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

BUDDING PROFESSIONALS: EXECUTIVE COMMITTEES IN THE SPOTLIGHT

M. Pownall

Primary Care Report, vol.5, no.16, Oct.8th 2003, p.12-14

Professional executive committees in primary care trusts (PCTs) are meant to maintain the involvement of GPs in the new structures. However, there is disagreement between the committees and the PCTs about the formers' proper role. As a result, some committees have spent their first year of operation trying to work out what they are supposed to be doing. There is considerable flexibility in the regulations establishing professional executive committees, and different models are emerging to suit local needs.

EARNED AUTONOMY FOR PCTS? DON'T MAKE ME LAUGH

B. Bates

Primary Care Report, vol.5, no.16, Oct.8th 2003, p.26-29

Top performing primary care trusts are in theory to be rewarded with increased autonomy. Greater Derby PCT was awarded three stars, but has been allowed little control over its destiny by its strategic health authority.

'IGNORANCE IS BLISS SOMETIMES': CONSTRAINTS ON THE EMERGENCE OF THE 'INFORMED PATIENT' IN THE CHANGING LANDSCAPES OF HEALTH INFORMATION

F. Henwood and others

Sociology of Health & Illness, Vol. 25, 2003, p.589-607

The article explores whether, in the age of digital media and specifically the Internet, patients are using sources of health information other than their GP. The information habits of 32 menopausal women were examined. These varied considerably, from those who were extremely well informed regarding health issues, to those who had no interest in research. However, almost all of the women felt there was (or would be) a constraint in discussing any information they had obtained with their GP, as they considered that demonstrating knowledge might intrude upon the doctor's role.

INTEGRATED COMMUNITY NURSING TEAMS: AN EVALUATION STUDY

J. Edmonstone, S. Hamer and S. Smith

Community Practitioner, vol.76, 2003, p.386-389

Paper reports on a project to develop integrated, self-managing community nursing teams in 12 locations in Coventry in 2000/01. Discusses the findings of the largely qualitative evaluation study which explored the expectations of the project, learning from experience, individual and team benefits derived, outcomes achieved and how the approach used might have been improved. The evaluation showed up the need for clarity of vision, the difficulties involved in steering multi-organisation complex projects of this type, the dangers of "reconfiguration blight" and the need for "variable geometry" to reflect the different settings, histories and cultures of teams.

LOST IN A WEB OF INCENTIVES, IMPERATIVES AND INJUNCTIONS

N. Bostock

Primary Care Report, vol.5, no.16, Oct.8th 2003, p.4-5

In order to meet its waiting time targets (and achieve three star status) Leeds Teaching Hospitals NHS Trust has decided to refuse to accept excess referrals from primary care. These will be returned to the point of referral and the GP concerned will be responsible for making alternative arrangements for the patient to be treated. Being seen at one's local hospital will become a lottery.

MEDICATION MANAGEMENT: EVERYONE'S RESPONSIBILITY?

A. Brown

Community Practitioner, vol.76, 2003, p.372

Medicines management is a high priority within the National Service Framework for Older People. It involves advice on prescribing, medicines monitoring, medicines review, management of repeat prescribing and education and training on prescribing and the use of medicines. Article discusses the role of community practitioners in this area

NURSE PRESCRIBING: IT'S NOT JUST THE THOUGHT THAT COUNTS

S. Prestwood

Primary Care Report, vol.5, no.16, Oct. 8th 2003, p.20-21

Under the supplementary prescribing programme, nurses have been able to issue prescriptions for any medication except a controlled drug since April 2003, provided that a clinical management plan is in place overseen by an independent prescriber such as a doctor. Nurses undergo intense training to develop their skills for the role, and need on-going support from GPs and practice staff.

PATIENTS WILL SOON BOOK HOSPITAL TIMES ONLINE

N. Hawkes

The Times, October 9th 2003, p.2

Patients will be able to book hospital appointments online from their GP's surgery, John Reid, the Health Secretary, said yesterday.

(See also Financial Times, October 9th 2003. p.8)

PRIMARY MEDICAL SERVICES (SCOTLAND) BILL

Edinburgh: TSO, 2003 (SP Bill 4, Session 2 (2003)

The Bill replaces the GP contract with a practice-based contract and delegates contract management from the Executive to NHS Boards. Regulations under the Bill will set out the different services that will be provided under the new contract, defined as essential, additional and enhanced.

SPECIAL NEEDS

C. Lewis

Health Service Journal, vol.113, Oct. 23rd 2003, p.22-23

Discusses the challenges faced by Primary Care Trusts in recruiting, managing and training GPs with special interests.

TAKING STOCK OF HEALTH NEEDS ASSESSMENT

D. Barwick

Primary Care Report, Vol. 5, No. 15, September 24th 2003, p.18-19

Primary Care Trusts are now responsible for health needs assessment. By identifying the health needs of their populations they will be able to deliver responsive services and meet government targets. The article describes how Stockport PCT has devised a systematic approach to health needs assessment using frontline staff.

THERE IS NO TELLING

G. Clews

Health Service Journal, vol.113, Oct. 23rd 2003, p.10-11

Reports on the attempts of the expert task group to apply the concept of patient choice to primary care. Current thinking is that "choice" has to encompass informed choice of treatment as well as choice of provider.

WHAT DO YOUR PATIENTS REALLY THINK OF YOU?

M. Greco

Primary Care Report, Vol. 5, No. 15, September 24th 2003, p.22-25

Under the new General Medical Services (GMS) contract, general practices will be expected to carry out annual patient surveys, reflect on the results and propose changes. The article introduces the Improving Practice Questionnaire, a survey instrument accredited for use under the GMS contact.

WHAT MAKES A GOOD HEALTHCARE SYSTEM? COMPARISONS, VALUES, DRIVERS

A. Gillies

Oxford: Radcliffe Medical Press, 2003

This book examines the various assumptions that underpin the different views of what makes a good healthcare system. The national systems in the UK, Australia and Canada are examined. Each country has a different view of what good healthcare is trying to achieve, and these are highlighted by examining policy documents and comments from key stakeholders. Case studies emphasise the diverse needs and expectations of individuals, examining and comparing concepts of health needs, quality as a measure of 'good-ness' and the various ideas on Gold Standards.

WHY PCT MERGERS CAN SNOWBALL OUT OF CONTROL

N. Goodwin and J. Smith

Primary Care Report, vol.5, no.16, Oct.8th 2003, p.23-25

Mergers are regarded as the means for primary care trusts to achieve both managerial efficiency and greater influence in their local health economies. However, there are costs in the process of organisational merger, especially in terms of damage to staff morale and to the relationship between managers and clinicians. Article goes on to discuss a number of alternatives to full mergers, focusing on the development of partnerships and networks.

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