Weekly news. Week beginning 14th April.

 

 

The professional body representing NHS managers have announced its support for Polyclinics, claiming that they could enhance patient care.

 The proposed clinics, announced last year by Health Minister Lord Darzi, will house GP services and also take over much of the work of local hospitals in providing secondary care services—for example, physiotherapy—all in one building. This would be done with the aim of providing convenient, quick and accessible care.

 The NHS Confederation, which represents local health chiefs, have published a report outlining the potential benefits of polyclinics for patients. In particular, they say the new proposals could help patients avoid endlessly being sent back-and-forth between GP and Specialist. It is hoped that the new clinics will make access to secondary services easier, more accessible and more efficient.

 However, the plans have drawn criticism from other quarters. Concerns have been raised by Doctors and Patients alike over the potential erosion of the patient-doctor relationship, the breakdown of continuity of care and the alleged ‘one-size-fits all’ approach being taken in the implementation of the clinics.

 The NHS Confederation has dismissed these criticisms as a knee-jerk reaction. Nigel Edwards, Director of Policy at the NHS Confederation, said: "While it may sound like the polyclinic system will not resemble the service currently provided by family doctors, in reality it should build on what is best in general practice".

 

Figures obtained by the Conservative Party Health Spokesman Andrew Lansley show that up to half the country have received no NHS dental care in the last two years.

 Furthermore, the number of patients turning up at accident and emergency wards for dental problems has gone up dramatically. According to figures seen by the Daily Mail, hospital admissions have gone up by 27,000 since the introduction of the new Dental Contract in 2006.

 Speaking on the findings, Andrew Lansley said: “Dentists are being forced out of the NHS and some patients clearly have no other option but to take their dental problems to hospital A&E, a service which is already under great pressure.”

 Michael Summers, Vice-Chair of the Patients Association’s Board of Trustees, said: "This really is a scandal. People tell us it is almost impossible to find an NHS dentist in many parts of the country. So they either have to find the money to pay for private treatment or they go without check-ups and treatment for years on end. There are real dangers in that, because one of the objects of regular check-ups is to identify infections or signs of oral cancers."

 The Patients Associations report on the 2006 Dental Contract, ‘The New Dental Contract: Full of Holes and Causing Pain?’ is available on our website.

 

 

Private firms in charge of running out-of-hours care are using nurses and less qualified ‘emergency care practitioners’ for patient visits in an attempt to make savings on the money it would cost to send a GP.

 Leaked emails also show that many firms are monitoring the amount of home-calls GPs are making, as well as the time GPS spend dealing with telephone consultations, in an attempt to make the service more ‘cost effective’. Targets are being used by some firms to put pressure on GPs to minimize the amount of time they spend delivering care. Other doctors have reported receiving pressure to limit the amount of referrals they make to secondary services over evenings and weekends.

 The provision of out-of-hours care changed in 2004 after the introduction of the new GP Contract. This allowed GPs to opt-out of providing out-of-hours care in return for a small cut in their salary. 9 out of 10 doctors chose to opt out, and the responsibility of providing such care was picked up by Primary Care Trusts (PCTs), who commission out a range of providers, including private firms, to meet the need.

 Dr Laurence Buckman, a member of the British Medical Association's GPs committee, said: "We deprecate any attempt to persuade doctors who work for out-of-hours providers to alter their clinical behaviour for any reason, except to move it to a higher standard for the benefit of patients.

 Vanessa Bourne, from the Patients Association, said: "Is this really about best practice or is it just a crude way to make ends meet? Is it more about weak management than anything else? Above all, the NHS is about face-to-face care - patient to clinician. There is no substitute."

 

Scientists have called for two guides promoting alternative medicine published by the Prince of Wales to be withdrawn on the basis that they make misleading and inaccurate claims.

 The Foundation for Integrated Health, of which the Prince of Wales President, received a £900,000 grant from the Department of Health to produce one of the publications called for withdrawal.

 The Calls were made by Professor Edzard Ernst and Simon Singh, who analysed the two publications—Complementary Health Care: A Guide for Patients and the Smallwood report.—for their new book, Trick or Treatment: Alternative Medicine on Trial.

 In a letter to the times, Professor Edzard Ernst and Simon Singh said: “They both contain numerous misleading and inaccurate claims concerning the supposed benefits of alternative medicine. The nation cannot be served by promoting ineffective and sometimes dangerous alternative treatments.”

 Natasha Finlayson, of the Prince’s Foundation for Integrated Health, said: “We entirely reject the accusation that our online publication Complementary Healthcare: A Guide contains any misleading or inaccurate claims about the benefits of complementary therapies. On the contrary, it treats people as adults and takes a responsible approach by encouraging people to look at reliable sources of information . . . so that they can make informed decisions. The foundation does not promote complementary therapies.”

 

 

A recent High Court ruling, which will mean that up to 100,000 patients will be denied access to drugs which would delay the onset of Alzheimer’s disease, is to be contested in the Court of Appeals.

 The case concerns a decision made in November 2006 by the National Institute for Health and Clinical Excellence (NICE)—who provide guidance on the use of new and existing medicines, treatments and procedures within the NHS—which recommended that the drug Aricept should not be available to all Alzheimer’s patients, on the grounds that it was not cost-effective. This guidance, when implemented, will make the treatment unavailable to almost 100,000 patients with Alzheimer’s.

 This decision has been the source of great controversy. The decision was upheld by the High court, and a case has now been bought to the Court of Appeals by an alliance of drug manufacturers, pharmaceutical companies and the patient’s group, The Alzheimer’s Society. It is alleged that NICE did not follow a fair and transparent process when reaching the decision.

David Pannick QC, who is representing the pharmaceutical company leading the appeal, Eisai, said "The evidence suggests that, when the guidance takes full effect annually 96,600 patients with mild Alzheimer's disease will be refused treatment."