Tax planning can lead to considerable efficiencies, but few GPs have been trained as businessmen. This book in "The Business Side of General Practice" series, provides a guide to the regulations, identifies the pitfalls and opportunities and shows how to maximize the income retained by the practice. John Dean is known for his writing on financial management in general practice and has also written "Making Sense of Practice Finance" (Radcliff).
NHS Primary Care Trusts (PCTs) were created in 2002 to commission health services for their local populations, and are currently responsible for controlling about 80 per cent of the £76 billion NHS annual budget. In addition, PCTs have responsibility for public health, and many also provide community-based health services such as district nursing and community hospitals. The Committee's report examines the Government's proposals (set out in the Department of Health paper 'Commissioning a Patient-led NHS' published in July 2005, which can be downloaded at http://www.dh.gov.uk/assetRoot/04/11/67/17/04116717.pdf) to cut the number of PCTs and to contract out community health services by the end of 2008. The report raises a number of serious concerns about the proposals, including in relation to: failings in the consultation process; the impact of PCT restructuring and divestment of provider services; and the likelihood that the estimated financial savings of £250 million will be achieved.
With the advent of the new health authorities, multifunds and consortia, it is likely that the GP's professional leadership of primary care will rapidly become only one of a number of provider options. This book defines some of the future options for the organization of primary care. The evolving possible roles of GPs and practices in these changing circumstances are examined closely. As the new health authorities come into full legislative force, how will they deploy the combined financial allocations for primary and secondary care to support their new capacity to enter into local contracts? Which health care providers will emerge in this market place in response to this shift in commissioning power? These are critical questions for general practice. With contributions from a variety of sources that reflect the varied origins of organizational initiatives, this is a book for planners, providers and purchasers of extended primary care.
This book is for anyone who is interested in the leadership and management of the National Health Service at the start of the 21st century. At a time when the NHS, the biggest organisation in the UK, is facing massive change through modernisation, the authors represent the positive and constructive approaches many clinical leaders and senior managers are taking to become better leaders. It is hoped that the book will contribute to a better understanding of the need to work with complexity and change in a radically different way. The separate chapters of this book have been contributed by practitioners who are - or who have recently been - senior managers and professionals in the National Health Service. They have been asked to write for people like themselves - practical, experienced contributors to the NHS, who know there are no instant solutions, no magic cures, and are prepared to spend a little time standing back for a moment from the bustle of immediate demands to understand the patterns and the problems and the possibilities of leadership in the health service. Clinicians and managers in the UK healthcare system have been subjected to a relentless stream of changes imposed by one political initiative or another over the past twenty years. This has made some practitioners passive. Even at senior levels in some organisations we find managers who say: 'I can't influence strategy. I can't lead. I can't innovate. I'm told what to do.' In these challenging times, we believe that healthcare organisations need more than ever people who are prepared to take what opportunities they can find to lead, rather than just to follow, who are pre- pared to develop the new ideas and practices that will shape their organisations. These leaders are needed at every level. Those at the top of the organisation's structures have the added responsibility of creating sufficient space for leaders at lower levels to be able to take action. Effective leadership is not the business of minutely directing the behaviour of others, as many of our contributors make clear. Effective leadership in modern healthcare is more about working well in partnership, influencing others and also being prepared to influence, working cooperatively rather than in competition.
The 'modernization' of the NHS is at the heart of the UK government's policies for public sector services. This modernization programme represents the most radical and ambitious restructuring of the NHS since its inception in 1948. The new Primary Care Groups and Trusts (PCG/Ts) are the main organizational mechanism for delivering the modernization agenda and are therefore key to the success or otherwise of these reforms.
Common Mental Disorders in Primary Care provides a thorough overview of the diagnosis, treatment and management of the most common mental disorders encountered in primary care. In this book, published to mark the retirement of Professor Sir David Goldberg, distinguished contributors bring together clinical and research work drawn from psychiatry, medicine, psychology, social work and sociology, covering such topics as: * the biological basis of common mental disorders * disability and depression in primary care * the limits of mental health care in general medical clinics * improving the management of mental disorders in the elderly * training the whole primary care team. Common Mental Disorders in Primary Care provides an authoritative review of the subject for professionals working in the area of primary care.
This second edition reviews recent reforms and the likely impact of future developments in management and competition in the NHS. In particular, it reflects the growing importance of primary care and the continuing debates about health care rationing. It concentrates on the realities and how they can be interpreted to help strategists, managers, clinicians, students and those supplying the NHS understand the mechanism of efficient health care delivery.
Anxiety about medicine becoming impersonal and mechanised permeates the NHS. In addition, the popular media is full of stories about the health service and its unhappy staff, focusing on the belief that professionals and patients are being turned into assembly-line workers and objects. This is particularly prevalent in general practice, as plans for massive policlinics are revealed and payment systems shift seemingly inexorably towards incentives and targets. The ethos of family medicine, which places so much stress on continuity of care, psychosocial understanding of illness, and the careful management of doubt, is challenged by guidelines, governance, quality frameworks, and patient satisfaction surveys. General practice is being industrialized into primary care, or so it can seem. This book explores the many dimensions of industrialization as it has occurred to others in the past, and analyses the origins of the current wave of reform in general practice. It analyses why industrialization is being pursued as a government strategy, and explores its benefits and dangers. It concludes that the medical profession has reasons for being perturbed by industrialization, but that it has advantages as well as disadvantages for the NHS and the public. Its conclusions may not please either policy makers or practitioners, but they offer ways for professionals working in the community to customise current changes in potentially beneficial ways.
'Fundamental changes in the Health Service demand a radical shift in approaches to patient core. The NHS is becoming increasingly led by the primary care sector. This has a greater meaning than simply more involvement of GPs in secondary care purchasing. It means that we start from where the patient is, in their own home and community. We provide care for them there and only move them into secondary services if and when it is appropriate to do so. 'Extending Primary Care shows that it is possible to experiment beyond traditional boundaries in these areas. It will provide encouragement to people who work in some of these difficult settings by showing what can be done...This book could not be more timely as a resource to many managers who will need to extend their own understanding of primary care - in the fullest sense of the whole team of people in primary care and the associated community health services.' From the Foreword by Barbara Stocking
Examines the forces for change in health politics and tries to predict the future for health politics in the next decade. Examines the issues surrounding many areas including the impact of market reforms; gp fundholding; resource allocation issues; rights and accountability; funding for the health service and the private finance initiative.
