Senior Lecturer in Pharmacy Practice in the Univeristy of Bradford's School of Pharmacy and Medical Sciences. Co-ordinator of the School's strategy for student capability (key skills), work-based learning, employer engagement and alumni relations. Teacher and researcher in evidence based practice, public health and medicines optimisation. Phone: 44 (0)1274 236624 Address: Richmond Road Bradford West Yorks BD7 1DP United Kingdom
Primary care pharmacists carry out clinical and administrative work directly for family doctors a... more Primary care pharmacists carry out clinical and administrative work directly for family doctors and primary care organisations. They are a relatively recent innovation and their role in the United Kingdom (UK)'s National Health Service (NHS) is still developing. The economic liberalization of the NHS in the 1990s seems to have provided a major stimulus for the growth of primary care pharmacy. The establishment of the new professional group was not linked to a deliberate plan or change in health policy with respect to pharmacist development. Primary care pharmacy practice is much more varied and flexible than traditional pharmacy practice in the community and hospitals. Standards and professional organisation for primary care pharmacy are slowly emerging. Modernization of the NHS is providing many new opportunities, which primary care pharmacists are well placed to take advantage of. Traditional community pharmacy faces many problems unless it can learn to develop alongside primacy care pharmacy. Pharmaceutical care is set to improve in the United Kingdom, but the precise nature of future services and providers remains uncertain.
An evaluation of a training workshop for ... Hazel Sinclair, Christine Bond, A Scott Lennox, Jona... more An evaluation of a training workshop for ... Hazel Sinclair, Christine Bond, A Scott Lennox, Jonathan Silcock, Arthur Winfield ... HK Sinclair, Research Assistant, CM Bond, Senior Lecturer, AS Lennox, Clinical Research Fellow, Department of General Practice and Primary Care, ...
OBJECTIVES: To assess the cost effectiveness of community thrombolysis relative to hospital throm... more OBJECTIVES: To assess the cost effectiveness of community thrombolysis relative to hospital thrombolysis by investigating the extra costs and benefits of a policy of community thrombolysis, then establishing the extra cost per life saved by community thrombolysis. DESIGN: Economic evaluation based on the results of the Grampian region early anistreplase trial. SETTING: 29 rural general practices and one secondary care provider in Grampian, Scotland. SUBJECTS: 311 patients recruited to the Grampian region early anistreplase trial. INTERVENTIONS: Intravenous anistreplase given either by general practitioners or secondary care clinicians. MAIN OUTCOME MEASURES: Survival at 4 years and costs of administration of thrombolysis. RESULTS: Relative to hospital thrombolysis, community thrombolysis gives an additional probability of survival at 4 years of 11% (95% confidence interval 1% to 22%) at an additional cost of 425 pounds per patient. This gives a marginal cost of life saved at 4 years of 3,890 pounds (1,990 pounds to 42,820 pounds). CONCLUSIONS: The cost per life saved by community thrombolysis is modest compared with, for example, the cost of changing the thrombolytic drug used in hospital from streptokinase to alteplase.
This paper reviews the empirical evidence about the effects of the 1990 general practitioner (GP)... more This paper reviews the empirical evidence about the effects of the 1990 general practitioner (GP) contract on the provision of medical services in the United Kingdom. A brief outline of the major changes instigated by the 1990 GP contract is given. Studies of the implementation of the changes tend to focus on either trend analysis, cost-effectiveness or medical practice variation. These studies are reviewed and the implications for the efficiency of primary health care are discussed.
... The 1990 GP Contract: Modelling variation in minor surgery provision JONATHAN SILCOCK AND JUL... more ... The 1990 GP Contract: Modelling variation in minor surgery provision JONATHAN SILCOCK AND JULIE RATCLIFFE Health Economics Research Unit, Polwarth Building, University of Aberdeen, Aberdeen AB9 2ZD, UK ... 204 JONATHAN SILCOCK AND JULIE RATCLIFFE ...
Primary care pharmacists carry out clinical and administrative work directly for family doctors a... more Primary care pharmacists carry out clinical and administrative work directly for family doctors and primary care organisations. They are a relatively recent innovation and their role in the United Kingdom (UK)'s National Health Service (NHS) is still developing. The economic liberalization of the NHS in the 1990s seems to have provided a major stimulus for the growth of primary care pharmacy. The establishment of the new professional group was not linked to a deliberate plan or change in health policy with respect to pharmacist development. Primary care pharmacy practice is much more varied and flexible than traditional pharmacy practice in the community and hospitals. Standards and professional organisation for primary care pharmacy are slowly emerging. Modernization of the NHS is providing many new opportunities, which primary care pharmacists are well placed to take advantage of. Traditional community pharmacy faces many problems unless it can learn to develop alongside primacy care pharmacy. Pharmaceutical care is set to improve in the United Kingdom, but the precise nature of future services and providers remains uncertain.
An evaluation of a training workshop for ... Hazel Sinclair, Christine Bond, A Scott Lennox, Jona... more An evaluation of a training workshop for ... Hazel Sinclair, Christine Bond, A Scott Lennox, Jonathan Silcock, Arthur Winfield ... HK Sinclair, Research Assistant, CM Bond, Senior Lecturer, AS Lennox, Clinical Research Fellow, Department of General Practice and Primary Care, ...
OBJECTIVES: To assess the cost effectiveness of community thrombolysis relative to hospital throm... more OBJECTIVES: To assess the cost effectiveness of community thrombolysis relative to hospital thrombolysis by investigating the extra costs and benefits of a policy of community thrombolysis, then establishing the extra cost per life saved by community thrombolysis. DESIGN: Economic evaluation based on the results of the Grampian region early anistreplase trial. SETTING: 29 rural general practices and one secondary care provider in Grampian, Scotland. SUBJECTS: 311 patients recruited to the Grampian region early anistreplase trial. INTERVENTIONS: Intravenous anistreplase given either by general practitioners or secondary care clinicians. MAIN OUTCOME MEASURES: Survival at 4 years and costs of administration of thrombolysis. RESULTS: Relative to hospital thrombolysis, community thrombolysis gives an additional probability of survival at 4 years of 11% (95% confidence interval 1% to 22%) at an additional cost of 425 pounds per patient. This gives a marginal cost of life saved at 4 years of 3,890 pounds (1,990 pounds to 42,820 pounds). CONCLUSIONS: The cost per life saved by community thrombolysis is modest compared with, for example, the cost of changing the thrombolytic drug used in hospital from streptokinase to alteplase.
This paper reviews the empirical evidence about the effects of the 1990 general practitioner (GP)... more This paper reviews the empirical evidence about the effects of the 1990 general practitioner (GP) contract on the provision of medical services in the United Kingdom. A brief outline of the major changes instigated by the 1990 GP contract is given. Studies of the implementation of the changes tend to focus on either trend analysis, cost-effectiveness or medical practice variation. These studies are reviewed and the implications for the efficiency of primary health care are discussed.
... The 1990 GP Contract: Modelling variation in minor surgery provision JONATHAN SILCOCK AND JUL... more ... The 1990 GP Contract: Modelling variation in minor surgery provision JONATHAN SILCOCK AND JULIE RATCLIFFE Health Economics Research Unit, Polwarth Building, University of Aberdeen, Aberdeen AB9 2ZD, UK ... 204 JONATHAN SILCOCK AND JULIE RATCLIFFE ...
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