Clinical commissioning: GPs in charge?

"Clinically led approaches to planning and designing health services are more likely to be both innovative and effective. For this reason, clinical commissioning groups (CCGs) were set up to put GPs at the heart of NHS planning decisions. What progress have CCGs made in implementing their clinically led model and what more needs to be done? This report looks at what has been learnt – including strategies to overcome challenges and identification of the main barriers to effective involvement – and makes recommendations for the future. Its findings about clinical involvement are relevant not only to policy-makers and CCGs but also to other organisations across the NHS involved in planning and designing services."

Clinical commissioning: GPs in charge?
R Robertson, S Ross, C Naylor, H Holder, S Machaqueiro
The King's Fund
July 2016

Read more here.

Making IT work

"The goal of digitisation of health systems is to promote what has become widely known as healthcare’s Triple Aim: better health, better healthcare, and lower cost. These aims are consistent with those of the NHS’s 2014 Five Year Forward View, which called for improvements in quality and service, as well as £22 billion in efficiencies. The Advisory Group believes that trying to achieve the aims of the Five Year Forward View without giving highest priority to digitisation would be a costly and painful mistake."

Making IT work: Harnessing the power of health information technology to improve care in England
R Wachter
Department of Health
September 2016

Read more here.

Multidisciplinary team-led community case management programme

"This study has identified that a programme of MDT-led case management was generally very well received by patients and their families."

Patients’ experiences of a multidisciplinary team-led community case management programme: a qualitative study
A Gowing, C Dickinson, T Gorman, L Robinson, R Duncan
BMJ Open, 2016, 6:e012019

Read more here.

Patient care: A unified approach: A case study report

"This report highlights case studies that exemplify how integration between GPs and physicians can be achieved. The case studies span a wide range of services in England and Wales, and cover a variety of learning points involving different specialties, different population groups and different ways of addressing complex issues. This report has been compiled to share learning from successful examples of integration, and to encourage GPs and physicians to reflect on their own practice."

Patient care: A unified approach: A case study report
Royal College of Physicians, Royal College of General Practitioners
March 2016

Read more here.

Commonwealth Fund's 2015 international survey of general practitioners

"Every three years, the US-based Commonwealth Fund coordinates a survey of general practitioners (GPs) and primary care physicians across 11 countries. This report provides UK-focused analysis by the Health Foundation of the 2015 survey, which included several UK-specific questions funded by the Health Foundation. The report centres on three topics of particular interest: GP satisfaction, care coordination and use of electronic medical records."

Under pressure: What the Commonwealth Fund’s 2015 international survey of general practitioners means for the UK
S Martin, E Davies, B Gershlick
The Health Foundation
February 2016

Read more here.

Collaboration in general practice: surveys of GPs and CCGs

"GPs and CCGs report that the growth in collaborative working is driven primarily by CCG encouragement alongside financial pressures faced within general practice and a desire to expand the range of services offered in primary care."

Collaboration in general practice: surveys of GPs and CCGs
S Kumpunen, N Curry, N Edwards, M Holmes, H Price, T Ballard
Royal College of General Practitioners, Nuffield Trust
December 2015

Read more here.

Exploring the GP ‘added value’ in commissioning

"In our observation of various meetings, we found a degree of complexity associated with CCG structures and governance arrangements. Unlike PCTs (their immediate predecessor organisations), CCGs are often quite different from one another, with different structures and distribution of responsibilities between the various committees, sub-committees etc. We were often unable to clearly define which body was responsible for which type of decisions and who was a member of a particular body."

Exploring the GP ‘added value’ in commissioning: What works, in what circumstances, and how? Final Report
I McDermott, A Coleman, N Perkins, D Osipovic, C Petsoulas, K Checkland
PRUComm
October 2015

Read more here.

Towards a new future for general practice

"This report will not only examine the current problems in general practice, but also look at the future of primary care within a rapidly changing system. We will set out our principles and vision and – by examining what patients want and how practices and practitioners should be configured and assisted to respond – put forward the key actions that will be required to enable us to realise that future vision."

Responsive, safe and sustainable: Towards a new future for general practice
British Medical Association
2015

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Managing conflicts of interest in NHS clinical commissioning groups

"The new arrangements from April 2015 for co-commissioning primary care services from GPs increase the risk of significant conflicts of interest in CCGs."

Managing conflicts of interest in NHS clinical commissioning groups
National Audit Office
September 2015

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Patient safety implications of general practice workload

"The paper intends to act as a catalyst for the development of new solutions to both fatigue and workload in general practice. RCGP is asking GPs, patients, other healthcare professionals and policy makers for their views on this paper, and suggestions – at a practice, system, and national level – for how GP workload can be alleviated, therefore reducing the risk of fatigue and burnout."

Patient safety implications of general practice workload
Royal College of General Practitioners
July 2015

Read more here.

The NHS: Busting the myths

"The NHS Confederation is publishing a series of myth busters, which challenge common misconceptions and enrich the debates on topical, sometimes controversial, issues regarding our health and care." These are the first three:

• Primary care in the NHS 
• Competition in the NHS 
• NHS Managers

The state of general practice

"In the run-up to the 2015 General Election, the Nuffield Trust is regularly surveying a panel of 100 health and social care leaders in England for their views on a range of issues, including the state of the NHS and social care system, and what they believe should be the priority areas for reform during the next Parliament."

The state of general practice: the views of health and social care leaders: Health and Social Care Leaders' Panel: Survey no. 2
J Smith, R Thorlby
Nuffield Trust
November 2014

Read more here.

Is general practice in crisis?

"Not enough GPs are being trained, more trainees now work part-time, and more existing GPs plan to retire early. Numbers are not keeping up with hospital doctors."

Is general practice in crisis?
M Dayan, S Arora, R Rosen, N Curry
Nuffield Trust
November 2014

Read more here.

GPs’ perspectives on the management of patients with multimorbidity

"This systematic review shows that the problem areas for GPs in the management of multimorbidity may be classified into four domains. There will be no ‘one size fits all’ intervention for multimorbidity but these domains may be useful targets to guide the development of interventions that will assist and improve the provision of care to multimorbid patients."

GPs’ perspectives on the management of patients with multimorbidity: systematic review and synthesis of qualitative research
C Sinnott, S McHugh, J Browne, C Bradley
BMJ Open, 2013: e003610

Read more here.

Recommended content of referral letters from GPs to specialised mental health care

"Compared with general guidelines and guidelines for somatic care, the results of this study suggest that the referral letter to specialised mental health care should have a larger emphasis on the overall treatment plan, on the specific role of specialised health care in the continuum of care, and on patient involvement."

Recommended content of referral letters from general practitioners to specialised mental health care: a qualitative multi-perspective study
M Hartveit, O Thorsen, E Biringer, K Vanhaecht, B Carlsen, A Aslaksen
BMC Health Services Research, 2013, 13:329

Read more here.

Influences on prescribing in general practice: why is there variation in prescribing practices?

"Prescribing is a core activity for general practitioners, yet significant variation in the quality of prescribing has been reported. This suggests there may be room for improvement in the application of the current best research evidence."

An ethnographic exploration of influences on prescribing in general practice: why is there variation in prescribing practices?
A Grant, F Sullivan, J Dowell
Implementation Science, 2013, 8:72

Read more here.

Read a summary from the Commissioning Elf here.

Commissioning a good child health service

"This guide sets out for these important stakeholders a shared vision developed with GPs, paediatricians and children’s nurses of what a good children’s health service looks like from a primary care perspective."

Commissioning a good child health service
CIRC - Clinical Innovation and Research Centre
Royal College of General Practitioners
April 2013

Read more here.

Read a summary from the Commissioning Elf here.

RCGP commissioning guidance in end of life care

"Guidance for GPs, Clinical Commissioning Group advisers and commissioners in supporting better care for all people nearing the end of their life."

RCGP commissioning guidance in end of life care
K Thomas, D Paynton
Royal College of General Practitioners
March 2013

Read more here.

Sessional GPs in commissioning

"This report has been written for Clinical Commissioning Groups, GPs and NHS organisations to help primary care meet its future challenges by harnessing the potential that exists within the GP workforce."

Sessional GPs in commissioning
A Howe, S Stone, P Newman, T Rippon
Royal College of General Practitioners
October 2012

Read more here.

Primary care for the 21st century

"Although independent practitioner associations in New Zealand have not held budgets on the scale of that planned for clinical commissioning groups in England, they nevertheless demonstrate the significant potential of organised general practice to enable innovation and expansion in the local provision of care."

Primary care for the 21st century
R Thorlby, J Smith, P Barnett, N Mays
Nuffield Trust
September 2012

Read more here.