Gridley, Kate orcid.org/0000-0003-1488-4516, Spiers, Gemma Frances orcid.org/0000-0003-2121-4529, Aspinal, Fiona Jane orcid.org/0000-0003-3170-7570 et al. (3 more authors) (2012) Can general practitioner commissioning deliver equity and excellence?:Evidence from two studies of service improvement in the English NHS. Journal of Health Services Research & Policy. pp. 87-93. ISSN 1758-1060
Abstract
Objectives: To explore some of the key assumptions underpinning the continued development of general practitioner-led commissioning in health services. Methods: Qualitative data from two studies of service improvement in the English NHS were considered against England's plans for GP-led commissioning. These data were collected through in-depth interviews with a total of 187 professionals and 99 people affected by services in 10 different primary care trust areas across England between 2008 and 2009. Results: Internationally, GPs are seen to have a central position in health systems. In keeping with this, the English policy places emphasis on the 'pivotal role' of general practitioners, considered to be ideally placed to commission in the best interests of their patients. However, our evidence suggests that general practitioners do not always have a pivotal role for all patients. Moreover, it is planned that the new commissioning groups in England will not be subject to top-down performance management and this raises the question of how agreed quality standards will be met under the proposed new system. Conclusions: This paper questions the assumption that GPs are best placed to commission health services in a way that meets quality standards and leads to equitable outcomes. There is little evidence to suggest that GPs will succeed where others have failed and a risk that, without top-down performance management, service improvement will be patchy, leading to greater, not reduced, inequity.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Keywords: | NHS,health services,commissioning,general practitioners,GPs,England |
Dates: |
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Institution: | The University of York |
Academic Units: | The University of York > Research Groups (York) > Social Policy Research Unit (York) The University of York > Faculty of Sciences (York) > Health Sciences (York) |
Funding Information: | Funder Grant number NCCSDO 08/1704/151 NCCSDO 08/1610/124 |
Depositing User: | Pure (York) |
Date Deposited: | 07 Jun 2012 17:01 |
Last Modified: | 19 Nov 2024 00:26 |
Published Version: | https://doi.org/10.1258/jhsrp.2011.010176 |
Status: | Published |
Refereed: | Yes |
Identification Number: | 10.1258/jhsrp.2011.010176 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:64410 |
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Description: Can General Practitioner Commissioning Deliver Equity