A report explored how community pharmacy was developing, in terms of service delivery and organisation. It examined the factors that influenced innovation in the context of governmental pharmacy policy and the competitive nature of retail pharmacy.
Source: Christine Bond et al., Change and Evolution in Community Pharmacy, Royal Pharmaceutical Society of Great Britain (020 7572 2276)
Links: Report (pdf links) | Summary (pdf)
Date: 2003-Dec
The National Health Service inspectorate said that NHS Direct provided good quality advice and reassurance, and was appreciated by the people who used it. NHS Direct was handling half a million telephone calls and half a million internet enquiries a month across England and Wales: the majority of calls were outside the working hours of family doctor surgeries, and a quarter related to children under 5. The inspectorate warned that the volume of traffic was such that some call centres were missing - or close to missing - national targets to answer 90 per cent of calls within 30 seconds and conduct an initial assessment of symptoms within 20 minutes.
Source: What CHI has Found in: NHS Direct Services, Commission for Health Improvement (020 7448 9200)
Links: Report (pdf) | CHI press release | DH press release | Guardian report
Date: 2003-Nov
Researchers found that the NHS Direct service was largely used by the middle classes, white people, and people aged between 30 and 60. It also appealed in particular to men (who often found the National Health Service 'unfriendly') and new parents. It was rarely used by those who would arguably benefit most from it.
Source: Gerard Hanlon et al., NHS Direct: Patient Empowerment or Dependency?, Economic and Social Research Council (01793 413000)
Links: Report (Word file) | ESRC press release | BBC report
Date: 2003-Sep
The government began consultation on detailed proposals to modernise and improve the range of services offered by pharmacies in England. The package of proposals included a new duty for primary care trusts to consider the impact on consumer choice when new pharmacies applied to dispense National Health Service prescriptions; boosting patient choice and access by removing restrictions on pharmacies wishing to locate in large shopping developments, on pharmacies prepared to open for more than 100 hours a week, and on new one-stop primary care centres where pharmacists worked with a number of other NHS services. A think tank said the government's policies could trigger the slow death of community pharmacies.
Source: Proposals to Reform and Modernise the NHS (Pharmaceutical Services) Regulations 1992, Department of Health (08701 555455) | Press release 20.8.03, New Economics Foundation (020 7820 6300)
Links: Consultation document (pdf) | DH press release | Pharmaceutical Society press release (pdf) | NEF press release
Date: 2003-Aug
A paper investigated the impact of the fundholding scheme under which family doctors could elect to hold a budget to meet the costs of elective surgery for their patients. Fundholding incentives were found to reduce fundholder elective admission rates by 3.3 per cent, and accounted for 57 per cent of the difference between fundholder and non-fundholder elective admissions. Fundholding had no effect on emergency admissions.
Source: Mark Dusheiko, Hugh Gravelle, Rowena Jacobs and Peter Smith, The Effects of Budgets on Doctors' Behaviour: Evidence from a natural experiment, Working Paper Series 03/064, Centre for Market and Public Organisation/University of Bristol (0117 954 6943)
Links: Paper (pdf)
Date: 2003-Aug
The government published a strategy document (for consultation) on the future of pharmacies. It said that the key aims were to provide high quality professional advice in making the best use of medicines (both prescribed and those bought over the counter); to give patients more choice and convenience (including making it possible for people to get repeat medicines for up to a year without having to contact their family doctor); to promote more pharmacies, with longer opening times; and to make the best use of pharmacists (for example so that they provided advice on healthy eating, smoking, and sexual health).
Source: A Vision for Pharmacy in the New NHS, Department of Health (08701 555455)
Links: Report (pdf)
Date: 2003-Jul
A report warned that family doctors were becoming disillusioned with primary care trusts (PCTs), and that many felt the trusts were becoming as bureaucratic as the old health authorities they replaced. It said that family doctors needed to be fully involved if the trusts were to successfully reform the National Health Service.
Source: Engaging GPs with the New NHS, NHS Alliance (01777 869080), British Medical Association, National Association of Primary Care, and Royal College of General Practitioners
Links: NHS Alliance press release | Guardian report
Date: 2003-Jul
The government published its response to an Office of Fair Trading report on the retail pharmacy market, and to an associated report by MPs. It set out a package of measures (for England) designed to increase competition and choice for patients and consumers, while maintaining and improving access to better quality services. It said these reforms would not diminish the 'crucial' role of pharmacies in rural and poorer areas, and promised measures to prevent adverse effects on local community provision. A consumer group said: 'In opposing sensible reforms of the sector the Government has today thrown its weight behind the vested interests in the pharmacy sector'.
Source: House of Commons Hansard, Written Ministerial Statement 17.7.03, columns 76-78WS, TSO (0870 600 5522) | Press release 17.7.03, Department of Trade and Industry (020 7215 5000) | Response to the Health Select Committee 5th Report of the Session 2002-03 on Control of Entry Regulations and Retail Pharmacy Services in the UK, Cm 5896, Department of Health, TSO (0870 600 5522) | Framework for a New Community Pharmacy Contract, Department of Health (08701 555455) | Press release 17.7.03, Consumers' Association (020 7770 7000)
Links: Hansard | DTI press release | Response to MPs (pdf) | Framework (pdf) | Consumers' Association press release
Date: 2003-Jul
The Scottish Executive published a Bill designed to make local health services more responsive to the specific health needs of local communities, and to introduce a 'fairer and more flexible contract' for family doctors.
Source: Primary Medical Services (Scotland) Bill, Scottish Executive, TSO (0870 606 5566)
Links: Bill (pdf) | SE press release
Date: 2003-Jun
An article said that not being able to see a doctor who knew you, or with whom you had developed a relationship, could have an impact on the level of care received.
Source: Carolyn Tarrant, Kate Windridge, Mary Boulton, Richard Baker and George Freeman, 'How important is personal care in general practice?', British Medical Journal 14.6.03
Links: Article
Date: 2003-Jun
A study found that patients who were removed from a family doctor's list felt threatened, and saw their removal as an attack on their right to be a National Health Service patient.
Source: Tim Stokes, Mary Dixon-Woods, Kate Windridge and Robert McKinley, 'Patients' accounts of being removed from their general practitioner's list: qualitative study', British Medical Journal 14.6.03
Links: Article
Date: 2003-Jun
Family doctors voted to accept a new contract with the National Health Service for the provision of general medical services. Pay would be increased in return for changes in working practices. Subject to legislation, primary care organisations would be able to provide services directly to patients (thus allowing access to services in the evenings and at weekends where family doctors exercised a new right to opt out of responsibility for out-of-hours cover).
Source: Press release 20.6.03, British Medical Association (020 7387 4499)
Links: BMA press release | Guardian report
Date: 2003-Jun
A committee of MPs expressed a series of concerns over proposals to deregulate the retail pharmacy market. It said that if deregulation led to some communities being left without access to local pharmacy services, the social impact among elderly and less privileged groups could be 'grave'.
Source: The Control of Entry Regulations and Retail Pharmacy Services in the UK, Fifth Report (Session 2002-03), HC 571, House of Commons Health Select Committee, TSO (0870 600 5522)
Links: Report | RPS press release (pdf)
Date: 2003-Jun
A survey of general practitioners found that overall job satisfaction and satisfaction with seven out of nine aspects of work were significantly lower among general practice principals in 2001 than in 1998. In both years doctors were least satisfied with their hours of work and remuneration.
Source: Bonnie Sibbald and Chris Bojke, General Practitioner Job Satisfaction in England, National Primary Care Research and Development Centre (0161 275 0611)
Links: Report (Word file)
Date: 2003-May
Leaders of the family doctors' union decided to reject a new draft contract which would have increased doctors' incomes in return for changes in working practices.
Source: Press release 14.5.03, British Medical Association (020 7387 4499)
Links: BMA press release | Guardian report
Date: 2003-May
A survey found that half of the doctors, nurses and other professionals running primary care trusts said they planned to leave within two years. More than one in five said they would leave within twelve months.
Source: Clinician Engagement: National survey, NHS Alliance (01777 869080) and Primary Care Report
Links: Report (pdf) | NHS Alliance press release
Date: 2003-Apr
The government announced that NHS Direct's call handling capacity would more than double to 16 million calls annually by 2006, backed by an 80 per cent funding increase to 182 million. It said that improved 24-hour access to clinical advice by telephone from home would cut the burden on general practitioners and the emergency services.
Source: Developing NHS Direct: Strategy for the next three years, Department of Health (08701 555455)
Links: Report (pdf) | DH press release
Date: 2003-Apr
An Audit Commission report said that the cost of drugs prescribed by family doctors increased by 29 per cent between 1998-99 and 2001-02, to reach an all-time high of over 5.5 billion: but during this time overall spending on family health services increased by only 21 per cent.
Source: Primary Care Prescribing: Bulletin for primary care trusts, Audit Commission (0800 502030)
Links: All links removed by Audit Commission
Date: 2003-Mar
A report said that 90 per cent of primary care trusts are failing to comply with government guidelines on disability access, and risk breaching the Disability Discrimination Act. It called for compulsory disability training for health staff.
Source: Fair Treatment?: Survey of disability access policies in primary care trusts, Leonard Cheshire (020 7802 8204)
Links: Report (pdf) | Press release
Date: 2003-Mar
The Welsh Assembly Government said that it rejected a report by the Office of Fair Trading (published in February 2003) on pharmacies, which recommended that the current control arrangements for National Health Service pharmacy contracts should be abolished.
Source: Press release 26.3.03, Welsh Assembly Government (029 2082 5111)
Links: Press release | OFT report (pdf)
Date: 2003-Mar
A study of private dentistry by the Office of Fair Trading said that better information on prices and treatments is required to improve competition and give consumers greater choice.
Source: The Private Dentistry Market in the UK, OFT630, Office of Fair Trading (0870 6060321)
Links: Report (pdf) | OFT press release | DH press release | Consumers' Association press release | Observer report
Date: 2003-Mar
Researchers examined the feasibility of monitoring death rates in general practices, in the wake of the conviction of Harold Shipman for multiple murders.
Source: Richard Baker, David Jones and Peter Goldblatt, 'Monitoring mortality rates in general practice after Shipman', British Medical Journal 1.2.03
Links: Article
Date: 2003-Feb
A pamphlet argued that community pharmacies were too important to both local economic life and front-line healthcare services to be left to vagaries of the market. (In January 2003 the Office of Fair Trading had announced a plan to deregulate pharmacies.)
Source: Molly Conisbee, Ghost Town: A lethal prescription, New Economics Foundation, available from Central Books (020 8986 5488)
Links: Pamphlet (pdf) | OFT report (pdf) | OFT press release
Date: 2003-Feb
Agreement was reached (subject to consultation) on the terms of a new general medical services contract for general practitioners. Under the proposed contract, payment will be linked to the quality and range of services provided, rather than just the number of patients treated.
Source: Investing in General Practice: The New General Medical Services Contract, British Medical Association (020 7383 6244) | Press release 21.2.03, Department of Health (020 7210 4850)
Links: Draft contract | DH press release | BMA press release | NHS Confed press release
Date: 2003-Feb
A study found that patients may have expectations for access to primary care which are in excess of current government targets.
Source: Peter Bower, Martin Roland, John Campbell and Nicola Mead, 'Setting standards based on patients' views on access and continuity: secondary analysis of data from the general practice assessment survey', British Medical Journal 1.2.03
Links: Article
Date: 2003-Feb
Researchers suggested that the trend in the National Health Service towards larger general practices by itself has had little impact on the quality of chronic disease management in primary care.
Source: Azeem Majeed, Jeremy Gray, Gareth Ambler, Kevin Carroll and Andrew Bindman, 'Association between practice size and quality of care of patients with ischaemic heart disease: cross sectional study', British Medical Journal 15.2.03
Links: Article
Date: 2003-Feb
A survey of primary care trusts found that 71.4 per cent of those responding indicated that they are inadequately staffed to discharge their responsibilities appropriately.
Source: NAPC Survey: Winter 2002, National Association of Primary Care (020 7636 7228)
Links: Report (Word file) | Analysis (Word file)
Date: 2003-Feb
A survey found that 51 per cent of aggregate dentists income is now generated from treating private patients. More than a quarter of all dental patients pay privately for their care. In response the government reportedly promised a fundamental reform of National Health Service dental services.
Source: Philip Blackburn, UK Dental Care - Market sector report 2003, Laing & Buisson (020 7833 9123) | The Guardian, 6.1.03
Links: Summary | Press release | Guardian report
Date: 2003-Jan
The Office of Fair Trading recommended that removing restrictions on entry to the community pharmacy market would give consumers greater choice, benefits from greater competition and better access to pharmacy services. Rural campaigners said it would lead to a further erosion of services to isolated areas.
Source: The Control of Entry Regulations and Retail Pharmacy Services in the UK, OFT609, Office of Fair Trading (0870 6060321) | Press release 21.1.03, Action with Communities in Rural England (01285 653477)
Links: Report (pdf) | OFT press release | ACRE press release
Date: 2003-Jan
An article said that the proportion of general practitioners intending to quit direct patient care within the next five years rose from 14 per cent in 1998 to 22 per cent in 2001.
Source: Bonnie Sibbald, Chris Bojke and Hugh Gravelle, 'National survey of job satisfaction and retirement intentions among general practitioners in England', British Medical Journal 4.1.03
Links: Article
Date: 2003-Jan
