NEWS
A major report into general prac- tice in the UK has uncovered “widespread variations” in per- formance and recommends “rad- ical change”.
The inquiry, commissioned by health think thank The King’s Fund, demands a stronger com- mitment to transparency, a stronger focus on peer review and benchmarking, and better use of information, data and IT for quality control purposes.
Chris Ham, chief executive of The King’s Fund, said: “Although general practice in this country remains the envy of the world, there is no room for complacen- cy. While many practices have been at the vanguard of innova- tion and quality improvement, too many GPs remain unaware of sig- nificant variations in performance and do not give priority to improv- ing quality. I hope this report will act as a spur to GPs and others working in general practice to ac- celerate the pace of change.”
The report highlights variations in the quality of diagnosis, with a third of patients with stomach or oesophageal cancer requiring urgent referral to hospital actu-
tensity and complexity of general practice work nowadays, GPs need time off the treadmill so they can look critically at what they do and make improvements. A reduction in bureaucracy would help them to do this, as would stopping the constant reorgani- sations within the NHS.”
ally given non-urgent referrals. It also says there is a disparity in the rate of referrals, the quality of prescribing, the ability of patients to see their preferred doctors in the lowest-performing practices, and highlights the lack of care plans for 10% of patients with long-term conditions as well as wide variations in admission rates for patients with conditions that could equally be treated outside hospital.
The inquiry, chaired by Sir Ian Kennedy, represents “the most extensive review of quality across general practice carried out in re- cent years”, the think thank said.
It wants GPs to be generalists, rather than specialists, wants more multi-professional teams at
practices with specialists working alongside GPs, wants patients more closely involved in their own care decisions, and for GPs to move from being ‘gatekeep- ers’ to ‘navigators’, co-ordinat- ing care for people with complex needs, signposting patients to other public services and being held accountable for the quality of care provided.
Dr Laurence Buckman, chair- man of the BMA’s GPs Commit- tee, said: “We are pleased The King’s Fund report recognises the importance of generalism and that most practices provide good quality care.
“A culture of self-scrutiny has ex- isted for many years but now more than ever, given the increased in-
NHS Confederation acting chief executive Nigel Edwards said: “Much of the care delivered by GPs is excellent, and primary care generally remains one of the great strengths of our healthcare system. However until now, we have had little information about the variability of GP performance. This report highlights the need to address the major variations in the standards of care patients are receiving.
“There is uncertainty with the NHS reforms about how GP per- formance will be managed. One of the big tests for the NHS re- forms is whether the best GPs will be willing and able to get to grips with those who are perform- ing less well and whether they will have the tools to do so. The Gov- ernment needs to clearly demon- strate how its reform programme will achieve this improvement.”
Government slammed by health groups over alcohol ‘deal’ Controversial maternity move approved
Six medical organisations have abandoned the Government’s ‘responsibility deal’ over alcohol, claiming that the drinks industry is dictating health policy.
Alcohol Concern, the BMA and the Royal College of Physicians have said their advice was all but ignored, in preference for weak, non-specific and non-measurable targets from the drinks industry.
Chief executive of Alcohol Con- cern Don Shenker said: “This is the worst possible deal for eve- ryone who wants to see alcohol harm reduced. There are no firm targets or any sanctions if the drinks industry fails to fulfil its pledges.”
Professor Vivienne Nathanson of the BMA said: “The Government
Shropshire health chiefs have pressed ahead with a decision to merge key services in the county. More than 33,000 people from across Shropshire and mid-Wales signed a petition calling for women and children’s services to remain at the Royal Shrewsbury Hospital instead of being moved to Telford. Both Shropshire County Primary Care Trust and NHS Telford and Wrekin unanimously backed the move, which has been given the go-ahead by regulators.
has talked the talk, but when it comes to taking tough action that will achieve results, it falls short.”
Health Secretary Andrew Lans- ley said tough action was being taken, including taxes on super- strength beers and a ban on be- low-cost alcohol.
He added: “We have made clear from the start that the respon- sibility deal is just one strand of the Government’s public health policy.
“It explicitly excludes cost and price competition to avoid con- flicts of interest.”
Under the plans, a midwife-led ma- ternity unit for low-risk pregnancies and acute in-patient abdominal and vascular surgery would be based at the Royal Shrewsbury Hospital, but the bulk of maternity services would be shifted to the Princess Royal in Telford.
national health executive Mar/Apr 11 | 7
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