Feasibility of developing and selecting criteria for the assessment of clinical performance

This study was undertaken to assess the feasibility of one method of initiating the setting of standards in United Kingdom general practice by the development and selection of criteria for clinical care. Three clinical topics were chosen. An 'academic phase' was used to develop precise criteria, which formed the basis of a draft questionnaire for each of the three topics. A 'consultation phase' followed in which the three questionnaires were sent to a randomly selected sample of general practitioners throughout the UK. Although 53% of the 62 general practitioners invited were willing to be involved in the academic phase only 13% were able to attend a meeting. Of the 262 general practitioners sent one of the questionnaires 63% responded. Using a strict definition of consensus one quarter of the criteria were identified by the respondents to the questionnaire as important or not important; using a less strict definition a further one quarter to one half of the criteria were identified. The study demonstrates that it is possible to develop and select criteria in this way. If this approach were to be developed for performance review, criteria would need to be selected, appropriate target levels of performance set, and suitable methods for their application identified.