DoH view of under-doctored areas 'inaccurate'

UK researchers call for practice nurses and other staff to be accounted for in provision calculations.

The DoH's assessment of GP provision might be inaccurate, according to UK research findings.

It means the list of 50 PCTs identified as 'under-doctored' and earmarked for new GP surgeries by health secretary Alan Johnson might not be correct.

The research also showed that distribution of GPs across England has changed little since the mid-80s, and may have even become worse. But assessment of under-doctored areas must take into account the number of other staff, like nurses, and not just GPs, say researchers at the University of York Centre for Health Economics. The researchers assessed a variety of measures of general practice provision.

They found that just one in three of the 30 most under-doctored PCTs identified in the White Paper 'Our Health, Our Care, Our Say' remained in the bottom 30 when factors other than the level of GP provision were accounted for.

A hard core of 10 PCTs were badly under-doctored, whatever measure was used.

Currently the DoH ranks PCTs according to the number of GPs per head of need adjusted population.

GPs make up only 30 per cent of the staff in general practice and the mix of GPs, practice nurses, and practice staff can vary across PCTs.

The implication of the report is that some PCTs may not have been identified as under-doctored when they are in need of extra surgeries.

The researchers said the current measure was 'not unacceptable', but suggested 'broadening the definition of the practice staff from GPs to include practice nurses and non-clinical staff '.

A further report has been commissioned to identify whether the policies to reduce health inequalities by 2010 have had an impact.

tom.ireland@haymarket.com

University of York primary care report

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