AFA FIAB MIHM MAMS FinstCPD
Independent Healthcare Consultant
Director of Primary Care
National Services for Health Improvement
Steve is a former Royal Navy Officer, and joined the health service as a chief management accountant in 1984. He has worked at all levels of the NHS. He was an associate tutor at the Institute for Health Policy Studies at the University of Southampton and has worked for the professional development committee of the Institute of Healthcare Management
The work carried out by voluntary and charitable organisations has become increasingly important to primary care. It is likely that a large percentage of your practice population will experience personal circumstances where wider support is needed. Although you are the first point of call for their clinical needs, you can also ensure the provision of relevant support for wider social and health issues.
Proactive practices will recognise the wealth of knowledge these organisations possess and how you may best access this information for your patients. The NHS Constitution has already stipulated certain patient expectations, and one of the areas being considered under consultation is patients' right to die at home. If this is legalised, there will be a greater need to understand how the voluntary and charitable sector can contribute.
These organisations often have a more personal understanding of how the patient care pathway is mapped out for a specific condition. They may be able to provide information on a national or local level that may help the commissioning process. Very often, you will find well-established support groups for certain conditions. Box 1 lists some of the better-known organisations.
Information for commissioning needs
The best way of collating all the available information about different conditions is to keep a register of organisations and details about where you could obtain information if you need it.
Practice managers should, of course, be aware of the conditions that affect patients in the UK. The Quality and Outcomes Framework (QOF) is reflective of the preventative work that is undertaken at practice level. If we are truly going to move towards self-care and even self-management, then relevant and trusted sources of information are going to be needed. Charitable and voluntary organisations have already had many years' experience in providing this.
When considering the commissioning needs of the practice population, most decisions will be based upon historic activity. However, by liasing with local voluntary or charitable groups, you will be able to ensure that these opinions are included in the practice's overall plans, so that your commissioning plan truly reflects patient involvement. A fundamental standard of world class commissioning is that patient views are sought.
If the needs of local people are to be adequately met, the practice needs to ensure that it understands the necessary care pathways for all of its patients. There are so many diversifying needs that it would be almost impossible to be anything other than reactive to the medical conditions of your registered practice population.
However, by analysing the patient list, you might find prevalence in a particular condition. It might then be possible to engage this group of patients in a discussion forum or partake in a brief questionnaire or survey that will help decide how services will be commissioned in the future.
With the concept of a patient-led NHS and patient participation, the use and acknowledgement of the amount of work charitable and voluntary groups do for patients will be put
Over the years, through media campaigns and charitable work, the British public has become increasingly aware of national campaigns organised to address the issues surrounding health conditions faced by both young and old in the UK today.
National campaigns may be of relevance to a greater or lesser part of your practice population. Promotional information is often sent directly to the practice or via the primary care trust.
This promotional information can be displayed around the practice and handed out to interested patients. However, this means of course that only patients visiting at that time will be able to see this information, while many others who might benefit from the information will not receive it.
All practices have a web presence via NHS choices and many have their own sites, which can be regularly updated with topical news and events – for example, February 2010 was National Heart Month.
A good way of addressing this issue would be to provide information in the surgery notifying in advance any health promotional weeks that are going to be dealt with in the practice.
One of the roles of the modern practice is to provide information and education to patients. In an era when preventative medicine is seen as an increasingly important part of general practice, events and campaigns like this can greatly assist the practice in achieving a healthier population.
In the first instance, a practice might consider compiling its own list of national campaigns and displaying these in the practice. Box 2 gives a sample list of the types of national campaigns currently being promoted in the UK.
Many of these organisations will provide you with literature and details that you may reproduce and distribute in the surgery. You should not underestimate the importance of working in collaboration with charitable and voluntary organisations. They can work seamlessly with your practice and help demonstrate that your practice truly understands the health needs of your practice population.
1. See www.asthma-uk.co.uk/asthma4.htm
2. See www.arthritiscare.org.uk/AboutArthritis
3. Department of Health. The Musculoskeletal Services Framework. London: DH; 2006. Available from: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/Publicati...
4. See www.lunguk.org/abouttheblf