GPs face challenge from regional variations in surgery rates

GPs face an uphill struggle to address regional variations in surgical admission rates when they take on commissioning, the King's Fund has warned.

Knee replacement rates varied four-fold across regions (Photograph: SPL)
Knee replacement rates varied four-fold across regions (Photograph: SPL)

The think tank found there were variations of as much as 400% for some for routine operations, such as hip and knee replacements.

In addition, the rate of tonsillectomies in Coventry was 100 times higher than in Kingston and there was a three-fold variation in cataract replacement rates.

But the Kings Fund warned that it will be more difficult to accurately measure these variations once GPs take on commissioning.

‘Moves to GP commissioning raise some practical and technical issues with respect to health care variations, not least the unit of analysis,’ the King’s Fund report said.

‘[PCTs] replacement with GP commissioning consortia creates new boundaries that will require reworking.’

The think tank fears variations could be dealt with in ‘crude ways’ by PCTs and commissioning consortia if detailed, accurate information is not available for analysis. This could include cutting access to certain procedures with an above average admission rate.

GPC deputy chairman Richard Vautrey says that if changes to GP practice boundaries go ahead the situation will become more muddied.

‘There’s no question that with boundaries changing, including the added complication of practice boundaries being removed, that it will be difficult to utilise the information properly,’ he said.

Despite the technical complications around patient data the report does suggest that GP’s clinical knowledge may lead to some reduction in variations.

He added: ‘GPs will be able to take a more clinical approach to these decisions and be able to question them much more robustly than perhaps NHS managers are at the moment.’

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register

Already registered?

Sign in

Follow Us:

Just published

Practices face £50,000 pension cost hike under plan to raise employer contribution to 20.6%

Practices face £50,000 pension cost hike under plan to raise employer contribution to 20.6%

GP practices could face a five-figure hike in pension costs under plans to increase...

What medico-legal challenges will GPs face in 2019?

What medico-legal challenges will GPs face in 2019?

The MDU's head of advisory services, Dr Caroline Fryar, predicts which medico-legal...

GP practices providing online consultations doubled in 12 months, survey suggests

GP practices providing online consultations doubled in 12 months, survey suggests

The proportion of GP practices in England providing online consultations has almost...

Dr Nikita Kanani: Why peer support is the key to building a stronger general practice

Dr Nikita Kanani: Why peer support is the key to building a stronger general practice

NHS England's acting director of primary care Dr Nikita Kanani says connecting with...

Next-day GP appointments three times as likely to be missed as same-day bookings

Next-day GP appointments three times as likely to be missed as same-day bookings

Patients are nearly three times as likely to miss appointments booked with GP practices...

Outsourcing GP services overseas could be 'legal minefield', experts warn

Outsourcing GP services overseas could be 'legal minefield', experts warn

Using digital technology to outsource GP consultations overseas could leave the NHS...