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Last Updated: Monday, 30 January 2006, 16:36 GMT
At a glance: Out-of-hospital care plans
Ministers have outlined measures to improve access to NHS care outside hospitals.

The white paper includes measures for GP, nursing and mental health services in a bid to reduce unnecessary hospital admissions.

The main proposals are:


  • Bringing some specialties out of the hospital nearer to people, including dermatology, ear, nose and throat, orthopaedics and gynaecology. Would be achieved either through outreach clinics run by hospital consultants or specialist services provided for by GPs

  • Introducing a new generation of community hospitals that will provide diagnostics, minor surgery, outpatient facilities and access to social services in one location


  • Pilot a new NHS "life check" or "health MoT" from 2007 to assess people's lifestyle risks, the right steps to take and provide referrals to specialists if needed

  • The life check will be run on a two-stage basis with patients first filling in a paper-based or online self-assessment.

  • If the assessments indicate the person is at significant risk of poor health for conditions such as diabetes, cancer or heart disease, the individual would then be given access to a health trainer who could advise about diet and exercise. If problems are more complex, patient would be referred to a GP or nurse


  • Give patients a guarantee of registration on to a GP practice list in their locality and simplifying the system for doing this

  • Introducing incentives to GP practices to offer opening times that respond to the needs of patients in their area

  • Consideration was given to dual registration - allowing patients to register with more than one GP - but was thrown out because it would "undermine the underlying principles" of the family doctor system


  • New responsibilities placed on local councils and the NHS to work together to provide joined up care plans for those who need them

  • Supporting people to improve self care by trebling the investment in the Expert Patient Programme, which teaches patients with long-term illnesses, such as asthma and diabetes, how to control their condition

  • Developing an "information prescription" for people with long-term health and social care needs and for their carers

  • More support for carers, including improved emergency respite arrangements and the establishment of a national helpline for carers

  • Extension of direct payments and piloting of individual budgets for social care to allow people to decide what their allocations are spent on


  • Increasing the quantity and quality of primary care in under-served, deprived areas through a national procurement programme which would open the GP market to the private and voluntary sectors

  • Encourage nurses and other health professionals, such as physios, to take on more responsibility

  • Set up pilots to allow patients to self-refer themselves to professionals other than GPs, who currently act as gatekeepers to the NHS. First pilot to start with physios

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