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Martin Roland Comments from the UK on 2012 Commonwealth Fund Survey Martin Roland Comments from the UK on 2012 Commonwealth Fund Survey

Martin Roland Comments from the UK on 2012 Commonwealth Fund Survey - PowerPoint Presentation

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Uploaded On 2018-11-08

Martin Roland Comments from the UK on 2012 Commonwealth Fund Survey - PPT Presentation

Its good but twittercom cchsr Electronic medical record usage High rates of utilisation 97 highest for multifunctional use eg most GPs will now get lab results downloaded to the EMR the same day ID: 721445

patients care quality cchsr care patients cchsr quality integration scores specialist gps clinical hospital primary evidence patient problems managers

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Slide1

Martin RolandComments from the UK on 2012 Commonwealth Fund Survey“It’s good ……but ….”

twitter.com/

cchsr

Slide2

Electronic medical record usageHigh rates of utilisation (97%), highest for ‘multi-functional’ use – e.g. most GPs will now get lab results downloaded to the EMR the same day….

b

ut ….

Continued problems of integration with specialist care

Major problems of integration with social careSlide3

Waiting to see a specialistUK has finally got on top of this – 28% now report barriers – equal to US and bettered only by Netherlands and SwitzerlandEvidence that targets (especially associated with penalties) can work

….

b

ut …..

Guaranteed two week wait for suspected cancer has not resulted in earlier presentation of cancer to specialistsSlide4

Access to primary careWe are now ‘average’ for patients being able to get a same or next day appointment… but ….

Our improvement in this (which had a financial incentive) was at the expense of patients being able to book ahead

Patients also find it harder to see their own doctor

E

xample of an unintended consequence of an incentivised performance indicatorSlide5

Nurse case managers for serious chronic conditionsWe are now no. 1 (78%)

….

b

ut ….

Little evidence that case managers have reduced unplanned hospital admission, and some evidence that they may have led to increased admissions

Much easier to improve quality than to reduce costSlide6

Feedback on clinical qualityWe are now no. 1 for clinical outcomes (84%) and patient satisfaction (84%)

….

b

ut ….

f

inancial incentives are not a magic bullet. They may have some effect combined with other quality improvement initiatives but may have unintended consequences

l

ittle impact of feeding back patient satisfaction scores (including making scores publicly available)Slide7

ConclusionsIn the UK, we are doing “OK”…. b

ut …..

t

here’s a long way to go

the

government continues to invest

in

primary

care

England

is giving 70% of the

hospital/specialist

budget to consortia of

GPs which will do something ….. but we don’t know what ……. www.cchsr.iph.cam.ac.uk twitter.com/cchsr