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Deja vu at the King's Fund

There was something a bit Groundhog Day about the press briefing held ahead of today’s launch of the King’s Fund inquiry into quality in general practice.

By Steve Nowottny

There was something a bit Groundhog Day about the press briefing held ahead of today's launch of the King's Fund inquiry into quality in general practice.

A wide-ranging, root-and-branch review of every aspect of medical care? Project teams to focus on specific areas such as long-term conditions, health inequalities and end-of-life care? A national consultation process including not only key stakeholders but GPs, patients and the public to try to ensure a genuinely inclusive report?

Haven't we been here before?

It's true, certainly, that the King's Fund inquiry has certain similarities to Lord Darzi's NHS Next Stage Review which concluded, let's not forget, only last year. Why, even the line-up is familiar - RCGP chair Professor Steve Field and NHS Alliance chairman Dr Michael Dixon, both key figures on the King's Fund inquiry's expert panel, also served as advisers to Lord Darzi's review.

But there are at least four key differences too.

  • Firstly and most obviously, it's all about primary care. The Darzi review, true, encompassed primary care as part of its overall remit, and in fact had a dedicated Primary and Community Care Strategy attached. But the feeling of many – including Professor Field and Dr Dixon – was that primary care came off second best under Lord Darzi. This inquiry aims to redress that.
  • Secondly, it's independent. Ministers will be paying close attention, of course, but it's the King's Fund's show. ‘The independence is really important,' Professor Field said, arguing that with if the Government were to draw together a report on quality instead GPs would be automatically ‘sceptical.'
  • Thirdly, it will have one clear, practical outcome – to develop a ‘quality dashboard' of indicators that can be used to assess GPs. GPs may have cause to be nervous about how exactly it will be ‘used by professionals, managers, commissioners and regulators to improve the quality of patient care' – but the argument is that if tools like balanced scorecards are to be used to assess GPs anyway, better to make sure they're based on sound evidence.
  • Finally – and most importantly – the sheer scale and length of the inquiry is significant. With 10 major research projects and five discussion papers, a protracted consultation phase and eighteen months until the final report, no stone will be left unturned, and we can expect the scope to be both broad and deep.

Right now, coming just a year after the Darzi review and amid a blizzard of new ways to assess GPs – revalidation, scorecards, NHS Choices and so on – the timing may seem a little odd.

Come September 2010, when the report is published just after the next general election and just before the Care Quality Commission takes over the regulation of GPs, it may seem just about perfect.

NHS Alliance chair Dr Michael Dixon will serve on the inquiry's expert panel NHS Alliance chair Dr Michael Dixon Recent posts

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