Impact of key GP characteristics on unscheduled secondary care use and patient outcomes Frontier Economics

This Frontier Economics project examined whether GPs who are involved in training, commissioning and other initiatives achieve better outcomes for patients with long-term conditions, and contribute to reduced secondary care costs. It focused on five aspects of GP ‘activeness’:

• participation in GP with Special Interest (GPSI) programmes
• participation in other training
• prescription of new drugs
• adoption of new technologies
• involvement in the management of clinical commissioning groups (CCGs).

The project team collated and analysed data from a range of sources, including secondary care usage data and GP practice prescription data, as well as their own survey of 500 practices.

An in-depth econometric analysis was undertaken, looking at the links between GP activeness and quality of care.

The analysis showed that there are aspects of patient outcomes that, in some conditions, are improved by the engagement of GPs with up-to-date practices, for example in new technology, clinical expertise or prescribing. There are other GP activities – particularly participation in commissioning – which do not appear to consistently improve patient outcomes.

The results revealed that the biggest barrier to improved activeness is GPs’ inability to think strategically about long-term quality improvement due to their clinical workload. Local context also had an impact. For example, GPs working in deprived areas face a considerably higher workload, which could explain why these practices are less likely to engage in some activeness behaviours.

It is possible that the introduction of Primary Care Networks will help address current pressures. However, GPs said that creating these networks requires time, and managing the expanded workforce could reduce the amount of time available for patient-facing activity or for strategic thinking.

Contact details

For more information, contact Nick Fitzpatrick, Frontier Economics.