How to assess quality in primary care

Jim Parle, of the University of Birmingham, and I have an editorial just out in the BMJ responding to the recent Health Foundation report on quality indicators in primary care. There’s a lot one could say about this subject but we had to be brief and engaging. Hopefully the references serve as a springboard for readers who want to dig in more. In brief:

  • We think it’s great that composite indicators received a strongly worded ‘no’; remember that Jeremy Hunt (and probably Jennifer Dixon too) started this process quite keen on global measures of quality reducing all the complexity of primary care organisation and care to a traffic light.
  • We agree that a single port of call would be invaluable. Too much of this information is scattered about online
    • but along with that, there’s a need for standardised methods of analysis and presentation; this is not talked about much but it causes a lot of confusion. At NAGCAE, my role is to keep banging on about this to make analysts learn from the best in the business and to stop spending taxpayers’ money reinventing wheels via expensive private-sector agencies
    • and interactive online content is ideally suited to this, viz ‘State of Obesity’
  • We think they should have talked about the value of accurate communication of uncertainty, arising from many different sources. Consider Elizabeth Ford’s work on GP coding, or George Leckie and Harvey Goldstein on school league tables (googlez-vous).
  • We also think they should have talked about perverse incentives and gaming. It never hurts to remind politicians of Mr Blair’s uncomfortable appearance on Question Time
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