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Welfare Reform on the Web (July 2005): National Health Service - Primary and Community Care

The case management approach

A. Alcock

Caring Times, Apr. 2005, p.15 + 41

One of the central planks of government policy for care of people with long-term conditions is the case management approach. This involves the development of a personalised package of care aimed at avoiding emergency hospital admissions and allowing people to remain in their own homes.

Councils and trusts: a winning partnership

W. Little

Health Service Journal, vol.115, June 23rd 2005, p.30-31

Presents four case studies of joint working between NHS bodies and local authorities. These are: sharing back office functions; joint NHS-social services posts; sharing of public health information; and recruitment of people from disadvantaged groups to entry level jobs.

Europe's GPs fly into cover unwanted shifts

S. Morris and L. Harding

The Guardian, June 17th 2005, p.8

On some occasions now a third of the 40 or so doctors on duty covering 1.2 million patients in the north-east region will be from Europe. The influx of health professionals from abroad serves to highlight shortfalls in the out-of-hours service. A fundamental change in the way the services are organised has led to a dearth of local GPs for the most urgent cases, according to GPs.

Flattening the National Health Service hierarchy: the case of public health

S. Abbott and others

Policy Studies, vol.26, 2005, p.133-148

In 2001 the public health service was fragmented through its devolution from health authorities to 303 primary care trusts. Article examines the consequences of the devolution and localisation of the NHS public health function. Two recent studies have found public health practitioners to be very concerned about the fragmentation of their profession, and the resulting isolation in which individuals work. Directors of public health feared that their new primary care trust responsibilities would limit their time for public health work. Multiple local organisations are not well placed to address strategically the problems of an inadequate national public health workforce.

Hewitt plans GPs shake-up

P. Wintour

The Guardian, June 23rd 2005, p.1

A radical shake-up of primary care to make GP surgeries more flexible and patient-friendly, including the prospect of specialist surgeries for teenagers, is to be outlined today by the Health Secretary, Patricia Hewitt. People could also register with GPs nearer their workplace and family doctors would be given greater autonomy to order diagnostic scans rather than having to refer patients to a hospital. Ms Hewitt also launched an ambitious public consultation plan that will culminate in a white paper on "health outside hospitals" in the late autumn.

Managing violence in general practice

J. Cornell, L. Ristic and L. Bond

British Journal of Health Care Management, vol.11, 2005, p.178-183

In the context of escalating violence towards health care staff, article describes the Doncaster Local Development Scheme for providing general medical services to a small number of violent or potentially violent patients in a "safe haven".

The patient will see you now

S. Ward

Public Finance, May 20th-26th 2005, p.24-26

The Government's target that by 2004 patients would be seen by a GP within 48 hours has had the unintended consequence of making it more difficult for them to book an advance appointment. Author argues that the problem could be solved by increasing capacity by allowing nurses and pharmacists to treat minor ailments.

Ringing the changes

A. Nolan

Health Service Journal, vol.115, June 9th 2005, p.29-30

The Healthcare Foundation has begun a benchmarking service that compares the performance of out-of-hours services in nearly 30 primary care trusts. Results show that missed targets for call assessments, insufficient staff to meet demand at week-ends, inequalities between different providers, poor liaison with ambulance services and minimal use of nurses to replace doctors are hampering progress.

Substance misuse in primary care: a multi-disciplinary approach

R. Winyard (editor)

Oxford: Radcliffe, 2005

The unique theme of this book is multi-disciplinary partnership. It includes contributions from a range of healthcare professionals, with a common desire to share their perspective on developing primary care services. The reader is encouraged to share in the skills of these practitioners, and develop their own skills in providing effective assessments, treatments and care plans, including dealing with crack cocaine addiction, alcohol problems, dual diagnosis and homelessness. This approach is furthered by a discussion of the context of care including the recent changes to the policy making agenda and to the National Treatment Agency, and the new GP contract.

A survey and audit of the first “Guides to Local Health Services” produced by primary care trusts in England

J. Noble and others

Health Expectations, vol.8, 2005, p.138-148

Since 2002, all primary care trusts (PCTs) have been required to produce guides to local NHS services. Authors audited the first guides and surveyed the people who produced them. Most PCTs had produced guides that covered the various content areas stipulated by the Department of Health, but this led to a focus on information about financial and strategic accountability rather than on the kinds of information wanted by the public. The authors suggest that there should be more scope for the guides to be shaped by the input of local service providers and audiences.

Voluntary or compulsory health care reform? The case of primary care organisations in Scotland

S. Simoens and A. Scott

Health Policy, vol.72, 2005, p.351-358

New primary care organisations (local healthcare co-operatives) were introduced in 1999. These are groups of general practices and membership was voluntary. Study examined whether the voluntary nature of membership was likely to exacerbate or reduce inequalities in the provision of primary care services. Results showed that practices located in deprived areas were more likely to join a co-operative. This suggests that voluntary participation in these new primary care organisations may reduce rather than exacerbate inequalities in the provision of primary care.

Wanna be in my gang?

T. Riley and W. Blandamer

Health Service Journal, vol.115, June 2nd 2005, p.22-23

Primary care trusts (PCTs) are being urged to collaborate to negotiate more effectively with acute trusts. In Manchester, an association of 14 PCTs has enjoyed considerable success, with member trusts sharing a statement of strategic intent. The experience of the Manchester PCTs suggests that collaborations of this type are more effective when not driven by strategic health authorities or central legislation.

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