Library Bulletin – Journal Articles – February 2010
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HEALTH SERVICES
O'CATHAIN, Alicia and COSTER, Joanne and others. Do walk-in centres for commuters work? A mixed methods evaluation. British Journal of General Practice Vol 59, No 569 - December 2009: 934-939
Abstract: Background: Between 2005 and 2007, six pilot walk-in centres were opened in or near train stations, to provide health care to commuters. They are run by independent providers on behalf of the NHS, providing access to doctors and nurses. Aim: To evaluate the policy of commuter walk-in centres. Design of study: Mixed methods evaluation. Setting: Six centres in England. Method: Site visits, interviews with 28 users, survey of 1828 users, economic estimates, and interviews with six commissioning managers. Results: Each centre was located near a train station, although two were not within the main commuter flow. The average number of patients attending each centre on days when the user survey was undertaken was between 33 and 101 per day, considerably lower than the planned capacity of 150-180. Sixty-two per cent (1004/1627) of users identified themselves as commuters within the user survey, and 38% (95% confidence interval = 13% to 62%) had travelled to work by train that day. A large proportion of users worked in the local area (61%). The estimated cost per attendance, based on limited activity and price data, was between £52 and £150 for different centres at estimated current activity levels. Primary care trust managers' plans for the future of the centres involved changing the focus of the service to fit their local health economy. Conclusion: Pilot walk-in centres placed near train stations for commuters had low activity levels and high costs. A policy of placing healthcare centres in areas of high worker density may be more successful.
RUMMERY, Kirstein. Healthy partnerships, healthy citizens? An international review of partnerships in health and social care and patient/user outcomes. Social Science and Medicine Vol 69, No 12 - December 2009: 1997-1804
Abstract: As a result of changes in the governance of health and social care organizations across developed welfare states they are under increasing pressure to work in partnership with each other (at an organizational and inter-professional level) and with the private and voluntary sector. Drawing on a comparative literature review of the theoretical and empirical evidence from health and social care partnerships across developed welfare states, this paper aims to examine the policy drivers behind such changes and the effects the changes have had on the governance of health and social care, the results for service commissioners and practitioners, and particularly the results for patients and service users. It examines some of the evidence that suggests that patient/user involvement and outcomes may at best be unaffected, and at worst be negatively compromised by shifts towards increasing partnership working in health and social care. It will conclude by discussing what lessons can be drawn about service re-organization and user involvement in welfare organizations generally, and how best to protect the interests of vulnerable and disenfranchised groups of service users.