Abstract
Clinical targets are relatively easy to set but can be extremely difficult to implement. It is important to have organisational targets, in addition to clinical targets. The National Service Framework (NSF) for coronary heart disease sets national standards, defines service models, and establishes performance indicators for clinicians to meet. The new National Health Service ethos, in which front line staff are being empowered to develop innovative services tailored to local needs, is helping health professionals in primary care to deliver better care and improved "patient pathways" as promised in the NSF. However, there is still a need for additional resources in order to build capacity and provide support to the health care staff who are delivering the service.
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Figure 1 .
Barriers preventing implementation of guidelines. Adapted from Hobbs and Erhardt,3 with permission.
Figure 2 .
As indicated by quarterly ingredient costs, the use of statins has increased notably since publication of the NSF.
Figure 3 .
The new NHS ethos: networks of care. DGHs, district general hospitals, LITs, local implementation teams; PCOs, primary care organisations.
Figure 4 .
Durham Dales: number of patients with cholesterol recorded.
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Hobbs F. D. Richard, Erhardt Leif. Acceptance of guideline recommendations and perceived implementation of coronary heart disease prevention among primary care physicians in five European countries: the Reassessing European Attitudes about Cardiovascular Treatment (REACT) survey. Fam Pract. 2002 Dec;19(6):596–604. doi: 10.1093/fampra/19.6.596. [DOI] [PubMed] [Google Scholar]
- Ramsay L., Williams B., Johnston G., MacGregor G., Poston L., Potter J., Poulter N., Russell G. Guidelines for management of hypertension: report of the third working party of the British Hypertension Society. J Hum Hypertens. 1999 Sep;13(9):569–592. doi: 10.1038/sj.jhh.1000917. [DOI] [PubMed] [Google Scholar]