Realising benefits in primary healthcare infrastructures

Purpose: This paper focuses upon the requirements to manage change, tangible and intangible benefits in a joint approach to deliver outputs on time, to quality and cost without failing to realise the benefits of the change. The aim of the paper is to demonstrate the need for benefits driven programme/project management as well as the importance of identifying the stakeholders’ level of involvement and contribution throughout the process, and manage their expectations. Design/methodology/approach: The methodology used is based on an action research approach, combining findings from a literature review and case studies within UK’s primary healthcare sector. Findings: Findings demonstrate development of a Benefits Realisation (BeReal) approach in healthcare through looking at case studies taking place within UK’s primary and acute healthcare sector Research limitations/implications: The framework development is based upon theoretical evidence and further research is needed to test and validate its robustness. Originality/value: The application of Benefits Realisation and Management in developing and delivering primary healthcare facilities. Keywords: Benefits management, Benefits realisation, healthcare infrastructures, process and LIF

Front‐line perspectives on ‘joined‐up’ working relationships: a qualitative study of social prescribing in the west of Scotland

Cross-sector collaboration has been promoted by government policies in the United Kingdom and many western welfare states for decades. Literature on joint working has focused predominantly on the strategic level, neglecting the role of individual practitioners in putting ‘joined-up working’ into practice. This paper takes the case of ‘social prescribing’ in the West of Scotland as an instance of joined-up working, in which primary healthcare professionals are encouraged to refer patients to non-medical sources of support in the third sector. This study draws on social capital theory to analyse the quality of the relationships between primary healthcare professionals and third sector practitioners. Eighteen health professionals and 15 representatives of third sector organisations participated in a qualitative interview study. Significant barriers to collaborative working were evident. The two stakeholder groups expressed different understandings of health, with few primary healthcare professionals considering non-medical sources of support to be useful or relevant. Health professionals were mistrustful of unknown third sector organisations, and concerned about their accountability for referrals that were not successful or positive for the patient. Third sector practitioners sought to build trust through face-to-face interactions with health professionals. However, primary healthcare professionals and third sector practitioners were not connected in effective networks. We highlight the on-going imbalance of power between primary healthcare professionals and third sector organisations. Strategic collaborations should be complemented by efforts to build shared understandings, trust and connections between the diverse frontline workers whose mutual co-operation is necessary to achieve effective joined-up working

Views of patients about sickle cell disease management in primary care: a questionnaire-based pilot study.

OBJECTIVES: To determine how patients with sickle cell disease (SCD) perceive the quality of care that they receive from their primary healthcare providers. DESIGN: A questionnaire-based pilot study was used to elicit the views of patients about the quality of care they have been receiving from their primary healthcare providers and what they thought was the role of primary care in SCD management. SETTING: Sickle Cell Society and Sickle Cell and Thalassaemia Centre, in the London Borough of Brent. PARTICIPANTS: One hundred questionnaires were distributed to potential participants with SCD between November 2010 and July 2011 of which 40 participants responded. MAIN OUTCOME MEASURES: Analysis of 40 patient questionnaires collected over a nine-month period. RESULTS: Most patients are generally not satisfied with the quality of care that they are receiving from their primary healthcare providers for SCD. Most do not make use of general practitioner (GP) services for management of their SCD. Collecting prescriptions was the reason most cited for visiting the GP. CONCLUSION: GPs could help improve the day-to-day management of patients with SCD. This could be facilitated by local quality improvement schemes in areas with high disease prevalence. The results of the survey have been used to help develop a GP education intervention and a local enhanced service to support primary healthcare clinicians with SCDs ongoing management

Self-care in primary care: findings from a longitudinal comparison study.

To examine the effects of self-care training workshops for primary healthcare workers on frequently attending patients

Competition in Primary Healthcare in Ireland:More and Better Services for Less Money

Understanding precisely the nature of competition in primary healthcare has an important role to play in understanding how to improve the delivery of healthcare services. This is particularly the case in Ireland, where the private sector plays such a large role in primary care. If we do not understand competition, well-intentioned regulations and policies are less likely to be effective and more likely to result in excessive costs and under-utilisation of primary healthcare. This in turn can increase Ireland’s overall health expenditure and contribute to a higher cost of living in Ireland and thus lower competitiveness. This paper shows how well-designed regulations and systems for State funding of primary healthcare can ensure that competition works well and contributes to the better availability and quality of services at the lowest possible cost. The most common barriers to entry and expansion in primary healthcare markets are outlined and pricesetting mechanisms examined. Examples are used to illustrate the benefits to consumers and the State where these obstacles to competition have been removed, and the difficulties where they remain. Conclusions are drawn on the implications of this analysis for the governance of regulatory bodies, for regulatory Codes of Conduct, and for achieving value for money. It is time for the culture of the healthcare professions to move towards one where it is no longer considered “unprofessional” to provide a competitive service.

Electronic Medical Record Adoption in New Zealand Primary Care Physician Offices

Describes EMR adoption in New Zealand's primary healthcare system, including how government investment was secured and data protection laws, unique patient identifiers, and standards and certification were established, with lessons for the United States

Crisis in Primary Healthcare

Crisis in Primary Healthcar