News

Within three years, primary care trusts should have special arrangements in place for asylum seekers, refugees, single teenage mothers and isolated older people, according to the primary care representative body the NHS Alliance.

In a report published to coincide with primary care trusts taking on new powers and control over resources to shape and commission services, the organisation said tackling at PCT level the social factors that cause ill-health required closer working with local communities to identify priority target groups and "imaginative, joined-up approaches across all the local agencies".

Once priority target groups were agreed, PCTs should work with them to identify their needs and involve them and all the other relevant agencies in developing services, the report suggested.

PCTs with an already significant number of refugees and asylum seekers should have by April 2005 advanced warning of any more likely to be dispersed to the area, a named PCT lead who takes part in a co-ordinated PCT approach, and a dedicated GP service or local development scheme project with an agreed strategy "for moving towards long-term integration rather than continuing segregation".

The report, Vision in Practice, also calls for PCTs to develop "tailored services" to meet the needs of single teenage mothers, including establishing a systematic approach to supporting them during and after pregnancy and de-stigmatising adolescent sexual behaviour in order to improve uptake of contraception.

Social services departments, with the support of PCTs, should develop strategies for addressing the needs of isolated older people, including setting up a register of them to be shared across the health and social care services, the report adds.

The report is the third in a series by the NHS Alliance on implementing the NHS Plan and the Shifting the Balance of Power report. The organisation believes PCTs are the answer to creating a "more agile, effective and locally sensitive service". But it warns that PCTs risk falling at the first hurdle if they are forced to inherit health authorities' debts and overspent NHS trusts' commitments and liabilities.

The NHS Alliance is also concerned that the original aims of commissioning are in danger of being lost unless "unified commissioning" of secondary and primary care is introduced.

- Vision in Practice is available to members from www.nhsalliance.org