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

CHRONIC DISEASE MANAGEMENT

F. Robinson

Community Practitioner, Vol. 76, 2003, p.412

Asthma and chronic obstructive pulmonary disease management will earn practices quality payments through a points system when the new GP contract comes into force in 2004

E-BOOKING REFERRAL SYSTEM FOR GENERAL DENTAL PRACTICE

P.V. Dyer

British Journal of Health Care Management, vol.9, 2003, p.366-368

Article reports on a booked admission scheme in Morecambe Bay which linked general dental practitioners to their local Department of Oral and Maxillofacial Surgery. The scheme enables patients to be given hospital appointments at a time of their choice, using a computerised referral system.

EMPOWER OF GOOD

N. Edwards

Health Service Journal, Vol. 113, Nov. 13th 2003, p.26-27

The article is a report of an interview with the Chief Nursing Officer for England, in which she discusses the expanding role of nurses in primary care. It goes on to look at the implications of child protection and patient choice for nurses and the need for managers to encourage nurse-led innovation.

EVERY WHICH WAY BUT LOOSE

G. Clews

Health Service Journal, Vol. 113, Nov. 13th 2003, p.10-11

The article discusses the challenges faced by primary care trusts in implementing the new GP contract. It offers an opportunity for new strategic thinking about delivery of primary care. It could potentially lead to innovation in provision of out-of-hours services, management of chronic disease, partnership with pharmacists and other health professionals and development of enhanced services to shift treatment from the acute sector.

GENERIC AND SPECIALIST NURSING ROLES IN THE COMMUNITY: AN INVESTIGATION OF PROFESSIONAL AND LAY VIEWS

H. McKenna, S. Keeney and M. Bradley

Health and Social Care in the Community, vol. 11, 2003, p.537-545

The increasing specialisation of community nursing has been the topic of much debate in the UK and Ireland. Study aimed to investigate the perceptions of community nurses, GPs, members of the public, and senior strategists and policy-makers in relation to specialist and generalist community nursing roles in Northern Ireland and the Irish Republic. Most respondents accepted the need for more specialist nurses but acknowledged that this could lead to conflict and confusion. There was also concern that too many specialist nurses could be trained, leaving insufficient generalists to meet the general needs of clients. Members of the public expressed a preference for contact with one main nurse, who would co-ordinate interventions.

IS THE OUT-OF-HOURS TARGET OUT OF REACH?

A. Elliott

Primary Care Report, vol.5, no.17, Oct. 29th 2003, p.4, 6

From 2005 primary care trusts (PCTs) will assume responsibility for providing out-of-hours services for patients. Discusses how PCTs are progressing in developing their plans.

JOINT WORKING: THE HEALTH SERVICE AGENDA

C. Glendinning and A. Coleman

Local Government Studies, Vol. 29, No. 3, Autumn 2003, p. 51-72

New Labour's aim for the NHS during its first term of office was dominated by a new agenda for collaboration and partnership. A government White Paper in 1997 announced the end of GP fundholding, which was replaced in 1999 by Primary Care Groups (later Trusts), with a statutory duty to work in partnership. The '97 White Paper was succeeded by a stream of further policy documents and prescriptions, culminating in the publication of the NHS Plan for England in 2000. This contained targets and new implementation timetables in key health service areas and placed great emphasis on collaboration between health and local authority services. After surveying the legislation, the article examines the progress that has been made through a longitudinal survey of a nationally representative sample of 15% of English Primary Care Groups/Trusts. It concludes that although the measures introduced to ensure collaboration are both extensive and thorough, other pressures (the dominance of GP's, traditional individualistic culture and legacy of fund-holder type of purchasing styles) are likely to impede developments.

LEAD IN THEIR PENCILS

K. Walshe

Health Service Journal, Vol. 113, Oct. 30th 2003, p.18-19

There are both risks and benefits and benefits for primary care trusts in the development of foundation trusts. There is a risk that acute-trusts foundation trusts will be able to exercise control over their local health economy, drawing resources from primary care. On the other hand, primary care trusts could collaborate with enlightened foundation trusts to reconfigure services to meet local needs.

LOOK AND LEARN: HELP FOR LOW-STARRED PCTS

N. Bostock

Primary Care Report, vol. 5 no.18 Nov. 12th 2003, p 4-6

Primary Care Trusts are being asked to produce performance improvement plans (PIPs) which show how they intend to reach three star status. PCTs are receiving targeted support in this process from the National Primary and Care Trust Development Programme (NATPACT) and other branches of the Modernisation Agency. A self-assessment tool and a PIP template created by NATPACT aim to guide PCTs through the process in tandem with face-to-face support.

MISSION POSITION

E. Forrest

Health Service Journal, vol.113, Nov.20th 2003, p.30-31

Many primary care trusts do not see sexual health as a priority, preferring simply to meet national targets. At the same time, gentio-urinary medicine clinics do not have the capacity to reduce waiting times. The problem needs to be tackled through preventive measures implemented by health promotion, youth, and voluntary services and through better information on levels of infection in different localities.

MODERNISING HEALTH VISITING EDUCATION: POTENTIAL, PROBLEMS AND PROGRESS

S. Cowley

Community Practitioner, vol.76, 2003, p418-422

Argues that the establishment of a three-year degree or a two-year postgraduate qualification in health visiting, in addition to the post-registration route, would enhance recruitment to the profession. However such developments are being prevented by constraints within the Nursing and Midwifery Order 2001 which does not allow the regulation of health visiting as a profession in its own right.

THE NATIONAL STRATEGY FOR SEXUAL HEALTH AND HIV: ISSUES FOR COMMUNITY PRACTITIONERS

L. Serrant-Green

Community Practitioner, Vol. 76. 2003, p 410 - 411

The National Strategy for Sexual Health and HIV (NSSHH) identified primary and community based health care provision as key components in the drive to reduce levels of sexual ill-health in the UK. Nurses and community practitioners have been identified as having a central role in achieving the objectives set out in the NSSHH

THE NEW PRIMARY CARE: MODERN, DEPENDABLE, SUCCESSFUL?

C. Dowling and C. Glendinning

Milton Keynes: Open University Press 2003

The book asks three questions:

  • how new is the 'new' NHS?
  • how far is control devolved to frontline health professionals?
  • what are the prospects for modernising the NHS?

The 'modernisation' of the National Health Service is at the heart of the UK government's policies for public sector services. This modernisation programme represents the most radical and ambitious restructuring of the NHS since its inception. The new Primary Care Trusts (PCTs), and before them Primary Care Groups, are at the heart of NHS modernisation. Until now there has been no comprehensive evaluation of how PCTs are implementing the modernisation programme. This book aims to fill that gap and provide clear evidence about the performance of PCTs to date. This forms the basis for discussions about future prospects and a benchmark for future research.

OPEN 24 HOURS

G. Clews

Health Service Journal, Vol. 113, Dec. 4th 2003, p.12-13

Under the new GP contract family doctors will be able to shed responsibility for out-of-hours care. The change offers primary care trusts the opportunity to revolutionise services through a range of alternative procedures such as dedicated public interest companies.

WALK-IN UNIT A GODSEND TO THOSE WITH NO GP

S. Boseley and J. Carvel

The Guardian, November 17th 2003

As part of an on-going series of articles on Labour's public service reforms this article looks at the North Middlesex Hospital walk-in centre, noting the improvement in primary care services in the London Borough of Enfield but asking if it will be enough to attract new doctors?

WHICH BRANCHES OF COMMUNITY PRACTICE SHOULD BE INCLUDED IN THE THIRD PART OF THE REGISTER?

B. Poulton

Community Practitioner, Vol.76, 2003, p.414-417

A radical change in the regulation of nursing comes into being in April 2004 when the new Nursing and Midwifery Council (NMC) register is implemented. A third part of the register for specialist community public health nursing will come into being and NMC is consulting on the competency framework required to support it. Paper demonstrates that all community nurses make a contribution to public health, although with different emphases according to their area of practice. It is proposed that if new community health nursing programmes meet the NMC competencies for the third part of the register, there should be no reason why all kinds of community health nurses could not register as specialist community public health nurses.

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