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Showing posts from October, 2010

Implications of White Paper for General Practitioners

In the period since the establishment of the new coalition government, we have seen radical changes proposed for the NHS in England. These are laid out in the new White Paper, Equity and Excellence: Liberating the NHS. These changes will have major implications for GPs and will lead to a period of major organisational change in the NHS in England. This is turn may lead to some general practices having less time to support non-core activities such as teaching and research.

GP contracts
The Government plans to abolish the current General Medical Services (GMS) and Personal Medical Services (PMS) contracts and bring in a new single contract for all general practitioners (GPs) in England. This new contract will include responsibility for commissioning health services. The White Paper also discusses linking GPs’ pay more closely to health outcomes (but it is currently unclear how this will be achieved in practice). The White Paper states that the Government ‘seeks over time to establish a s…

Trends in admission rates and in-hospital mortality for hip fractures in England

The incidence of hip fractures is an index of the overall burden of osteoporosis in a society. Hip fractures are a major cause of morbidity, mortality and hospital admissions amongst older people. A study published recently in the Journal of Public Health Medicine by Tai-Yin Wu and colleagues examined trends in hip fracture admissions and mortality in England. They found that between 1998 and 2009, there was little change in age-standardized hip fracture rates (102.0 to 101.8 fractures per 100,000 person-years), but age-standardized in-hospital mortality decreased by 17%, from 127 to 106 deaths per 1,000 hip fracture admissions. Most hip fractures and deaths occurred in women and older people. A socioeconomic gradient was present for mortality, with a 26% difference in mortality in 2008 (94 to 118 deaths per 1,000) between the most affluent and most deprived areas in England. As the number of older people in the population rises, hips fractures will continue to be an important public …

Impact of Pay-for-Performance on Disparities in Diabetes Management in UK Primary Care

Health systems like the UK's NHS aim to provide high-quality care for all groups of patients. Consequently, it is important to examine the impact of new initiatives in the delivery of health care on health disparities. A recent study by Fiona Hamilton and colleagues published in the Journal of Ambulatory Care Management examined the impact of a major pay-for-performance initiative introduced into UK primary care in 2004 on disparities in diabetes management. The study used data from the UK General Practice Research Database, which is widely used for epidemiological and health services research. The authors found that existing disparities in risk factor management (HbA1c, blood pressure, cholesterol) narrowed between men and women. Younger patients (under 45 years of age) with diabetes appear to have benefited less from Pay for Performance incentives than older patients, resulting in some widening of existing age group disparities. Patients living in affluent and deprived areas app…

2011 SAPC London Regional Meeting

The SAPC’s annual meeting of academic departments of general practice and primary care from London and the South East is a longstanding fixture in the academic calendar. The 2011 Meeting will be held from February 4-6 at Madingley Hall, Cambridge. The meeting is organised by the departments of primary care in the five main London medical schools. The 2011 meeting is being organised by the Department of Primary Care & Public Health at Imperial College London. For the 2011, our guest speakers include Dr Fiona Godlee (Editor of the BMJ), Professor Jan De Maeseneer (Professor of Family Medicine at the University of Ghent in Belgium); and Dr Roger Kneebone from the Department of Surgery & Cancer at Imperial College London. The meeting offers a good opportunity to present any research, development or teaching work that you have carried out in primary care. See the 2011 Meeting Website for further details.