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

Benefit or burden: introducing paraprofessional support staff to health visiting teams: the case of Starting Well

M. Mackenzie

Health and Social Care in the Community, vol.14, 2006, p.523-531

With increased public sector funding to expand frontline services under the New Labour government, pre-existing skill shortages within key professional workforces have become more acute. One response to this has been to introduce paraprofessional staff who take over tasks previously carried out by professionals. This study reports on the introduction of paraprofessional workers to support health visitors working intensively with families in deprived areas of Glasgow. The project aimed to deliver an intensive home visiting service to the families of all new babies. The service was staffed by two teams of health visitors, who were given space to develop therapeutic relationships with families through reduced caseloads and the employment of paraprofessional support workers. The new workers were employed by a voluntary sector organisation. They were dual-managed by this body and by project health visitors who, in the main, had no previous experience of delegation and skill-mix approaches.

GPs revolt over patient files privacy

J. Carvel

The Guardian, Nov. 21st 2006, p.1-2

A Guardian poll of GPs and hospital doctors revealed that 50% of GPs would not be willing to upload sensitive patient records to a new central electronic database without patient consent. Doctors believed that if their records were held in a central electronic database, patients would be at risk from hackers, blackmailers and unauthorised access. However, the poll, conducted by medical research organisation Medix, shows that 51% of GPs and 65% of hospital doctors agree that the new system, could have clinical benefits. 50 NHS primary trusts have signed up for limited trials of the £12bn system, although only summaries of patient records will be available on the trial system.

Is self-care an effective use of resources? Evidence from a randomized trial in inflammatory bowel disease

G. Richardson and others

Journal of Health Services Research and Policy, vol.11, 2006, p.225-230

This paper reports on an analysis of whether a whole system approach to self-management of inflammatory bowel disease (IBD) using a guidebook is more cost-effective than routine care using a fixed appointment scheme. The intervention was associated with a mean reduction in costs of £148.00 per patient and a small mean reduction in QALYs (Quality -adjusted life years) of 0.00022 per patient compared with the control group. More widespread use of this method in chronic disease management seems likely to reduce healthcare costs without any visible adverse effects on patient outcomes.

Predicting the future

D. Carlisle

Health Service Journal, vol.116, Nov. 2nd 2006, p.24-25

Cutting hospital admissions among those with long-term conditions would save the NHS millions of pounds. The predictive risk project aims to reduce hospital bed use associated with long-term conditions by targeting frequently admitted patients in the community. The project also uses an algorithm to identify patients at risk of future admissions, with evidence of promising results to date. A different approach has been developed in Norfolk, where a coaching system aims to prevent admissions by encouraging at risk patients to manage their own care.

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