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From quantity to quality

The last 10 years of the Labour government focused on expanding the capacity of the NHS. But recent announcements suggest that the next few years will concentrate on improving quality and developing more personalised care

Lynn Young
Primary Healthcare Adviser for the RCN

This article was written within a few days of the Right Honourable Alan Johnson MP, Secretary of State for Health, making his statement to the House of Commons following the announcements made by the Right Honourable Alan Darling, Chancellor of the Exchequer, on the comprehensive spending review and the 2007 budget.
According to Alan Johnson, the previous 10 years of the Labour government focused successfully on expanding the capacity of the NHS, and the next few years will concentrate mainly on improving quality and developing more personalised care.
Clearly we have a long way to go when you consider the disastrous levels of outbreaks of Clostridium difficile at Maidstone and Tunbridge Wells Trust. The immediate response from the RCN was: "Allegations in this report don't get any more serious than this and the findings represent an unacceptable breakdown from the ward to the board. The RCN is not a refuge for poor practice and will be examining these findings to draw learning from the failings both within the system and by individuals. We can only hope that we will never be compromised in this way again."(1)
What on earth went wrong within this hospital for such a shocking state of affairs to occur, which included the untimely deaths of a significant number (approximately 100) of patients? In this case, and quite rightly, the Healthcare Commission has shown its teeth and gone public in its condemnation of such dire practice and terrible consequences for patients who entered the hospital in the good faith that they would receive safe and much as treating it. Opening hours are to be extended allowing the working population to access their practice with greater ease.
A new access fund is being set up that will allow 150 new GP-run health centres to be developed and for them to provide truly consumer-friendly services. They are to be open from 8am to 8pm, seven days a week and offer walk-in and bookable services. A number of these centres will also provide physiotherapy, diagnostic and social care services, which brings to mind a new organisation called a polyclinic.

Better management of mental health
We also have a new emphasis on the better management of mental health in primary care. While some of us are beginning to get hooked into the initiative led by the Department of Work and Pensions, which aims to help people come off their current incapacity benefits and return to appropriate work, it is important to remember that mental illness accounts for 40% of those people in this group.
While World Mental Health day has now passed it was on this day that Alan Johnson announced that by 2010/11 England will have £170m to develop widespread psychological therapy services. The hope is that such a service will help 900,000 patients suffering from anxiety and depression manage their condition, recover, and be in a good position to prevent further episodes.

More care on the cards
It seems that England is about to enjoy far more primary care and in addition a whole host of accessible diagnostic services and mental healthcare. Huge amounts of money are to continue to slosh around healthcare organisations. It behoves all of us to be absolutely responsible for not only providing safe patient care, but also for making quite certain that public funds are spent wisely. Patients must be reassured that hospitals are spotlessly clean and staffed by people who are obsessed by infection control. More primary care may result in far fewer of us requiring hospital care. l competent care.

Expanding primary care
But let's move on to more cheerful news and talk about future developments in primary care that Alan Johnson and Professor Ara Darzi wish to see in place in the forthcoming months.
More general practice is in order - particularly in poor areas in need of expanded primary care. A sum of £250m has been pledged to fund another 100 general practices, which will focus on preventing disease as much as treating it. Opening hours are to be extended allowing the working population to access their practice with greater ease.
A new access fund is being set up that will allow 150 new GP-run health centres to be developed and for them to provide truly consumer-friendly services. They are to be open from 8am to 8pm, seven days a week and offer walk-in and bookable services. A number of these centres will also provide physiotherapy, diagnostic and social care services, which brings to mind a new organisation called a polyclinic.

Better management of mental health
We also have a new emphasis on the better management of mental health in primary care. While some of us are beginning to get hooked into the initiative led by the Department of Work and Pensions, which aims to help people come off their current incapacity benefits and return to appropriate work, it is important to remember that mental illness accounts for 40% of those people in this group.
While World Mental Health day has now passed it was on this day that Alan Johnson announced that by 2010/11 England will have £170m to develop widespread psychological therapy services. The hope is that such a service will help 900,000 patients suffering from anxiety and depression manage their condition, recover, and be in a good position to prevent further episodes.

More care on the cards
It seems that England is about to enjoy far more primary care and in addition a whole host of accessible diagnostic services and mental healthcare. Huge amounts of money are to continue to slosh around healthcare organisations. It behoves all of us to be absolutely responsible for not only providing safe patient care, but also for making quite certain that public funds are spent wisely. Patients must be reassured that hospitals are spotlessly clean and staffed by people who are obsessed by infection control. More primary care may result in far fewer of us requiring hospital care.