Specialist outreach clinics in Sheffield: a faster tier of out-patient provision for the patients of fundholding GPs?
- PMID: 9347462
- DOI: 10.1093/oxfordjournals.pubmed.a024642
Specialist outreach clinics in Sheffield: a faster tier of out-patient provision for the patients of fundholding GPs?
Abstract
Background: Little is known about the activity of the many new specialist outreach clinics in fundholding general practices that have emerged since the introduction of fundholding in 1991, though it has been claimed that specialist outreach clinics have shortened waiting times for fundholders' patients. This study describes the activity of specialist outreach clinics in fundholding practices in Sheffield, focusing on comparative waiting times between fundholding and non-fundholding practices.
Methods: A descriptive study was carried out using routine out-patient activity data and a listing of outreach clinics obtained from fundholding practices.
Results: Thirty-seven specialist outreach clinics were established in fundholding practices by November 1994; 23 in surgical specialties. In 1994-1995, for gynaecology, orthopaedics and general surgery, the leading outreach specialties, 22.5 per cent of fundholders' first attendances were in outreach clinics. In those three specialties, 87.0 per cent of patients in specialist outreach clinics in fundholding practices vs 67.1 per cent in hospital clinics were routine appointments, and 17.4 per cent vs 9.4 per cent, respectively, were added to an in-patient waiting list. The proportion of first attendees seen in less than three months was 97.0 per cent in specialist outreach clinics in fundholding practices vs 88.1 per cent in hospital clinics; 90.4 per cent for the patients of fundholders who had outreach clinics vs 85.2 per cent for fundholders who did not; 88.1 per cent for all fundholders' patients vs 88.6 per cent for non-fundholders' patients.
Conclusions: The new specialist outreach service in fundholding practices in Sheffield is largely for surgical patients classified as routine patients. Although patients were seen more quickly in specialist outreach clinics, no overall inequality of waiting times between fundholding and non-fundholding practices was shown.
Similar articles
-
Private provision of 'outreach' clinics to fundholding general practices in England.J Health Serv Res Policy. 1998 Jan;3(1):20-2. doi: 10.1177/135581969800300106. J Health Serv Res Policy. 1998. PMID: 10180385
-
Specialist outreach clinics in general practice.BMJ. 1994 Apr 23;308(6936):1083-6. doi: 10.1136/bmj.308.6936.1083. BMJ. 1994. PMID: 8173432 Free PMC article.
-
A national evaluation of specialists' clinics in primary care settings.Br J Gen Pract. 2001 Apr;51(465):264-9. Br J Gen Pract. 2001. PMID: 11458477 Free PMC article.
-
The challenge of long waiting lists: how we implemented a GP referral system for non-urgent specialist' appointments at an Australian public hospital.BMC Health Serv Res. 2010 Nov 4;10:303. doi: 10.1186/1472-6963-10-303. BMC Health Serv Res. 2010. PMID: 21050488 Free PMC article. Review.
-
The effect of fundholding on prescribing and referral costs: a review of the evidence.Health Policy. 1997 May;40(2):103-14. doi: 10.1016/s0168-8510(96)00888-3. Health Policy. 1997. PMID: 10167066 Review.
Cited by
-
Surgical outreach clinics in Canada: one neurosurgeon's experience.Can J Surg. 2004 Feb;47(1):25-8. Can J Surg. 2004. PMID: 14997921 Free PMC article.
-
[Organisational reforms in the relationships between general doctors and specialists: impact on referrals].Aten Primaria. 2010 Jan;42(1):52-6. doi: 10.1016/j.aprim.2009.02.007. Epub 2009 May 15. Aten Primaria. 2010. PMID: 19446926 Free PMC article. Spanish. No abstract available.
-
Specialist outreach clinics in primary care and rural hospital settings.Cochrane Database Syst Rev. 2004;2003(1):CD003798. doi: 10.1002/14651858.CD003798.pub2. Cochrane Database Syst Rev. 2004. PMID: 14974038 Free PMC article.