title: Improving health and care for patients by redesigning services: the development and implementation of a clinical assessment service in Harrow Primary Care Trust.
abstract: The redesign of healthcare services in Harrow Primary Care Trust is due to a number of drivers including: centrally imposed targets as outlined in various policy documents; shifting the balance of care; service delivery in a challenging financial climate; response to national consultations which indicate that patients want services nearer to home; and local and national knowledge of providing different types of services. A local enhanced scheme was devised by the trust to support general practitioners to follow care pathways using evidence-based literature, best practice and discussions with clinicians, nurses and patient representatives. The result was an ambitious and innovative service which has attracted attention from neighbouring London primary care trusts, which are seeking to replicate the model.
authors.affiliation: CRIPACC, University of Hertfordshire, UK. m.v.offredy@herts.ac.uk
authors.forename: Maxine
authors.initials: M
authors.lastname: Offredy
authors.forename: Mary
authors.initials: M
authors.lastname: Cleary
authors.forename: Andrew
authors.initials: A
authors.lastname: Bland
authors.forename: Anna
authors.initials: A
authors.lastname: Donovan
authors.forename: Amol
authors.initials: A
authors.lastname: Kelshiker
mesh_terms: D000554:Ambulatory Care Facilities / Q000458:organization & administration*; D003365:Costs and Cost Analysis; D003695:Delivery of Health Care / Q000458:organization & administration*; D017598:Efficiency, Organizational; D005260:Female; D020773:Headache Disorders / Q000175:diagnosis / Q000628:therapy*; D006297:Health Services Accessibility / Q000458:organization & administration; D006301:Health Services Needs and Demand; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D011320:Primary Health Care / Q000458:organization & administration*