The ability to consult by telephone is now an integral part of any modern patient-centred healthcare system and the British Medical Association (BMA) has provided guidance for general practitioners (Consulting in the modern world, which was published in 2001). The BMA concludes that "telephone consultations when correctly conducted can be considered to be safe and acceptable practice". In a protocol for a Cochrane Review, Rumant Grewal and colleagues explain how they will identify and measure the effectiveness of interventions that aim to improve the clinician telephone consultation skills of clinicians. Grewal and colleagues believe that their review will provide evidence about the most effective interventions for improving telephone consultation skills and thereby improve both quality of care and patients' experiences of their health care.
NHS budgets are under considerable pressure. It is therefore unsurprising that many NHS Integrated Care Boards (ICBs) In England will aim to prioritise price in contract awards, But this approach is a significant threat to community-centred healthcare. While competitive tendering is a legally required, an excessive focus on costs in awarding NHS contracts risks overshadowing key factors such as established community trust, local expertise, and the long-term impact on continuity of care. This shift towards cheaper, often external, commercial providers threatens to cut the links between communities and their local health services. The argument that competitive tendering is solely about legal compliance, and not cost, is undermined by the very nature of such tendering, which by design encourages the lowest bid. This approach risks eroding the social fabric of local healthcare provision, where established relationships and understanding of specific community needs are essential. Establishe...
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