A report described a new approach to setting target allocations for hospital care to commissioning general practices – 'person-based resource allocation'. The approach used complex data sets to build up estimated budgets at family doctor practice level, based on the needs of people registered on practice lists.
Source: Martin Bardsley and Jennifer Dixon, Person-Based Resource Allocation: New approaches to estimating commissioning budgets for GP practices, Nuffield Trust
Links: Report
Date: 2011-Dec
A report examined the relationship between patients? primary care costs (consultations, tests, drugs) and their age, gender, deprivation, and alternative measures of their morbidity and multimorbidity.
Source: Samuel Brilleman, Hugh Gravelle, Sandra Hollinghurst, Sarah Purdy, Chris Salisbury, and Frank Windmeijer, Keep It Simple? Predicting primary health care costs with measures of morbidity and multimorbidity, Research Paper 72, Centre for Health Economics (University of York)
Links: Paper
>Date: 2011-Dec
A report called for a renewed investment in community nursing. Despite many 'outstanding examples' of community nursing, the health service had fewer district nurses and health visitors than a decade previously.
Source: Community Nursing: Transforming Health Care, Royal College of Nursing
Links: Report | RCN press release | Nursing Times report
Date: 2011-Nov
A report examined how family doctors could use their expertise to act as community leaders in tackling health inequalities.
Source: Social Determinants of Health – What Doctors Can Do, British Medical Association
Links: Report
Date: 2011-Oct
A paper examined whether better primary care management of chronic diseases was associated with reduced hospital costs. Only primary care performance in stroke care was associated with lower hospital costs – mainly due to reductions in emergency admissions and outpatient visits, rather than to lower costs for patients treated in hospital or to reductions in elective admissions.
Source: Mark Dusheiko, Hugh Gravelle, Stephen Martin, Nigel Rice, and Peter Smith, Does Better Disease Management in Primary Care Reduce Hospital Costs?, Research Paper 65, Centre for Health Economics (University of York)
Links: Paper
Date: 2011-Sep
A study examined how primary care trusts made decisions about funding priorities. Although most commissioners had established robust systems in relation to funding new services and exceptional treatments, they generally struggled to apply the same rigour to 'core' spending.
Source: Suzanne Robinson, Helen Dickinson, Iestyn Williams, Tim Freeman, Benedict Rumbold, and Katie Spence, Setting Priorities in Health: A study of English primary care trusts, Nuffield Trust
Links: Report | Nuffield Trust press release
Date: 2011-Sep
A quantitative survey examined family doctors' attitudes to health and work issues among their patients, and their views on whether and how the 'fit note' had changed their clinical practice. Almost all family doctors thought that work was beneficial for health, and that helping patients to stay in or return to work was an important part of the family doctor's role. 96 per cent agreed that worklessness was generally detrimental to people's health.
Source: Mark Hann and Bonnie Sibbald, General Practitioners Attitudes Towards Patients Health and Work, Research Report 733, Department for Work and Pensions
Links: Report | Summary | DWP press release
Date: 2011-Jul
A study found that at least one-half of the board members of some family doctor consortiums (the new bodies that would take over healthcare commissioning under coalition government plans) had links with a single private healthcare company.
Source: Press release 15 June 2011, Bureau of Investigative Journalism
Links: BIJ press release | Telegraph report
Date: 2011-Jun
A report made a series of recommendations (based on experiences in the United States of America) in relation to plans by the coalition government to give greater commissioning powers to consortiums of family doctors. In order to succeed, consortiums would have to invest heavily in leadership, management, and infrastructure. Consortium objectives should be balanced between quality, patient experience, and cost incentives. Incentives for consortiums to generate cost savings should not be excessively strong. Hospitals and specialist physicians should be encouraged, and supported, to co-operate with consortiums.
Source: Lawrence Casalino, GP Commissioning in the NHS in England: Ten Suggestions from the United States, Nuffield Trust
Links: Report
Date: 2011-Jun
A paper examined the relationship between the quality of family doctor practices in England and the degree of competition that they faced (as indicated by the number of nearby rival practices). Those practices that were located close to other rival practices provided a higher quality of care than that provided by practices that lacked competitors.
Source: Chris Pike, An Empirical Analysis of the Effects of GP Competition, Co-Operation and Competition Panel for NHS-Funded Services
Links: Paper
Date: 2011-May
A think-tank report said that there was no evidence that the pay-for-performance scheme for family doctors introduced in April 2004, known as the Quality and Outcomes Framework (QOF), had resulted in improved ill-health prevention or health promotion, or reduced health inequalities.
Source: Anna Dixon et al., Impact of Quality and Outcomes Framework on Health Inequalities, King s Fund
Links: Summary | Kings Fund press release
Date: 2011-Apr
A report examined the future of family doctor services in Scotland. It called for longer training, better communication between different health services, and the empowering of patients to take a more active role in managing their health. Better incentives were needed to attract family doctor trainees to work in deprived or remote and rural practices.
Source: The Future of General Practice in Scotland: A Vision – A 5-10 year plan for 2011 onwards, Royal College of General Practitioners Scotland
Links: Report
Date: 2011-Mar
A paper examined the fact that family doctor visits per person under the National Health Service had increased in England since the mid-1970s, while list sizes had decreased over the same period.
Source: Matthew Polisson, Do waiting times matter in primary care? GP visits and list sizes in England, Working Paper 541, Department of Economics, University of Oxford
Links: Paper
Date: 2011-Mar
The government published a 'working document' that described the proposed statutory functions of family doctor (GP) commissioning consortia.
Source: The Functions of GP Commissioning Consortia: A Working Document, Department of Health
Links: Working document
Date: 2011-Mar
A think-tank report said that more consistent, high-quality work from family doctors could save the National Health Service hundreds of millions of pounds in prescribing and hospital costs. It urged family doctors to take responsibility for improving quality, with a stronger commitment to transparency, more peer review, and better use of data and information technology to monitor performance.
Source: Nick Goodwin, Anna Dixon, Teresa Poole, and Veena Raleigh, Improving the Quality of Care in General Practice, King s Fund
Links: Report | Kings Fund press release | DH press release | BMA press release | RCGP press release | Community Care report | Public Finance report
>Date: 2011-Mar
The competition watchdog for the National Health Service said that attempts by primary care trusts to cap referrals to private providers, in order to control costs, breached National Health Service competition rules.
Source: Review of the Operation of 'Any Willing Provider' for the Provision of Routine Elective Care: Interim assessment, Co-Operation and Competition Panel for NHS-Funded Services
Links: Report | CCP press release
Date: 2011-Feb
An audit report said that a government scheme that 'incentivized' family doctors to improve their services to patients might not be having the impact it should, because of poor oversight of the payments being made.
Source: Paying GPs to Improve Quality: Auditing payments under the Quality and Outcomes Framework, Audit Commission
Links: Report | Audit Commission press release
Date: 2011-Feb
A briefing paper examined the commissioning function in the National Health Service in England. It briefly defined commissioning, set out how it currently operated, and outlined the coalition government's policy for reform.
Source: David Turner and Thomas Powell, NHS Commissioning, Standard Note SN/SP/5607, House of Commons Library
Links: Briefing paper
Date: 2011-Jan
A think-tank report (based on a study of experiences in the United States of America) said that substantial investment in leadership, management, and information technology – combined with a focus on helping family doctors to work in new ways, and collaborate more closely with their specialist colleagues – was vital if the government's plan to give control of National Health Service budgets to groups of family doctors were to succeed.
Source: Ruth Thorlby, Rebecca Rosen and Judith Smith, GP Commissioning: Insights from Medical Groups in the United States, Nuffield Trust
Links: Report | Nuffield Trust press release | Guardian report
Date: 2011-Jan
The government responded to a report by a committee of MPs on its plans for wholesale reform of commissioning in the National Health Service. It said that although the proposal to abolish primary care trusts had not been in the Conservative or Liberal Democrat election manifestos, or even in the coalition government's agreed programme, it was simply a 'logical consequence' of other proposals – that is, to transfer the trusts' main responsibilities to other bodies including local government.
Source: Government Response to the House of Commons Health Select Committee Third Report of Session 2010-11: Commissioning, Cm 8009, Department of Health, TSO
Notes: The MPs' report had said that the proposal represented a 'high-risk' strategy.
Date: 2011-Jan
