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GPs with special interest praised for cost efficiency

By Cato Pedder

The Government's drive to create more GPs with special interests has been praised

by the NHS modernisation agency for generating major savings.

In its annual review the agency ­ launched in 2001 to help improve quality of care and outcomes for patients ­ highlighted the fact that GPwSI clinics in ENT cost about £30-40 per consultation,

compared with £60-80 for each ENT outpatient consultation.

This was one of the findings of a Government-commissioned and funded report by the University of York on GPwSI in ENT that also found attendance rates at GPwSI clinics were very high ­ 98-99 per cent.

Around 85 per cent of

patients did not need referring to secondary care.

However, the report, compiled by the university's York Health Economics Consortium, warns additional costs, such as those from CT and MRI scans 'should not be overlooked'.

And a recent review on GPwSIs, published in this month's British Journal of General Practice, warns 'it is not clear that GPwSIs are cost-effective' as cost comparisons with hospitals are 'fraught with difficulties'.

Cost savings were not a specified aim of the Government's ongoing GPwSI initiative, which has already resulted in 1,345 GPwSIs nationwide.

The initiative, part of a wider programme to increase primary care services, was instead targeted at cutting hospital waiting times and improving patient access.

The York report into GP-wSI pilot projects in the modernisation agency's Action On ENT programme found that 30-40 per cent of ENT patients referred to secondary care could be seen by a GP-wSI and that GPwSIs discharge around 80 per cent of

patients back to the care of their GP.

The Action on ENT programme aims to streamline and improve access to ENT services.

Report author Diana Sanderson, senior research fellow at York Health Economics Consortium, said: 'The experiences of the pilot sites show that GPwSIs can help local health economies to meet some of the key NHS objectives, such as improving patient access.'

But she warned GPwSIs can take 'considerable time and resources to establish'.

British Journal of General Practice review author Dr Brenda Leese, reader in primary care research at the University of Leeds, said: 'If you compare what is provided by a GP with what is provided by a hospital it is not necessarily cheaper.

'But that might depend on the area of the country and the specific disease.'

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