From cottage industry to post-industrial care? The King's Fund report on quality in general practice

Abstract

The recently published King's Fund Report, Improving the Quality of Care in General Practice , suggests that there are significant opportunities for general practices in England to improve the quality of care provided to patients.1 This independent inquiry assessed evidence relating to 14 aspects of general practice, debated the findings in seminars attended by a range of stakeholders, including members of the public, and made a number of key recommendations about how general practice needs to change if it is to meet the challenges of gaps and variations in the quality of primary care. The report suggests improvements could be made in a number of areas including care of patients with long-term conditions, continuity and coordination of care, patient involvement and engagement, and prescribing. It proposes that the skill mix in general practice be improved and that general practice moves from a ‘cottage industry to post-industrial care’. The report, while generally welcomed, has also been challenged by a number of commentators. Iona Heath, for example, suggested that it assumed patients are ‘units of health need’ instead of individuals with their (our) own inconsistencies and foibles.2 While acknowledging the good intentions and scholarship of …