Sexual health services

The Royal of General Practitioners has responded to the new sexual health campaign from Public Health England by publishing Time to Act.

This report highlights that fragmented commissioning practices mean that GPs are increasingly unable to direct patients to the most appropriate sexual health services for their needs, and GPs are not being given adequate training to administer all different types of contraception thgenerat might benefit patients.

Full report available here

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Commissioning primary care services

NHS England has updated the Primary medical care policy and guidance manual to reflect the changing landscape in primary care co-commissioning.   This document provides commissioners of primary care services the context, information and tools to safely commission and contract manage primary medical care contracts.

The document is split into four sections:

Part A – Excellent Commissioning and Partnership Working

Part B – General Contract Management

Part C – When things go wrong

Part D – General

Nine in 10 GPs rated good or outstanding following CQC inspection

Care Quality Commission (CQC) report finds that at the end of its first inspection programme of general practices 4% were rated ‘outstanding’, 86% were ‘good’, 8% were ‘requires improvement’ and 2% were ‘inadequate’.

state of cqc

Image source: http://www.cqc.org.uk

The state of care in general practice 2014 to 2017 presents findings from CQCs  programme of inspections of GP practices. This detailed analysis of the quality and safety of general medical practice in England has found that nearly 90% of general practices in England have been rated as ‘good’, making this the highest performing sector CQC regulates.

Full document: The state of care in general practice 2014 to 2017

Large scale general practice

Rosen, R. Kumpunen, S. Curry, N. Davies, A. Pettigrew, L. Kossarova, L. (2017) Summary booklets on lessons for large-scale general practice. | Nuffield Trust

In July 2016, the Nuffield Trust published Is bigger better? Lessons for large-scale general practice  which examined the factors affecting the evolution of general practice and its impact on quality, staff and patient experience.

The Nuffield Trust has now released four booklets which sit alongside this main report covering:

 

Plans announced to fast-track NHS digital technology

New technology designed to improve patient access, won’t solve the GP workforce problem, lead doctors have said today | OnMedica

https://www.flickr.com/photos/opensourceway/6810048752/

Image source: opensource.com – Flickr // CC BY-SA 2.0

Dr Richard Vautrey, chair of the British Medical Association’s GP Committee, has responded to health secretary Jeremy Hunt’s promise that every patient should be able to access medical records and book an appointment via an integrated app in 2018.

The health secretary is to outline the measures at today’s Health and Care Innovation Expo in Manchester.

The digital expansion plans include:

  • The expansion of the existing NHS 111 non-emergency phone line service to include a new online ‘triage’ service for less serious health problems.
  • An NHS-approved health apps to guide patient choice – NHS England will launch a library of NHS-assessed apps, as well as advising on other wearable devices, to ensure people can select reputable and effective products to monitor and improve their health.
  • A relaunch of the NHS Choices website to improve the range of services – it will be relaunched as NHS.UK with a fuller range of online patient services, including the ability to register with a GP, see and book appointments, and order and track prescriptions.
  • Instant access to personal health records online – inspired by the ‘blue button’ app in the US, the new NHS.UK site will also enable patients to securely download their personal health records.
  • More interactive, local information about the performance of health services.

Read the full overview here

Day in the life of a General Practice Nurse

Health Education England today launches a short film showcasing a day in the life of a general practice nurse | HEE

The film shows the depth and breadth of activities a general practice nurse can get involved with in a regular day.

This has been developed as part of the General Practice Nursing Workforce Development Plan to help promote the importance of expanding and developing the general practice nursing workforce.

Targeted at pre-registration student nurses and those that want to transition into general practice from other areas – have a look at the HEE website to find out if this could be the career for you.

Find the full overview here

Point of care testing in primary care

Research concerning point of care testing (POCT) in primary care finds that the total expected cost of using POCT to deliver an NHS Health Check in primary care is lower than the laboratory-led pathway.  It also minimises DNA rates and only requires one visit from the patient.

Abstract:
Objective: To determine if use of point of care testing (POCT) is less costly than laboratory testing to the National Health Service (NHS) in delivering the NHS Health Check (NHSHC) programme in the primary care setting.

Design: Observational study and theoretical mathematical model with microcosting approach.

Setting: We collected data on NHSHC delivered at nine general practices (seven using POCT; two not using POCT).

Participants: We recruited nine general practices offering NHSHC and a pathology services laboratory in the same area.

Methods: We conducted mathematical modelling with permutations in the following fields: provider type (healthcare assistant or nurse), type of test performed (total cholesterol with either lab fasting glucose or HbA1c), cost of consumables and variable uptake rates, including rate of non-response to invite letter and rate of missed [did not attend (DNA)] appointments. We calculated total expected cost (TEC) per 100 invites, number of NHSHC conducted per 100 invites and costs for completed NHSHC for laboratory and POCT-based pathways. A univariate and probabilistic sensitivity analysis was conducted to account for uncertainty in the input parameters.

Main outcome measures: We collected data on cost, volume and type of pathology services performed at seven general practices using POCT and a pathology services laboratory. We collected data on response to the NHSHC invitation letter and DNA rates from two general practices.

Results: TEC of using POCT to deliver a routine NHSHC is lower than the laboratory-led pathway with savings of £29 per 100 invited patients up the point of cardiovascular disease risk score presentation. Use of POCT can deliver NHSHC in one sitting, whereas the laboratory pathway offers patients several opportunities to DNA appointment.

Conclusions: TEC of using POCT to deliver an NHSHC in the primary care setting is lower than the laboratory-led pathway. Using POCT minimises DNA rates associated with laboratory testing and enables completion of NHSHC in one sitting.

Full reference: Does use of point-of-care testing improving cost-effectiveness of the NHS Health Check programme in the primary care setting?  A cost-minimisation analysis