Innovations in services and the appliance of science

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Abstract
Many current innovations are concerned with the interface between primary and secondary care because of the (largely untested) belief that shifting care to the community will be more cost effective and more acceptable to the public than current patterns of provision of hospital services. Such innovations include hospitals at home, specialist outreach schemes, primary care emergency centres, and the development of discharge planning. Other innovations include changes in skill mix and professional roles, such as the introduction of practice counsellors, nurse practitioners, and health advocates for ethnic minority groups. Research on several of these topics is now being commissioned4 as part of the …

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