On 3 December Healthwatch Camden issued a report entitled ‘GP practices in Camden: A study of variation 2015’.The report revealed wide variations in both patient experience and in the delivery of clinical services across Camden’s 36 GP practices.
The overall picture is of good quality GP services across Camden. However where there is variation there must be room for improvement. Variations included the percentage of diabetes patients being tested to check their risk of developing kidney disease (an albumin-creatinine test) ranging from 100% at one practice to around 80% or below at others. (That is, the percentage of patients on the diabetes register who have a record of an albumin-creatinine test in the preceding 12 months.)
Publicly available information on patient experience and on the prevention and management of common conditions such as cancer, diabetes, and dementia was analysed. The report explored themes that are important to local people, such as the service provided to unpaid carers and differences in what patients can access online.
A key finding is that no single GP practice can be described as the best or worst across the whole range of indicators, and there is no single factor that appears to fully explain the differences in scores across the borough.
Other key findings were:
- Most people in Camden are happy with their GP – 83%.
- No single practice can be described as the best or least good across the whole range of services.
- Practices in the less deprived areas of Camden tend to perform better. However, the social and economic circumstances of the patients registered at each practice do not fully explain the differences in clinical performance.
- People with sensory impairments face barriers in many practices, most commonly related to communication challenges.
- Health advocates based in GP practices report variation in types of non-medical support sought by different patient groups. Patients from black, minority and ethnic groups are more likely to seek help with housing or benefits while white British patients are more likely to seek support around healthy living.
Healthwatch Camden made five recommendations:
- Local commissioners and providers of primary medical services should continue to note the variations between GP practices in Camden and seek to explore and understand the reasons for those variations as part of their ongoing efforts towards quality improvement and reduction of inequalities.
- Local commissioners and providers of primary medical services should outline their plans to support and improve those GP practices which are most challenged, on either patient satisfaction or clinical indicators (including in areas such as medicines management that lie beyond the scope of this report).
- Local commissioners, providers of primary medical services and patient representatives should encourage and support GP practices to share experience and learn from each other.
- Camden’s Health and Wellbeing Board partners should collaborate with GPs to support their role in tackling health inequalities.
- Within the limitations of constrained resources, local commissioners should seek to redress the imbalance of investment in primary care compared to secondary and tertiary health services.
Healthwatch Camden hopes that the report encourages sharing good practice and collaboration so that variations in quality of service can be addressed. We want to see individuals and different organisations that have an interest in commissioning and providing primary care services in Camden working towards addressing variations in quality, so that every patient, wherever they live in the borough, can enjoy the best possible service.
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