The development of English primary care group governance. A scenario analysis

At present there is a policy vacuum about what English Primary Care Groups' (PCGs) governance will be when they develop into Primary Care Trusts (PCTs). Draft legislation leaves many options open, so PCT governance is likely to 'emerge' as PCTs are created. It also remains uncertain how general practitioners (GPs) will react to the formation of PCTs and how the UK government will then respond in turn. A scenario analysis suggests three possible lines of development. The base (likeliest) scenario predicts a mainly networked form of PCT governance. An alternative scenario is of PCT governance resembling the former National Health Service internal market. A third scenario predicts 'franchise model' PCTs employing some GPs and subcontracting others. To different degrees all three scenarios predict that PCTs will retain elements of networked governance. If it fails to make GPs as accountable to NHS management as the UK government wishes, networked governance may prove only a transitional stage before English PCTs adopt either quasi-market or hierarchical governance.     

Management development. The MESOL (Management Education Scheme by Open Learning) experience

Explores and attempts to reconcile some of the differences between traditional professional and academic management qualifications and those based on the NVQ competence model. Based on the experience of Universities and Higher Education institutions delivering open learning MESOL materials to the UK health and social care sector, focuses on the different assessment methodologies used by each. Concludes that it is necessary to differentiate clearly between the traditional input/knowledge-based model and the competence-based approach of the NVQ. This will allow candidates to contextualize and consolidate learning in the workplace prior to revisiting their performance at a later date.     

体格发育先进少年的手腕骨发育特征

观察了11～15岁的37名体格发育先进少年手腕骨发育状况。结果表明，高身材者绝大多数（32例）骨龄不同程度地高于时间年龄，其中有8人骨龄大于时间年龄2岁以上，各年龄男性骨龄超值均大于女性。采用克托莱指数划分体型，有近40％的观察对象列为粗壮型，无论在男性、女性，都呈现出粗壮型骨龄均值明显大于适中型。被检者Ⅱ掌骨长度明显高于国内对普通儿童少年人群检测的发育水平，Ⅱ掌骨指数均值多数年龄处于9．0以上，且女性此值较高，提示在青春发育初期，采用Ⅱ掌骨长度或指数预测儿童未来身高具有一定价值。     

Management development

This paper is the account of one area health authority's attempt to give its managers some positive help with their own, and their subordinates', development and to provide a focus for the discussion of ideas on the development of the organisation. The last three years have seen an attempt to conceive and give birth to a management development philosophy which despite its hybrid nature (being the product of both theory and circumstances) seems to meet the needs of one health authority.     

Management services organization for group practices

This article analyzes why management service organizations (MSOs) have become the major interface between group practices and managed care organizations as well as their advantages and disadvantages. It provides this information in the context of The University of Texas Southwestern Medical Center's development and operation of an MSO in the Dallas/Fort Worth market.