Welfare Reform on the Web (February 2000): National Health Service - Community and Primary Care Services

CARING FOR CHILDREN WITH SPECIALIZED HEALTH CARE NEEDS IN THE COMMUNITY: THE CHALLENGES FOR PRIMARY CARE

S. Kirk

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.

CLINICAL EFFECTIVENESS. PART 3, INTERPRETING YOUR EVIDENCE

C. Adams

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.

CLINICAL EFFECTIVENESS. PART 4, PUTTING EVIDENCE INTO PRACTICE

C. Adams

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.

THE CONCEPTS OF COMMUNITY CARE AND PRIMARY CARE IN THE UK: THE 1960s TO THE 1990s

J. Lewis

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.

CRASH, BANG, WALLOP

M. Crail

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.

DEVELOPING PRIMARY CARE IN LONDON: FROM 1990 TO PCGs

D. Florin et al

London: King's Fund, 1999

Suggests a five part framework for primary care development, comprising:

• practice development, including people and buildings;
• service development, changing the range and types of service offered;
• professional development of medical and non-medical primary care staff;
• organisational development of practice teams and primary care organisations;
• strategic development across sectoral boundaries.

HEALTH NEEDS ASSESSMENT: HELPING CHANGE HAPPEN

J. Hooper

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.

JOINT COMMISSIONING ACROSS THE PRIMARY HEALTH CARE-SOCIAL CARE BOUNDARY: CAN IT WORK?

B. Hudson

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.

MEDICAL PRACTICES COMMITTEE

Annual report 1998-99

London: 1999

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.

NURSE CONSULTANTS IN PRIMARY CARE

S. Forester

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.

ON DEVELOPING PRIMARY CARE GROUPS AS EFFECTIVE ORGANISATIONS

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.

SHINING A LIGHT ON THE PLIGHT OF COMMUNITY TRUST USERS

G. Meads

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.

SOCIAL CLIMBERS

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.

TRANSFORMING PRIMARY CARE :

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.