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Welfare Reform on the Web (October 1999): National Health Service - Community and Primary Care Services

CHEQUE IT OUT

A. Moore

Health Service Journal, vol. 109, July 22nd 1999, p. 24-26

Over the past decade there have been moves to offer GPs alternatives to independent contractor status, including a number of schemes which allow them to be salaried, often with fixed working hours and no out-of-hours commitment. In consequence, the number of salaried GPs has soared. This trend is likely to continue with the advent of Primary Care Trusts which can employ GPs directly.

A HEALTH VISITOR-RUN HELPLINE: MEETING FAMILY HEALTH NEEDS

N. Hawley and E. Howkins

Community Practitioner, vol. 72, 1999, p. 208-211

Describes the setting up, running and evaluation of a health visitor-run helpline in Hampshire. The aim is not to duplicate nurse-led telephone helplines that are being introduced across the country, but to complement them. Rather than creating dependency, it empowers clients and should encourage the appropriate use of A&E and on-call GP services allowing best use of their limited resources.

HERE'S LOOKING AT YOU

P. Healy

Health Service Journal, vol. 109, July 15th 1999, p. 14

Community Health Councils are calling for strong scrutiny of primary care groups in the public interest. They would like similar statutory powers to scrutinise primary care as they already have in relation to hospitals.

INCOME OUTCOME

F. Bradshaw

Health Service Journal, vol. 109, August 5th 1999, p. 30

Results of a survey of 500 GPs in the North West region shows widespread interest in a salaried service, with opportunities for further education and research among the attractions.

KING-PIN WIZARDS

R. Banyard

Health Service Journal, July 29th 1999, p. 26-29

The traditional hierarchical management pyramid, with the chief executive at the pinnacle, is not appropriate to the size and function of PCGs. The essential function of the PCG chief executive is to guide and support the work of others rather than to seek status and power over others. The customary functions of the chief executive, although still necessary, will be of a lesser order initially than the new roles required in this new and rapidly developing environment.

MANAGERS WARN ON PCT FUNDING

K. McIntosh

Health Service Journal, vol. 109, 1999, p. 6-7

Managers have warned that funding to smooth the development of primary care trusts must be pledged in the next batch of guidance on the reforms.

PC COD OFFERS COUNSEL OF DESPAIR

M. Rigge

Health Service Journal, vol. 109, August 5th 1999, p. 16-17

Reports uncertainty as to whether the new primary care groups will commission counselling services. Up to April counselling was available in over half of practices. These were almost exclusively fundholding practices which had used their freedom to purchase services such as counselling, physiotherapy and chiropody.

PCG TIPS

J. Davis and P. Lambert

Health Service Journal, vol. 109, July 29th 1999, p. 33

Nurses and therapists are hopeful of at last being able to share with doctors the responsibility for guiding health care services, but are disappointed at the level of GP representations at board level compared to nurses. The changes are seen as an opportunity to improve patient care through joint working, and the government's emphasis on quality is welcomed. There is a need for a professional development programme to underpin implementation.

PCGs: AN EARLY VIEW OF PRIMARY CARE GROUPS IN ENGLAND

Audit Commission

Abingdon: Audit Commission Publications, 1999

The Audit Commission conducted a snapshot survey of all 481 PCGs in England in the run-up to their launch in April. Results showed that PCGs covering populations of up to 75,000 typically had management budgets as low as £100,000. The largest groups of up to 250,000 people had been awarded up to £500,000. Most PCGs had taken advantage of delegated budgets, with 83% starting at 'level 2' as sub committees of their health authorities. An average PCG, if all eligible funds were delegated, would control a budget of £62 million.

PLIGHT OF THE NAVIGATOR

S. de Lusignan

British Journal of Health Care Management, vol. 5, 1999, p. 276-278

Drawing on experiences gained orchestrating the 'Doctors Desk', author explains how the new National Electronic Library for Health can be used in a primary care setting.

RIGHTS AND RESPONSIBILITIES

Institute for Public Policy Research

London: 1998

Research has shown patients to be highly critical of the loss of the personal touch in their contacts with GPs. Developments which ministers and managers perceive as progress, including primary care groups, high tech medicine and computerisation, had alienated patients in the four focus groups.

SHIFTING SERVICES FROM SECONDARY TO PRIMARY CARE: STAKEHOLDERS' VIEWS OF THE BARRIERS

A. O'Cathain, G. Musson and J. Munro

Journal of Health Services Research and Policy, vol. 4, 1999, p. 154-160

A major feature of British healthcare policy over the past 10 years has been the increasing importance accorded to primary care. Article reports evaluations of two initiatives that attempted, but ultimately did not succeed in, moving services from secondary to primary care. Stakeholders perceived similar barriers in both initiatives: disinvesting from existing providers; lack of information on activity and costs; uncertainty over the quality of the proposed alternative service; concern about an increasing workload in primary care; difficulties in communication between the many agencies involved; and lack of leadership by purchasers.

SHUTTING UP SHOP

M. Crail

Health Service Journal, vol. 109, July 29th 1999, p. 14-15

Reports the closure of five private walk-in medical centres in the North of England in the face of competition from the NHS version.

SOUND BACKING FOR LITTLE VOICE

P. Johns

Health Service Journal, vol. 109, July 8th 1999, p. 30

Argues that lay members will need advice and support if they are to have a credible voice on PCG boards. The ideal source of this support would be Community Health Councils.

WALK-IN MEDICAL CENTRES AT BOOTS AND SAINSBURY'S

G. Jones

Daily Telegraph, July 16th 1999, p. 2

Describes some of the first 18 successful bids to establish the new NHS walk-in medical centres offering free health advice and treatment for minor illnesses.

(See also Health Service Journal, vol. 109, July 22nd 1999, p. 8)

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