Socioeconomic status and geographical factors associated with active listing in primary care

Socioeconomic status and geographical factors are associated with health and use of healthcare. Well-performing primary care contributes to better health and more adequate healthcare. In a primary care system based on patient’s choice of practice, this choice (listing) is a key to understand the system | BMJ Open

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Objective: To explore the relationship between population and practices in a primary care system based on listing.

Conclusions: Higher income, shorter education, shorter distance to primary care or longer distance to hospital is associated with active listing in primary care.

Multimorbidity, age, geographical location and type of primary care practice are more important to active listing in primary care than socioeconomic status and distance to healthcare.

Full reference: Ranstad. K. et al. (2017) Socioeconomic status and geographical factors associated with active listing in primary care: a cross-sectional population study accounting for multimorbidity, age, sex and primary care. BMJ Open. 7:e014984.

Developing sustainable primary care

Challenges facing general practice are increasing. This comes at a time of increased patient need, high demand for services and growing challenges in retaining and recruiting clinical team members | PCC

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PCC has been supporting practices to prepare for the future by looking at ways they can become more sustainable. From our work so far, the following themes have emerged:

  • The need to ensure practices are well run, claiming appropriately and considering how the practice, as a whole, could work smarter.
  • Planning for the future –how a practice will need to change in the next three to five years and how steps towards this can start now, to achieve early wins and boost morale.

General practices are responding to the increasing demands they face in several ways. Some are merging with other like-minded practices or working with other partners in the health economy. Others are collaborating to share back office or clinical skills to enable them to manage patients and workloads most appropriately. This includes signposting to alternative local services.

Read the full overview here

UK top in primary care co-ordination according to international survey

The UK emerges as the first of 11 countries in an international survey of care co-ordination in primary care settings | The Commonwealth Fund

In a survey of health care experiences in 11 high-income countries, the rate of poor primary care coordination was 5.2 percent overall and 9.8 percent in the United States, the highest rate. Patients who have a positive, established relationship with their provider were less likely to report poor primary care coordination. Being young or having a chronic illness was associated with poor care coordination.

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Image source: The Commonwealth Fund

The dimensions of care coordination assessed for this study were:

  • access to medical records or test results;
  • receiving conflicting information;
  • use of diagnostic tests that the patient felt were unnecessary; sharing of information between primary care doctor and specialist.

The UK had the highest percentage of patients reporting no care coordination gaps within primary care.

Full results can be accessed here

 

Improving accountability in provision of new models

The National association of primary care has published Improving accountability in the provision of new models of care: winter review report. This is the latest report from the association’s quarterly meeting, which concentrated on whole population budgets and the metrics that may be used in the new care models that are prioritising primary care provision.

Winter Insight: NHS 111

An analysis of how NHS 111 has fared, especially over the winter period | Nuffield Trust

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Image source: Nuffield Trust

Key Points:

  • The proportion of callers being dispatched from NHS 111 to emergency services over the last three years has risen. There has been a particular rise in the share of people who are passed to ambulances.
  • There is great variability between different areas in how likely NHS 111 is to send people to A&E or the ambulance service. This might suggest that some areas are too likely, or not likely enough, to send people to emergency services. NHS 111 is also more likely to dispatch an ambulance than to simply send people to A&E – which is the reverse of the usual pattern of NHS use. This lends credence to claims that the service is too risk-averse in some cases.
  • However, contrary to criticism that it adds to the pressure on A&E, the service overall seems to steer people away from emergency services. Patient surveys suggest as many as 8 million more people would have gone to A&E and the ambulance service over the last three years without 111. The call line also soaks up extra demand during winter, when it becomes less likely to refer people to urgent services.
  • NHS 111 still answers the vast majority of calls within a minute, and few people hang up after having to hold for more than 30 seconds. However, it has not met its target of answering 95 per cent of calls within 60 seconds for two-and-a-half years, and it seems prone to serious under-performance when calls spike after Christmas and the New Year.

Read the full report here

Dentists’ morale has generally fallen

This report explores the relationship between the motivation and morale of selfemployed primary care dentists and their working patterns.

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Despite this, over half of dentists (57 per cent) report that they have the opportunity to do challenging and interesting work and 55 per cent agreed that they feel good about their job. However, the report also found that the more time dentists spent on NHS work, the lower their levels of motivation.

The report explores the relationship between dentists’ motivation and morale and their working patterns, considering in particular:

  •  Weekly hours of work
  •  Division of time between NHS and private dentistry
  •  Division of time between clinical and non-clinical work
  •  Weeks of annual leave
  •  Age

Read the full overview here

Read the full report hereDentists’ morale has generally fallen, according to official statistics from NHS Digital

Freedom to speak up in primary care

Freedom to speak up in primary care: guidance to primary care providers on supporting whistleblowing in the NHS | NHS England

kick-off-879382_1280This guidance aims to make it easier for all staff providing NHS primary care services to raise their concerns so that action can be taken and improvements made.

It details the principles and actions to apply in primary care when raising concerns about the delivery of primary care services to patients.

The guidance comes after Sir Robert Francis recommended that the principles outlined in his Freedom to Speak Up report be adapted for primary care, where smaller work settings can present challenges around anonymity and conflicts with employers.