Patients consulting with Crohnʼs disease in primary care in England and Wales

1998 ◽  
Vol 10 (12) ◽  
pp. 1007 ◽  
Author(s):  
Nick P. Thompson ◽  
Douglas M. Fleming ◽  
John Charlton ◽  
Roy E. Pounder ◽  
Andrew J. Wakefield
Keyword(s):  
Primary Care ◽  
England And Wales

scholarly journals Vertical integration of primary care practices with acute hospitals in England and Wales: why, how and so what? Findings from a qualitative, rapid evaluation

BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e053222
Author(s):  
Manbinder Sidhu ◽  
Jack Pollard ◽  
Jon Sussex
Keyword(s):  
Primary Care ◽  
Vertical Integration ◽  
Secondary Care ◽  
Primary Care Providers ◽  
Health Economy ◽  
Service Utilisation ◽  
England And Wales ◽  
Acute Hospitals ◽  
Care Practices ◽  
Primary Care Practices

ObjectivesTo understand the rationale, implementation and early impact of vertical integration between primary care medical practices and the organisations running acute hospitals in the National Health Service in England and Wales.Design and settingA qualitative, cross-comparative case study evaluation at two sites in England and one in Wales, consisting of interviews with stakeholders at the sites, alongside observations of strategic meetings and analysis of key documents.ResultsWe interviewed 52 stakeholders across the three sites in the second half of 2019 and observed four meetings from late 2019 to early 2020 (further observation was prevented by the onset of the COVID-19 pandemic). The single most important driver of vertical integration was found to be to maintain primary care local to where patients live and thereby manage demand pressure on acute hospital services, especially emergency care. The opportunities created by maintaining local primary care providers—to develop patient services in primary care settings and better integrate them with secondary care—were exploited to differing degrees across the sites. There were notable differences between sites in operational and management arrangements, and in organisational and clinical integration. Closer organisational integration was attributed to previous good relationships between primary and secondary care locally, and to historical planning and preparation towards integrated working across the local health economy. The net impact of vertical integration on health system costs is argued by local stakeholders to be beneficial.ConclusionsVertical integration is a valuable option when primary care practices are at risk of closing, and may be a route to better integration of patient care. But it is not the only route and vertical integration is not attractive to all primary care physicians. A future evaluation of vertical integration is intended; of patients’ experience and of the impact on secondary care service utilisation.

NHS Purchaser-Provider Relationships in England and Wales: The View from Primary Care

2009 ◽  
Vol 43 (1) ◽  
pp. 1-14 ◽  
Author(s):  
Stephen Abbott ◽  
Susan Procter ◽  
Nicci Iacovou
Keyword(s):  
Primary Care ◽  
England And Wales

scholarly journals 413 - Delivering tailored, holistic support to people living with dementia and their families: a new primary care intervention

2021 ◽  
Vol 33 (S1) ◽  
pp. 37-37
Author(s):  
Greta Brunskill ◽  
Claire Bamford ◽  
Jane Wilcock ◽  
Alison Wheatley ◽  
Louise Robinson
Keyword(s):  
Primary Care ◽  
Best Practice ◽  
Public Involvement ◽  
Relevant Literature ◽  
Dementia Care ◽  
Long Term Conditions ◽  
England And Wales ◽  
Care Community ◽  
Care And Support ◽  
Diagnostic Support

Background:Currently, post-diagnostic dementia care and support in England and Wales is highly variable, and often insufficient in meeting the needs of people living with dementia and their families.Objective:To develop and deliver a new primary care based intervention to enable people living with dementia and their carers to live as well as possible from the point of diagnosis to end of life.Method:We conducted a survey and interviews with managers and commissioners of dementia services, and in-depth qualitative studies of six different existing service models to understand current post-diagnostic support in England and Wales. We also reviewed relevant literature on the management of long-term conditions and models of post-diagnostic support. Using the findings, a new intervention has been produced through a co-development process involving stakeholder task groups, our patient and public involvement group (the Dementia Care Community), and the multidisciplinary programme management board.Results:Our findings highlighted key priorities from the perspective of people living with dementia, their carers, and professionals which focus on the need for personalised, proactive and holistic care. We also identified a number of challenges in the provision of good quality post-diagnostic support, and examples of how these could be overcome to deliver best practice. Importantly, we found that no one service model delivered all aspects of post-diagnostic dementia support well.The new intervention will focus on three main areas: developing systems for delivering evidence-based support; delivering tailored care and support; and building capacity and capability. A clinical dementia expert, a specialist nurse or similar professional with dementia expertise, will be based in primary care to lead and facilitate change across these three interlinked areas to develop systems and services that meet the needs of all older people living with dementia.Conclusion:Our new intervention will now be tested in practice in a feasibility and implementation study.

scholarly journals Patient Safety Incidents in Primary Care Dentistry in England and Wales

2018 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Eduardo Ensaldo-Carrasco ◽  
Asiyah Sheikh ◽  
Kathrin Cresswell ◽  
Raman Bedi ◽  
Andrew Carson-Stevens ◽  
...  
Keyword(s):  
Primary Care ◽  
Patient Safety ◽  
England And Wales ◽  
Patient Safety Incidents

scholarly journals Managing dyspepsia without alarm signs in primary care: new national guidance for England and Wales

2005 ◽  
Vol 21 (9) ◽  
pp. 1135-1143 ◽  
Author(s):  
J. M. Mason ◽  
B. Delaney ◽  
P. Moayyedi ◽  
M. Thomas ◽  
R. Walt ◽  
...  
Keyword(s):  
Primary Care ◽  
England And Wales ◽  
National Guidance

scholarly journals Patient Safety Incidents Involving Sick Children in Primary Care in England and Wales: A Mixed Methods Analysis

PLoS Medicine ◽  
2017 ◽  
Vol 14 (1) ◽  
pp. e1002217 ◽  
Author(s):  
Philippa Rees ◽  
Adrian Edwards ◽  
Colin Powell ◽  
Peter Hibbert ◽  
Huw Williams ◽  
...  
Keyword(s):  
Primary Care ◽  
Patient Safety ◽  
Mixed Methods ◽  
England And Wales ◽  
Sick Children ◽  
Patient Safety Incidents
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