary data collection, and that all primary care services are available somewhere on their patch, as GPs can now opt out of providing some.
ROLE CALL
J Carvel
Guardian Society, February 25th 2003, p.10-11
The new GP contract is set to be unveiled. Practices that need more doctors hope the changes can ease their problems.
THE SKIN TRADE
S Cocker and L Elliott
Health Service Journal, vol. 113, February 13th 2003, p.32
Describes how long waits for dermatology outpatient appointments were reduced by a hospital trust through the development of a community service run by GP specialists.
TO THE ENT DEGREE
D Sanderson and others
Health Service Journal, vol. 113, February 27th 2003, p.26-27
Evaluation of six pilot schemes using specialist GPs to provide ENT (ear, nose and throat) services in the community suggests these innovations have the potential to reduce waiting times. Found that in one area where a specialist GP had been in post for three years, waiting times were down to 24 days.
WAIT OF EXPECTATION
G Clews
Health Service Journal, vol. 113, February 13th 2003, p.10-11
Reports that the NHS is on track to meet its target of 90% of GP practices being able to offer their patients a doctor's appointment within two days by April 2003. However, the methodology for compiling the figures is suspect, as it is based on a single phone call from the primary care trust employee producing the data.
WHY ARE LARGE PRACTICES SHUNNING PCT INVOLVEMENT?
M Pownall
Primary Care Report, vol. 5, February 5th 2003, p.23-27
Some large GP practices are deciding not to be formally involved with the management of their primary care trust and not to belong to the professional executive committee. Reasons include lack of time, perceived lack of GP influence, and the PCTs' continued focus on secondary care.