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Welfare Reform on the Web (April 2007): National Health Service - primary and community care

Listen and learn: keys to good commissioning

D. Colin-Thomé

Health Service Journal, vol.117, Mar. 22nd 2007, p.18-19

This article explores how local authority overview and scrutiny committees and the new local involvement networks (LINks) can bring their influence to bear on NHS commissioning.

One to one interventions to reduce the transmission of sexually transmitted infections (STIs) including HIV, and to reduce the rate of under 18 conceptions, especially among vulnerable and at risk groups

National Institute for Health and Clinical Excellence

London: 2007 (NICE public health intervention guidance; 3)

Sexual health in the UK has deteriorated significantly over the last 12 years, with large increases in many STIs including Chlamydia (up 300%), gonorrhoea (up 200%) and HIV (up 300%). This guidance focuses on one-to-one interventions that address the personal factors that influence an individual's sexual behaviour in order to reduce the transmission of venereal diseases and to reduce the rate of under-18 conceptions, especially among vulnerable groups.

URL: http://guidance.nice.org.uk/PHI3

Power of two

K. McIntosh

Health Service Journal, vol.117, Mar. 22nd 2007, p. 22-23

The Local Government and Public Involvement in Health Bill currently before Parliament places a duty on local councils and primary care trusts to work together to assess health needs. It is hoped that a new era of joint working can encourage local authorities and PCTs to find overlaps and gaps in services. The government also hopes that more joint working can help it shift care out of hospitals into the community.

Primary care chiefs: a reorganisation too far

V. Vaughan

Health Service Journal, vol.117, Mar. 8th 2007, p. 14-15

A survey of primary care trust chief executives has shown that almost all are angry and frustrated by the amount of time and money organisations have wasted coping with constant reorganisations and reconfigurations. Many hope that the creation of an independent board to run the NHS, as proposed by Chancellor Gordon Brown, would reduce political interference. Chief executives generally agreed that the NHS should prioritise better collaboration with local government and targeted prevention of ill health.

Treatment of minor illness in primary care: a national survey of patient satisfaction, attitudes and preferences regarding a wider nursing role

J. Caldow and others

Health Expectations, vol. 10, 2007, p. 30-45

The roles of nurses in primary care are being extended in a number of ways. This study used a postal questionnaire and telephone interviews to investigate what people in Scotland thought about these new roles. It found few differences in satisfaction between those who had consulted a doctor and those who had consulted a nurse at their most recent primary care visit. A discrete choice experiment revealed a general preference for seeing a doctor rather than a practice nurse about a persistent cough, but shorter waiting times, longer consultations or greater continuity could shift this preference. Women, younger people and those with more education and higher incomes had more positive attitudes towards practice nurses. Results suggest that patients will accept extensions to practice nurses' roles, but need to be given information about nurses' qualifications and capabilities.

The urgent care muddle may mean more nights to forget

A. Moore

Health Service Journal, vol. 117, Mar. 22nd 2007, p. 14-15

The transfer of responsibility for out-of-hours care from family doctors to primary care trusts has been described as "shambolic" by the Commons Public Accounts Committee. The situation could be improved by creation of more primary care led "walk in" clinics, restoration of Saturday morning surgeries, and better integration of services.

Who can make the health service listen?

P. Day and R. Klein

Health Service Journal, vol. 117, Mar. 15th 2007, p. 18-19

A reconnaissance of the mechanisms for scrutinising NHS change has shown that the advice of independent expert panels is often ignored by central government ministers, who are possibly more influenced by likely loss of votes. However local authority overview and scrutiny committees (OSCs) are showing increasing confidence in challenging the proposals of their local primary care trusts (PCTs). The committees offer at best a partial solution to the NHS's local democratic deficit; they can only compel PCTs to explain and justify their policies, not to change them in the face of financial constraints.

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