Click here to skip to content

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

T. Shifrin

Public Finance, March 17th-23rd 2006, p.24-26

Community hospitals were promoted in the recent White Paper Our health, our care, our say as having the potential to offer a range of health care services near patients’ homes. However 80 are now under threat of closure as cash-strapped primary care trusts seek to cut costs.

N. Timmins

Financial Times, March 14th 2006, p.1

Barrister style groups of doctors and health specialists opting out of the NHS and forming “chambers” are among the new models of service organisation considered in a draft report. Acute hospitals are facing pressure for change exerted by competition for patients, cuts to hours worked by junior doctors and the ability to shift care outside hospitals.

[See also Financial Times, March 22nd 2006, p.4]

Getting better all the time: what sort of commissioners and providers will deliver the best patient care?

NHS Alliance

[Retford]: 2006

This new report on the future shape of commissioning and provision in primary care suggests that:

  1. New providers should emphasize that they serve the local community
  2. New organisations will have to decide how they will function financially. They will have to choose between being ruthless competitors or community interest companies
  3. They will need to draw on the “public service ethos” to motivate their staff
  4. They will need to focus on improving the quality of care and the patient experience
  5. GPs will need to function as care path managers, not gatekeepers
  6. A commitment to standard complaint handling and to continuous quality improvement should be built into the new organisations
  7. Commissioners must demand evidence of quality of care from providers to act as the basis of patient choice.
  8. Commissioners will need explicit, rigorous and robust mechanisms to assess fairly the respective merits of alternative providers (NHS, private or charities)


D. Carlisle

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

Article records concerns about the new dental services contract which comes into force in April 2006. It is designed to give primary care trusts (PCTs) control of local services so that if a dentist leaves the NHS, the trust can buy in replacement services. However there are fears that the Department of Health has not allowed for extra costs such as maternity leave when calculating the budgets devolved to PCTs, leaving them with an instant funding shortfall. There is also a danger that higher patient charges will reduce use of dental services, hitting practice incomes. Finally, practices report that PCTs are already saying they cannot fund all of the courses of treatment (units of dental activity) practices say they need to give.

M.-L. Harding

Health Service Journal, vol.116, Mar.9h 2006, p.14-15

Recently published government guidance says that GPs must be given autonomy over their practice based commissioning (PBC) plans, which must be based on their population’s needs rather than their primary care trust’s priorities. It also says that practices’ purchasing power has to be maintained year on year. Unfortunately this clashes with the needs of primary care trust managers, who want cost savings and aligned priorities.

D. Hynes

British Journal of Health Care Management, vol.12, 2006, p.86-88

The task of practice-based commissioning is to ensure that patients’ needs are matched by an appropriate range of provision. In order to encourage practices to take on the commissioning role, primary care trusts will need to ensure that: 1) devolved budgets accurately represent the practices’ patient activity; and 2) practices have real control over their budgets. There is considerable scope for practices to reduce current levels of spending on emergency hospital care by developing preventative services. Levels of engagement with practice-based commissioning will also depend on how well the package is sold to practices.

R. Lewis

Guardian Society, March 15th, 2006, p.6

Within the context of the newly opening health care market, East London Integrated Care (ELIC) are expected to act as trail blazers for a new model of care delivery by social enterprises. Looking at this Hackney group of almost 50 general practices, the article examines the viability of the model.

What is the scope to reduce workload from home visits?

M. Jiwa and others

British Journal of Health Care Management, vol.12, 2006, p.78-82

Research sought to review the rationale for home visiting by general practitioners through an examination of medical records at two practices in Yorkshire. Results showed that the bulk of home visits are to older patients and those with chronic conditions. It may be difficult to reduce the home visiting workload by denying individual requests without clinical risk to patients. However, it may be possible to reduce workload by offering to transport patients to the surgery or expanding the skill mix in this area of practice activity.

Search Welfare Reform on the Web