GPs 'as good as specialists', researchers claim

04 Dec 09

The systematic review of 22 studies found a lack of evidence that specialist care resulted in better outcomes for patients with diabetes, arthritis and cystic fibrosis, when compared with generalist care.

The Dutch study provides a much-needed boost for generalist skills after several high level attacks on the care that GPs provide.

Last month, Pulse revealed NHS managers' plan to devolve responsibility for children’s care to specialist practitioners, and there is an ongoing controversy about NICE guidelines that increase the involvement of specialists in minor surgery.

The authors of the study said it was difficult to draw firm conclusions from the ‘heterogeneous’ data set, but said it did demonstrate specialist care was not always best.

Dr Piet Post, senior consultant at the Dutch Institute for Healthcare Improvement, said: ‘The available literature suggests that among patients with rheumatoid arthritis, diabetes mellitus or cystic fibrosis, outcomes are not superior in specialised centres or with subspecialists compared with other forms of chronic illness care.'

‘The lack of an association between treatment of chronic diseases in a high-volume or specialist centre and the outcome of medical care does not exclude the potential value of such centres,’ he added.

The paper is published in this month’s issue of the International Journal for Quality in Health Care.