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Welfare reform on the Web (January 2007): National Health Service - Primary and Community Care

General practitioners with special clinical interests: a qualitative study of the views of doctors, health managers and patients

A.R.J. Boggis and C.S. Cornford

Health Policy, vol.80, 2007, p.172-178

In order to address shortages of hospital consultants, the UK has developed the concept of general practitioners with special clinical interests. These provide services traditionally supplied by hospital consultants and take referrals from other GPs. This study examines the opinions of a range of health professionals and patients regarding the expansion of GP with special clinical interests (GPSCI) services and the benefits and challenges that might be expected. It reveals complex views about GPSCI services. They are understood to enable patients to be seen more quickly. They also offer advantages for the professional development of doctors in both primary and secondary care, especially in relation to job satisfaction among GPs. However, the services need managing well, ensuring that they do not rely on one individual and that robust accreditation and governance mechanisms are in place. There are potential conflicts of interest between doctors and managers responsible for organising such services.

Implementing the NHS leadership qualities framework in the West Berkshire primary care trusts

R. Crowder and M. Woods

British Journal of Leadership in Public Services, vol.2, Sept. 2006, p.15-18

The leadership qualities framework is a tool developed by the NHS Leadership Centre in 2002 specifically for NHS staff. It is based on research carried out with NHS trust chief executives to determine the qualities required for leadership in the NHS. However, it was used successfully with a wide range of Berkshire primary care staff.

Joined-up working: improving young people’s sexual health and enhancing social inclusion?

K. Philip and others

Journal of Youth Studies, vol.9, 2006, p.615-628

This paper uses findings from a four-year independent evaluation of Healthy Respect, a Scottish demonstration project on teenage sexual health, to examine ways in which attempts to improve young people’s sexual health can be construed as a way of promoting social inclusion. In particular, the paper asks whether Healthy Respect’s multi-agency approach to the provision of health education and sexual health services allowed the project to foster social inclusion more effectively than would have been the case if services had been offered from separate professional “silos”.

Learning lessons from health visiting modernisation in Bromley

K. Plumb

Community Practitioner, vol.79, 2006, p.400-405

Bromley Primary Care Trust initiated a project to transform its generic health visiting services from traditional and universal to needs-led and evidence-based. A model was developed that placed greater emphasis on early intervention, the support of vulnerable families and partnership working through:

  1. The introduction of a family health assessment tool aimed at engaging clients in the assessment of their own health needs
  2. A core programme of universal and targeted health visiting interventions aligned to key milestones when practitioners have most contact with families.

This article analyses the change process using a framework incorporating Nadler’s Organisational Change Model.

“The only thing you can’t predict is where it will go”

N. Edwards

Health Service Journal, vol.116, Dec. 7th 2006, p.18-19

Report of an interview with Cliff Prior, chief executive of UnLtd, in which he discusses the potential for social enterprises to revolutionise NHS community services.

PCT commissioning: an innovative approach

J. Beenstock and others

British Journal of Health Care Management, vol.12, 2006, p.334-337

This article describes an innovative strategic approach to commissioning developed by three primary care trusts (PCTs) in North West England. The primary aim of the strategy is to prevent or delay the on-set of ill-health in the population by tackling life-style determinants of disease such as poor diet, alcohol consumption and smoking.

Primary health care in England: the coming of age of Alma Ata?

A. Green, D. Ross and T. Mirzoev

Health Policy, vol.80, 2007, p.11-31

The Alma Ata Declaration was signed in 1978 by health ministers at an international conference organised by the WHO and UNICEF. It set out a strategy for attaining Health for All which included two levels of thinking: an operational set of services and a number of principles. This article assesses the current health policies and system in England against the principles enshrined in the Alma Ata Declaration. It suggests that the Alma Ata focus on equity is being modified by the advent of patient choice. It explores tensions between central priorities, often reflected in targets, and local needs. There appears to be a genuine interest in seeking population health improvement, with attendant public health and partnership policies, but the gap between policy and practice still needs to be bridged, and questions about the appropriate locus and leadership for health promotion activities addressed. However, there have been numerous institutional changes which may distract practitioners from the goal of achieving population health improvement.

UK health policy and “underage” smokers: the case for smoking cessation services

M. Denscombe

Health Policy, vol.80, 2007, p.69-76

The 1998 UK government White Paper Smoking Kills set targets for reducing the prevalence of smoking. In order to achieve these targets, a raft of measures was introduced, including NHS Stop Smoking Services. Smoking among children aged 11 to 15 is a persistent cause for concern in Britain, and this article argues for smoking cessation services to be more explicitly targeted on this group. The relative lack of provision for young people is curious because there is evidence that between one-half and two-thirds of under-16s who currently smoke would like to stop.

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