Biomedical subjects
Publications and source records attributed to Alexis Nolan.
A mental health trust is tackling out-of-area care by reducing available beds. Its recovery model of care reduces the reliance on hospital care. Out-of-area treatment has dropped to zero and bed usage is at 84 percent.
The National Audit Office predicts that 60-70 per cent of hospitals and GP practices will be linked to the electronic booking service by the end of the year. By the end of last year the system had seen just 63 referrals, despite an earlier target of 250,000. Various surveys continue to show strong suspicion and lack of knowledge among GPs.
Alternative provider medical services contracts are encouraging primary care trusts to innovate in the way they invite tenders--but private companies have had mixed success in winning business. However, now the situation seems to be changing, with about half of all out-of-hours contracts run under APMS rules and a small number of prison and general practice 'wins'.
With the official toll from the Boxing Day tsunami now standing at 300,000, Alexis Nolan and Emma Forrest talk to health service managers who gave more than money to the relief effort--they travelled to the disaster area and gave their time and expertise. The impact on their professional and personal lives was considerable. As Mathi Chandrakumar, clinical director of Kent Health Protection Unit, puts it: 'My heart is there, I feel very sad. I will probably go back.'
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Suffolk's HSJ Award-nominated People Project aims to empower service users and carers. Participants attend workshops on subjects including getting ahead. The project has secured a new round of funding to take it through to August 2006.
From April 1, practice-based commissioning will be operational; meaning practices can request indicative budgets from PCTs. Practices should be incentivised to take on budget deficits. There are concerns that the role of practice-based commissioning as a counterweight to payment by results will reinforce divisions between acute and primary care.
A policy think tank for PCT chief executives has been set up by Warwick University's Health Service Partnership. It aims to increase PCTs' influence on wider policy issues, as well as acting as a networking and research group.
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A lack of high-quality managers and a need for more commissioning muscle will encourage PCTs to merge. They will not be forced to do so by the government. Practice-based commissioning will take some responsibilities away from PCTs, but they will still have a big agenda. Trusts that have merged in all but name extol the benefits of keeping a local focus while freeing up resources from improved management capacity.