Health and Social Care in the Community, vol. 7, 1999, p. 350-357
People needing intensive and specialized health care are now being cared for in community settings. This has implications for both primary health care professionals and family carers. Paper draws on research investigating how services can be developed to support families caring for children with complex health care needs, and considers the challenges facing professionals working in the primary health care sector. Interviews conducted with parents, professionals and those who fund and commission specialized health services reveal particular problems in relation to provision and purchasing of short term care and specialist equipment/therapies in the community. These problems need to be addressed if people with specialized needs are to be cared for outside hospitals.
Community Practitioner, vol. 72, 1999, p. 289-292
Having identified the best and most relevant research evidence, it is necessary to look objectively at the evidence, and to determine what it means, whether it is robust, and whether it is relevant to practice. Article suggests simply ways in which the practitioner may critically appraise evidence.
Community Practitioner, vol. 72, 1999, p. 354-357
Successfully changing practice to incorporate new evidence remains a considerable challenge. Article offers a practical focus and insight into the process of putting evidence into practice.
Health and Social Care in the Community, vol. 7, 1999, p. 333-341
Paper uses historical methods to investigate the changing definitions of community care and primary care in health policy since the 1960s. The emergence and substantially separate development of the two concepts in policy and professional practice between 1960 and 1990 is described and analysed, illustrating the structural constraints on integration but noting the increasing tendency for the boundaries to be called into question. The second part of the paper examines the impact of the 1990 NHS and Community Care Act, the implementation of the reforms during the 1990s and the policies currently being implemented by the Labour government. Policy on community care has been largely driven by the government's concern to control social security and NHS spending, whilst primary care policy focused on the role of GPs in implementing market reforms.
Health Service Journal, vol. 109, Oct. 14th 1999, p. 12-13
Reports concerns expressed at the NHS Primary Care Group Alliance about under-resourcing. There was also anxiety about the effect of the increase in the price of generic medicines on Primary Care Group's prescribing budgets.
D. Florin et al
London: King's Fund, 1999
Suggests a five part framework for primary care development, comprising:
Community Practitioner, vol. 72, 1999, p. 286-288
Improving health and reducing inequalities are major planks of current government policy but achieving these goals requires a shared view of the needs for change in a given population. Article outlines the basic processes of health needs assessment (HNA) and its implementation.
Health and Social Care in the Community, vol. 7, 1999, p. 358-366
The Labour government is placing a heavy emphasis upon 'partnership working' and expects this to create renewed interest in joint commissioning initiatives, especially those involving social care and primary health care. Article reviews joint commissioning as a policy concept, describes some recent research findings, and pulls out messages for policy and practice. It concludes that, although effective joint commissioning is attainable, there can be no 'quick fix' at local level.
Annual report 1998-99
The increase in salaried GPs could lead to a recruitment crisis in deprived inner city areas, with affluent health authorities employing more and more doctors, while those which are less affluent have fewer.
Community Practitioner, vol. 72, 1999, p. 365-366
Nurse consultants were established to promote a practice-based career structure and to improve retention and morale within the profession. Within community practice there are many new, developing roles which need to be recognized both professionally and financially, but a hierarchical model does not fit well with the breadth and depth of practice that is currently undertaken in primary care. In view of the wide variety of roles in primary care it may be more appropriate to have career pathways based on flexible transferable skills.
P. Waddington and M. Filby
Managing Community Care, vol. 7, Oct. 1999, p. 25-34
Paper examines PCG's relationships with their health authorities, given the inherent contradictions in national policy, and recommends a devolved approach to ensure that a range of stakeholders can participate in their work.
British Journal of Health Care Management, vol. 5, 1999, p. 347-348
Under the government's latest reorganisation of the NHS, there is a danger that Community Health Services Trusts will be squeezed out of existence, and absorbed either by Primary Care Trusts or by dominant secondary care trusts. Community services may follow the European pattern and be taken over by the private or voluntary sector.
B. Hudson and H. Lewis
Health Service Journal, vol. 109, Oct. 28th 1999, p. 28-29
A national survey of PCG chief executives and social services representatives on PCG boards showed that most consider the social services role 'very useful'. Most social services representatives spent two to four days per month on PCG business. Two-thirds felt they needed more time, and almost half felt they had little or no support. Better feedback mechanisms are needed for social services representatives.
R. Lewis and S. Gilliam (eds)
London: King's Fund, 1999
Study looks at nine personal medical services pilots and concludes that they represent a significant challenge to the traditional model of primary care. The pilots allow for salaried GPs and nurse-led services.