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Our Health, Our Care, Our Say. The Dept of Health White Paper January 2006. Aims. Why is it important? Background to White Paper Key Changes Proposed How they will be implemented. The ‘Primary Care’ White Paper. Focus on primary & community health rather than secondary care

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our health our care our say

Our Health, Our Care, Our Say

The Dept of Health White Paper

January 2006

  • Why is it important?
  • Background to White Paper
  • Key Changes Proposed
  • How they will be implemented
the primary care white paper
The ‘Primary Care’ White Paper
  • Focus on primary & community health rather than secondary care
  • May have significant impact on way primary care services are organised therefore important document (for all of us, not just people doing the exam!)
why now
Why Now?
  • Half way through NHS Plan (2000)
  • This was a plan for the NHS for following 10yrs
  • 2 key aims were Investment & Reform
  • Focus on disease & treatment rather than healthy living & disease prevention
  • Inc emphasis on public involvement
  • ?worsening inequality
  • Prior to white paper extensive consultation with public
  • People want
    • Choice re:accessing healthcare
    • Local services that fit in around their lives
    • Investment in most deprived areas
    • Focus on mental health
access to primary care
Access to Primary Care
  • Book ahead & book on the day appts
  • Choice over which Dr you see
  • Longer opening hours- WIC, OOH, ?financial incentives to surgeries to stay open
  • Inc access to Telephone consultations
  • Idea of dual registration abolished
access to primary care7
Access to Primary Care
  • Tackle areas with ‘closed lists’
    • Encourage private firm involvement in taking on practices
    • Giving practices money- ‘Expanding Practice Allowance’ so they can employ more staff & stay open longer
community hospitals
Community Hospitals
  • Recognises potential use of community hospitals in terms of local access therefore aims to keep them open
  • Could be used for diagnostic procedures eg. OGD, coloposcopy
  • Move some hospital op services into community hospitals & consider GPwSI, specialist nurses etc to run them
chronic disease management
Chronic Disease Management
  • Use of QOF to improve management of chronic diseases (do targets actually inc pt care??)
  • Invest more money in the Expert Patient Programme- lay ‘experts’ give courses in self-management of chronic disease
    • Inc social involvement, self-mx techniques, reduction in pain & depression
chronic disease management10
Chronic Disease Management
  • Joint working with social services
  • Direct Payments- pts given budget with which they purchase healthcare they want
    • Eg. Diabetic could purchase eye care, foot care etc from the provider of their choice
  • Improve support for carers
    • National helpline
    • ?Expert Carers Programme
mental health
Mental Health
  • Inc number crisis teams, A&E liason teams & access to MH services
  • Improve child & adolescent services across country
  • Inc access to computer based CBT (recent NICE guidance)
life checks
Life Checks
  • Initially just for people aged 50 but idea is they will spread to 4 other ages incl childhood
  • Computer based questionnaire, followed by advice produced by programme based on your answers
  • Access to health trainer- a member of public who can help pts access different services
  • ?measurements eg BP, BMI involved
how will they do this
How will they do this?
  • Virtually no increase in funding to make these changes (surprise surprise!) so need re-distribution of current funds
  • 3 main ways to achieve this
    • QOF
    • Practice Based Commissioning
    • Payment by Results
  • Will be main way of improving clinical care.
  • Already new framework of points for 2006-07 incl AF, depression, dementia, obesity & recording ethnicity of new pts.
practice based commisioning
Practice Based Commisioning
  • Practices will have a budget (indicative budget) with which they then purchase services directly from service providers
  • Allows planning of healthcare services to suit practice population
  • A National Tariff will be set for each service so it costs the same regardless of who it is purchased from
payment by results
Payment By Results
  • Previously hospitals have been paid a lump sum for doing, for eg, all the orthopaedics for a PCT
  • This will change & they will now be paid based on the number of procedures they do
  • Sounds fair but could lead to demise of certain procedures in certain places
rcgp views
RCGP Views

“We welcome the White Paper as a major step forward in strengthening Primary Care with General Practice as the backbone of the NHS. It is good news for patients & GPs, giving them greater say in improving standards & local services”

  • Important new White Paper focussing on Primary Care
  • One of the main focuses is access to primary care
  • PBC, PBR & QOF will be used to implement the changes
  • Minimal increased funding.