Primary medical services: market structure, investment and outcomes. (NHS Ayrshire & Arran)


Sutton, M. (HERU)


This study used new data which has become available under the Quality and Outcomes Framework of the new GMS contract. Achievement levels are related to population, GP and practice characteristics and levels of investment and competition. This was complemented by a cross-sectional analysis of structure and inputs to inform future investment decisions and longitudinal analysis of relationships between inputs, activity and outcome using NHS administrative data for the whole of Scotland. The results showed that population characteristics showed little association with thequality of primary medical care incentivised under the UK generalmedical services contract. Larger clinical teams delivered higherquality clinical care, but the nurse-doctor composition of theclinical team did not influence quality. Practices that weremore likely to respond to financial incentives because of previousbehaviour or lower income from other sources recorded higherquality.


D Skåtun




Sutton, M. and McLean, G. Determinants of primary medical care quality measured under the new UK contract: cross sectional study. British Medical Journal. 2006; 332: 389-390.


Sutton, M. and McLean, G. Determinants of primary medical care quality: analysis of data from the new GMS contract. HESG, Newcastle. June 2005.