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General practitioner obstetrics in Bradford.

F C Bryce1, J K Clayton, R J Rand

  • 1St Luke's Hospital, Bradford, West Yorshire.

BMJ (Clinical Research Ed.)
|March 17, 1990
PubMed
Summary
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General practitioners (GPs) in Bradford had high transfer rates and poor outcomes for obstetric care in 1988. Tighter controls are needed for GPs in integrated obstetrics systems.

Area of Science:

  • Obstetrics and Gynecology
  • General Practice
  • Healthcare Quality

Background:

  • Assessing the quality of obstetric care provided by general practitioners (GPs) is crucial for patient safety.
  • Integrated obstetric care systems require clear standards for GP involvement.

Purpose of the Study:

  • To evaluate the standard of obstetrics care delivered by general practitioners in Bradford.
  • To identify areas for improvement in GP-led obstetric care and transfer protocols.

Main Methods:

  • Retrospective review of case records for women booked under GPs for delivery in Bradford in 1988.
  • Analysis of transfer rates from GP to consultant care, reasons for transfer, and perinatal outcomes.

Main Results:

Related Experiment Videos

  • Of 1289 women booked under GPs, 637 (49.4%) required transfer to consultant care.
  • 263 women transferred were deemed unsuitable for GP booking; 259 transfers occurred during labor, with only 37 GP visits.
  • High perinatal mortality (10.1/1000) and stillbirth rates (7.8/1000) for GP-booked patients.

    • Conclusions:

    • The standard of obstetrics care by Bradford GPs in 1988 was suboptimal, with high transfer rates and concerning mortality figures.
    • Predictable and preventable issues contributed to transfers, indicating a need for improved GP selection and oversight.
    • Stricter controls on GP qualifications and experience are recommended for integrated obstetric care systems.