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At the core of health care in this country are the relationships between GPs, practice nurses, therapists and their patients.  What matters most for these users of health services is that they have access to professionals they can trust.  Yet for many decades, the health care relationship has been unequal.  Doctors have the power and NHS patients are expected to be grateful for what they get.  However, the balance is changing and there is growing evidence that patients who are involved in decisions about their treatment may experience better health care results.  \"New beginnings\" sets out to explore the value of public and patient involvement in primary care.    No DIY manual, this book analyses the complex issues surrounding user involvement in an accessible way.  In particular, the authors explain the shifts in culture and attitudes that are required in order for health practitioners to achieve effective user involvement.  Drawn from recent research with a wide range of user groups undertaken by the King's Fund and the Institute for Health Services Research at the University of Luton, the book uses illustrative case studies to show the impact user involvement can have on primary care.  The NHS Plan outlines how the health service will become more responsive to patients and the public.  This timely book takes up the challenge of effective public involvement and explains how it can add to the value of the NHS."],"date_published_tesim":["2001"],"date_published_ssi":"2001","editor_tesim":["Brooks, Fiona","Gillam, Steve"],"isbn_tesim":["1857174399"],"pagination_tesim":["153"],"place_of_publication_tesim":["London"],"rights_statement_tesim":["http://rightsstatements.org/vocab/InC/1.0/"],"license_tesim":["http://creativecommons.org/licenses/by-nc-nd/4.0/"],"creator_tesim":["Institute for Health Services Research (University of Luton)","King's Fund"],"date_tesim":["2001"],"date_ssi":"2001","publisher_tesim":["King's Fund"],"resource_type_tesim":["Monograph"],"subject_tesim":["Clinical effectiveness","Primary care","General practice partnerships","Patient participation","User participation"],"note_tesim":["Pagination: xiii, 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After two years of the pilots, there are a number of lessons to be learnt: nurse-led care is not simply a description of the role of nurses but describes a culture of professional equality and patient-focused services; this new model of care has created some local controversy and hostility from doctors, but has nevertheless managed to negotiate a new doctor nurse relationship within primary care and with hospital colleagues; nurse-led pilots have tended to serve vulnerable populations, often poorly served by general practice, which raises the spectre of a two-tier service with the disadvantaged receiving their care from nurses and the mainstream population from doctors; current NHS and welfare regulations are not sufficiently sensitive to the new role of nurses and need review; and a new infrastructure is required to support new nursing roles.  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Six of the nine centres are located in hospital sites.  The other three centres are in Soho in central London, the High Street in Croydon, and Parsons Green in Fulham.  NHS walk-in centres are nurse-led and offer primary care services without an appointment.  All nine centres offer assessment and treatment for minor illnesses and minor injuries and advice and information about other services.  Additional services offered vary by walk-in centre.  This project provides a snapshot of how NHS walk-in centres are developing in London.  The data were collected between February and April 2001.  The focus of this study is on staffing issues, such as recruitment, training and developing the nursing role, and the interaction with other services.  Face-to-face interviews were conducted with a range of walk-in centre staff and other local stakeholders from primary care and accident and emergency (A\u0026E) departments.  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