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Fundholding: the next five years

B Yule1, A Healey, J Grimshaw

  • 1Health Economics Research Unit, University of Aberdeen, Medical School, Foresterhill.

Journal of Public Health Medicine
|March 1, 1994
PubMed
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Third-wave fundholders received budgets in 1993, serving over 50% of the population in some areas. This paper reviews limited evidence on fundholding effects, identifying key concerns and suggesting improvements for priority setting, financial risk, and resource allocation.

Area of Science:

  • Health Services Research
  • Healthcare Management
  • Primary Care Policy

Background:

  • The introduction of fundholding practices in the UK aimed to devolve budget control to primary care practices.
  • By April 1993, third-wave fundholders (and second-wave in Scotland) received their budgets, significantly increasing population coverage.
  • Fundholding initiatives represent a major shift in primary care resource allocation and management.

Purpose of the Study:

  • To examine the emerging evidence on the effects of general practice fundholding.
  • To identify key areas of concern within the fundholding scheme.
  • To propose potential improvements for the fundholding system.

Main Methods:

  • Review of limited available evidence on fundholding effects.

Related Experiment Videos

  • Analysis of four specific areas of concern: priority setting, financial risk management, budget setting, and resource allocation.
  • Discussion of potential scheme enhancements.

    • Main Results:

    • Limited evidence exists regarding the impact of fundholding on healthcare delivery and outcomes.
    • Four critical areas require attention: priority setting, financial risk management, budget setting, and resource allocation between fundholding and non-fundholding practices.
    • The current evidence base is insufficient to fully assess the scheme's effectiveness.

    Conclusions:

    • Fundholding schemes necessitate careful consideration of priority setting and financial risk management.
    • Equitable resource allocation between fundholding and non-fundholding practices is a significant challenge.
    • Further research and evidence are crucial to refine and improve the fundholding model.