Primary healthcare premises are increasingly becoming more sophisticated, offering health promotion, minor surgery and specialist services. The acquisition of new premises, expansion or investment in traditional surgeries can be the greatest financial commitment and also one of the most daunting. This book is specifically written to enable development with minimal disruption to the daily medical routine. The book contains viewpoints of specialists with many years' experience gained from working in their individual fields. It is essential reading for GPs, trainees, practice managers and professional advisers to general practice. Specialist architects, solicitors, financial advisors, accountants and health authority managers will also achieve a better understanding of this complex subject.

Private medical practice is an attractive option for career development. In the United Kingdom it forms a significant industry, yet little has been done to assist medical consultants in managing their businesses. This book gives clear advice to all medical practitioners on both business management and performance. It outlines ways to improve financial performance and economic efficiency in a constantly changing market. It reveals some of the 'secrets' of the successful business professional, and relates business management theories and techniques to real day-to-day problems. Written by a practising accountant and business advisor, this book provides help with finance, banking, taxation, staffing, marketing, medical insurance companies, and business planning, and considers future developments. It is essential for all those contemplating or currently working in private medical practice, and valuable to business, legal and financial professionals servicing this field.

Rewritten with the new primary care environment in mind, this greatly expanded and updated edition of Child Mental Health in Primary Care extends the structured approach of the first edition to adoelscent mental health. As in the first edition, Primary Child and Adolescent Mental Health covers each problem in a uniform way, offering definitions, assessment outlines, detailed management options and indications for referral. Numerous case examples further illuminate aspects of many conditions. Comprehensive and practical, the forty-eight chapters of Primary Child and Adolescent Mental Health cover the full range of difficulties and disabilities affecting the mental health of children and young people. The book is divided into three volumes, and can either be read from cover to cover or used as a resource to be consulted for guidance on specific problems. This book is vital for all healthcare professionals including general practitioners, health visitors and other staff working in primary care to assess, manage and refer children and adolescents with mental health problems. School medical officers, social workers and educational psychologists, many of whom are in the front line of mental health provision for children and young people, will also find it extremely useful. Reviews of the first edition: 'This very comprehensive and detailed book provides the tools for primary care health professionals not only to assess a child's needs but in many cases also to implement an initial package of care.' JUST FOR NURSES 'I have no reservation in recommending the book to all people working with children and families in any capacity. An important training text for a variety of professions. A very effective text to be used in daily practice for quick reference.' CHILD AND ADOLESCENT MENTAL HEALTH 'This book is well produced and clearly written. A useful book for anyone interested or involved with children.' FAMILY PRACTICE 'I looked through the book again and again but could not find anything missing.' NURSING TIMES

In order to run a successful practice GPs need to have good management skills. This book guides the GP through practical issues such as how to construct a business plan, how to handle staff and encourage teamwork, how to make partnerships work, how to develop and maintain relationships with GHSAs, consultants, suppliers, and much more.

As a result of recent changes in health care, nurses, GPs and health visitors find that they are required to take a major role in nutrition education and dietary advice. Health promotion is now an important aspect of general practice and community care. Shorter periods of hospitalisation, increased care of the chronically ill 'in the community' and the management of disorders like diabetes within general practice have meant that many more people now require specialised nutritional care. At the same time, rapid advances in nutrition have left some health professionals feeling that their dietary knowledge is inadequate. This book updates the reader on the relationships between diet and health and the use of diet in the management of disease. Topical but less familiar nutrients such as antioxidant vitamins or long-chain fatty acids are explained in ways that are easily understood. Adviceis given on the types on nutritional problems that can be successfully identified and managed in the primary-care setting and those that may require specialised dietetic help.

Though medically minor and very common, herpes simplex is a condition which is capable of causing considerable distress, for psychological and social as much as physical reasons. Herpes Simplex contrasts the image of the condition presented in the media with the medical and epidemiological evidence, and discusses ways in which the distress associated with the condition can be alleviated.
The first part of the book examines the impact of diagnosis and then explains the roles of accurate information and empathic support, medical treatment and support groups in learning to live with recurrent symptoms. Other chapters use the experiences of people with the condition in different parts of their bodies to illustrate how the meaning of herpes simplex and response to the symptoms alters in association with life changes. The final chapters review psychosocial research, discuss the importance of the Herpes Viruses Association in acquiring a store of knowledge about people's experiences, and highlight the significance of herpes simplex as a public health problem.
Herpes Simplex demonstrates the importance of a biopsychosocial approach. It will be invaluable to doctors, nurses and other health professionals, as well as to people troubled by the condition.

eBook available with sample pages: 0203137132

This book is vital for health service managers and clinicians, in both purchaser and provider organizations, in community and hospital settings. It helps the reader understand the principles and purposes of casemix and provides practical examples of using casemix groupings to manage services better. Its lessons are not just for acute services, but provide a way of understanding the complete spectrum of services required for a wide range of conditions, from individuals at risk to those with irreversible and progressive disease. The book explains why casemix groups are useful and the reasons for grouping and analysing patient records. It focuses on the difference between groupings of patients with conditions, and groupings of intervention episodes. Using both enables better identification of the services required to meet the needs of the population, and better communication between purchasers and providers. It has potential for managing the whole healthcare system from a population based perspective.

Other titles in the National Primary Care Research and Development Centre series: NPCRDC: What is the Future for a Primary Care-led NHS? NPCRDC: Primary Care: Understanding Health Need and Demand NPCRDC: Better Building for Better Services NPCRDC: Primary Care and Social Services: developing new partnerships for older people NPCRDC: Primary Health Care and the Private Sector

Presents information and advice on the extended role of the practice manager for both those with experience and increasing responsibility, and for those new to the primary care team. The book: identifies the various members of the primary health-care team; describes their individual roles; explores the management skills needed to manage the team and the practice; provides examples of real problems experienced in general practice; and examines communication in all its forms.

What happens when you include the family in the delivery of primary care? Do patients rehabilitate faster? How are prevention, treatment, and diagnosis affected? In Family Health Care, an interdisciplinary group of scholars addresses these questions and provides insight into the awakening interest in family-oriented care. This timely volume shows how recent changes in family life challenge traditional approaches to family-oriented care, examines models for training physicians to "think family," presents exemplars of family-oriented care, and provides models for intervention in applying family practice. The contributors also furnish an overview of research on family health care and discuss future directions in the methodology of family-oriented health care. Family Health Care is destined to become an indispensable resource for teachers and academics in family medicine and nursing, as well as specialists working in the field including social workers, psychologists, family therapists, and family/health care researchers. "It is a valuable book because it makes both theory and practice very accessible even to the reader who may not previously have considered these issues in any depth." --Health and Social Care "This text is well referenced with a helpful index. It provides a concise overview of relevant family systems theory, methodology, and approaches toward family therapy and research. The dialogue is thought provoking and, at times, controversial. . . . This book contributes importantly to one of the most critical issues in family medicine affecting our conceptual foundation, our self-perception, and our future."

There are many changes in the skin, hair, and nails during and after pregnancy. Patients are certainly aware that those changes are occurring, but few physicians and even fewer patients know how to predict the course of those changes. Pigmentary changes occur, but are they permanent? Can they be prevented or reversed? Hair may become thicker during pregnancy, only to fall out in the postpartum period. When will hair stop falling out? Will it grow back? What hormonal changes are occurring to produce these effects on the skin, hair, and nails? Will those hormonal changes affect other organs? Some cutaneous manifestations of pregnancy are common and recognized by most physicians. Abdominal striae, for example, are easily identified, but physicians have many questions about them. Why do they develop? Can they be prevented or treated? Other cutaneous manifestations of pregnancy are less common and recognized by few. For example, pruritic urticarial papules and plaques of pregnancy is a debilitating condition that is treatable once diagnosed. Even more important than the treatment, the knowledge imparted to a worried mother that her child will be fine and that the condition is se- limited is priceless; but the condition must first be recognized by the patient's physician. All of these questions and conditions are addressed in this extraordinary book. Pigm- tary disorders are addressed in detail in Chap. 2.

Managed care organizations are paving the way to the future of health care delivery in the United States and countries around the world. As managed care systems evolve, a major concern is quality. Managed Care Quality: A Practical Guide is a collection of applications and experiences gathered from practicing health professionals in the field of managed care. This first "how to" guide was written to help managed care organizations meet the common objective of ensuring the best quality of services and care. Managed Care Quality: A Practical Guide presents successive steps in implementing quality in health care organizations. It introduces the methods, skills, and practices involved in quality health care programs and offers solutions to problems typically encountered in managed care.

Examines how evidence-based medicine can be applied in general practice, and how its benefits can be realized in the form of effective treatments. It argues for rational rationing, using clinical effectiveness to exclude ineffective measures.

Today we face the painful reality of the prevalence of chronic, rather than acute, diseases. The technologies developed to manager long-term, incurable illnesses have radically and irrevocably altered the organizational structure of health care, presenting us with a frequently bewildering array of medical specialties. Social Organization of Medical Work offers essential insight into this new era of health care.

Through richly documented, often gripping case studies, Anselm Strauss and his co-authors show us exactly how health workers are confronting the problems created by chronic disease and coping with today's highly technologized hospitals. They guide us through the various hospital work sites, describing in detail the kinds of tasks performed by medical personnel, the interactions of staff members with each other and with patients, and the overall resulting patient treatment and response.

Focusing on the concept of illness trajectory, the authors vividly illustrate the complex, contingent nature of modern medical work. For example, open heart surgery keeps ill persons alive and may even improve them symptomatically, but those who do survive must face an uncertain future in terms of the physiological consequences of the surgery and the drugs required. They also have to adjust t altered lifestyles. In the new introduction, Anselm Strauss discusses the continuing importance of this work to sociologists, medical scholars, and medical professionals.

This second edition reviews recent reforms and the likely impact of future developments in management and competition in the NHS. In particular, it reflects the growing importance of primary care and the continuing debates about health care rationing. It concentrates on the realities and how they can be interpreted to help strategists, managers, clinicians, students and those supplying the NHS understand the mechanism of efficient health care delivery.

An integrated, collaborative model for more comprehensive patient care Creating Effective Mental and Primary Health Care Teams provides the practical information, skills, and clinical approaches needed to implement an integrated collaborative care program and support the members of the care team as they learn this new, evidence-based, legislatively mandated care delivery system. Unique in presenting information specifically designed to be used in an integrated, collaborative care workflow, this book provides specific guidance for each member of the team. Care managers, consulting psychiatrists, primary care providers, and administrators alike can finally get on the same page in regard to patient care by referring to the same resource and employing a common framework. Written by recognized experts with broad research, clinical, implementation, and training experience, this book provides a complete solution to the problem of fragmented care. Escalating costs and federal legislation expanding access to healthcare are forcing the industry to transition to a new model of health care delivery. This book provides guidance on navigating the changes as a team to provide the best possible patient care. * Integrate physical and behavioral care * Use evidence-based treatments for both * Exploit leading-edge technology for patient management * Support each member of the collaborative care team Strong evidence has demonstrated the efficacy of a collaborative care approach for delivering mental health care to patients in a primary care setting. The field is rapidly growing, but few resources are available and working models are limited. This book provides a roadmap for transitioning from traditional methods of health care to the new integrated model. Providers ready to move to the next level of care will find Creating Effective Mental and Primary Health Care Teams an invaluable resource.

Evaluating Treatment Environments describes how to assess the quality of psychiatric and substance abuse programs and how to use that information to monitor and improve these programs. Its aim is to identify environments that promote opportunities for personal growth, simultaneously enhancing both physical and psychological well-being. Although treatment programs are diverse, Moos asserts that a common conceptual framework can be used to evaluate them, and more emphasis should be placed on the process of matching personal and program factors and on the connections between such matches and patients' outcomes. The book is divided into three main parts. Part I focuses on hospital programs, using a sample of 160 programs throughout the United States. Part II evaluates community programs. Moos describes how to monitor and improve these programs, and assesses program implementation. Part III considers treatment environments, examining factors that shape the treatment environment, patients' satisfaction with and participation in program activities, patients' adaptation and community living skills, and patient-program congruence and the influence of treatment environments on patients with different levels of impairment. It also highlights the importance of the health care workplace and its impact on staff and the treatment environment. Treatment programs vary substantially in their policies and services, especially in what they expect of clients, rules about clients' daily life choices, and to what extent clients must be governed by the program, and whether or not the programs provide health and treatment services. Comparison studies are becoming more important as clients move more quickly from acute in-patient to community residential care. Moos stresses the need to pay special attention to how programs and services affect clients when conducting evaluations. Evaluating Treatment Environments will be a necessary addition to the libraries of mental health service professionals, as well as sociologists, psychiatrists, psychologists, and social workers.

This text is based on the practical experience of pilot schemes which have identified a variety of opportunities and innovative ideas which others can adopt and develop. This book is a reference for principals and managers of fundholding practices, those thinking about becoming fundholders, and for the managers of provider units seeking to expand their services, including the commissioning authorities.

'Fundamental changes in the Health Service demand a radical shift in approaches to patient core. The NHS is becoming increasingly led by the primary care sector. This has a greater meaning than simply more involvement of GPs in secondary care purchasing. It means that we start from where the patient is, in their own home and community. We provide care for them there and only move them into secondary services if and when it is appropriate to do so. 'Extending Primary Care shows that it is possible to experiment beyond traditional boundaries in these areas. It will provide encouragement to people who work in some of these difficult settings by showing what can be done... This book could not be more timely as a resource to many managers who will need to extend their own understanding of primary care - in the fullest sense of the whole team of people in primary care and the associated community health services.' From the Foreword by Barbara Stocking

This overview of the NHS Research and Development Programme is written by people who are at the leading edge of its implementation. It integrates the issues of research management and funding with the importance of focusing research on the needs of the customer (the NHS) and the challenges of implementing the findings of research into clinical practice. The experience of the authors extends from developing local research networks to managing a national research programme, reflecting the scope of the NHS strategy and the potential of this book.

This work adopts a modern approach to quality assurance and quality improvement in general practice. It provides an introduction to the subject, enabling readers to see how best to proceed in their own practices. It revises and updates previous books by Donald and Sally Irvine on clinical audit by placing audit within the wider quality context. It is designed to provide an easily accessible approach to the basic tenets as well as speculating on the future developments in this area, and should be of interest to all members of the practice team. The themes of the book are illustrated by reference to the five major case studies provided, which describe in some detail the various ways of starting, implementing and maintaining quality assurance in general practice today. Practical examples of Total Quality Management, the use of British Standard 5750, Kings Fund organizational audit, Investors in People, and Fellowship of the Royal College of General Practitioners by assessment, are also provided. These studies are written by the practitioners, medical and non-medical, who have themselves been through the experience of turning theory into practice.

Management controls on prescribing have greater impact on a GP's freedom of choice than on any other matter requiring clinical judgement. However, in order to deliver the most effective patient care, the GP needs a much broader base of knowledge including, for example, an understanding of basic pharmacological principles and the process of conducting clinical trials. This book deals systematically with the practical aspects of prescribing throughout primary care. It provides the busy GP with readily-accessible information so that the benefit to patients and the pratice can be maximized.

With the advent of the new health authorities, multifunds and consortia, it is likely that the GP's professional leadership of primary care will rapidly become only one of a number of provider options. This book defines some of the future options for the organization of primary care. The evolving possible roles of GPs and practices in these changing circumstances are examined closely. As the new health authorities come into full legislative force, how will they deploy the combined financial allocations for primary and secondary care to support their new capacity to enter into local contracts? Which health care providers will emerge in this market place in response to this shift in commissioning power? These are critical questions for general practice. With contributions from a variety of sources that reflect the varied origins of organizational initiatives, this is a book for planners, providers and purchasers of extended primary care.

All GPs undertake the non-NHS work, some of which can add substantially to practice income. This book describes a wide range of fee-paying work which GPs are uniquely qualified to undertake; it shows how opportunities for this work arise and how to become involved in it. For many, the financial benefits are greatly enhanced by the professional satisfaction such work brings.

The management function is practice-based primary care and who performs it varies by practice. While the number of practice managers increase and their role continues to unfold in response to NHS changes, the development of practice management as a profession is contained if not constrained by GPs, as both employers and as the dominant profession within primary care. This stimulating review of the responsibilities, opportunities and future prospects of management in primary care, based on workshops with GPs and practice managers, identifies their respective management development needs and the ways in which these might be met.