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

Access to health services: care leavers and young people 'in difficulty'

C. Cameron

ChildRight, issue 238, 2007, p. 22-25

This article presents the findings of a study which aimed to compare the experiences of care leavers (aged 17-24) with those of other young people who have had difficulties but have not been in Local Authority care, in relation to their access to, and use of, a range of health and welfare services. For reasons of space limitations, this article focuses on data relating to young people's use of health services. As a result of their elevated health needs, the young people in the study were experienced users of GP surgeries and hospital accident and emergency departments. Young people 'in difficulty' reported worse health than care leavers. The model preferred by all young people consisted of broadly based, open access provision where a range of services, including health, education and training, were provided under one roof through multi-agency partnerships.

Anticipatory case management and practice-based commissioning in Oxfordshire

L. Peretz and S. Bright

Journal of Integrated Care, vol. 15, Aug. 2007, p. 13-19

This case study shows how practice-based commissioning is being used in Oxfordshire to integrate health and social care practice and so promote independent living in the community. A model of anticipatory case management is being developed at local level, focusing on individuals identified by use of a standard tool as at risk of readmission to hospital.

Doctors' leader hails peace - in his own time

O. Evans

Health Service Journal, vol. 117, Aug. 9th 2007, p. 16-17

Report of an interview with new British Medical Association Chair Dr Hamish Meldrum in which he discusses the cost of extending opening hours of GP surgeries, the implementation of practice-based commissioning, and the role of the private sector in delivering NHS services.

Early learning is key weapon in obesity war

L. Kendall

Health Service Journal, vol. 117, Aug. 2nd 2007, p. 16-17

Concerns are mounting over rising levels of childhood obesity. In order to get to the root of the problem, parents must be better engaged and services and support must be effectively targeted on disadvantaged areas. It is suggested that midwives and health visitors are key to delivering such support, possibly through children's centres.

Facing the future: a review of the role of health visitors

Department of Health

London: the Department, 2007

This review of health visiting in England has identified and defined the profession's role. The review recommendations define the core elements of health visiting, state that health visitors should primarily work with young children and their families, with a view to preventing social exclusion, reducing inequalities, and tackling key public health priorities such as obesity, call for services to remain universal, envisage health visitors playing a key role in an integrated children's service, and propose that the implementation of the review should be supported by government guidance.

GP tendering could herald new era of competition for practices

V. Vaughan

Health Service Journal, vol. 117, Aug. 9th 2007, p. 5

The Department of Health has renewed its attempts to get more GPs into under-doctored areas through a scheme called Fairness in Primary Care procurement. This will see care provided under an alternative provider medical services contract, which will allow primary care trusts to specify obligations such as longer opening hours. The bidding is open to independent and third-sector providers, as well as existing practices.

Health visitors are key to child-centred services

K. Cernik, S. Kelly and B. Grimes

Community Practitioner, vol. 80, Aug. 2007, p. 16-17

The Early Support Programme (ESP) was established by central government in 2004 and set out to develop better co-ordinated, family focused services for young disabled people and their families across England. The ESP was created to:

  1. help parents make sense of the roles of different agencies and professionals
  2. get parents' own knowledge of their child recognised by professionals
  3. get professionals to better understand parents' needs.

This article considers the key role of health visitors in delivering the programme.

Mothers' views of the health visiting services in the UK: a web-based survey

S. Russell and V. Drennan

Community Practitioner, vol. 80, Aug. 2007, p. 22-26

This paper reports on a user-led UK wide survey of mothers' views about sources of support and experiences accessing the health visiting service. Netmums, a family of web sites run by local mothers, undertook the survey following concerns that the health visiting service was proving increasingly difficult to access. The results show that the majority of respondents (n=4,665) rate the service as quite or very good, valuing most the characteristics of a) expertise in child development and parenting; and b) time and willingness to listen on the part of health visitors. In all areas but one, the service was seen as changing for the worse.

One size does not fit all

P. Watson

Community Practitioner, vol. 80, Aug. 2007, p. 14-15

The Equality Act 2006 requires NHS organisations to actively promote equality between men and women. Specific action needs to be taken to improve the health of men, who are less proactive in using services than women. The author argues for the creation of male health promotion teams staffed by men and for measures to encourage more men to enter the health, education and social care professions. Such men could act as positive role models for young boys without a father figure at home.

PCTs under pressure to open doors wider

D. Sout

Health Service Journal, vol. 117, Aug. 30th 2007, p. 16-17

The results of a survey of patient satisfaction with access to primary care in England published in July 2007 were disappointing, and displayed wide variations between primary care trusts. There are also worrying differences in satisfaction levels in different ethnic and age groups. Access could be improved by commissioning longer opening hours from practices, through encouraging competition, allowing working patients to register with a practice close to their workplace, or giving patients the right to register with a walk-in or urgent care centre or an Accident & Emergency (A&E) Department for primary care services instead of with a GP. Alternatively, practices could be encouraged to improve their urgent care arrangements by being made to pay for patients on their list using A&E services.

Shifting end of life care back into the community

A. Shiner and J. Stothard

Journal of Integrated Care, vol.15, Aug. 2007, p. 28-35

National evidence shows that 60% of patients would prefer to die at home, but in North Derbyshire only 20% of patients were supported to do so. This article describes the tools used to improve end of life care services in the community, and discusses the enablers and barriers.

Why minorities still stand out from the primary care crowd

R. Evans

Health Service Journal, vol.117, Aug. 2nd 2007, p. 12-13

Patients from black and minority ethnic communities are significantly less happy with access to GPs than white British patients. In order to get to the root of the problem, improvements in ethnic monitoring in primary care are needed. However it is possible to speculate that dissatisfaction may stem from language barriers, lack of knowledge of the health system, institutional racism, and lack of culturally appropriate services.

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