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At the heart of general practice since 1960

Either ­ not both ­ for ticks

Pulse has asked

a selection of prominent GPs to write open letters to ministers to contribute to the Government's heavily trailed 'listening exercise' on future primary care policy. This week, Professor Martin Roland

has his say

Dear health ministers

So primary care is to be reviewed again, and we expect a White Paper in the autumn. But what do patients actually want from primary care? We at the National Primary Care Research and Development Centre have recently reviewed what is known about this and published a briefing paper on the issue.

We found that more than anything else patients value a high standard of inter-personal care ­ being able to talk to a doctor or nurse who they believe is committed to them as a person.

We found little published evidence to illuminate two important recent aspects of Government policy ­ choice and locating services close to patients. Patients definitely want choice about some aspects of care ­ for example, appointment time and, sometimes, which doctor or nurse they see. But we found little information that was relevant to the UK on other aspects of the current choice agenda ­ choice of services close to home, or choice of hospital.

Quality of care has been regarded by many as the Achilles heel of general practice. In fact, our research shows that the quality of clinical care in general practice has improved greatly in recent years, especially for conditions like heart disease, asthma and diabetes. This improvement is built on the foundations of audit in the early 1990s, and, more recently, clinical governance. Major improvements certainly pre-dated the new contract.

Now it is time to turn the focus onto some of the softer aspects of GP care. These are harder to measure and to incorporate into performance indicators.

The key challenge facing the Government is to see that these crucial aspects of primary care are not lost among attempts to improve more readily measured aspects of care.

Professor Martin Roland

Director of the National Primary Care Research and Development Centre and a GP in Manchester

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