The public are provided with ngns to access a diverse range of services and information. As we all know, GP practices and NHS services are also accessed via these.
Because of the cost of these calls, this is a social exclusion issue.
The exclusive nature of the costs of ngns impacts on the very people who are least able to bear these costs.
Improving access to primary care is currently a big political imperative. The Department of Health has a
Primary Care Access Team. They deal with access to primary care issues, such as providing timely access, and making sure that services reach the neediest. For those of you not familiar with the jargon, the GP and NHS advice line are usually our first (primary) points of contact when we have a health problem or need information - so they are 'primary care'. Hence, the PCAT is a good starting point for us. I think the PCAT used to be based in London with the DH, but I believe it is now tucked away in the provinces somewhere. I will find out, and post it if anyone wants the info.
The current situation: the Dept of Health states the standards under which GP practices operate. It lays out the regulations and guidelines under which this aspect (GP provision) of Primary Care is procurred. This subject is called
Primary Care Procurement.Now, GPs are private contractors - they are self-employed. The services they provide are bought by individual Primary Care Trusts. And that is how you get your doctor's services. Under DH guidelines, the PCTs work to 'best value'. Best Value of course need not be measured solely in monetary terms.....
The NHS advice line belongs to the DH, but the IT backup is procurred from 'outside' companies.
Think about 'best value' - for who, exactly?
Think about ease of access to who those who need it most
Think about guidelines - they are merely that: just guidelines. I am sure you senior members know far more about how big orgs treat 'guidelines'
Think particularly long and hard about
access
and
social exclusion[color=#ff0000][/color] and the exclusive nature of accessing health services via a ngn:
High Frequency Users of health services are extremely likely to be in low Socio-Economic Groups. HFUs are more likley to live in poverty. Lower SEGs are more likely to use health services sooner in their lives, more frequently and more urgently. They are unlikely to have the confidence, resources, money or knowledge to self-medicate when compared to, say, a higher socio-economic group.
Think about someone having to decide whether to blow their familiy's entire food money for the day on a ngm call to get precious health care or advice..... or forget the doctor's appt they need, because it's more important to feed their children.
So, you have a situation where GP practices are Small Businesses, your PCT is buying those services for you, and you are paying (but you don't know what that cost is) when you start dialling for those essential services. Hmmmm....
I strongly urge you to explore and pursue Social Exclusion through a Dept of Health route
Primary Care Procurement Team - who are part of the DH - who is the head of the PCPT? who in the DH has recommended that the current regs and guidelines be adopted?
Primary Care Access Team - who are part of the DH - who is in charge of this? PCAS measure such things as ease of access. How easy is it to get a GP appt? How long do you have to wait? Obviously what I am concerned about is the cost and difficulty of actually accessing GP services. Call them to task on the
exclusive nature (costs) of accessing something so essential as a gp appointment. Am I put off even phoning for an appt because I don't know what it's going to cost me? In other words - what is the cost to me of actually making an appt? ( the technical term for making an appt is a Request for First Contact)
Primary Care Trusts - they are procurring (buying) GP services for us - provision should be made in their contracts with GPs that thos serivces are accessible on geo numbers.
The Cabinet Office (cabinetoffice.gov.uk) I think now deals with Social Exclusion issues - you should be able to find out the person in charge of their Social Exclusion Unit. Remember that people try to budget for and control their living costs by buying inclusive calling plans. This is particularly important for poorer people. I'm sure the Govt will have a policy somewhere on Taking Control of Ones Finances. And they will have a team working on it.
I think the
DTI will also have a SEU.
Don't presume that if you deal with 1 govt office, the other will somehow know of your communications. They are 2 seperate offices, working on their own briefs.
And this is only highlighting the situation re: Dept of Health. What about other depts who use ngms? The same social exclusion issues apply......so go forth and multiply!
But for goodness sake, remember: generic letters and signed petitions fare badly against honestly written, acute, pertinent individual communication. Get the name of the adult in charge of whatever dept or team or org you're writing to, and if appropriate, the name of their boss, and their boss's boss etc. Above all, find out how such orgs work and which depts and teams allow services to be provided in this way. Good luck.