Cost and quality of GPSI services questioned
The services provided by GPs with a special interest vary substantially and there is still a lack of robust data on their cost-effectiveness, the official evaluation of the Government's Care Closer to Home pilot sites warns.
The report says the data on the quality of dermatology services is limited and that ‘there appears to be significant variation in quality of service provided by GPSI in dermatology'.
It attributes much of the variation to the ‘lack of a robust accreditation framework.' – a shortfall since addressed by the Department of Health with a framework announced earlier in the year.
Questions are set to remain over whether the Care Closer to Home programme is cost-effective, following a sceptical preliminary report by the National Primary Care Research and Development Centre in March.
The new report for the De-partment of Health concludes: ‘The cost-effectiveness of GPSI services is unclear at present. The evaluation was inconclusive in this respect but appeared to bear out the view that closer to home services in general should not be assumed to be cheaper than services delivered within the current framework.'
Lack of cost-effectiveness data is common to several GPSI specialities – with gynaecology, general surgery and ENT singled out as examples.
The report states: ‘There has been no overall audit of the quality of service provided by GPSIs in general surgery or of patient satisfaction levels. Both are good with regard to the demonstration sites, but there will certainly be variation in quality on a national level.'
In the case of ENT, it urged the Department of Health to ensure that ‘GPSIs should have access to the same levels of equipment regardless of where they are working'.Evaluation of 'Closer to Home' Demonstration Sites Evaluation of 'Closer to Home' Demonstration Sites