An article examined the determinants of primary care service use in families with preschool children. It said there were a range of socio-demographic determinants, and that they differed between use of the health visitor and family doctor.
Source: Claire Wilson, Rhona Hogg, Marion Henderson, and Philip Wilson, 'Patterns of primary care service use by families with young children', Family Practice, Volume 30 Number 6
Links: Abstract
Date: 2013-Dec
An article examined the determinants of primary care service use in families with preschool children. It said there were a range of socio-demographic determinants, and that they differed between use of the health visitor and family doctor.
Source: Claire Wilson, Rhona Hogg, Marion Henderson, and Philip Wilson, 'Patterns of primary care service use by families with young children', Family Practice, Online first
Links: Abstract
Date: 2013-Nov
The government announced fourteen initiatives in delivering more coordinated health care. Building on recent initiatives in areas such as Greenwich and Devon, the aim was for health and social care services to work together to provide better support at home and earlier treatment in the community.
Source: Integration Pioneers Leading the Way for Health and Care Reform, Press release 1 November 2013, Department of Health
Links: DH press release | King's Fund press release | NHS England press release
Date: 2013-Nov
The regulator for National Health Service foundation trusts said that almost one in four National Health Service walk-in centres had closed in recent years, despite being popular with patients. Commissioners who had closed centres cited concerns that included: that the centres were generating unwarranted demand; that they led to duplication when patients self-referred to multiple services; and that they caused confusion among patients about where to go for care. Commissioners also commonly said they felt they were 'paying twice' for patients who attend walk-in centres, since most users were registered with a family doctor practice elsewhere. The report invited further evidence to be submitted.
Source: Walk-in Centre Review: Preliminary report, Monitor
Links: Report | Survey | DOH press release | Monitor press release | NHS Partners press release | Guardian report
Date: 2013-Nov
A study examined the impact of 'virtual wards' on hospital admissions and other, community based, health and social care services. 'Virtual wards' were designed to use the staffing and systems of a hospital ward to deliver preventive care to patients in their own homes. The study found no evidence of a reduction in emergency hospital admissions, and no evidence of impact on mortality, compared with matched cases from a national sample. There was a reduction in elective hospital admissions and in outpatient attendances in the six months after starting the intervention. The study noted that the three participating sites used different models of 'virtual wards' and raised methodological questions.
Source: Geraint Lewis, Theo Georghiou, Adam Steventon, Rhema Vaithianathan, Xavier Chitnis, John Billings, Ian Blunt, Lorraine Wright, Adam Roberts, and Martin Bardsley, Impact of Virtual Wards on Hospital Use: A research study using propensity matched controls and a cost analysis, National Institute for Health Research
Links: Report
Date: 2013-Nov
A government minister said that agreement had been reached on changes to contracts with family doctors in England. The new contract would: reduce the number of quality indicators; introduce a new 'enhanced service' for patients with complex health needs; assign a named, accountable family doctor to everyone over the age of 75 to co-ordinate care; commit practices to monitoring the quality of out-of-hours services; and introduce new information technology systems that would enable patients to book appointments online and access their records.
Source: , Press release 15 November 2013, Department of Health
Links: DH press release | Summary of changes | NHS Employers press release | Alzheimer's Society press release | BBC report | Guardian report | Telegraph report
Date: 2013-Nov
A think-tank report examined a case study of integrated teams of health and social care professionals, known as community resource teams (CRTs). The report outlined how CRTs worked to co-ordinate care for people living at home and identified key lessons.
Source: Veronika Thiel, Lara Sonola, Nick Goodwin, and Dennis Kodner, Developing Community Resource Teams in Pembrokeshire, Wales: Integration of health and social care in progress, King s Fund
Links: Report
Date: 2013-Oct
The government announced that people in England would be able to see their family doctor seven days a week from 8am to 8pm. A first wave of family doctor groups offering extended opening hours would be piloted in every region, covering up to half a million patients. Innovative practices would be able to apply to a new £50 million Challenge Fund to set up a pioneer programme. The new pioneer family doctor groups would also test a variety of new services, including greater use of Skype, email, and phone consultations.
Source: Press release 1 October 2013, Department of Health
Links: DH press release | Guardian comment | RCN press release | Kings Fund press release | BMA press release | NHS England comment | BBC report | NCB press release
Date: 2013-Oct
An article examined early evidence from the development of clinical commissioning groups in the English National Health Service, against the background of what was known from previous studies of family doctor involvement in commissioning.
Source: Kath Checkland, Ann Coleman, Imeld McDermott, Juli Segar, Rosalind Miller, Christin Petsoulas, Andrew Wallace, Stephen Harrison, and Stephen Peckham, 'Primary care-led commissioning: applying lessons from the past to the early development of clinical commissioning groups in England', British Journal of General Practice, Volume 63 Number 614
Links: Abstract
Date: 2013-Aug
An article said that the family nurse partnership could be targeted more effectively, based on an analysis of a cohort study of risk factors for child maltreatment in England. By targeting risk factors that were more prevalent among abusive families, fewer specialist health visitors would be needed to prevent a higher percentage of child maltreatment.
Source: Kevin Browne and Vicki Jackson, 'Community intervention to prevent child maltreatment in England: evaluating the contribution of the family nurse partnership', Journal of Public Health, Volume 35 Number 3
Links: Abstract
Date: 2013-Aug
Researchers examined whether the quality of family doctor practices affected which practice patients chose. It was found that patients were more likely to choose practices that were nearer to their home, had a higher proportion of family doctors qualified in Europe, had a higher proportion of female family doctors, and had a lower average family doctor age. Given other practice characteristics, patients were more likely to choose practices that earned more quality points under the 'QOF' pay-for-performance scheme.
Source: Rita Santos, Hugh Gravelle, and Carol Propper, Does Quality Affect Patients Choice of Doctor? Evidence from the UK, Research Paper 88, Centre for Health Economics (University of York)
Links: Paper
Notes: Also published as Working Paper 13/306, Centre for Market and Public Organisation (University of Bristol)
Date: 2013-Jul
A think-tank report said that family doctor practices should be put in charge of administering direct payments to patients as part of the personal health budget scheme.
Source: Gail Beer, Jon Paxman, and Charlotte Morris, Personal Health Budgets: A Revolution in Personalisation, 2020health
Links: Report | 2020 press release
Date: 2013-Jul
A report said that many family doctors did not yet have a strong sense of ownership of their local clinical commissioning groups (CCGs). Although there was a great deal of support for what CCGs were trying to achieve, many family doctors felt that decisions being taken by their CCG did not always reflect their views.
Source: Chris Naylor, Natasha Curry, Holly Holder, Shilpa Ross, Louise Marshall, and Ellie Tait, Clinical Commissioning Groups: Supporting Improvement in General Practice?, King s Fund/
Links: Report | Appendix | Kings Fund press release | Nuffield Trust press release
Date: 2013-Jul
A report examined United Kingdom and international models of primary care, focusing on those that could increase capacity and help primary care meet the pressures that it faced. If policy-makers and commissioners wanted to develop the scope and scale of primary care services, they would need to put in place imaginative measures that made the most of the strong history of independence and innovation within general practice. This would include support and incentives, as well as permission for family doctors and other primary care practitioners to test out new approaches to the delivery and organization of care.
Source: Judith Smith, Holly Holder, Nigel Edwards, Jo Maybin, Helen Parker, Rebecca Rosen, and Nicola Walsh, Securing the Future of General Practice: New models of primary care, Nuffield Trust
Links: Report | Summary | Nuffield Trust press release
Date: 2013-Jul
A report said that major investment was needed in general practice in order to keep the National Health Service sustainable, and to ensure that it provided value for money while ensuring safe patient care. There needed to be a major shift in spending into general practice to address the existing imbalance in funding, which saw family doctors providing 90 per cent of NHS care for only 9 per cent of the budget. This included increasing the number of family doctors by at least 10,000, and investment in practice premises to allow more care to be provided in the community.
Source: The 2022 GP: A vision for general practice in the future NHS, Royal College of General Practitioners
Links: Report | RCGP press release
Date: 2013-Jun
An article examined patient experiences of, and satisfaction with, family doctor-led walk-in centres (designed to allow people to see a family doctor without prior appointment in case of urgent need). It was found that the centres increased access to primary care, and that most patients were satisfied with the service.
Source: Mubashir Arain, Jon Nicholl, and Mike Campbell, 'Patients' experience and satisfaction with GP led walk-in centres in the UK; a cross sectional study', BMC Health Services Research, Volume 13
Date: 2013-Apr
A report said that family doctors had untapped potential to engage in a more pro-active approach to improving the health and well-being of the local population. Such a focus was essential if the National Health Service were to meet the challenges of responding to rising rates of chronic illness at all population ages, during a time of financial austerity.
Source: Ruth Thorlby, Reclaiming a Population Health Perspective: Future challenges for primary care, Nuffield Trust
Links: Report | Summary | Nuffield Trust press release | NAPC press release
Date: 2013-Apr
An article said that strong primary care in European countries was associated with better population health; lower rates of unnecessary hospitalizations; and relatively lower socio-economic inequality. Overall health expenditures were higher in countries with stronger primary care structures: but comprehensive primary care was also associated with slower growth in healthcare spending.
Source: Dionne Kringos, Wienke Boerma, Jouke van der Zee, and Peter Groenewegen, 'Europe s strong primary care systems are linked to better population health but also to higher health spending', Health Affairs, Volume 32 Number 4
Links: Abstract
Date: 2013-Apr
A manifesto for primary care in England called for a fundamental shift from acute to primary settings. Every patient should be given the opportunity to create a personal health and well-being plan. Consultants' contracts in certain specialties should be held by the National Health Service Commissioning Board or local clinical commissioning groups, enabling these specialists to take a community-wide responsibility for groups of patients and to become an expert resource for primary care clinicians. There should be a review of the existing financial systems under which general practice was paid per head of population but hospitals were paid for activity.
Source: Breaking Boundaries, NHS Alliance
Links: Manifesto | NHS Alliance press release
Date: 2013-Mar
A study examined commissioning practice in three high-performing primary care trust areas. It said that new clinical commissioning groups would, in a climate of financial austerity, need to make sure that, alongside collaborative discussion and service planning, they left space for transactional work such as contract specification, service review, and decommissioning.
Source: Judith Smith, Sara Shaw, Alison Porter, Rebecca Rosen, Ian Blunt, Alisha Davies, Elizabeth Eastmure, and Nicholas Mays, Commissioning High Quality Care for People with Long-Term Conditions, National Institute for Health Research
Links: Report | Nuffield Trust press release
Date: 2013-Mar
An investigation found that more than one-third of family doctors on the boards of the new clinical commissioning groups (CCGs) in England had a conflict of interest resulting from directorships or shares held in private companies.
Source: British Medical Journal, 13 March 2013
Links: BMA press release | BBC report | Guardian report
Date: 2013-Mar
A survey found that almost two-thirds of people (61 per cent) had had to wait longer than 48 hours to book an appointment with their family doctor, and that more than half (57 per cent) said the process was either 'very difficult' or 'could have been easier'. As many as three-quarters of people (79 per cent) said that they would not feel safe relying on out-of-hours services in a medical emergency.
Source: Primary Care: Access Denied?, Patients Association
Links: Report | Labour Party press release | RCGP press release | Guardian report
Date: 2013-Mar
An article sought to develop a measure of the effectiveness of primary care in terms of population health outcomes. The public health impact (PHI) measure was a potential alternative metric of practice performance, measuring the estimated mortality reduction in the registered population. Rewards under the existing pay-for-performance scheme were not closely aligned to the public health impact of practices.
Source: Mark Ashworth, Peter Schofield, Tim Doran, Richard Cookson, Matthew Sutton, Paul Seed, Amanda Howe, and Robert Fleetcroft, 'The public health impact score: a new measure of public health effectiveness for general practices in England', British Journal of General Practice, Volume 63 Number 609
Links: Abstract
Date: 2013-Mar
A report examined the support needed by clinical commissioning group leaders to promote patient and public engagement. Group leaders understood the need to engage with patients: but questions remained about their ability to translate good intentions into effective plans.
Source: Embedding Patient and Public Engagement, Primary Care Commissioning
Links: Report | Summary | PCC press release
Date: 2013-Jan
An audit report said that the National Health Service in Scotland had improved how it managed prescribing in general practice during a period when it had faced considerable pressures. Spending on drugs had fallen in real terms over the previous seven years despite the volume of prescriptions rising significantly.
Source: Prescribing in General Practice in Scotland, Audit Scotland
Links: Report | Audit Scotland press release | BBC report
Date: 2013-Jan
A review presented evidence on the role of clinical engagement in primary care-led commissioning, and how this had contributed to the delivery of healthcare services.
Source: Rosalind Miller, Stephen Peckham, Kath Checkland, Anna Coleman, Imelda McDermott, Stephen Harrison, and Julia Segar, Clinical Engagement in Primary Care-Led Commissioning: A review of the evidence, Policy Research Unit in Commissioning and the Healthcare System
Links: Report
Date: 2013-Jan
