Working with a team of healthcare experts, Frontier Economics was commissioned by The Health Foundation to investigate how primary care variation affects quality of care. We examined how patient outcomes were affected by GP behaviours such as use of new technologies, participation in Clinical Commissioning Groups, prescribing behaviour (adherence to cost-effective guidelines and prescribing of novel drugs), and special GP training. These variables were brought together in a dataset on 8,000 GP practices, as well as a bespoke survey of 500 practices.
Drivers of health outcomes
After controlling for many factors such as local demographics and practice characteristics, we indeed found positive correlations between patient outcomes and the following ‘active GP’ measures: uptake of new technology, specialism, and adherence to prescribing guidelines. We found that larger practises tend to perform better, and that local context had an important effect on outcomes, with practices serving more deprived populations performing worse, even when this is supposedly controlled for in the funding formula.
Our findings were shared with clinicians and commissioners and feed into ongoing policy debates on workforce issues in primary care, and the design of incentive mechanisms.