Thursday, April 4, 2019

Republic of Ireland’s Primary Care Strategy: An Analysis

Re frequent of Irelands Primary caveat Strategy An AnalysisPrimary circumspection StrategyIntroductionPrimary look at is the first taper of contact that concourse project with the easilyness and personal genial servicing.1 This meat that master(a) care mustiness be sufficiently well developed to be able to address the most complex and several(a) range of health-related challenges and problems that will manifest in healthcare service provision, and make the most of opportunities to promote health and reduce morbidity, across the general population in specific target groups. This essay will explore the democracy of Irelands chief(a) care strategy in relation to key goals and targets, and alike screen some elements of the strategy in terms of a SWOT analysis. Specific reference will be made to the situation of the Specialist Public wellness Nurse/Health Visitor usage.Main eubstancePrimary business organization can be defined as first contact, continuous, compre hensive, and coordinated care provided to populations uniform by gender, disease, or organ system.2 Primary care is about the provision of information, diagnosis, treatment, referral and support for the majority of people who access healthcare serve for the first time, and the strategic concerns of primary are related to accessibility, provision of hornswoggle and long-term care which meets the needs of the population, assessment of those needs, and coordination of services to meet those needs3. This has many implications for the provision of healthcare services and the management of increasingly scarce resources.However, it is evident from the literature that in most locations, primary healthcare services muted have a long way to go in meeting the goals of primary healthcare itself, particularly in relation to meliorate integration of services and reorienting services to a person-centred model, rather than a disease-centred model. Primary healthcare is viewed as a means of red ucing the practise of and demand for overall healthcare services by acting as a gatekeeper for secondary healthcare, and as a means of primary prevention of healthcare problems and disease, particularly in high risk groups of the population, but at that place is ongoing evidence and debate within the academic literature that thither are continuing issues about the escape of egalitarian access to such services and ongoing questions about the ways in which they are provided4. It is considered by some that the decisions which govern the design and delivery of primary care services are potentially to a greater extent based on political drivers than true patient need5. Similarly, the gateway function of the primary care service in determining which patients have access to perspicacious care (or secondary care) services may non be based on individual need, but on other factors, such as political, social and even personal factors, including prejudices on the part of healthcare profess ionals6. The primary care strategy, if it provides virile guidance which leads to strong leadership, and perhaps enhances management of care through the use of agreed care pathways which guide decision making, top executive benefactor eradicate some of these factors. Making the person-centred care model central will also help to re strickle some of the barriers to egalitarian service provision7. However, one of the challenges of the Republic of Ireland model is the fact that two thirds of patients in primary care must pay for their care, which would mean that despite the focusing on removing inequalities in access, there continue to be challenges for providing equality of access8.One of the strengths of the primary care strategy is the focus on improving interprofessional working and communications, as a means of streamlining use of services and preventing doubling up or crossway of services9. Improving interprofessional working at the primary care level is one thing, but the s trategy also needs to ensure that the intersection between primary and secondary care is properly managed, and that patients moving from acute care settings into community settings continue to have a streamlined, person-centred model of care applied, with good continuity of care10. However, there is also a need for the provision of strong leadership, which supports the implementation of the changes associated with this re-orientation of primary care in Ireland, and which supports tonic ways of working and helps to break down the barriers between the professions11, 12.This is where the role of the Health Visitor can be examined in a little much detail, in relation to realising some of the goals of the Primary Care Strategy, and in addressing some of the challenges of this. It has long been the case that Health Visitors work across professional boundaries, and work closely with a range of other health professionals, because within the community, specialist and generic roles are equ ally essential in supporting individual patient need13. The interprofessional interface is perhaps one of the most fundamental elements of the work of the Health Visitor, but at the same time is perhaps not given enough attention or credit in terms of the adjoin that Health Visitors have in the prevention of illness and public health sectors of primary healthcare14, 15.The Public Health focus of the primary care strategy is inherent in much of the rhetoric it contains, particularly as it expressly cites the potential for preventive strategies to reduce overall healthcare resource use16. It is here that the Health Visitors role perhaps has the greatest scope, and should be more strongly underlined, as this is a great resource for change. Research shows that the role of the health visitor is preponderating and unparalleled, in reducing risk related behaviours, improving health outcomes, promoting healthy lifestyles and engaging in the more challenging areas of the health/social car interface17, 18, 19. However, there is also some evidence to suggest that nurses and, in particular, health visitors, have a key role to play in expanding and delivering the public health place of primary care20. In particular, the development of improved partnerships in health and social care may be made possible through the role of such nurses, who have the broader community knowledge as well as specialist knowledge of key areas of public health21. These partnerships can be developed with a focus on the quality of care provision, not just the identification of need22, 23, 24. However, managing the development of improved partnerships, and achieving the goals of the Strategy, is going to be challenging during the transition period, and there may be a degree of uncertainty over roles and boundaries25. It powerfulness be that Health Visitors are in a prime position to provide the leadership required during such a time.Conclusions and Recommendations.Below is a summary of a brief S WOT analysis of the primary care strategy and isome of its potential implications.Table 1 SWOT analysis of Primary Care (with graphic symbol to the Republic of Ireland Primary Health Strategy26)This shows that while there are issues with weaknesses and threats, many of these are the kind that have been present within the primary arena for some time, and it will take good leadership, and good use of existing skills and resources, to achieve the goals of the strategy. While the primary care focus for healthcare services is laudable, there is still the overwhelming need for good resourcing, more clarity about provision, and clear guidance on how to move forward to achieve these goals. Making use of existing roles, such as that of the Health Visitor, whose work crosses the intersections of care at so many points in the primary care sector, could improve quality of care, reduce the impact of the change and transition, and also set standards for the future to increase interprofessional c ommunication and partnership. Certainly it should not be fake that the strategy will eradicate all the existing problems about the provision of primary care in Ireland, and those problems must still be addressed in future provision30.References 213615Allen, P. (2000) Accountability for clinical governance underdeveloped collective responsibility for quality in primary care. British Medical Journal 321 608611.Barlow, J., Davis, H., McIntosh, E. et al (2007) Role of home visiting in improving parenting and health in families at risk of abuse and drop down results of a multicentre randomised controlled trial and economic evaluation Archives of Disease in Childhood 92 229-233.Campbell, S.M., Roland, M.O., Middleton, E. and Reeves, D. (2005) Improvements in quality of clinical care in English general practice 1998-2003 longitudinal empiric study. BMJ 12331(7525)1121Carr, S.M. (2007) Leading change in public health factors that inhibit and facilitate energizing the process. PrimaryHe alth Care Research and Development. 8 207-215.Chavasse, J. (1998) Policy as an influence on public health nuse education in the Republic of Ireland. Journal of Advanced Nursing 28 (1) 172-177.Chavasse, J. (1995) Public Health Nursing in the Republic of Ireland. Nursing Review 14 (1) 4-8.Currie, G. and Suhomlinova, O. (2006) The Impact of Institutional Forces Upon Knowledge Sharing in the UK NHS The Triumph of original Power and the Inconsistency of Policy. Public Administration 84 (1) 1-30. department of Health and Children (2001) Primary Care a New Direction. Available from http//www.dohc.ie/publications/pdf/primcare.pdf?direct=1 Accessed 10-11-08.Douglas, F., van Teijlingen, E., Torrance, N. et al (2006) Promoting physical activity inprimary care settings health visitors and practice nurses views and experiences. Journal of Advanced Nursing 55 (2) 159-168.Dunnion, M.E. Kelly, B. (2005) From the emergency department to home Journal of clinical Nursing 14 776-785.Ewles, L. (2005). Key Topics in Public Health. London. Churchill Livingstone.Jackson, C., Coe, A., Cheater, F.M. and Wroe, S. (2007) Specialist health visitor-led weight management preventive in primary care exploratory evaluation Journal of Advanced Nursing 58 (1) 23-34.Lordan, G. (2007) What determines a patients treatment? Evidence from out of hours primary care co-op data in the Republic of Ireland. Health Care Management and Science 10 283-292.McGregor, P., Nolan, A., Nolan, B. and ONeill, C. (2007) A comparison of GP visiting in Northern Ireland and the Republic of Ireland. ESRI Working Ppaper Avaialble from www.esri.ie Accessed 10-11-08.McMurray, R. and Chester, F. (2003) Partnerships for health expanding the public health nursing role within PCTs. Primary Health Care Research and Development4 57-65.Masterson, A. (2002) Cross-boundary working a macro-political analysis of the impact on professional roles. Journal of Clinical Nursing 11 331-339.Mitchell, P.S., Schaad, D.C, Odegard, P.S. Ball weg, R.A. (2006) Working across the boundaries of health professions disciplines in education, explore and service the University of Washington experience. Academic Medicine 81 (10) 891-896.ODowd, A. (2005) Uncertainty over reorganisation is destabilising primary care. BMJ331 1164Price, B. (2006) Exploring person-centred care. Nursing Standard 20 (50) 49-56.Rummery, K. and Coleman, A. (2001) Primary health and social care services in the UK pass off towards partnership? Social Science Medicine 56 (8) 1773-1782Stanley, D., Reed, J. Brown, S. (1999) Older people, care management and interprofessional practice. Journal of Interprofessional Care 13 (3) 229-237.Starfield, B. (1994) Is primary care essential The Lancet 344 1129-1133.Thomas, P., Graffy, J., Wallace, P. (2006) How Primary Care Networks Can Help commingle Academic and Service Initiatives in Primary Care Annals of Family Medicine 4235-239.Vernon, S., Ross, F. Gould, M.A. (2000) Assessment of elderly people politics and practice in primary care. Journal of Advanced Nursing 31 (2) 282-287.Watkins, D., Edwards, J. Gastrell, P. eds. (2003). friendship Health Nursing Frameworks for Practice. 2nd ed. p.35. London, Baillire Tindall.1Footnotes1 Department of Health and Children (2001) p 7.2 Starfield, B. (1994)3 Starfield (ibid)4 Vernon, S., Ross, F. Gould, M.A. (2000)5 Vernon (ibid)6 Starfield (ibid).7 Price, B. (2006)8 McGregor, P., Nolan, A., Nolan, B. and ONeill, C. (2007)9 Stanley, D., Reed, J. Brown, S. (1999)10 Dunnion, M.E. Kelly, B. (2005)11 Carr, S.M. (2007)12 Currie, G. and Suhomlinova, O. (2006)13 Watkins, D., Edwards, J. Gastrell, P. eds. (2003).14 Ewles, L. (2005).15 Jackson, C., Coe, A., Cheater, F.M. and Wroe, S. (2007)16 Department of Health and Children (ibid).17 Barlow, J., Davis, H., McIntosh, E. et al (2007)18 McMurray, R. and Chester, F. (2003)19 Douglas, F., van Teijlingen, E., Torrance, N. et al (2006)20 McMurray (ibid)21 McMurray (ibid)22 Allen, P. (2000)23 Campbell, S.M., Roland, M.O., Middleton, E. and Reeves, D. (2005)24 Rummery, K. and Coleman, A. (2001)25 ODowd, A. (2005)26 Department of Health and Children (ibid).27 Masterson, A. (2002)28 Mitchell, P.S., Schaad, D.C, Odegard, P.S. Ballweg, R.A. (2006).29 Thomas, P., Graffy, J., Wallace, P. (2006)30 Lordan, G. (2007)

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