The government began consultation on proposals (in its July 2010 White Paper) in respect of funding and commissioning routes for public health in England, including a ring-fenced budget provided to local authorities.
Source: Healthy Lives, Healthy People: Consultation on the Funding and Commissioning Routes for Public Health, Department of Health
Links: Consultation document | Hansard
Date: 2010-Dec
A think-tank report said that the wholesale abolition of primary care trusts proposed in the National Health Service White Paper (July 2010) could have a negative impact on patient care, and should be halted in favour of a more incremental approach to commissioning reform.
Source: James Gubb, A Risky Business: The White Paper and the NHS, Civitas
Links: Report | Civitas press release
Date: 2010-Dec
A think-tank report examined a case study of healthcare commissioning led by family doctors. It concluded that the system would increase efficiency and the quality of service in the National Health Service.
Source: Paul Corrigan, Practice Makes Perfect, Demos
Date: 2010-Oct
A report said that there was little, if any, evidence that smaller organizations were better at commissioning healthcare services than larger ones. The government's plans for devolving commissioning to family doctors would be costly, almost certainly resulting in a dip in performance in the short to medium term.
Source: Sebastian Baird, James Gubby and Kieran Walshe, NHS White Paper Proposals for GP Commissioning: Does Size Matter?, Civitas
Links: Report | Civitas press release | MBS press release
Date: 2010-Oct
A discussion paper examined the new coalition government's proposals for commissioning health services at a very local level through general practice consortia. It made suggestions about how commissioning could develop in a transparent, inclusive, and accountable way.
Source: Towards Transparent, Inclusive and Accountable GP Commissioning, Centre for Public Scrutiny/NHS Alliance
Links: Paper | CfPS press release
Date: 2010-Sep
An article estimated the potential reduction in population mortality from implementation of the pay-for-performance contract in primary care in England. The contract might have delivered a substantial health gain: but the gain was limited by performance targets for full payment being set lower than typical baseline performance.
Source: Robert Fleetcroft et al., 'The UK pay-for-performance programme in primary care: estimation of population mortality reduction', British Journal of General Practice, Volume 60 Number 578
Links: Abstract
Date: 2010-Sep
A study examined the impact of a range of incentives in primary care on professional behaviours and performance.
Source: Ruth McDonald, Sudeh Cheraghi-Sohi, Martin Tickle, Martin Roland and Tim Doran, The Impact of Incentives on the Behaviour and Performance of Primary Care Professionals, National Institute for Health Research Service Delivery and Organisation
Date: 2010-Sep
An article examined the comparative performance of small family doctor practices under the pay-for-performance 'Quality and Outcomes Framework'. Small practices were represented among both the best and the worst practices in terms of achievement of clinical quality targets. The effect of the pay-for-performance scheme appeared to have been to reduce variation in performance, and to reduce the difference between large and small practices.
Source: Tim Doran, Stephen Campbell, Catherine Fullwood, Evangelos Kontopantelis and Martin Roland, 'Performance of small general practices under the UK's Quality and Outcomes Framework', British Journal of General Practice, Volume 60 Number 578
Links: Abstract
Date: 2010-Sep
A think-tank report said that National Health Service referral management centres, and some other interventions to manage family doctor referrals to secondary care, were failing to improve quality and deliver cost savings.
Source: Candace Imison and Chris Naylor, Referral Management: Lessons for Success, King's Fund
Links: Report | King's Fund press release
Date: 2010-Aug
The Scottish Government published a 5-year action plan designed to improve the quality of patient care in primary healthcare services.
Source: Delivering Quality in Primary Care National Action Plan: Implementing the healthcare quality strategy for NHS Scotland, Scottish Government
Links: Action plan | Scottish Government press release | Nursing Times report
Date: 2010-Aug
A think-tank paper examined the existing state of general practice involvement in maternity care in England, what family doctors could do to stimulate and maintain care quality, and how care quality could be measured. It said that the care of pregnant women was being undermined by the lack of involvement of family doctors.
Source: Alex Smith, Judy Shakespeare and Anna Dixon, The Role of GPs in Maternity Care: What does the future hold?, King's Fund
Links: Paper | King's Fund press release | BMA press release | NCT press release | BBC report | Telegraph report | Guardian report | Children & Young People Now report
Date: 2010-Aug
A report said that plans by the new coalition government to give family doctors responsibility for holding budgets and commissioning health services on behalf of their local communities had the potential to help improve care: but they would need time and careful design if they were to be successful.
Source: Judith Smith and Ruth Thorlby, Giving GPs Budgets for Commissioning: What Needs to Be Done?, Nuffield Trust
Links: Report | Nuffield Trust press release | Kings Fund press release
Date: 2010-Jun
A report said that government plans to give family doctors greater control of National Health Service budgets were a step in the right direction, but needed to be implemented carefully if they were to deliver benefits for patients.
Source: Chris Ham, GP Budget Holding: Lessons from Across the Pond and from the NHS, Health Services Management Centre/University of Birmingham
Links: Report | HSMC press release
Date: 2010-Jun
A study examined the early progress that community health partnerships had made in Scotland, and identified the factors that had facilitated or possibly hindered progress.
Source: Glenys Watt, Onyema Ibe and Nicola McLelland, Study of Community Health Partnerships, Scottish Government
Date: 2010-May
A think-tank report said that the existing funding formula for primary care trusts in England 'could not be defended on any rational grounds'. Due to lack of evidence, it was not technically possible to determine the cost of reducing health inequalities between PCTs.
Source: Mervyn Stone, Formulas at War Over Two Sorts of Inequality in Health Funding, Civitas
Links: Report | Civitas press release
Date: 2010-Apr
A report by a committee of MSPs said that urgent action was needed to resolve serious shortcomings in the provision of out-of-hours healthcare in rural areas.
Source: Report on Out-of-Hours Healthcare Provision in Rural Areas, 4th Report 2010, SP Paper 421, Scottish Parliament Health and Sport Committee
Links: Report | Scottish Parliament press release | Nursing Times report
Date: 2010-Apr
An organization representing family doctors published a 50-point plan for the future of general practice. Recommendations included: increasing the role of general practice in promoting public health by making it a requirement to consider, through piloting, how policy changes would address health inequalities; and increasing patient involvement in the planning and arranging of services by linking patient participation groups.
Source: Fit for the Future: The evolution of general practice, British Medical Association
Links: Plan | Summary | BMA press release
Date: 2010-Apr
An article examined local variations in the interpretation and implementation of practice-based commissioning in the English National Health Service.
Source: Anna Coleman, Kath Checkland, Stephen Harrison and Urara Hiroeh, 'Local histories and local sensemaking: a case of policy implementation in the English National Health Service', Policy & Politics, Volume 38 Number 2
Links: Abstract
Date: 2010-Apr
A paper examined models for the successful integration of local councils and primary care trusts. Many PCTs were not large enough to remain viable in the longer term, and integration with a local authority could increase management capacity.
Source: Integration of Councils and PCTs: A discussion paper, Office of Public Management
Links: Link removed by OPM
Date: 2010-Apr
A report by a committee of MPs said that primary care trusts were failing to commission effectively. PCTs were too passive, and lacked the clinical knowledge and other skills to challenge hospitals over the provision of services. Constant reorganizations and high turnover of staff had made a bad situation worse.
Source: Commissioning, Fourth Report (Session 2009-10), HC 268, House of Commons Health Select Committee/TSO
Links: Report | RCP press release | Pulse report | BBC report | Guardian report
Date: 2010-Mar
The government began consultation on proposals designed to give patients a much greater choice of family doctor practice, for example by allowing people to choose a practice near where they worked rather than where they lived. The consultation examined the implications of such a change, such as for the organization of home visits.
Source: Your Choice of GP Practice: A consultation on how to enable people to register with the GP practice of their choice, Department of Health
Links: Consultation document | Summary | Hansard | DH press release | Nursing Times report | Telegraph report | Pulse report
Date: 2010-Mar
A manifesto made a number of proposals designed to produce a healthier society and promote healthier lifestyles – including a call for longer consultation times and longer family doctor training.
Source: Leading the Way: High quality care for all through general practice – A manifesto for patient care 2010, Royal College of General Practitioners
Links: Manifesto | RCGP press release | Pulse report
Date: 2010-Mar
A study examined the impact of using primary care within or alongside accident and emergency services. It concluded that the use of primary care clinicians in accident and emergency departments could benefit patients where services were integrated and clinicians worked together. But the proportion of cases that could have been dealt with in primary care was low – perhaps as little as 10 per cent.
Source: David Carson, Henry Clay and Rick Stern, Primary Care and Emergency Departments, Primary Care Foundation
Links: Report | PCF press release | Pulse report
Date: 2010-Mar
A paper discussed alternative measures of the volume of general practice input (a component of the volume of healthcare input, measured by the Office for National Statistics in order to produce estimates of public service healthcare productivity).
Source: Mark Chandler and llyas Malek, Measuring Growth in the Volume of Input for General Practice Services, UK Centre for the Measurement of Government Activity/Office for National Statistics
Links: Paper
Date: 2010-Mar
A report examined how well the primary healthcare needs of vulnerable groups were being met. It concluded that considerable progress had been made: but also highlighted that socially excluded groups often had complex needs and required a sophisticated and flexible response from service providers.
Source: Inclusion Health: Improving the way we meet the primary health care needs of the socially excluded, Social Exclusion Task Force/Cabinet Office
Links: Report
Note: The new coalition government has removed the report from the Cabinet Office website.
Date: 2010-Mar
An article examined family doctors' perceptions of the management of individuals in receipt of long-term incapacity benefits, and their attitudes to government-funded return-to-work programmes. There seemed to be a clear divide between managing patients' health concerns and their work-related activities. Some family doctors recognized that patients became 'lost' in their system once receiving long-term benefits.
Source: Debbie Cohen, Naomi Marfell, Katie Webb, Mike Robling and Mansel Aylward, 'Managing long-term worklessness in primary care: a focus group study', Occupational Medicine, Volume 60 Issue 2
Links: Abstract
Date: 2010-Mar
A think-tank report examined the progress made by the 'quality and outcomes framework' (QOF) for family doctors since its introduction, and considered the different ways in which the QOF could be reformed. Although the QOF had been a relative success in supporting the drive to increase standards of care, there was strong evidence that standards had tailed off in recent years. (The QOF is a voluntary incentive scheme that rewards family doctors based on the quality of care delivered to patients.)
Source: Gary Jones, Stuart Carroll and Jennifer White, The Quality and Outcomes Framework (QOF): What Type of Quality and Which Outcomes?, Bow Group
Links: Report | Pulse report
Date: 2010-Feb
An organization representing family doctors published a policy document on the future of general practice in Scotland. It said that local support teams should be created to help practices that were struggling to provide optimum levels of access for their patients; that changing the balance of care would only succeed if any shift in work from hospitals to general practice were planned and resourced; and that new standards for out-of-hours care should be developed.
Source: General Practice in Scotland: The Way Ahead, British Medical Association Scotland
Links: Report | BMA press release | BBC report
Date: 2010-Feb
A report said that out-of-hours services in primary care in England were improving. But many providers were falling short on the standard for definitive clinical assessment of urgent cases.
Source: Improving out of Hours Care: What lessons can be learned from a national benchmark of services?, Primary Care Foundation
Links: Report | Liberal Democrats press release | Telegraph report | BBC report | Nursing Times report
Date: 2010-Feb
The report of an official review made a number of recommendations for improving the system of family doctor out-of-hours care in England. The review found that there were robust requirements in place to ensure the commissioning and delivery of safe, high-quality out-of-hours services: but that there was unacceptable variation in how these were implemented and monitored by primary care trusts around the country. The government accepted all the recommendations in the report.
Source: David Colin-Thome and Steve Field, General Practice Out-of-Hours Services: Project to consider and assess current arrangements, Department of Health
Links: Report | Review press release | Hansard | DH press release | BMA press release | NHS Confederation press release | NHS Alliance press release | Pulse report | Guardian report | BBC report
Date: 2010-Feb
A think-tank report called for a radical reform of the way resources were allocated to family doctor practices. It said that fixed payments distorted the market in primary care, and should be removed. Patients should have to re-register with practices every 2-5 years in order to promote competition.
Source: Henry Featherstone and Carol Storey, Which Doctor? Putting patients in control of primary care, Policy Exchange
Links: Report | Policy Exchange press release
Date: 2010-Jan
An organization representing family doctors set out its solution for how to reform practice boundaries in England. It explored the possible consequences of completely abolishing practice boundaries, and suggested a solution that – although not amounting to total abolition – would significantly improve choice and access for patients without the 'huge cost, upheaval and unintended consequences' that completely free registration would cause.
Source: Reforming General Practice Boundaries, British Medical Association
Links: Report | BMA press release | Pulse report
Date: 2010-Jan
