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Measuring progress towards a primary care-led NHS.

P Miller1, N Craig, A Scott

  • 1Trent Institute for Health Services Research, Medical School, University of Nottingham.

The British Journal of General Practice : the Journal of the Royal College of General Practitioners
|January 6, 2000
PubMed
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The shift towards a primary care-led National Health Service (NHS) shows minimal resource reallocation from secondary to primary care. General practitioners' (GPs) ambivalent attitudes suggest this policy objective may not be fully realized.

Area of Science:

  • Health Services Research
  • Health Policy Analysis
  • Healthcare Management

Background:

  • The National Health Service (NHS) is undergoing a policy shift towards a 'primary care-led' model.
  • This involves increasing the role of primary care practitioners in commissioning services and shifting care from hospitals to primary and community settings.
  • This emphasis is reflected in recent health policy documents in both Scotland and England.

Purpose of the Study:

  • To evaluate the evidence supporting the transition to a primary care-led NHS.
  • To quantify the scale of changes in resource allocation towards primary care.
  • To identify barriers hindering the development of a primary care-led NHS.

Main Methods:

  • Analysis of NHS programme budgets from 1991/2 to 1995/6 for 15 Scottish health boards.

Related Experiment Videos

  • Categorization of total NHS revenue expenditure into primary care, secondary care, community services, and a residual.
  • Utilizing expenditure data provided by the Scottish Office.

    • Main Results:

    • Methodological challenges exist due to ambiguous definitions and poor data quality.
    • Aggregate data indicate a modest increase in relative investment in primary care.
    • This investment appears to stem from growth funding rather than a direct shift from secondary care, with limited impact from GP-led commissioning.

    Conclusions:

    • Progress towards a primary care-led NHS is likely to be inconsistent.
    • The limited resource shift and ambivalent attitudes among General Practitioners (GPs) suggest the policy objective may not be achieved.
    • Further research is needed to understand and overcome barriers to this healthcare transformation.