Community Health Care Development Community Health Care Series Series Editor: Professor David Sines Deborah Hennessy (ed.) Community Health Care Development Carolyn Mason (ed.) Achieving Quality in Community Health Care John 0vretveit, Peter Mathias and Tony Thompson (eds) Interprofessional Working for Health and Social Care Community Health Care Series Series Standing Order ISBN 978-0-333-64692-2 You can receive future titles in this series as they are published by placing a standing order. Please contact your bookseller or, in the case of difficulty, write to us at the address below with your name and address, the title of the series and the ISBN quoted above. Customer Services Department, Macmillan Distribution Ltd, Houndmills, Basingstoke, Hampshire, RG2l 6XS, England Community Health Care Development Edited by DEBORAH HENNESSY Foreword by Andrew Wall MACMILLAN Selection, editorial matter and Introduction © Deborah Hennessy 1997 Preface © David Sines 1996, 1997 Foreword © Andrew Wall 1997 Individual chapters (in order) © Deborah Hennessy and Geraldine Swain; Lesley Armitage; Liz Haggard; Caroline Taylor and Geoff Meads; Ainna Fawcett-Henesy; Rita Bell, Kath Johnson and Heather Scott; Kieran Walshe; Neil Small, Audrey Ashworth, Douglas Coyle, Sue Hennessy, Sue Jenkins-Clarke, Nigel Rice and Sam Ahmedzai; Lucy Hadfield; Sandra Legg and Helena Ellerington; Deborah Hennessy and Geraldine Swain 1997 All rights reserved. No reproduction, copy or transmission of this publication may be made without written permission. No paragraph of this publication may be reproduced, copied or transmitted save with written permission or in accordance with the provisions of the Copyright, Designs and Patents Act 1988, or under the terms of any licence permitting limited copying issued by the Copyright Licensing Agency, 90 Tottenham Court Road, London WIP 9HE. Any person who does any unauthorised act in relation to this publication may be liable to criminal prosecution and civil claims for damages. The authors have asserted their rights to be identified as the authors of this work in accordance with the Copyright, Designs and Patents Act 1988. First published 1997 by MACMILLAN PRESS LTD Houndmills, Basingstoke, Hampshire RG21 6XS and London Companies and representatives throughout the world ISBN 978-0-333-64692-2 ISBN 978-1-349-13906-4 (eBook) DOI 10.1007/978-1-349-13906-4 A catalogue record for this book is available from the British Library. This book is printed on paper suitable for recycling and made from fully managed and sustained forest sources. 10 9 8 7 6 5 4 3 2 I 06 05 04 03 02 01 00 99 98 97 Copy-edited and typeset by Povey-Edmondson Tavistock and Rochdale, England Dedicated with love to the Sisters of the Community of St John the Divine, Alum Rock Road, Birmingham, who as an Anglican Religious Nursing Order have given compassionate care in the development of community health since 1848 CONTENTS List of Figures ix List of Tables x Foreword by Andrew Wall Xl Preface by Professor David Sines Xlll Acknowledgements XV List of Contributors XVI Introduction 1 Deborah Hennessy 1. Developing community health care 3 Deborah Hennessy and Geraldine Swain 2. Identifying health needs 37 Lesley E. Armitage 3. Commissioning services to meet identified needs 62 Liz Haggard 4. The development of primary care 86 Caroline Taylor and Geoff Meads 5. Inner-city changes: health care services in Britain's inner cities 106 Ainna Fawcett-Henesy 6. Interprofessional education and curriculum development: 'A Model for the Future' 123 Rita Bell, Kath Johnson, Heather Scott 7. Clinical effectiveness: the challenge for community nursing 159 Kieran Walshe 8. Palliative care in the community 178 Neil Small, Audrey Ashworth, Douglas Coyle, Sue Hennessy, Sue Jenkins-Clarke, Nigel Rice and Sam Ahmedzai vii 9. How to deliver effective community health care 198 Lucy Hadfield 10. The effect of changes in hospital care on community health care 226 Sandra Legg and Helena Ellerington 11. Epilogue 253 Deborah Hennessy and Geraldine Swain Index of Names 255 Index of Subjects 259 viii LIST OF FIGURES 2.1 Diagram showing the relationship between need, supply and demand 43 2.2 Scoring grid to assist in the determination of priorities 56 6.1 Taxonomy of primary health care: a framework for interprofessional education 148 7.1 Definition of evidence-based health care 161 7.2 Publications indexed on CINAHL by year of publication 168 9.1 NHS key stakeholders and their roles 203 10.1 Organisational change resulting from new technologies 230 10.2 The political, economic and technical trends which have influenced changes in acute care 231 IX LIST OF TABLES 1.1 The development of NHS reforms 17 4.1 Primary care development (a motivational matrix) 96 6.1 National occupational standards and associated qualifications 132 6.2 Interprofessional initiatives by geographical distribution and combination of professions 136 7.1 Effective Health Care bulletins 170 7.2 Interventions to promote change 172 8.1 Hospice services in the UK and Republic of Ireland 180 8.2 Death rates per million population from common conditions in England 181 8.3 Place of death in 1991 of patients who were identified as having a terminal or palliative period in one health region 181 8.4 Socio-demographic characteristics of patients, recruited from the community 185 8.5 Medical characteristics of recruited patients, community 186 8.6 Profile of carers in the community 187 8.7 Number of patients receiving visits from GPs and nurses in the week before completion of baseline data 188 x