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An NHS equipped to meet demand for health

21. We will foster and expand a comprehensive range of community health improvement services that includes specialist practitioners who know how to:

  • help people develop their understanding and skills to improve their own health;
  • strengthen community action for health to tackle inequalities; and
  • work with communities, offering training, advice and support to a broad range of health professionals.

22. As part of these changes, new contracting arrangements for primary medical care, pharmacy(i) and dentistry(ii) are being introduced, to give more scope for PCTs to work with the health professions to shape services and introduce new providers to meet local need and local demand for health with high quality, professional services to support people in finding a healthy way of life. 

Footnotes:
(i) From early 2005, subject to the conclusion of negotiations.

(ii) From October 2005. 

23. For general practice, the new primary medical care contracting arrangements offer enormous potential to develop new ways to meet a growing demand for health, with more flexible services; greater choice; increased specialist activity; an improved range and quality of ser vices; and services tailored to local needs. 

24. In addition we will put in place measures which make the most of the contribution that pharmacists can make. Working at the heart of the communities that they serve, they have real opportunities to offer health messages and advice on issues such as diet, physical activity, alcohol, stopping smoking and looking after our own ailments ourselves. The strategy for pharmaceutical public health, to be published in 2005, will demonstrate how pharmacists and their staff can contribute to improving health and reduce inequalities and how we can develop new services in the places they work.

25. Many of the issues that affect people's general health are important for oral health too. Under the new contractual arrangements for NHS dentistry, from October 2005 dentists will give a new focus to advice on the prevention of disease, lifestyle advice and the discussion of options for care. They could, for example, work in conjunction with the wider primary care public health team to provide advice on smoking, and diet and nutrition - including prescribing sugar-free medicines where appropriate.

Maximising the reach of screening programmes

26. Each year the NHS offers health screening to about ten million people. The offer is of a specific screening test and it is for each individual to decide for themselves whether or not to accept it. Screening programmes(iii) do not operate in isolation; they have to be integrated with measures to encourage and promote the primary prevention of disease, and with the treatment services for those people who develop disease. 

Footnote: (iii) The screening programmes for individual conditions are grouped into four main programmes: the Antenatal and Newborn Screening Programme; Health for All Children - screening for children after the newborn period is integrated with a wide range of different measures to protect and promote health such as cancer screening; cardiovascular screening and diabetic retinopathy. 

27. There is evidence of inequalities in take up of screening. As discussed in Chapter 2, the first step in influencing health behaviours in any group is to understand why people make the choices that they do, and the second is to design and deliver any new initiatives in consultation with them. PCTs will need to use health equity audits(iv) to build a better understanding of why some people or groups are less likely to use the range of available opportunities for screening, and then act to promote take up. 

Footnote: (iv) See Annex B.

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