Spotlight: A realistic vision for primary care?

Jenni's (now rather battered) preview copy of the Commission report...

CCHSR Director Prof Martin Roland has been a little busy of late, as Chair of the Primary Care Workforce Commission. Their report has just been launched…so what does it say for the future of primary care?

CCHSR is recruiting health economists

We are seeking a Research Assistant/Associate in Health Economics to join the growing team of health economists at the Cambridge Centre for Health Services Research.  You’ll be working on a number of economic evaluations and other studies with an economic or econometric component. In addition, there will be opportunities to contribute to the broader health …read more

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“We torture them before they die”

This telling phrase comes from a paper by Liz Dzeng and colleagues (1) which describes the distress felt by young American doctors who feel obliged to deliver futile treatments to patients at the end of life. In part this comes from an excessive move away from paternalism (‘let the doctor decide’) to prioritise patient autonomy …read more

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Hospitals and avoidable mortality rates…the saga continues

Regular readers of this blog will now I’ve had a bit of a bee in my bonnet about government plans to rank hospitals on avoidable mortality based on retrospective case record review. I won’t go into the arguments in detail again (if you want you can read them in the original blog here, or the …read more

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NHS Health Checks: value for money?


Reports in the Guardian and Telegraph this week report on a study published in the Journal of Public Health suggesting that the NHS health checks are costing £450,000 per life saved and therefore represent very poor value for money. Unfortunately these press reports are woefully misleading, although the study itself does little to discourage such …read more

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High users don’t always stay high users (again)

OK, so maybe this is labouring the point as we’ve gone on about this out before – e.g. see our previous papers on the subject (here and here). Nevertheless, it’s nice to find that someone else agrees. This time it’s a study from the US. They call their frequent flyers ‘super-utilizers’ but it’s the same …read more

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Are NICE not being nice to GPs about antibiotics?

The new Antimicrobial Stewardship guidance was published this month by NICE, looking at organisational and system-wide approaches to optimising antimicrobial use. And the main message coming out of various news agencies today is that GPs will be “struck off” for not prescribing antibiotics appropriately. There is, of course, huge concern around the rising amount of …read more

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Timely diagnosis of cancer matters for patient experience

In our recent paper we studied how pre-diagnosis experience affects subsequent care experience in cancer patients (1). Our findings suggest that patients who experienced more pre-referral consultations in primary care are more likely to be less satisfied with their care. As perhaps could have been expected, the associations found were stronger for questions involving primary care …read more

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Why don’t care coordination interventions work?

Trials of care coordination are often disappointing. Well, they quite often show improved quality of care and improved patient experience but they rarely seem to save money. Which is a pity because that’s often why they’re set up. Or at least the mantra is “Fragmented care is wasteful, so if we get it better coordinated, …read more

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Wrong kind of care plans?

Doctors are pretty sceptical about care plans. No less so since the government started providing incentives for patients with long term conditions to have care plans. Yet a published Cochrane Review suggests that care plans can improve physical and mental health and improve people’s confidence in managing their own conditions [1]. So what’s the reason …read more

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  • The Cambridge Centre for Health Services Research (CCHSR) is a collaboration between the University of Cambridge and RAND Europe. We aim to inform health policy and practice by developing methods for measuring quality of care, and evaluating ways of improving the safety, effectiveness, efficiency and experience of care.