Incentivizing preventive services in primary care: perspectives on Local Enhanced Services

Marks, Linda and Cave, Sally and Hunter, David and Mason, Jonathan and Peckham, Stephen and Wallace, Andrew (2011) Incentivizing preventive services in primary care: perspectives on Local Enhanced Services. Journal of Public Health, 33 (4). pp. 556-564. ISSN 1741-3842. (The full text of this publication is not currently available from this repository. You may be able to access a copy if URLs are provided)

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Background General practitioners in the UK play a key role in prevention but provision of preventive services is variable. The 2004 General Medical Services contract allows Primary Care Trusts (PCTs) to address health needs through providing locally agreed payments for Local Enhanced Services (LESs). This study identifies how this contractual flexibility is used for preventive services and explores its perceived effectiveness. Methods Semi-structured interviews were carried out (2008–09) in 10 purposively selected case study sites in England. Details of LESs for these sites were collected (2009) through Freedom of Information requests or local contacts. A national on-line survey of PCTs (2009) provided a national context for case study findings. Results LESs were considered to be effective in incentivizing preventive activity. However, specifications and performance management were often weak, awareness of how to optimize incentives was low and, as optional services, LESs were perceived to be at risk in a financial downturn. Conclusions Using LESs for preventive services highlights gaps in ‘core’ primary care responsibilities and in the national pay-for-performance framework. Current incentive arrangements are complex, could increase inequalities and provide only a partial, short-term solution to developing a proactive approach to prevention in primary care.

Item Type: Article
Uncontrolled keywords: population based and preventative services primary care
Subjects: R Medicine > RA Public aspects of medicine
Divisions: Faculties > Social Sciences > School of Social Policy Sociology and Social Research > Centre for Health Services Studies
Depositing User: Tony Rees
Date Deposited: 04 Jul 2012 15:16
Last Modified: 17 Oct 2014 09:31
Resource URI: (The current URI for this page, for reference purposes)
ORCiD (Peckham, Stephen):
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