Clinical psychology in primary care

 Primary care services are most people’s first and most frequent point of contact with the NHS. However, they are struggling to meet ever-growing demand with limited resources, and GPs have variable levels of knowledge and confidence in meeting people’s mental health needs.

Click here for Centre of Mental Health report

Mental health and primary care networks: Understanding the opportunities

Read King's Fund publication here

Primary care mental health service improves health and saves NHS money, finds new report

A psychological treatment service working in GP surgeries in Nottingham offers hope to people other services can’t help and has already saved more money than its staffing costs in its first year, according to research published today by Centre for Mental Health with the NHS Confederation Mental Health Network. Read news item here

OTs in Primary Care

There is a growing need to be creative and proactive in the delivery of service in primary care.
An opportunity arose to develop a service looking at the role that Occupational Therapist in keeping the Frail Elderly well. Click here to read article

Speak up: annual report 2016/17

The Healthwatch network heard from 341,000 people, carers and staff during the last year about what they think of health and social care service.

This annual report to Parliament highlights a summary of the common theme in people's good and bad experiences and what could be improved.

Why should STPs worry about primary care?

Sustainability and transformation partnerships (STPs) have a tough job to do – focused on making the books balance, hamstrung by provider deficits, trying to make an unsustainable system sustainable.

Yet the majority of patient contacts and opportunity for upstream intervention is in primary care, most obviously general practice but also community pharmacies, dentists and optometrists. In this article, PCC chief executive Helen Northall makes the case for better understanding of and engagement with primary care by STPs.

Mental health and behavioural conditions account for nearly one-in-three known fit notes

Mental health and behavioural conditions have accounted for 31% of all fit notes, where the diagnosis was known, written in England between December 2014 and March 2017.

This was the most common known reason for issuing a fit note, new experimental figures from NHS Digital have revealed.

Anonymised information covering GP practices has been collected for the first time. These practices are responsible for around two-thirds of working age patients registered with a GP in England.

The safer management of controlled drugs

The CQC report sets out key changes to legislation and gives an overview of prescribing data and prescribing trends for controlled drugs across England in the primary care sector. It also makes recommendations to strengthen existing arrangements.

The interface between primary and secondary care: Key messages for NHS clinicians and managers

Good organisation of care across the interface between general practice and secondary care providers is crucial in ensuring that patients receive high-quality care and in making the best use of clinical time and NHS resources in both settings. This briefing document describes the key national requirements which clinicians and managers across the NHS need to be aware of. These are set out in the new NHS Standard Contract for 2017-19, under which clinical commissioning groups (CCGs) commission health services from providers, which came into effect on 1 April 2017 and which will remain in place until 31 March 2019.

• The interface between primary and secondary care: Key messages for NHS clinicians and managers
• Joint letter from NHS England and NHS Improvement

Stevens sets out programme of action for NHS

Meeting the A&E waiting time target and turning the corner on primary care investment will be key priorities for the NHS over the next 12 to 14 months, the head of NHS England has said.

Speaking at Confed17, Simon Stevens said the NHS will need to achieve the 95 per cent four-hour A&E waiting time target by the end of this year – echoing statements made by health secretary Jeremy Hunt this morning.

Further ‘overriding priorities’ include primary care, mental health and cancer treatments waiting times. “This needs to be firmly on our agenda for the year ahead,” he said.

How to support integration to promote care for people with multimorbidity in Europe?

The complex care needs of people with multimorbidity heighten the demand for integrated care. This European Observatory on Health Systems and Policies' policy brief identifies the most promising service arrangements for integrated care and examines how to support coordination and promote collaboration between care professionals and, strengthen professional competencies.

Shared care across the interface between primary and specialty care in management of long term conditions

Shared care has been used in the management of many chronic conditions with the assumption that it delivers better care than primary or specialty care alone; however, little is known about the effectiveness of shared care.

This Cochrane Systematic Review's aim was to determine the effectiveness of shared care health service interventions designed to improve the management of chronic disease across the primary/specialty care interface. This is an update of a previously published review.

Does the primary care home make a difference?

Thousands of patients benefit from NAPC’s Primary Care Home programme: new report shows drop in emergency hospital admissions and waiting times for GP appointments

The Primary Care Home (PCH) programme is delivering a range of benefits for patients, staff and the wider health system, according to a new report released today (Friday 31 March).

Key findings from an early analysis of three rapid test sites show significant reductions in A&E attendances, emergency hospital admissions and GP referrals to hospital.

Collaborative care provides improvement for older adults with mild depression

Among older adults with subthreshold depression (insufficient levels of depressive symptoms to meet diagnostic criteria), collaborative care compared with usual care resulted in an improvement in depressive symptoms after four months, although it is of uncertain clinical importance, according to a study.

Delegated commissioning case studies

Case studies on delegated commissioning published my NHS England.

STPs: Community and primary care grow fastest as acute spend held down

Community and primary care would see the fastest increases in funding, at the expense of slow growth in mental health and general acute spending falling in real terms, under detailed STP forecasts analysed by HSJ.

Adding Better Mental Health Care to Primary Care

Many people visit a primary health care provider (such as a doctor, nurse practitioner, or physician assistant) to treat physical diseases and injuries. However, it is also common for patients to see a primary care provider because of behavioral health issues including mental illnesses such as depression, anxiety, or problems with alcohol use.

The primary care provider can treat mental disorders, particularly through medication, but that may not be enough. Historically, it has been difficult for a primary care provider alone to offer effective, high quality behavioral health care.

South Somerset Symphony Programme – Leading the way in new models of care

South Somerset Symphony Programme(@Symphonyproj) are one of the vanguards showcasing areas of their work at the annual NHS Providers conference.

South Somerset is an integrated primary and acute care system vanguard.  Through vanguard funding, we have been able to develop our enhanced primary care model. This model focusses on prevention and education, as well as providing the specialist care that our patients with the most complex long-term health conditions need.

Prescribing costs in hospitals and the community

The report from NHS Digital presents summary cost figures relating to medicine use through prescribing in hospitals and the community in England in 2015/16, which includes the estimated prescribing cost of prescriptions in millions of pounds from 2010/11 to 2015/16 for primary care prescribing dispensed in the community, hospital prescribing dispensed in the community and for medicines issued from hospital pharmacy departments. It also shows the proportions of the total cost for each sector and the corresponding annual percentage change between each year.

Current evidence does not support the widespread use of collaborative care for PTSD, but it is limited by not evaluating context

Posttraumatic stress disorder (PTSD) is a common disorder that affects many patients in the primary care (PC) setting. There are multiple evidence-based treatments for PTSD, and some of which could easily be delivered in a PC setting. Collaborative care (CC) models have been used to improve depression care in PC. In comparison to depression, PTSD is less commonly treated in PC. There have been several attempts to examine CC models for PTSD; however, the results have been inconclusive. This study seeks to examine the effectiveness of CC for PTSD in Federally Qualified Health Centers (FQHCs).


Evid Based Med 2016;21:176 doi:10.1136/ebmed-2016-110482.  Access using your Athens username and password.