An examination of the role of the concept of the community within the current reorganisation of English local government

The thesis will examine the role and impact of the concept of the community within the structural reorganisation of English local government between 1992 and 1995. The methodological approach adopted within this thesis has been to compare the use, application and significance of the community with a case study of a specific local authority and its preparations for reorganisation. The authority in question was Wychavon District Council located in the County of Hereford and Worcester. The conclusions from this case study were then compared to the role and significance of the community in the reviews of other local authorities in England. This study produced two important results. These were that there was an established body of literature which argued that the community could be of value to local government and that the community should be identified by measuring individuals sense of belonging and feelings of attachment, as well as such daily activities as shopping and working (which help to stimulate these feelings). The then Conservative Government even instructed the specially appointed Commission to apply this particular interpretation of the community to their reviews, and to attempt to base any new unitary authorities upon the social and spatial area it created. The Conservative Government also gave the Commission a Community Index to assist with the identification of communities, and appointed the pollsters MORI to support the Commission with the task of identifying the emotional and more subjective senses of community. The Commission eventually came to rely entirely on the MORI polls, and whilst these polls attempted to faithfully apply the Governments interpretation of the community, they unfortunately produced small and often complex communities, which the Commission felt could not be applied to its reviews. This therefore led to the community becoming a secondary consideration to the factors of cost and efficiency. Furthermore the problematic nature of the community - that is, the production of small and complex communities - was repeated in this thesis' own survey of community identities in the District of Wychavon. In fact this authority's proposals for reorganisation were based almost entirely upon the factors of cost, size and efficiency.

A study of the role of the community pharmacist in responding to symptons

Factors affecting the current role of the community pharmacist in responding to symptoms are investigated. Communication and collaboration with general medical practitioners (GPs), and the competency of pharmacists and counter assistants to perform the role of responding to symptoms, are examined. A national survey of GPs, conducted by postal questionnaire, explores attitudes towards the role of the community pharmacist in the treatment of patients' symptoms, and towards future extension of such a role. A majority (over 90%) of respondents thought that the counter prescribing activities of the pharmacist should be maintained or increased. Doctors supported treatment of most minor illnesses by pharmacists, but there was relatively little support for the deregulation of selected Prescription Only Medicines. Three quarters of respondents were in favour of joint educational meetings for pharmacists and doctors. Most GPs (85%) expressed support for a formal referral route from pharmacists to doctors, using a "notification card". A pilot study of the use of a notification card was conducted . Two thirds of the patients who were advised to see their doctor by the pharmacist subsequently did so. In most cases , the GP rated the patients' symptoms " significant" and the card "helpful". Pharmacists' and counter assistants' competency in responding to symptoms was assessed by a programme of pharmacy visits, where previously-defined symptoms were presented. Some pharmacists' questioning skills were found to be inadequate, and their knowledge not sufficiently current. Counter assistants asked fewer and less appropriate questions than did pharmacists, and assistants ' knowledge base was shown to be inadequate. Recommendations are made in relation to the education and training of pharmacists and counter assistants in responding to symptoms .