Group Archives: Quality of care

Quality and safety: Reflecting on the state of general practice

The vast majority of English GP practices provide good or outstanding care, according to inspections of 7,365 practices in a new report by the Care Quality Commission. This is welcome news not just for patients, but also for GPs working hard at the front line. Perhaps most impressive is evidence of continual quality improvement, with …read more

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Trouble getting an appointment at your GP surgery? Findings from an evaluation of a ‘telephone first’ approach to demand management in general practice

Martin Roland and Jenny Newbould, Cambridge Centre for Health Services Research It’s certainly an increasingly common problem.  You spend ages trying to get through to your GP surgery, only to be told there is not an appointment for a week or two; maybe even six weeks if you want to see Dr Popular.  So, why …read more

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New developments in diabetes technology: challenges and opportunities

New medical technologies are often developed and introduced at a much slower rate than patients and clinicians could wish. There are many reasons for this, including unanticipated complications arising during trials and the overarching need to ensure patient safety. In some cases, moreover, concepts emerge well before the technology exists to make their realisation a …read more

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Choose and Book should be scrapped and outpatients could be reduced by 50%

There’s nothing like a good bold assertion to start a debate. Martin Roland, our CCHSR co-director, and  Sam Everington, general all-star GP, have made some rather dramatic suggestions and claims in the HSJ this week. They think that the present referral system is an archaic hangover from 1948 which services the needs of neither GPs, …read more

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GP triage and the case of NHS 111

A small study can sometimes have a greater than expected impact. Here’s a case in point – over the weekend, unexpected press coverage came our way over the fact that (in the words of the Daily Mail) there is an “NHS 111 farce” as “75% of patients referred to A&E do not actually need to …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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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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So has QOF reduced death rates or not?

The question of whether improving healthcare leads to improvements in health remains an important one. Martin Roland outlines why a recent BMJ analysis on the relationship between QOF and mortality may not take the right approach to answering this.

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What can we do to promote person-centred primary care? Response to BMJ spotlight

 Patient centred care invites doctors and patients to work collaboratively to improve the way healthcare is designed and delivered so that it better meets the needs and priorities of patients. Charlotte Paddison reflects on the BMJ spotlight on patient centred care, and asks what this might mean for primary care? How can we get better …read more

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So does QOF really reduce emergency hospital admissions?

What should you make of our latest paper suggesting that QOF reduced emergency admissions? There have now been over 20 systematic reviews of pay for performance (P4P) and even a systematic review of systematic reviews. A reasonable summary would be that P4P seems to improve the processes of care somewhat (and with the potential for …read more

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  • The Cambridge Centre for Health Services Research (CCHSR) is a thriving collaboration between the University of Cambridge and RAND Europe. We aim to inform health policy and practice by conducting research and evaluation studies of organisation and delivery of healthcare, including safety, effectiveness, efficiency and patient experience.