Editorial: How can PCTs fail despite GPs' success?

We all know that quality scores are high across the UK, confirming that chronic disease management in primary care is highly successful. Indeed, the DoH has used the quality framework to illustrate ‘its' successes in tackling conditions such as diabetes and CHD.

So, one can be forgiven for being ever so slightly perplexed when looking at the Healthcare Commission’s PCT ratings. These tell us that fewer than half of PCTs in England are meeting targets for CHD and diabetes. Yet, this is the same England in which GP quality scores are over 1,000.
Let’s get this straight. The same doctors, with the same primary healthcare teams, in the same locations are seeing the same patients with the same chronic diseases and the same outcomes. One of the outcomes being that this same care is simultaneously a roaring success and a dismal failure — according to what are effectively both sets of government figures.
We’ve all heard of lies, damned lies and statistics, but this is bordering on the ridiculous.
The problem is that PCTs are judged against different targets from those in the quality framework.

Yes, that’s right; GPs are working to a set of targets, stringently developed and argued over, that are intended to improve the health of the chronically ill. Vast numbers of man hours and millions of pounds have been invested in this process.
But the Healthcare Commission has its own views on quality and is using criteria outside the quality framework.

It may be these are valid targets: it may be that GPs are already meeting them. However, because the efforts of reporting and data collection have gone into the quality framework, PCTs lack the evidence to show progress on them.
Back in the early days of New Labour government ministers often referred to the idea of ‘joined-up thinking and joined-up government’. Such thinking is clearly missing in this process. The Healthcare Commission and the quality framework review must work together to agree a set of targets that all in primary care can aim for.

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins


Already registered?

Sign in

Follow Us:

Just published

Woman holding face in pain

Should GPs treat patients presenting with dental problems?

The MDU's Dr Kathryn Leask considers what GPs should do if a patient presents with...

Conservative Party leadership candidate and foreign secretary Liz Truss

Liz Truss vows to resolve GP pension tax crisis if she becomes prime minister

Liz Truss has affirmed her commitment to resolving the GP pensions crisis but has...

Baby receiving a vaccine in their thigh

JCVI advises changes to routine childhood and HPV immunisation schedules

The Joint Committee on Vaccination and Immunisation (JCVI) has recommended a change...

GP consultation

General practice delivering 'up to double the appointments it is paid for'

General practice in England may be delivering as many as double the number of appointments...

Sign outside BMA House

GP suicide sparks calls for measures to protect doctors from spiralling workloads

The government and policymakers must do more to safeguard doctors and NHS staff from...

Talking General Practice logo

Podcast: Living with long COVID

In August we’re bringing you some of the best interviews from series one of the podcast....