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UK primary care fares well in Commonwealth Fund survey

Primary care in the UK has been rated highly compared with other countries in a survey conducted by The Commonwealth Fund

Primary care in the UK has been rated highly compared with other countries in a survey conducted by The Commonwealth Fund.

The survey, sent to GPs in 11 countries — Australia, Canada, France, Germany, Italy, the Netherlands, New Zealand, Norway, Sweden, the US and the UK — suggests that the UK primary care system has particular strengths in the reported use of electronic patient medical records, patient access to out-of-hours care, guideline-based treatment for certain conditions, and the provision of written lists of medicines to patients.

The UK also performed well with respect to the use of non-physician clinical staff for sharing the responsibility of patient care, as well as reviewing data on clinical outcomes and patient satisfaction. GPs in the UK were also the most likely to receive data comparing their clinical outcomes to other practices.

However, the UK was found to be lagging behind when it came to being able to order laboratory tests electronically and providing chronically ill patients with written instructions on managing care at home.

When asked about their overall view of the UK healthcare system, 97 per cent of UK GPs thought that changes were needed. With regard to the treatment their patients received, 51 per cent thought it had improved in the past three years, 37 per cent thought it had stayed the same and 12 per cent thought it had got worse.

However, the survey authors say that the UK results need to be interpreted with caution because of a low response rate among UK GPs (20 per cent). They add: “The survey highlights diverse international initiatives to invest in primary care and to incorporate incentives to innovate.”

Health Secretary Andy Burnham said of the findings: “We will build on these great achievements [of the NHS over the past few years], and focus on the challenge for the next decade — greater choice, more personalised and high quality care, taking the NHS from good to great.”

The survey was published online in Health Affairs on 2 November 2009.

Key Findings for the UK, presented as percentage of doctors surveyed

  • Use of electronic patient medical records by doctors — 96 per cent(highest 99 per cent Netherlands, lowest 37 per cent Canada).
  • Electronic ordering of laboratory tests — 35 per cent (highest 86 per cent Australia, lowest 6 per cent Netherlands).
  • Arrangements for patient after-hours care to see doctor/nurse — 89per cent (highest 97 per cent Netherlands, lowest 29 per cent US).
  • Patients routinely given written list of all medicines by practice— 83 per cent (highest 83 per cent UK, lowest 4 per cent Netherlands).
  • Practice regularly uses written treatment guidelines for diabetes— 96 per cent (highest 98 per cent Netherlands, lowest 62 per centFrance) and depression 80 per cent (highest 80 per cent UK, lowest 26per cent Germany).
  • Patients provided by doctor with written instructions on how tomanage chronic conditions at home — 33 per cent (highest 63 per centItaly, lowest 9 per cent Norway/France).
  • Use of non-physician clinical staff for patient care — 98 per cent(highest 98 per cent UK/Sweden, lowest 11 per cent France).
  • Practice routinely receives and reviews data on patient clinicaloutcomes — 89 per cent (highest 89 per cent UK, lowest 12 per centFrance).
  • Practice routinely receives and reviews data on patientsatisfaction and experience — 96 per cent (highest 96 per cent UK,lowest 2 per cent France).

Citation: The Pharmaceutical Journal URI: 10985195

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