Quality of general practice inquiry

King's Fund denies lack of quality is motivation for its 18-month study.

The King's Fund is launching an 18-month investigation into the quality of general practice.

The investigation will search for ways to define and measure the quality of general practice, and will include more than a dozen pieces of research on topics including access, public health and the management of long-term conditions.

It will be overseen by an expert panel including RCGP chairman Professor Steve Field and NHS Alliance chairman Dr Michael Dixon.

Niall Dickson, the think-tank's chief executive, said that quality was the 'buzzword' of the moment. 'We have moved from a world that tends to assume quality was there to one seeking assurance,' he said.

But he added that the government's focus on secondary care meant there were no standard measures for the quality of core services such as diagnostics, referrals and prescribing habits.

Dr Nick Goodwin, the senior King's Fund fellow leading the research, said the report would attempt to find scientific measures of quality practice, but would ensure they were pragmatic through discussions with the profession.

The intention is to develop a 'quality dashboard', with which practices can judge their own performance, he added.

Dr Dixon described the research as 'an immensely important and courageous initiative'. He welcomed its independence from government.

The panel stressed that the research had not been motivated by any concern about the quality of existing practices, or to force practices into standard models.

The inquiry will discuss its initial findings after their release in the autumn.


King's Fund chief executive Niall Dickson explains why the think tank is launching an inquiry into the quality of general practice.

General practice in this country is rightly regarded with envy by health systems around the world. It lies at the centre of our health service and it is one of the main reasons why the NHS has been ranked as one of the best.

We know the overall quality of general practice has improved in the past few years and that many GPs deliver outstanding care.

But good care is not universal. There are unexplained variations in the quality of services but little information to compare the quality of care at different practices.

Despite the introduction of the QOF, much debate about quality centres on hospitals. Lord Darzi's Next Stage Review was right to put quality centre stage but the debate has focused far less on identifying and nurturing good care in general practice.

Key dimensions of care
That's why The King's Fund has launched a major inquiry into the quality of general practice in England. The panel, which I chair, comprises four GPs and a senior nurse, and includes the chairmen of the RCGP and the NHS Alliance.

We will cover key dimensions of care including access, the quality of diagnosis and referral, and the management of patients with long-term conditions.

For each of these areas, we will examine what high-quality care looks like, define the role of GPs and general practice in the delivery of that care, and recommend how it should be measured.

Our aim is to produce measures practices can use to assess the quality of care they offer as well as providing a tool for commissioners and regulators. We hope it will be used to improve patient care.

We aim to test our findings with GPs and others this autumn to ensure they are relevant, accurate, useful and effective - and complement other initiatives, such as the RCGP's work on accreditation.

General practice faces many challenges in the coming years - we hope this work will strengthen it by demonstrating its commitment to quality and improvement.

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