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Welfare Reform on the Web (July 2003): National Health Service - Community and Primary Care Services

ARE PATIENT SURVEYS HITTING THE RIGHT SPOT?

N. Bostock

Primary Care Report, vol. 5, 14 May 2003, p.4

Patient surveys of Primary Care Trusts (PCTs) were introduced this year. The 60% response rate set by the Department of Health is not being met. Finds little difference in response rates between surveys carried out by PCTs and those contracted out. Suggests there are too many surveys and a more integrated approach, maybe a health community wide survey, is needed. Greater flexibility in the survey so PCTs can add specific questions they want answers to would be an improvement. Argues that the current surveys are useful for the Department of Health to make a comparison of PCTs and increase accountability, but they do not provide the PCTs with information to help them develop their service. Argues for a more coherent approach next year.

BUILDING BRIDGES

J. Smith, N. Goodwin and E. Peck

Health Service Journal, vol. 113, May 22nd 2003, p.24-26

Primary care trusts can be torn between the need for critical mass created through mergers to form larger organisations and the danger of losing local vision and ownership. Article presents an innovative solution developed by North and South Trafford Primary Care Trusts in Birmingham. Two PCTs have been retained in Trafford, but with a single common secretariat and executive team. This entails the maintenance of two PCT boards and professional executive committees, with a joint and integrated management structure.

DON'T SLIP UP: HOW PCOs ARE ROAD TESTING PATIENT SAFETY

R. Lewis

Primary Care Report, vol. 5, 14 May 2003, p.16, 19

Looks at the role of the National Patient Safety Agency (NPSA) set up in 2001. It aims to create a national reporting and learning system for dangerous incidents. Hospital care was the initial focus, but now the NPSA is also working with Primary Care Trusts (PCTs) and Local Health Boards (LHBs). Suggests steps that primary care teams could take to start to prepare for adverse incident reporting. A database of incidents is being created that is accessible using the Internet. To ensure participation, incidents are reported anonymously. The NPSA aims to identify problems and trends and feedback its findings to the NHS. It has developed learning materials on patient safety and supports the In Safer Hands collaboration, led by the Royal College of General Practitioners.

END OF THE LINE

J. Davies

Health Service Journal, vol. 113, June 6th 2003, p.12-13

Describes innovative approaches adopted by some primary care trusts to cutting waiting lists through referral management. This involves monitoring GP referrals to secondary care and encouraging the diversion of patients to alternative sources of treatment such as clinics run by the PCT itself.

FUTURE DIRECTIONS FOR PRIMARY CARE TRUSTS

R. Lewis, J. Dixon and S. Gillam

London: King's Fund, 2003

Discusses possible future development trajectories for primary care trusts in an NHS in which policy emphases on decentralisation and market incentives are pre-eminent. In the new system the goal of greater responsiveness of providers to patients is key, and market forces will be curbed through new models of social ownership. Report presents three scenarios for the future of PCTs. In the first, PCTs are given foundation status and compete with each other for patients. In the second, use of competition outside of elective care is minimal and "foundation systems" ensure integration of primary and secondary care services based on collaboration. "Foundation systems" link local health resources at a strategic level, with agreed autonomy for component organisations. The third scenario proposes an ethical market in which more incentives are employed where consistent with the social mission of the PCT.

GP DISENGAGEMENT: A LOGICAL SOLUTION

M. Lakhani

Primary Care Report, vol. 5, Apr. 30th 2003, p.16-18

GPs are not engaging with primary care trusts and their change agenda. Article suggests some practical solutions.

GPs WILL OWN UP TO ERRORS IN 'NEAR MISS' LOG

O. Wright

The Times, May 21st 2003, p.4

The Government is to introduce a system of aviation-style near-miss reports for family doctors in an attempt to reduce medical errors. From next year every GP in Britain will be encouraged to report mistakes to the National Patient Safety Agency.

HOW WILL LOCAL HEALTH BOARDS SIZE UP IN WALES?

N. Bostock

Primary Care Report, vol. 5, Apr 30th 2003, p.20-25

Wales's five health authorities have now been scrapped and replaced by 22 new local health boards. These will receive about 75% of the health service budget and will undertake commissioning of services and other responsibilities previously within the remit of health authorities. They are coterminous with their local government counterparts, with whom they have a statutory duty to collaborate.

IN THE FRAME

T. Yole and A. Barrett

Health Service Journal, vol. 113, May 20th 2003, p.26-27

To improve nurse retention, a group of primary care trusts has developed a series of competency-based frameworks which aid career progression. The frameworks cover community nursing, school nursing and health visitors from grades A-H. Each framework maps out the knowledge and skills required of nursing staff at each grade.

INNOVATION IN HEALTHCARE: HOW DOES CREDIBLE EVIDENCE INFLUENCE PROFESSIONALS?

L. Fitzgerald, E. Ferlie and C. Hawkins

Health and Social Care in the Community, vol. 11, 2003, p.219-228

Investigates how innovations are adopted in primary care settings. Takes four innovations and traces their adoption. Finds a complex system of adoption. Identifies a range of factors influencing the spread of an innovation and finds adoption is frequently preceded by debate in the primary care setting. Finds that the adoption of innovation in primary care practice is markedly different to adoption in acute settings. Suggests that these differences mean the implementation of change must be handled differently in a primary care settings and sets out some ways in which change can be facilitated.

PRACTITIONERS WITH SPECIAL INTERESTS: A STEP-BY-STEP GUIDE TO SETTING UP A GENERAL PRACTITIONER WITH A SPECIAL INTEREST (GPwSI) SERVICE

Practitioners with Special Interest Team

National Primary Care Trust Development Programme, 2003

Guide covers current service review, new service design, clinical governance and audit and evaluation.

STRIKING THE SPECIALIST SERVICES BALANCE

S. Prestwood

Primary Care Report, vol. 5, Apr 30th 2003, p.4-7

Primary Care Trusts have to strike a balance between high volume local commissioning and funding specialist services. Recent Department of Health guidance has emphasised the need for PCTs to act collaboratively and to delegate specialist commissioning to joint subcommitties.

VALUE ADDED FACTS

K. Blears

Health Service Journal, vol.113, June 5th 2003, p.26-27

South Manchester PCT set up a one-day-a-month course to aid the professional development of practice managers. This was the first time they had been engaged through a tailored programme. GPs now encourage their practice managers to attend, having seen the benefits.

WHEN LONDON'S FOUND WANTING

N. Buxton and others

Health Service Journal, vol. 113, May 15th 2003, p.34-35

Article discusses results of focus groups and interviews with trainee GPs which identified motivating factors that might induce them to work in a deprived area. These were:

  • a good patient mix and working in more than one location;
  • flexible working hours;
  • opportunities to develop specialist knowledge;
  • introduction of "pre-partnership" salaried posts;
  • a well-developed and desirable working environment;
  • ongoing post-training support.

WILL HEADHUNTING ABROAD SOLVE THE GP RECRUITMENT CRISIS?

S. Prestwood

Primary Care Report, vol 5, 14 May 2003, p.13-15

The government is trying to attract 2000 extra General Practitioners (GPs) to work in the UK by April 2004. Finds scepticism that this target can be reached, despite the Department of Health saying it is still attainable. Higher salaries, stronger support networks and increased training opportunities have attracted some overseas GPs to the UK. Looks at the recruitment and selection process and finds the full cost of the process is not known.

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