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Primary Care Trusts: modernising the NHS?

Primary Care Trusts: modernising the NHS? . Diane Jones Research Fellow. Overview. PCGs and PCTs in the new NHS National Tracker Survey of PCGs & PCTs Research findings Conclusions. Primary Care Groups and Trusts in the New NHS. One of the most radical reforms since 1948

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Primary Care Trusts: modernising the NHS?

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  1. Primary Care Trusts:modernising the NHS? Diane Jones Research Fellow

  2. Overview • PCGs and PCTs in the new NHS • National Tracker Survey of PCGs & PCTs • Research findings • Conclusions

  3. Primary Care Groups and Trusts in the New NHS • One of the most radical reforms since 1948 • Modernisation agenda reliant on PCTs • IfH reliant on PCTs

  4. Health Service Reforms Core Functions of PCG/Ts: • Improve health of the local population • Commission hospital & community based health services • Develop primary & community healthservices

  5. Funding Strategic Health Authorities approx. 1.5 million population Hospitals Primary Care Trusts approx. 200,000 population Primary Care Community Services Health Services

  6. Information Flows Strategic Health Authorities approx. 1.5 million population Hospitals Primary Care Trusts approx. 200,000 population Primary Care Community Services Health Services

  7. The National Tracker Survey of PCGs and PCTs in England • Longitudinal survey - 72 PCGs • Oct-Dec 1999, Oct-Dec 2000 Jan-Mar 2002 • Describe/evaluate achievements and obstacles • Interviews - CEO, Chair, HA Lead • Postal questionnaires

  8. Modernising Primary Care • Improving access • Extending the range of services • Increasing the workforce capacity • Integrating primary and community services • Improving quality • Information and IT systems

  9. Initiatives to improve access

  10. Extending the range of services through sharing

  11. Enhancing workforce capacity

  12. The Vision Mental Health Services Electronic Patient Record Hospital based Electronic Patient Record Primary Care Electronic Patient Record Community Services Electronic Patient Record Social Care Records

  13. Modernising Information Systems • Are information systems meeting the needs of PCG/Ts? • Will the targets set out in Information for Health and NHS Plan be met? • Development of IM&T in general practice

  14. GP systems - current position • High level of computerisation • Accredited GP systems • Erratic development • Data quality questionable

  15. Research Questions • What are the information needs of PCGs and PCTs? • Do current information systems meet needs? • How can information systems be improved?

  16. IM&T in PCGs and PCTs • Postal questionnaire - IM&T Lead • Response rates • Year 1 53 % (n=38) • Year 2 72% (n=51) • Case Studies • Selected Findings

  17. % of PCG/Ts where information systems meet needs well or very well

  18. PCG/T Information Systems • Poor/ very poor data from: • Community Health systems (84%) • GP systems (63%) • Hospital based systems(63%) • Most had e-links to NHS Net & Internet • Few with e-links to practices & hospitals

  19. % of PCG/Ts reporting more than half of practices using selected links

  20. % of PCG/Ts reporting more than half of practices using information management tools

  21. Education and Training • 24% had an E & T policy for IM&T • 46% aimed to by April 01 • 23% of PCG/Ts signed up to PRIMIS • 26% had plans to sign up to PRIMIS

  22. % of PCG/Ts confident of meeting national targets

  23. Obstacles to progress on IM&T targets • Inadequate levels of IM&T staff (71%) • Poor budget information • LIS does not reflect PCG/T needs • Funding diverted

  24. Obstacles to Progress - general (PCG/T Chief Officers)

  25. Conclusions PCG/Ts are: • taking action to improve access to primary care • extending the range of services by sharing resources between practices • working to increase capacity through extended professional roles

  26. Conclusions • Development of primary and community services - high priority for PCG/Ts • PCG/Ts are making an important contribution to NHS modernisation • Inadequate management capacity and resources are seen as major obstacles to further progress • Continuing tension between central control and local autonomy

  27. Conclusions • Information to support core functions is inadequate • Ability to meet national targets is doubtful • Practice systems - key source of data • GP systems advanced but data quality inadequate • Use of information tools in general practice very low • Essential to improve data quality • Substantial investment required

  28. The Third Tracker Survey • Third survey underway • Findings published in Autumn 2002 • www.npcrdc.man.ac.uk

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