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Welfare Reform on the Web (January 2004): National Health Service - Primary and Community Care

DEVELOPING NHS DIRECT: A STRATEGY DOCUMENT FOR THE NEXT THREE YEARS

Department of Health

Leeds: 2003

The government is investing in NHS Direct to meet anticipated growth in demand for its core services and to enable the service to play its part in the modernisation of out-of-hours provision. The NHS Direct telephone number will provide a single point of access to out-of-hours care by the end of 2006, enabling fast and easy access to emergency care networks. NHS Direct will aim to expand its call taking capacity threefold in the next three years, whilst at the same time developing the various channels through which patients can access the service. Major organisational changes will also be introduced. From April 2004 a dedicated NHS Direct provider will be responsible for delivering the service. From 2004/2005 funding for NHS Direct will be devolved to primary care trusts, enabling them to shape its priorities.

ESSENTIAL AND ENHANCED SERVICES

R. McQuarrie

Community Practitioner, Vol. 76, 2003, p.454

The new general medical services contract that comes into place in April 2004 will allow GPs to control their workload for the first time. The article explains how this will work in practice, and the opportunities community nurses and health visitors may have to organise their work differently.

"FOLLOW THE FISH": INVOLVING YOUNG PEOPLE IN PRIMARY CARE IN MIDLOTHIAN

A.M. Jackson

Health Expectations, Vol. 6, 2003, p. 342-351

Article 12 of the UN Convention on the Rights of the Child established the right of young people to be consulted and listened to by public service providers. However, although young people's views are frequently sought on sexual health, drugs and alcohol, their involvement in general health issues is limited. This study sought to change the status quo. Young people interviewed their peers about their experience and views of health services and drama workshops were conducted to help the young people express their opinions. A play was produced around the young peoples' experiences and was performed to 30 health and education professionals. The drama brought a number of issues to light - including issues of confidentiality and parental consent and of young people feeling unwelcome and patronised when seeking medical advice. A number of positive initiatives resulted from the project, for example the setting up of an information guide to health services specifically for young people.

FOREIGNERS MAY BE BARRED FROM SEEKING FREE NHS HELP

D. Demtriou and M. Wolff

The Independent, December 31st 2003, p.4

Patients with foreign accents may be vetted before receiving free NHS treatment as part of a Government clampdown on "health tourism". Failed asylum-seekers and foreign business travellers are among those who will no longer be able to receive free treatment. Patients may also be requested to produce documentation to prove that they are eligible for free health care.

See also (The Guardian, December 31st 2003, p.4)

HOW TO ENTICE LOCAL PRACTICES TO WORK WITH YOUR PCO (PRIMARY CARE ORGANISATIONS)

J. Lockley

Primary Care Report, vol. 5, no.19, Nov.26th 2003, p18-21

If primary care organisations provided greater managerial support to GP practices in their area, wasteful duplication of functions would be eliminated

INVESTIGATING HOW HEALTH VISITORS DEFINE VULNERABILITY

R. Newland and S. Cowley

Community Practitioner, Vol. 76, Dec. 2003, p.464-467

The concept of vulnerability is difficult to define, but it has been linked to several features within the life experiences of children and families. It has also been recognised as a potential precursor to child protection issues. The article explores how health visitors define vulnerability and how they interact with vulnerable families. Results show that health visitors frequently follow their "gut reaction", backed up by their personal knowledge and experience, when dealing with vulnerable families. This can make their actions hard to articulate and justify and as a result their work is often unrecognised and undervalued by managers and other professionals. The article concludes that health visitors must market their role in the field of vulnerability in order to increase their visibility, effectiveness and credibility in this area.

IT'S TIME FOR PCTS TO PLACE A WATCH ON NEUROLOGICAL CONDITIONS

A. Elliot

Primary Care Report, Vol. 5, Issue 20, Dec. 10th 2003, p.19-21

The article reports on progress in the development of the National Service Framework for Long Term Conditions and its implications for Primary Care Trusts.

LOCAL PLANNING: WHY PCTS ARE SWIMMING AGAINST THE TIDE

N. Bostock

Primary Care Report, Vol. 5, Issue 20, Dec. 10th 2003, p.4-5

Patient choice, the new GP contract, introduction of foundation hospitals and payment by results are complicating preparation of local delivery plans by Primary Care Trusts. The plans are now "live" documents, requiring amendment on a rolling basis.

NEW CONTRACTS COULD SEE GPS OPT OUT OF SERVICES TO SOCIAL CARE CLIENTS

C. Jerrom

Community care, Dec.11th-17th 2003, p. 16-17

The new GP contract will allow doctors to opt out of provision of out-of-hours care and certain enhanced services such as treatment of drug and alcohol abuse. There are concerns about the impact of these changes on vulnerable patients and doubts about whether or not cash-strapped PCTs will have enough resources to fund alternative provisions.

OUT-OF-HOURS FEAR AS AMBULANCE CALLS LEAP

G. Clews and M L Harding

Health Service Journal, vol. 113, Dec.11th, 2003, p.6-7

Reports that emergency calls to ambulance trusts in England have risen sharply. This may be due to the gradual curtailment of GP out of hours services in the run up to the implementation of the new GP contract.

REGISTERING A PROBLEM

A. Cohen

Primary Care Report, Vol. 5, Issue 20, Dec. 10th 2003, p.14-15

General practices place patients with a range of long-term conditions such as diabetes on registers so that they can provide structured, proactive care to the whole group. However, placing patients with severe mental illness on registers is discretionary for fear of stigmatisation. The author argues that this impedes the planning of effective services.

UNDER THE INFLUENCE

C. Lewis

Health Service Journal, vol.113, Dec.18th 2003, p.28-29

It is estimated that alcohol related illnesses cost the NHS up to £1.6bn a year to treat. Charities are pushing for the inclusion of provision of alcohol intervention services in the new GP contract. Article looks at a range of services already being developed in primary care, including screening and employment of alcohol counsellors.

WAITING TIMES ABOLISHED BY NEW COMMISSIONING?

D.M. Hynes

British Journal of Health Care Management, Vol. 9, 2003, p.406-408

The article explores the new referral management centres launched by Somerset Coast primary care trust, which aim to eradicate waiting lists by matching capacity with demand. Management of the patient is retained at all times within the primary care sector and no patient is matched with a procedure for which there is no available capacity.

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