Primary care trusts need to tackle disparities in general practice
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《英国医生杂志》
Resources and services offered to patients in primary care vary widely, with the best resourced practices able to afford twice as much for each registered patient as the least well resourced practices, finds a report by the public spending watchdog, the Audit Commission. Primary care trusts need to tackle this disparity, says the report.
The report aims to help managers of primary care trusts to maximise the benefits of the new contract for general practitioners, which comes into effect next month, and the additional planned investment by the government of ￡1.9bn ($3.5bn; �2.8bn) in the health service by 2006.
The study, one of two published this week by the Audit Commission on primary care trusts, looked at over 200 practices in nine primary care trusts in England last year. It found that the cost per consultation—measured by the number of consultations for each whole time equivalent GP—varied between practices by a factor of at least two.
"The most striking feature is the wide variation on both indicators within some of the PCTs ," says the report. "In most study sites, the best resourced practices had over twice as much income per registered patients as the least well resourced sites," it said.
The study also found that the average length of a consultation was consistently longer than the allocated 10 minutes for booked appointments. Consultations averaged 13.3 minutes for GPs and 19.6 minutes for practice nurses, but with wide variation among practices in the same trust. The report recommends that trusts use incentives to improve scheduling of appointments.
The report also recommends that trusts improve their understanding of the resources available to general practice and that they combine this with information about the health needs of their population and the views of patients to develop strategies to establish equity.
The second study published this week by the Audit Commission also exemplifies the importance that primary care trusts will play in developing primary care. It looks at their role in forming new care pathways, as alternatives to secondary care and to relieve pressure on hospitals. Practitioners with a special interest will be helpful in this regard, ensuring that patients are treated by the "most appropriate healthcare professional in the most appropriate location," says the report.
James Strachan, chairman of the Audit Commission, said: "There must be concern about the variation in the range and quality of services available to communities with similar health needs. This has a direct bearing on equity and the choices available to patients. With an extra ￡1.9bn flowing into primary care to fund the new GP contract it is essential that issues of equity and efficiency are addressed."(London Debashis Singh)
The report aims to help managers of primary care trusts to maximise the benefits of the new contract for general practitioners, which comes into effect next month, and the additional planned investment by the government of ￡1.9bn ($3.5bn; �2.8bn) in the health service by 2006.
The study, one of two published this week by the Audit Commission on primary care trusts, looked at over 200 practices in nine primary care trusts in England last year. It found that the cost per consultation—measured by the number of consultations for each whole time equivalent GP—varied between practices by a factor of at least two.
"The most striking feature is the wide variation on both indicators within some of the PCTs ," says the report. "In most study sites, the best resourced practices had over twice as much income per registered patients as the least well resourced sites," it said.
The study also found that the average length of a consultation was consistently longer than the allocated 10 minutes for booked appointments. Consultations averaged 13.3 minutes for GPs and 19.6 minutes for practice nurses, but with wide variation among practices in the same trust. The report recommends that trusts use incentives to improve scheduling of appointments.
The report also recommends that trusts improve their understanding of the resources available to general practice and that they combine this with information about the health needs of their population and the views of patients to develop strategies to establish equity.
The second study published this week by the Audit Commission also exemplifies the importance that primary care trusts will play in developing primary care. It looks at their role in forming new care pathways, as alternatives to secondary care and to relieve pressure on hospitals. Practitioners with a special interest will be helpful in this regard, ensuring that patients are treated by the "most appropriate healthcare professional in the most appropriate location," says the report.
James Strachan, chairman of the Audit Commission, said: "There must be concern about the variation in the range and quality of services available to communities with similar health needs. This has a direct bearing on equity and the choices available to patients. With an extra ￡1.9bn flowing into primary care to fund the new GP contract it is essential that issues of equity and efficiency are addressed."(London Debashis Singh)