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Welfare Reform on the Web (March 2006): National Health Service - Primary and Community Care

N. Edwards (editor)

Health Service Journal, vol.116, Feb.16th 2006, supplement, 13p

This special supplement focuses on clinical engagement in primary care. It covers the opportunity offered by the introduction of practice-based commissioning, the adverse impact of the planned creation of larger primary care trusts, and the benefits of involving nurses in organisational development and decision-making. It also offers some case studies of how increased clinical engagement created better services.

A. Thomson & R. Sylvester

Daily Telegraph, January 28th 2006, p.8

Personal health trainers will follow up those identified as most at risk by “Life-checks” at five key life stages. The health MOTs, and other concerns revealed by patient consultation, are covered by this report of a meeting with the Health Secretary. The article also touches on the Minister’s background and sexism in Cabinet politics.

[See also Times, January 28th 2006 p.2; Guardian, January 28th 2006, p.12]

W. Richards and L. Evans

British Journal of Health Care Management, vol.12, 2006, p.50-54

Effective public and patient involvement in health requires: 1) involvement of patients and the public in shaping health and social care services; 2) ensuring that citizens are involved in decisions about health and social services; 3) empowering people to take greater responsibility for their own health; 4) facilitating shared decision-making between professionals and service users.

Article looks at how this model can be applied to dentistry.

N. Timmins

Financial Times, January 30th 2006, p.4

One in twelve outpatient appointments will be shifted out of hospitals and closer to people’s homes according to the white paper on healthcare outside hospital. The article discusses the white paper covering:

  • Commercial and entrepreneurial GP contracting
  • Patient MOTs
  • Surgery opening hours and the GPs’ contract
  • Service rationalisation
  • PFIs and the reappraisal of the hospital building programme

[See also Guardian, January 30th, p.4; Independent, January 30th, p.4]

K. Gerard and others

Health Expectations, vol.9, 2006, p.60-69

Article reports the responses of 871 adults to a questionnaire that included a discrete choice experiment designed to investigate how people in the UK value and are willing to make trade-offs between six features of out-of-hours primary care. Results show that being seen by a doctor rather than a nurse was the most important feature, followed by consulting face to face rather than by telephone and being informed about expected waiting times. However, people were willing to make trade-offs, for example being willing to see a nurse rather than a doctor if this meant waiting an hour less for initial contact and/or provision of advice or treatment. These preferences suggest that services which are fully integrated are likely to yield higher utility than partially or non-integrated services.

M. Gould

Health Service Journal, vol.116, Feb. 23rd 2006, p.14-15

Reports that many community and cottage hospitals are not clinically viable or suitable to provide a modern health care environment. They are likely to be closed in spite of instructions from the Health Secretary that community facilities should not be lost due to short term budgetary pressures.

B. Hudson

Community Care, Feb.9th-15th 2006, p.34-35

The new White Paper on health and social care proposes shifting services from hospitals to the community and encourages partnership working. However there are unanswered questions about how the changes are to be funded and implemented in practice.

C. A. Melville and others

Journal of Intellectual Disability Research, vol.50, 2006, p.11-17

People with intellectual disabilities face barriers in accessing health services, due in part to professionals’ unmet training needs. This research tested the hypothesis that a training intervention for primary health care professionals would increase the knowledge and self-efficacy of participants. The intervention had two components: a written training pack and a three hour face-to-face training event. One group of study participants received the training pack and attended the event, a second group received the training pack only, and a third group did not participate in the intervention. Participants in the training intervention reported that it had a positive impact on their knowledge, skills and clinical practice.

R. Booth

Guardian, February 17th 2006, p.4

A woman, having waited for six hours for an emergency home oxygen delivery, has died after being rushed to hospital before the private supplier managed to deliver. The event in North Cumbria comes as doctors now procure directly from gas manufacturers rather than ordering through local pharmacists. The Department of Health has admitted that the transfer has resulted in oxygen shortages. 60,000 U.K. patients rely on home delivery.

[See also Times, February 17th 2006, p.1 & 4

N. Timmins

Financial Times, January 28th 2006, p.2

Proposals for a pilot scheme opening the primary care market in GP-starved areas to private companies, are expected to be announced shortly. The article touches on:

  • the white paper on healthcare outside hospitals
  • shifting services closer to homes and service rationalisation
  • social enterprise and entrepreneurial GPs
  • PFI reappraisals
  • purchaser/provider split

G. Carson, M. Samuel and M. Ahmed

Community Care, Feb.9th-15th 2006, p.16-18

The new White Paper on health and social care focuses on service integration and joint working, promises a shift of resources from acute care to illness prevention and health promotion, and calls for users to exercise more choice and control over services. Article presents comment from a range of professionals.

A. Moore

Health Service Journal, vol.116, Feb.16th 2006, p.31-32

Most progress towards the implementation of practice-based commissioning in primary care has come through groups of practices, or locality groups, rather than through individual practices deciding to go it alone. Lack of clarity about how efficiency savings from practice-based commissioning will be divided up is putting some practices off joining groups. It is argued that GPs need financial incentives to encourage them to engage with the new system. GP contract changes in 2006/07 will introduce some small financial rewards for engagement.

J. Barlow

ChildRight, issue 223, 2006, p.9-11

Recent policy developments are threatening to undermine access to confidential sexual health advice and services for young people under 16. There are moves under the child protection reform agenda to make it mandatory for under-age sexual activity to be reported to the police and to set up information sharing databases through which professionals routinely record their involvement with young people. There is concern that if confidentiality is not assured sexually active young teenagers will not seek professional advice.

E. Anderson, M. Shepherd and C. Salisbury

Health Expectations, vol.9, 2006, p.70-80

Article reports on two case studies of public involvement in the planning of primary care services in deprived areas of Bristol and Weston-super-Mare. They used individual interviews and focus groups to elicit the views of health professionals and local residents who had been involved in the planning process. It is suggested that meaningful public involvement is more likely to occur if exceptional individuals in statutory agencies are committed to it, if processes for involvement are tailored to local cultures, and if support for it is sustained.

N. Timmins

Financial Times, February 7th 2006, p. 3

The private sector has attacked as unfair a bold move by East Elmbridge and Mid-Surrey PCT to allow staff to leave their employment and contract their services back to NHS whilst retaining generous NHS pension terms. The article reports varied opinions about non-level playing fields as problems grow for the government attempts to create markets in public services.

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