Limited research suggests that successful implementation of integrated nursing increases perceptions of overall primary health care team functioning. This paper reviews those studies and also reports on the findings of relevant studies of teamwork in the wider primary care context. Effective teamwork is essential if the concept of a primary care-led NHS is to become a reality. Achieving effective teamwork however is fraught with difficulties and requires skilled facilitation to overcome obstacles such as fear of change, professional jealousies and diverse lines of accountability. The facets of good teamwork include a high level of participation by all members, support for innovation, clarity of team objectives, task orientation and mutual role understanding. The diversity of problems encountered in primary care makes auditing the collective work of teams very difficult. As a result, most research in nursing and primary health care teams has concentrated on team process rather than outcome. Efforts should now be channelled into refining existing methods of evaluation and developing new outcome measures.

This article originates from a DoH funded survey of midwifery services based on three sites in England in 1994-1996 conducted by the NPEU. The author, the project researcher, outlines her personal concerns that Increased choice and Individualized care for pregnant women, advocated by the Expert Medical Committee, were not feasible, given the existing financial and political situation In the NHS. There was also a dearth of reliable data on which to plan and monitor change. Furthermore, pursuit of the principle of a woman knowing the midwife present at her child's birth may lead to fragmented antenatal and postnatal care, compromised safety and an unsustainable service.

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Fungal infections can be made worse by use of topical steroids, but on occasion relief of pain and inflammation can be the priority. Canesten Hydrocortisone can provide a solution.

Cystitis literally means inflammation of the urinary bladder and is a term often used by individuals to describe the symptoms of dysuria and frequency. It is not synonymous with the diagnosis of urinary tract infection (UTI) as it can be either infective or non-infective (Mead, 1996). It can occur in both genders and at any age, but by far the most commonly affected group is sexually active women between the ages of 20 and 50.