Better services and more choice in the NHS

BMJ 2006; 333 doi: http://dx.doi.org/10.1136/bmj.333.7558.56 (Published 6 July 2006)
Cite this as: BMJ 2006;333:56

Get access to this article and all of bmj.com for the next 14 days

Sign up for a 14 day free trial today

Access to the full text of this article requires a subscription or payment. Please log in or subscribe below.

  1. Paul Wallace, professor of primary care,
  2. Ann Bowling, professor of health services research (a.bowling@ucl.ac.uk),
  3. Jennifer A Roberts, emeritus professor of economics of public health
  1. Department of Primary Care and Population Sciences, University College London, London NW3 2PF
  2. Department of Primary Care and Population Sciences, University College London, London NW3 2PF
  3. Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London WC1E 7HT

    Leaders should not ignore the pitfalls and benefits of bringing services to the doorstep

    The English public wants three things from community services: to have more control of their health and care; support and enablement to maintain their health, independence, and wellbeing; and rapid and convenient access to high quality, cost effective care, closer to their homes.1 2 Hence, in a white paper—Our Health, Our Care, Our Say: A New Direction for Community Services—earlier this year the Department of Health recommended a substantial transfer of NHS functions to the community, proposing that up to 15 million outpatient attendances should be delivered in community settings.1

    To avoid fragmentation, control of most local health resources will be given to general practices via practice based commissioning while primary care trusts develop the necessary infrastructures to shift specialist care. Primary care trusts will be given the incentives for change through the mechanism of payment by results, a method already being used with hospital trusts to pay providers a fixed price for …

    Get access to this article and all of bmj.com for the next 14 days

    Sign up for a 14 day free trial today

    Access to the full text of this article requires a subscription or payment. Please log in or subscribe below.

    Article access

    Article access for 1 day

    Purchase this article for £20 $30 €32*

    The PDF version can be downloaded as your personal record

    * Prices do not include VAT

    THIS WEEK'S POLL