ORCID Profile
0000-0001-8964-0984
Current Organisation
University of Manchester
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Publisher: Royal College of General Practitioners
Date: 08-03-2023
Abstract: Two general practices close every week in the UK. Given the pressure on UK general practices, such closures are likely to persist. Yet little is known about the consequences. Closure refers to when a practice ceases to exist, merges, or is taken over. To explore whether practice funding, list size, workforce composition, and quality change in surviving practices when surrounding general practices close. A cross-sectional study of English general practices was undertaken, using data from 2016–2020. The exposure to closure for all practices existing on 31 March 2020 was estimated. This is the estimation proportion of a practice’s patient list that had been through a closure in the preceding 3 years, between 1 April 2016 and 3 March 2019. The interaction between the exposure to closure estimate and the outcome variables (list size, funding, workforce, and quality) was analysed through multiple linear regression, while controlling for confounders (age profile, deprivation, ethnic group, and rurality). A total of 694 (8.41%) practices closed. A 10% increase in exposure to closure resulted in 1925.6 (95% confidence interval [CI] = 1675.8 to 2175.4) more patients in the practice with £2.37 (95% CI = £4.22 to £0.51) less funding per patient. While numbers of all staff types increased, there were 86.9 (95% CI = 50.5 to 123.3), 4.3%, more patients per GP. Increases for other staff types were proportionate to increases in patients. Patient satisfaction with services declined across all domains. No significant difference in Quality and Outcomes Framework (QOF) scores was identified. Higher exposure to closure led to larger practice sizes in remaining practices. Closure of practices changes workforce composition and reduces patient satisfaction with services.
Publisher: Royal College of General Practitioners
Date: 27-01-2022
Publisher: Royal College of General Practitioners
Date: 26-08-2021
Publisher: Royal College of General Practitioners
Date: 04-07-2023
Abstract: There are inequalities in the geographical distribution of the primary care workforce in England. Primary care networks (PCNs), and the associated Additional Roles Reimbursement Scheme (ARRS) funding, have stimulated employment of new healthcare roles. However, it is not clear whether this will impact inequalities. To examine whether the ARRS impacted inequality in the distribution of the primary care workforce. A retrospective before-and-after study of English PCNs in 2019 and 2022. The study combined workforce, population, and deprivation data at network level for March 2019 and March 2022. The change was estimated between 2019 and 2022 in the slope index of inequality (SII) across deprivation of full-time equivalent (FTE) GPs (total doctors, qualified GPs, and doctors-in-training), nurses, direct patient care, administrative, ARRS and non- ARRS, and total staff per 10 000 patients. A total of 1255 networks were included. Nurses and qualified GPs decreased in number while all other staff roles increased, with ARRS staff having the greatest increase. There was a pro- rich change in the SII for administrative staff (−0.482, 95% confidence interval [CI] = −0.841 to −0.122, P .01) and a pro- poor change for doctors-in-training (0.161, 95% CI = 0.049 to 0.274, P .01). Changes in distribution of all other staff types were not statistically significant. Between 2019 and 2022 the distribution of administrative staff became less pro-poor, and doctors-in-training became pro-poor. The changes in inequality in all other staff groups were mixed. The introduction of PCNs has not substantially changed the longstanding inequalities in the geographical distribution of the primary care workforce.
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Joseph Hutchinson.