The Health service journal
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A model in use in a primary care trust enables the prediction of acute admissions to hospital over a two-year period. The results show that the rise in emergency medical admissions threatens the local hospital's capacity to meet waiting-time targets for planned work. The research also showed that the establishment of a local diagnostic and treatment centre would reduce levels of occupancy in the acute hospitals to a level that could threaten its survival.
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The government's proposals for cross-charging could hamper the development of effective partnerships between the NHS and social services. It is regrettable that the system is being developed at a time when primary care trusts have not had a chance to influence the whole commissioning process. The problem of delayed discharges needs to be tackled from a broad approach that includes access to GP services and inappropriate use of accident and emergency departments. Reimbursements from the charging system should be given to PCTs, which then have greater influence in integrating health and social care.