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

'Brain circulation': the Spanish medical profession and international medical recruitment in the United Kingdom

B.K. Blitz

Journal of European Social Policy, vol.15, 2005, p.363-379

It is claimed that the temporary movement of skilled professionals from their home country to work abroad may be beneficial in that it facilitates the sharing of intellectual resources across states, and promotes economic growth in the home country through remittances sent back. Article tests these claims against the actual experiences of Spanish GPs who have relocated to work in the NHS. The study shows that most Spanish doctors who have relocated have no intention of returning home due to lack of job prospects. Due to the higher cost of living in the UK, they are also unable to send money home. Moreover, by relocating to the UK, Spanish doctors increased their social status, which makes it even less likely that their stay would be temporary.

'Dad was screaming in pain…he had a wicked death'

D. Carlisle

Health Service Journal, vol.115, Nov.17th 2005, p.32-34

A report by Norfolk County Council on services for the dying is the first of its kind. Palliative care provision in Norfolk, as elsewhere, is insufficient, with none available to many of those with non-malignant diseases. There are insufficient options in end-of-life care, with too much emphasis on specialist services.

Direct action

A. Cowper

Health Service Journal, vol.115, Nov.10th 2005, p.26-27

Presents case studies of three innovative schemes in which services are designed around vulnerable groups of patients:

  • An accessible sexual health clinic for young people in Kingston located at the local YMCA
  • Direct referral of elderly patients for cataract surgery by optometrists
  • A home care service for patients with chronic obstructive pulmonary disease in South Manchester.

Doctors oppose bigger role for nurses

N. Timmins

Financial Times, November 11th 2005, p.6

Apart from controlled drugs, nurses and pharmacists will be allowed to prescribe any drug for any condition from 2006. The UK will be the first country in the world to allow such freedom. However, doctors' leaders have branded the plans irresponsible and dangerous.

[See also Daily Telegraph, November 11th 2005, p.6; Times November 11th 2005, p.2; Daily Telegraph, November 12th 2005, p.12; Guardian, Nov.10th 2005, p.4]

GP surgeries must open evenings and weekends, says Hewitt

J. Carvel

Guardian, November 11th 2005, p.14

Health Secretary Hewitt, claiming public support, is expected to call for evening and weekend GP surgery opening at an NHS Alliance conference today. Alternative providers where GPs are unwilling, nurse-led practices, and commissioning of GP surgery based treatments from hospitals will be mentioned in the context of consumer needs and choice in moves towards a "patient friendly" NHS.

[See also Times, November 11th, p.1&2]

Hospital booking system 'will be year late'

N. Timmins

Financial Times, November 1st 2005, p.4

NHS Chief Executive Nigel Crisp yesterday revealed to the Commons Public Accounts Committee an anticipated one year delay in national roll-out of full electronic booking of hospital appointments by GPs. While the system is technically operational, uptake has been slow. Patients will be offered a choice of hospitals from next month, but anxieties over the system and fears that health inequalities may be exacerbated are voiced.

[See also Financial Times, Nov.10th 2005, p.2]

In sickness or in wealth?

R. Lewis and D. Reynolds

Public Finance, Nov.4th-10th 2005, p.24-27

The British government aims to widen patient choice and improve quality in primary care by opening up the system to private companies, breaking the monopoly enjoyed by independently contracted family doctors and introducing competition between providers. Article presents comment by a wide range of concerned professionals.

Out of favour

J. Carvel

Guardian Society, November 9th 2005, p.7

Contestability policy or competition between health care providers in primary care, on which health civil servants are currently working, does not receive the expected backing of "citizens' juries" which reveal that people do not necessarily want to shop around when ill, or support health centres in supermarkets and other outlets.

Out with the old

D. Carlisle

Health Service Journal, vol.115, Nov. 3rd 2005, Supplement, p.8-9

A system developed at Countess of Chester Hospital foundation trust refers 2,600 patients a month electronically. GPs fill in an on-screen form and transmit with a single key stroke. The hospital acknowledges receipt in three seconds. The system will be phased out under the in-coming Choose and Book initiative, except for GPs in Wales.

Patient choice is an effective lever for change in primary care

P. Corrigan and A. Maynard

Health Service Journal, vol.115, Nov.24th 2005, p.18-19

Authors debate the pros and cons of government plans to introduce competition between a diverse range of providers into primary care services. Corrigan argues that the introduction of patient choice and competition will drive up quality, while Maynard points out that there is no evidence of this.

Public flexes its muscles on healthcare outside hospitals

D. Martin

Health Service Journal, vol.115, Nov.10th 2005, p.12-13

Describes the conduct of a large "deliberative" public meeting at which a sample of 1000 members of the public were consulted on their priorities for the future development of healthcare outside hospitals. Their views will feed into the planned White Paper on the future of primary care.

Telephone triage, expert systems and clinical expertise

D. Greatbatch and others

Sociology of Health and Illness, vol.27, 2005, p.802-830

The CAS expert system was introduced into NHS Direct to standardise and control nurse-caller interaction. NHS Direct's senior management want CAS to deliver standardised care to callers and they want it to predominate over the experience and expertise of nurses. However, analysis of how NHS Direct nurses use CAS dispositions and advice indicates that CAS is not delivering the control managers are looking for. The nurses use CAS in a range of ways and, in doing so, privilege their own knowledge and expertise and deliver an individualised service.

United front

S. Mathieson

Health Service Journal, vol.115, Nov.3rd 2005, Supplement, p.4-7

Joint working in IT between health and local authority social services remains difficult, with technical and organisational barriers. A number of areas have tried information sharing, but so far have only been able to exchange very basic data. Two Cambridgeshire pilots of deeper integration had mixed results. Persuading the public to allow their information to be shared presents another hurdle to trusts and local authorities.

When know means know

J. Ellins

Health Service Journal, vol.115, Nov.10th 2005, p.24-25

Patients' health literacy, i.e understanding of information about their own health and healthcare options varies widely and unpredictably. There is a danger that the patient choice agenda will widen inequalities as the health literate will benefit most. Author argues that, as well as simple written and visual materials, primary care trusts should appoint patient care advisers to guide choices.

Will PCTs be open for business?

J. Smith and R. Lewis

Health Service Journal, vol.115, Nov.10th 2005, p.16-17

The authors give their perspectives on the impact on managers and clinicians of the introduction of contestability (competition) into primary care, as the market is opened up to a range of new service providers.

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