Reaction: King’s Fund inquiry into general practice

By Lilian Anekwe

Read reaction from the RCGP, BMA and other bodies following the publication of the two-year King's Fund inquiry into general practice

RCGP chair Dr Clare Gerada

'The report recognises that a lot of excellent work is already taking place and is confirmation that general practice remains strong as the cornerstone of the NHS while providing us with an opportunity to raise our game even higher.

'We must minimise unintended variation in quality, and make sure that patients get the best healthcare and services irrespective of where they live, or which clinician in a practice they might see.

'GPs need to constantly hone their skills, and to use appropriate diagnostic aids. What we must do is understand the complex issues that cause wide variation in prescribing, referral patterns – both high and low – and diagnosis, and address any learning needs for doctors. We know that patients benefit from continuity in their care, and this continuity should extend to inter- and intra-practice care provision.

'We must always strive to improve and deliver high quality care for patients, so we welcome this report and its findings.'

GPC chair Dr Laurence Buckman

'We are pleased the King's Fund report recognises the importance of generalism and that most practices provide good quality care. Recent research has shown that patient satisfaction with general practice has been increasing.

'Quality is at the centre of what general practice offers and, no matter how good the service and care, all practices can improve. We agree that GPs should be able to demonstrate the quality they offer to the public, however, as the report acknowledges, not all aspects of general practice work lend themselves to being measured easily.

'A culture of self-scrutiny has existed for many years but now more than ever, given the increased intensity and complexity of general practice work nowadays, GPs need time off the treadmill so they can look critically at what they do and make improvements. A reduction in bureaucracy would help them to do this, as would stopping the constant reorganisations within the NHS. Where GPs fall short, they need to be helped to see where they can make their service better and given the time, resources and staff support to do this.'

Nigel Edwards, chief executive NHS Confederation

'Much of the care delivered by GPs is excellent, and primary care generally remains one of the great strengths of our healthcare system. However until now, we have had little information about the variability of GP performance. This report highlights the need to address the major variations in the standards of care patients are receiving.

'The health service has shone a light on the performance most other parts of the system but has not done so with general practice.

'The introduction of a national process to compare general practice standards would be a major step in addressing this issue. Not only would it empower patients to compare the standard of care they are getting, but it would help drive down variation in diagnosis, referrals and prescriptions, all of which are central to saving lives.

'There is uncertainty with the NHS reforms about how GP performance will be managed. One of the big tests for the NHS reforms is whether the best GPs will be willing and able to get to grips with those who are performing less well and whether they will have the tools to do so. The Government needs to clearly demonstrate how its reform programme will achieve this improvement.'

Health Minister Lord Howe

'I welcome the Kings Fund report which reinforces the need for modernising the NHS. We have a very strong system of general practice in this country, but we agree that there is too much variation in quality. One of the key aims behind the Health and Social Care Bill is for groups of GPs to work together to reduce variation and improve quality of care.

'Ensuring that GPs and GP practices are held to account for the quality of care they provide and the outcomes they achieve for patients is vital. That's why there will be a strong emphasis on practices being much more open and transparent about the results they achieve, ultimately enabling patients to make more informed choices about their healthcare.'