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GPs go forth

GPs to have individual outcomes data published, claims NHS statistics chief

GPs will have their individual clinical outcomes data published so that patients can assess whether they are effective and safe, says the head of the NHS statistics body.

Setting out his priorities for the future, Health and Social Care Information Centre chair Kingsley Manning said that they were working on providing clearer data around individual GP performance to NHS England and the CQC.

He also said that the ‘direction of travel’ was also to publish this information – in a similar way to the recent publication of outcomes data for surgeons – to enable patients to assess their own GP.

Responding to a question at the E-Health Insider conference in Birmingham today on whether the UK would emulate the Swedish approach to publishing, and sharing health outcomes data with the public, Mr Manning noted that the system a similar system had already been implemented for surgeons, saying:

He said: ‘Bruce Keogh has already started publishing outcomes data by identifiable physicians, they will do next year, and surgeons.

‘As we collect the data - the NHS England rank - we will begin to be able to provide much more clear data around, for example, individual GP performance.

‘So the answer to your question is, yes, but this will be a process in partnership, very strongly in partnership with CQC. We’re already in dialogue with chief inspectors there, and with NHS England about how best to deal with it.’

‘But ultimately, we have to have transparency, people need to know whether or not the service being provided by an individual physician, clinician, is safe and effective.’

‘So that is the direction of travel, I don’t have any doubt about that.’

Mr Manning also cited four key themes to be addressed by HSCIC by 2015, which is the centre responsible for administering the controversial extractions from GP records, including promoting patient trust in the holding of information.

He said:  ‘We are in a privileged position where patients and social care users are prepared to share their information with us.

‘Overwhelmingly, and uniquely in this country, there is a contract, a compact, between the system and its patients, which is complex but is broadly on the assumption that we will use you information in a way that is going to benefit you, and your care, and the wider community as well.’

‘Sustaining the public’s trust and understanding as we wish to collect more information, as we wish to make more use of it, as we wish to use it more dynamically, is absolutely key.’

‘So a number of things we will be doing are: a, to demonstrate the security of the data, b, the effective use of it, and to demonstrate how the confidence that the patient or social care use has in us, has in the system, is repaid to them and to the wider system.’

Readers' comments (15)

  • How the hell are they going to do this for G E N E R A L practitioners.

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  • Given that a patient may see 5 or 6 doctors in a practice for the same condition, I'm intrigued to see how they are able to attribute this to an individual clinician. Sounds like more useless statistical nonsense that doesn't actually tell you anything.

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  • So what constitutes a good GP?

    One with highest referral rate - after all his Pts would be happy they are getting what they want.
    Or one with highest drug spend - again his patients will be happy there is no fight over non generic, over prescribing etc.
    Or GP with highest satisfaction rate? Easiest way to bump this up is again do as requested, nevermind the clinical appropriateness.
    Or GP with best cancer pick up rate? If I send everyone to every investigation and 2ww this will easily improve.
    Or GP with lowest admission rate? If I don't do oncall and see only routine pre-bookable app, this will easily drop.

    I remember as a registrar patients used to tell me how nice I was compared to the partners - it is easy to be "nice" when I have double the appointment time, no QoF responsibilities, no management responsibility, no extra patients, no pressure on drug budget etc etc. Would I have been rated higher on measurable outcome when I was an inexperienced clinician then now? Of course I would have been!

    Someone tell these academics real life is a little more complicated then what's written on their paper.

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  • If the GP is singlehanded this could be done but in a multi GP practice you could never be sure which outcome depended on which doctor.

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  • I've read Kingley's comments three times now and cannot understand the utter gibberish he is spouting.

    I suspect he will be left fiddling with his computer analysing the rapid evacuation of primary care by us disaffected souls who can get out before the lunatics pish and fart all over us.

    Day by day this just gets more ridiculous as the naked emperors fiddle while the NHS goes up in the smoke of the vapour trails of those jetting off from its madness. .

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  • Who are these morons? Why is it that so many "senior" NHS people have such a remedial knowledge of GP land. The primary determinant of " outcomes" is social demographics. My patients are unhealthier than those affluent, educated ones in non-deprived areas. This has **** *** to do with is about society and inequality and many other factors.

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  • Azeem Majeed

    In practice, this would be very difficult to achieve without a major overhaul of NHS IT systems and a substantial improvement in the quality of the data they hold. Current NHS IT systems can generate data at general practice level but not very much data at individual GP level. They also largely generate administrative data such as that produced from Hospital Episode Statistics. There are also numerous errors in the data, e.g., incorrect practice and GP codes for patients.

    Furthermore, the Health and Social Care Information Centre has struggled to put GPES into practice, the system that was supposed to generate more meaningful clinical data from GP systems. Past experience suggests the NHS would be better off trying to make more effective use of the data we currently collect and using IT to improve the quality and safety of health care, as well as using IT to reduce the administrative burden on general practices.

    Prof. Azeem Majeed, Imperial College London
    Twitter @Azeem_Majeed

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  • I still get hospital mail addressed to a partner who's been in Australia for ten years. Hard to have faith in the data......

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  • Stories like this make me increasingly sure that the Govt doesn't understand GP, doesn't understand GP IT, and has no idea of what is involved in terms of running the service.

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  • Peter Swinyard

    Prof. Azeem Majeed, Imperial College London puts it very eloquently. Mr Manning is a very pleasant man (I have shared a sandwich-filled room with him at DoH) but clearly has no idea at all about what actually happens in a general practice.
    I would put it more simply, at the risk of being "moderated".
    It's b*l****s, pure b*l****s.
    Can't they deal with glaring stupidities that now exist in the system rather than trying to micromanage us. Why not start with the £837 million public relations budget at the DoH???

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