Comprehensive health services cannot be planned on the basis of 7.000 people - the average list size of a fundholding practice. Services such as casualty and kidney transplantation must be planned on populations of hundreds of thousands. GP commissioning has developed from the spontaneous reaction against fundholding by some GPs ( both fundholding and non-fundholding) into a comprehensive, systematic approach towards the planning and monitoring of health services. This book is the first to explain GP commissioning in its own right. It documents the history, theory and practice of GP commissioning and places it within the current political situation faced by the NHS. It shows how commissioning goes beyond fundholding. Commissioning is a more cost-efficient alternative, is clinically effective and its spontaneous development implies it is more in keeping with the basic tenets of the National Health Service. The difficult areas of financing, commercialization and rationing of health care are all covered. The book also explores the relationship between GP commissioning and evidence-based medicine, both of which can contribute to a systematic approach towards the planning and provision of health care into the next century. With contributions from GP commissioners, health services managers, leading academics, the Secretary of State, and the former Shadow Secretary of State for Health, this book will inform the important debate on the structure of primary care. It is vital reading for all those with an interest in the future of the health service.

This book brings together findings from research and clinical practice, with comprehensive coverage of the important aspects of mental health in ageing persons with intellectual and developmental disabilities. It is crucial for professionals involved in the care of persons with all intellectual and developmental disabilities to have a broad understanding of the essential range of issues, and therefore this book provides a truly multi-disciplinary perspective, complete with many figures and illustrations to underline the key points. Undoubtedly, research and clinical practice are much more advanced in the general ageing population than in persons with intellectual and developmental disabilities, and so professionals and academics must be made fully aware of commonalities and idiosyncrasies of older people with intellectual and developmental disabilities. This book presents the ongoing developments concerning mental health and aging, which will become relevant to the intellectually disabled population. Through experience, this book also acknowledges that the impact on the persons themselves and on their carers always needs to be taken into account, with treatment programs established with a multi-faceted team approach in mind. Avoiding the jargon of many titles in this area while maintaining the hands-on approach of clinical practice, this book meshes the practical and scientific worlds, with all chapters written by leading experts in the field. Beyond the US, the IASSIDD support expands the book message worldwide.

It has been almost 150 years since Dr Langdon Down first brought to our attention people with Down syndrome. Life expectancy, level of intellectual functioning, physical health, psychological health, social functioning, and integration into society are all issues that have markedly changed since 1866. The matter of ageing in people with Down syndrome has consistently remained an area of intense interest. This book documents the most important published literature on the issue of dementia and Down syndrome published since Dr Langdon Down's momentous paper. Further, a number of publications from the general population which have had significant impact in the field of dementia and Down syndrome, and a number of papers in young adults and children with Down syndrome that have important implications for the ageing population have been included.