Click here to skip to content

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

Bradshaw calls for action to fix primary care democratic deficit

O. Evans

Health Service Journal, vol. 117, Sept. 13th 2007, p. 5

Health minister Ben Bradshaw has raised the prospect of a shake-up of local NHS governance after he issued a warning that primary care trusts lack democratic accountability and that people in their area find it difficult to get their voices heard. The minister also said that managers should communicate using simpler language. In this article, experts comment on how changes could be introduced.

Corporate solutions to caseload management: an evaluation

R. Hoskins, A. Gow and J. McDowell

Community Practitioner, vol. 80, Sept. 2007, p. 20-24

This paper describes an evaluation of a change in health visiting service delivery from GP caseload management to corporate caseload working in one inner city health centre located in a deprived area of Glasgow. Data were collected by means of a stress questionnaire, public health nursing diary, focus groups and semi-structured interviews. Findings show immediate improvements in team working, staff communication, sharing practice, enhanced clinical reflection and standards of documentation. However, corporate caseload working did not appear to reduce staff stress levels, increase public health nursing activity or improve quality of client service.

The Expert Patients Programme: a paradox of patient empowerment and medical dominance

P.M. Wilson, S. Kendall and F. Brooks

Health and Social Care in the Community, vol.15, 2007, p. 426-438

Self-care in chronic disease is seen as a significant element in managing resource demand and is also perceived as empowering patients. The Chronic Disease Self-Management Programme developed in the USA has been adapted for UK use and rolled out as the Expert Patients Programme. However, despite its potential as a lay-led empowering initiative, the Expert Patients Programme has been criticised as perpetuating the medical model and failing to reach those in most need. This paper draws on a qualitative study to explore whether the Expert Patients Programme enables empowerment or replicates the traditional patterns of the patient-professional relationship. The research revealed the paradoxical nature of the programme in that while course content and structure served to reinforce the medical paradigm, there was a concurrent acknowledgement of the subjective self and experience of living with a long-term condition. In addition there is emerging evidence that the programme may be triggering a health consumer movement.

A problem shared

D. Carlisle

Health Service Journal, vol.117, Sept. 6th 2007, p. 22-25

A wide range of work is in progress to build commissioning capability and capacity among primary care trusts (PCTs). PCTs in Manchester, London and the West Midlands are all working together to set up commissioning support services, which will provide high quality data to form a sound basis for commissioning decisions.

Providing a children's palliative care service in the community through fixed-term grants: the staff perspective

A.J. Beringer, N.M. Eaton and G.L. Jones

Child: Care, Health and Development, vol. 33, 2007, p. 619-624

This paper reports findings from a qualitative study conducted with a sample of community children's nursing teams in England providing palliative care for terminally ill children in their own homes. The teams involved had each received grants from the New Opportunities Fund to extend their services or set up new ones. The study aimed to identify factors that affect service delivery from the staff perspective and to suggest ways of promoting their sustainable development. The fixed-term nature of the funding for these services was implicated in the reluctance of some health professionals to make referrals, and staff recruitment difficulties. Funding also had an impact on the scope of services provided, particularly an unsustainable unfunded on-call service, which was possible only because of staff good will.

Working together to help people make the most of primary health care in Coventry

D. Martin and others

Learning Disability Today, vol. 7, Aug. 2007, p. 23-27

Visiting their GP can be especially challenging for people with learning disabilities. People with learning disabilities are more likely to need medical attention for physical conditions, but these are often not detected. Health screening (check ups) and health facilitation are effective ways of addressing the health inequalities experienced by people with learning disabilities. This article describes the work of a health facilitation team in Coventry. The team works with a GP practice to identify people with learning disabilities in the area and to offer thorough health checks to those identified.

Search Welfare Reform on the Web