Can primary care be both patient-centred and community-led?

Drummond, N., Iliffe, S., MacGregor, S., Craig, N. and Fischbacher, M. (2001) Can primary care be both patient-centred and community-led? Journal of Management in Medicine, 15(5), pp. 364-375. (doi: 10.1108/EUM0000000006183)

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Examines the relationships between the macro-, meso-, and micro-levels in the NHS at the end of the fundholding period and considers their contemporary implications for primary care groups (PCGs) and local health care co-operatives (LHCCs). Fundholding achieved some success in challenging the way in which services were provided at the micro-level (the practice), but had a less marked effect in terms of changing service provision at the health authority (meso-) level or in developing collaborative working with trusts and health authorities in strategic decision making. The health authorities prioritized alternative models of devolved commissioning. Trusts regarded fundholders as a distraction who exerted influence and commanded trust management time disproportionate to their “market share”. PCGs and LHCCs represent a shift back to the meso-level in service planning and purchasing. As such there is a risk that the micro-level benefits of fundholding and other forms of devolved commissioning will be lost, while uncertainties remain regarding the capacity of PCGs and LHCCs to incorporate GPs into a collaborative approach to strategic decision making.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Fischbacher-Smith, Professor Moira
Authors: Drummond, N., Iliffe, S., MacGregor, S., Craig, N., and Fischbacher, M.
Subjects:R Medicine > RA Public aspects of medicine
College/School:College of Social Sciences > Adam Smith Business School > Management
Journal Name:Journal of Management in Medicine

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