Welfare Reform on the Web (July 2006): National Health Service - primary and community care

Breaking down the walls: the future of specialist services in non-hospital settings

J. Dean, M. Dixon and M. Irani

British Journal of Health Care Management, vol.12, 2006, p.182-184

There are a growing number of practitioners and services providing specialist care in non-hospital settings. This paper highlights current issue and considers lessons from the US competitive health care market. It suggests that in future primary care trusts will increasingly employ specialists to work in partnership with GPs in providing, advisory and leadership roles.

Practice-based commissioning: the impact of motivational and organisational factors on its success

S. de Lusignan

British Journal of Health Care Management, vol.12, 2006, p.174-180

The Personal Medical Services contract allows general practitioners to commission locally sensitive, flexible forms of primary care. Evaluations report only a small number of practices making substantial service improvements within the scheme. This qualitative study of primary care professionals examines their perceptions of the factors that affected their ability to deliver their practice objectives using motivational theory as a framework for the investigation.

Taking the accent off the acute

M. Samuel

Community Care, June 15th-21st 2006, p.26-29

Article presents an overview of the phase of NHS reform introduced by the White Paper Our Health, Our Care, Our Say. This involves a shift of resources from acute to primary care, with an emphasis on preventative work and the management of people with long term conditions in the community. Changes will be achieved through the merger of primary care trusts to form larger bodies with more clout as commissioners, and the introduction of practice-based commissioning by GPs. The latter will offer practices financial incentives to use alternatives to hospital referral.

Time to put the chisel away

D. Callaghan

Community Care, June 15th-21st 2006, p.30-31

The financial crisis in the NHS is undermining joint working with social care in several parts of the country. Cash-strapped primary care and acute trusts are withdrawing funds from joint ventures with social services, using the system of fines for delayed discharges to boost their income, cutting services for older people and the mentally ill, and generally shunting costs onto local councils.