Abstract
Can general practitioner commissioning deliver equity and excellence? Evidence from two studies of service improvement in the English NHS.
Gridley K, Spiers G, Aspinal F, Bernard S, Atkin K, Parker G
Journal of Health Services Research & Policy 2012;epub ahead of print: doi:10.1258/jhsrp.2011.010176
Much of the controversy about the Health and Social Care Bill in England has focused on the role of GPs as commissioners in new NHS clinical commissioning groups (CCGs). This paper adds to the evidence on the likely effectiveness of GP-led commissioning, concluding that GPs are no more likely to succeed than their predecessors.
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Impact of increased patient choice of providers in Sweden: cataract surgery
Hanning M, Ahs A, Winblad U, Lundström M
Journal of Health Services Research & Policy 2012;epub ahead of print: doi:10.1258/jhsrp.2011.011070
Patient choice is seen by proponents of increasing competition as a key tool for improving performance. Sweden introduced choice for planned specialist care in 2001. This study highlights that patients who opted for out-of-area cataract surgery were younger and less visually impaired, suggesting that any benefits of greater choice may not be equally distributed.
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Dry self-sampling versus provider-sampling of cervicovaginal specimens for human papillomavirus detection in the Inuit population of Nunavik, Quebec
Cerigo H, Coutlée F, Franco EL, Brassard P
Journal of Medical Screening 2012;
An advantage of human papillomavirus (HPV) testing in screening for cervical cancer has been the potential for self-collection, a method especially of value in populations where traditional speculum examination has low uptake. Previous literature has shown that self-collected samples preserved in a liquid storage system showed similar yield in terms of HPV detection as provider-collected samples, but few studies have used a systematic approach comparing dry self-sampling technique to wet samples collected by providers. In a study conducted among Inuit women in Quebec, Paul Brassard and colleagues report the results of dry self-sampling. The sampling was simple and successful; High Risk HPV and type-specific HPV 16/18 were as likely to be detected in the self-collected samples compared with the provider obtained samples. Self-sampling with dry storage and transport appears to have great potential in the control and prevention of cervical cancer.
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Effect of mobile phone-based psychotherapy in suicide prevention: a randomized controlled trial in Sri Lanka
Marasinghe RB, Edirippulige S, Kavanagh D, Smith A, Jiffry MTM
Journal of Telemedicine and Telecare 2012;
Can therapy delivered by mobile phone help those who have attempted suicide? A randomized controlled trial in Sri Lanka was carried out to answer this question. A total of 68 patients were recruited who were undergoing hospital treatment following a suicide attempt. The intervention group were given a mobile phone and received ten telephone calls from a therapist over the following six months. Wait-list controls were used for comparison. Mobile treatment produced significant improvements in suicidal ideation and depression, and the intervention group also experienced a significant improvement in social support. However, the reduction in actual self-harm was not significant. Although the study could not identify which component of the intervention was most effective in preventing suicide, it showed its efficacy in reducing suicide as a whole.