Clinical Commissioning Groups in the UK

Author(s):  
Vikraman Baskaran ◽  
Steve E. Johns ◽  
Rajeev K. Bali ◽  
Raouf N. G. Naguib ◽  
Nilmini Wickramasinghe

This paper investigates whether Knowledge Management (KM) tools and techniques would be useful to General Practitioners within the new UK Commissioning Consortia when they adopt the role of General Practitioners commissioners from the current Primary Care Trusts. Empirical data based on questionnaires were sent to a small sample group made up of General Practitioners, Primary Care Staff and Academics in addition to data collected from a set of one to one interviews with some of the sample group. The authors’ findings show that stakeholders (n=30) are not accustomed to using KM as a way to maximize existing knowledge of commissioning of services within the Primary Care Trust but it does show that they are not too far away from possibly realizing that some type of KM strategy would probably work for them. General Practitioners are already using some of the knowledge management tools under different guises. A lot of resources will be saved if General Practitioners can capture as much of the knowledge already available within the Primary Care Trust by incorporating KM tools and techniques.

Author(s):  
JILL RUSSELL ◽  
TRISHA GREENHALGH

This chapter describes a study undertaken as part of the UCL Evidence programme to explore how policymakers talk about and reason with evidence. Specifically, researchers were interested in the micro-processes of deliberation and meaning-making practices of a group of people charged with prioritising health care in an NHS Primary Care Trust in the UK. The chapter describes how the research study brought together ideas from rhetorical theory and methods of discourse analysis to develop an innovative approach to exploring how evidence is constituted at the micro-level of social interaction and communication. It presents empirical data to illuminate the representation and meaning of evidence within one particular policymaking forum, and to highlight contrasting constructions of the policymaking process.


2014 ◽  
Author(s):  
Louis Leong ◽  
Chun Wah Michael Tam

Background: Routine use of alcohol screening questionnaires is recommended in primary care, but patient beliefs and attitudes towards the acceptability of receiving alcohol enquiry from general practitioners (GPs) are unclear. Methods: We searched medical databases to identify published empirical research on patient beliefs, attitudes and experiences towards receiving alcohol discussions from GPs. Coherent themes were synthesised from the results of the included studies using a realist perspective. Seventeen studies were included in the review – the majority were quantitative surveys from the UK, Nordic countries, North America and Australia. Results and Discussion: GPs are seen to be legitimate providers of lifestyle advice, but patients may not find alcohol enquiry acceptable in a specific consultation. Alcohol discussions are less acceptable than those on other health promotion topics. The context of the consultation, such as the reason for presenting and the patient-doctor relationship, has an important influence on the situational acceptability of alcohol enquiry. Conclusion: Although GP involvement in health promotion is perceived as legitimate, alcohol enquiry in consultations can be fraught and unwelcome. Contextual factors pertaining to the consultation appear to be important but these have not been well explored in the literature. Conclusions from this review should be restricted to societies with “Temperance” drinking cultures.


2014 ◽  
Vol 30 (1) ◽  
pp. 55-67 ◽  
Author(s):  
Armando Henrique Norman ◽  
Andrew J. Russell ◽  
Jane Macnaughton

This article explores some effects of the British payment for performance model on general practitioners’ principles and practice, which may contribute to issues related to financial incentive modalities and quality of primary healthcare services in low and middle-income countries. Aiming to investigate what general practitioners have to say about the effect of the British payment for performance on their professional ethos we carried out semi-structured interviews with 13 general practitioner educators and leaders working in academic medicine across the UK. The results show a shift towards a more biomedical practice model and fragmented care with nurse practitioners and other health care staff focused more on specific disease conditions. There has also been an increased medicalisation of the patient experience both through labelling and the tendency to prescribe medications rather than non-pharmacological interventions. Thus, the British payment for performance has gradually strengthened a scientific-bureaucratic model of medical practice which has had profound effects on the way family medicine is practiced in the UK.


2015 ◽  
Vol 32 (9) ◽  
pp. 982-996 ◽  
Author(s):  
Andrew Thomas ◽  
Jiju Antony ◽  
Mark Francis ◽  
Ron Fisher

Purpose – The purpose of this paper is to investigate and understand the differences that exist between educational institutions in the methods and practices employed in the development and implementation of Lean projects. Whilst many Higher Education Institutions (HEIs) are now starting their journey towards effectively implementing Lean, Further Education Institutions (FEIs) have treaded this well worn path many years previously and so the aim of this paper is to find what key features and issues FEIs have put in place to assist them in implementing Lean projects and whether HEIs can learn from such institutions. Design/methodology/approach – The paper applies two research methods in an attempt to understand the differences between the institutions and hence understand the key features that can be used to better implement Lean initiatives. First, through a series of focus groups, the authors employ a low-level form of Group Consensus Theory in an attempt to understand the organisational dynamics surrounding the adoption of Lean. This is used to understand whether Lean improvement teams within FEIs implement such initiatives with the autonomy and support from senior management. Second, the same group members, detailed interviews were held in order to identify further and more specific information around the tools and techniques employed in the implementation of Lean initiatives in both HEI and FEIs. Findings – The study found that although FEIs had much more experience in the design, development and implementation of Lean initiatives, the organisational infrastructure and dynamics towards driving Lean in FEIs was less well embedded in to the culture of the respective institutions than first thought and, that Lean had been developed and driven initially by a consultancy-based approach and around a tool-driven mentality. It was seen that whilst HEIs were generally slower in getting off the mark, there seemed to be more enthusiasm and willingness to drive such initiatives forward and in a more systematic and holistic manner even though some of the projects were in their very early stages of implementation. Research limitations/implications – Whilst this work provides key information on how Lean initiatives are implemented across different institution types, the work has only looked at a very small sample of two teaching focused HEI and two FEIs. The work will need to be extended much more widely to incorporate a larger set of HEIs (both research and teaching focused) in order to provide a more complete map of Lean development in HEIs. Practical implications – The aim of the paper is to provide Lean project leaders in HEIs with some additional key insights towards the cultural and organisation dynamics that exist in educational institutions other than HEIs in order to assist them in developing further and more comprehensive Lean programmes. Originality/value – This paper is the first of its kind to study the organisational and cultural dynamics that exist between differing educational institutions in their approaches towards the implementation of Lean and business improvement programmes. The key features highlighted in this work raise important issues regarding the need and importance of developing team dynamics around project implementation.


1999 ◽  
Vol 85 (3) ◽  
pp. 981-986 ◽  
Author(s):  
Usha Rout

This is a description comparing job stress, job satisfaction, and mental well-being of general practitioners ( n = 205) and practice nurses ( n = 119) in England, based on responses to a questionnaire. General practitioners reported lower job satisfaction and significantly greater pressure at work than did the practice nurses. Also, male general practitioners had significantly higher scores on anxiety and depression than a British normative population. Practice nurses, on the other hand, reported lower scores on anxiety and depression. The results should be interpreted with caution as the study is based on a small sample limited to the northwest region only; however, it does provide information which has important implications for the well-being of doctors and nurses in primary care.


Sign in / Sign up

Export Citation Format

Share Document