Clinicians, market players or bureaucrats? Changing expectations of the general practitioner role in the English and Welsh NHS, 1991-2005.

Purpose: The purpose of this paper is to explore the variety of mechanisms applied since 1991 to engage English and Welsh general practitioners (GPs) in local health services planning and implementation.

Design/methodology/approach: Three qualitative case studies.

Findings: The paper identifies three types of mechanism: separation, alliance and integration.

Leadership across boundaries: a qualitative study of the nurse consultant role in English primary care.

Aim: To explore the emerging role of nurse consultant in an English primary care setting.

Background: Nurse consultants have been introduced in England since 1999 as senior, non-managerial nurse leaders. They have generally found it that it takes time to negotiate manageable work-loads.

The subjective experiences of people who regularly receive depot neuroleptic medication in the community.

Little has been written on the subjective experiences of people who receive depot injections in the community. The authors of this paper have identified distinct gaps in the literature in terms of the views of service users regarding this particular intervention. Existing studies tend to focus upon the side effects of depot neuroleptic medication and the attitudes of Community Mental Health Nurses (CMHNs) towards administering depot medication and issues of compliance and non-compliance.

Delivering services to the Bangladeshi community: the views of healthcare professionals in East London.

Objective: To explore the views of primary care staff about delivering services to the local Bangladeshi community.

Study Design: Qualitative case study.

Methods: Six focus groups, each with a different healthcare profession: speech and language therapists; child development team; health advocacy team; salaried general practitioners; school nurses; and occupational therapists.

'Informal' learning to support breastfeeding: local problems and opportunities.

This study explored 'informal' learning opportunities in three health economies, both for National Health Service (NHS) staff and lay people wishing to promote and support breastfeeding and for new mothers wishing to breastfeed. The word 'informal' indicates local learning opportunities that are not part of recognized academic or professional training courses. Semi-structured telephone interviews were conducted with 31 key informants, including health visitors, midwives, infant feeding advisers, Sure Start personnel, voluntary organization representatives, Strategic Health Authority representatives, senior nurses and trainers.

Patients' feelings about ward nursing regimes and involvement in rule construction.

This study compared two acute psychiatric ward nursing regimes, focusing on ward rules as a means of investigating the relationship between the flexibility/inflexibility of the regimes and patient outcomes. Previous studies identified an association between ward rules and patient aggression. A link between absconding and nurses' attitudes towards rule enforcement has also been explored.

What sort of networks are public health networks?

Background: Re-organization of the English National Health Service (NHS) has fragmented the public health workforce, relocating teams from about 100 health authorities into over 300 primary care trusts (PCTs). The UK Government announced the setting up of public health networks (PHNs) as a solution to the problems created by fragmentation.

Methods: Fifty-seven semi-structured telephone interviews were held with key players in PHNs in all strategic health authority areas in England in early 2003.

Patient Advice and Liaison Services: strengthening the voices of individual service users in health-care organizations.

Objective: To explore the roles of Patient Advice and Liaison Services (PALS) in their interactions with service users.

Context: Every National Health Service health-care provider in England now has a PALS, which provides service users with information and help in resolving concerns and dissatisfactions with health care.

Design: Longitudinal qualitative study, 2002-4.

What is the impact on individual health of services in general practice settings which offer welfare benefits advice?

Welfare benefits advice services are increasingly being provided on primary care premises. It is assumed that the relief of financial deprivation will also relieve ill health, although there is only limited evidence to support this. This paper reports the findings of a study designed to measure changes in individual health associated with income increase as a result of such advice.

Developing career pathways for new nurses: lessons from inner London.

Inner city primary care trusts (PCTs) often have difficulty in recruiting nursing staff, while newly qualified nurses are often unaware of what opportunities community settings offer. This article reports the development of a rotational scheme designed to reduce recruitment problems and to assist understanding by newly qualified nurses of the interface between hospital and primary care. The scheme was jointly run by a PCT, a hospital and an academic unit.