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. 1995 Sep 16;311(7007):727–730. doi: 10.1136/bmj.311.7007.727

What do we known about fundholding in general practice?

J Dixon 1, H Glennerster 1
PMCID: PMC2550722  PMID: 7549689

Abstract

The general practice fundholding scheme was introduced four years ago. So far its impact has not been formally evaluated nationally, but review of published research shows some trends. Fundholding has curbed prescribing costs and given general practitioners greater power to lever improvements in hospital services--for example, reducing waiting times for hospital treatment--but fundholding practices may have received more money than non-fundholding practices. The impact of fundholding on transactions costs, equity, and quality of care (particularly for patients of non-fundholding general practitioners) is unknown. Research into costly reforms such as fundholding needs to be coordinated.

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Selected References

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  1. Bailey J. J., Black M. E., Wilkin D. Specialist outreach clinics in general practice. BMJ. 1994 Apr 23;308(6936):1083–1086. doi: 10.1136/bmj.308.6936.1083. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bain J. Fundholding: a two tier system? BMJ. 1994 Aug 6;309(6951):396–399. doi: 10.1136/bmj.309.6951.396. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Black D. G., Birchall A. D., Trimble I. M. Non-fundholding in Nottingham: a vision of the future. BMJ. 1994 Oct 8;309(6959):930–932. doi: 10.1136/bmj.309.6959.930. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Corney R. Experiences of first wave general practice fundholders in South East Thames Regional Health Authority. Br J Gen Pract. 1994 Jan;44(378):34–37. [PMC free article] [PubMed] [Google Scholar]
  5. Coulter A., Bradlow J. Effect of NHS reforms on general practitioners' referral patterns. BMJ. 1993 Feb 13;306(6875):433–437. doi: 10.1136/bmj.306.6875.433. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Dixon J. Can there be fair funding for fundholding practices? BMJ. 1994 Mar 19;308(6931):772–775. doi: 10.1136/bmj.308.6931.772. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Dixon J., Dinwoodie M., Hodson D., Dodd S., Poltorak T., Garrett C., Rice P., Doncaster I., Williams M. Distribution of NHS funds between fundholding and non-fundholding practices. BMJ. 1994 Jul 2;309(6946):30–34. doi: 10.1136/bmj.309.6946.30. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Dowell J. S., Snadden D., Dunbar J. A. Changing to generic formulary: how one fundholding practice reduced prescribing costs. BMJ. 1995 Feb 25;310(6978):505–508. doi: 10.1136/bmj.310.6978.505. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Dunne F. J. Subcortical dementia. BMJ. 1993 Jul 3;307(6895):1–2. doi: 10.1136/bmj.307.6895.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Fisher A. Fundholding. BMJ. 1993 Apr 10;306(6883):1003–1003. doi: 10.1136/bmj.306.6883.1003-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Graffy J. P., Williams J. Purchasing for all: an alternative to fundholding. BMJ. 1994 Feb 5;308(6925):391–394. doi: 10.1136/bmj.308.6925.391. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Ham C., Hunter D. J., Robinson R. Evidence based policymaking. BMJ. 1995 Jan 14;310(6972):71–72. doi: 10.1136/bmj.310.6972.71. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Harris A. Specialist outreach clinics. BMJ. 1994 Apr 23;308(6936):1053–1053. doi: 10.1136/bmj.308.6936.1053. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Howie J. G., Heaney D. J., Maxwell M. Care of patients with selected health problems in fundholding practices in Scotland in 1990 and 1992: needs, process and outcome. Br J Gen Pract. 1995 Mar;45(392):121–126. [PMC free article] [PubMed] [Google Scholar]
  15. Howie J. G., Heaney D. J., Maxwell M. Evaluating care of patients reporting pain in fundholding practices. BMJ. 1994 Sep 17;309(6956):705–710. doi: 10.1136/bmj.309.6956.705. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Iliffe S., Freudenstein U. Fundholding: from solution to problem. BMJ. 1994 Jan 1;308(6920):3–4. doi: 10.1136/bmj.308.6920.3. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Keeley D. Prescribing costs. Fundholders had a head start. BMJ. 1994 Jan 15;308(6922):206–207. doi: 10.1136/bmj.308.6922.206c. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. King M., Broster G., Lloyd M., Horder J. Controlled trials in the evaluation of counselling in general practice. Br J Gen Pract. 1994 May;44(382):229–232. [PMC free article] [PubMed] [Google Scholar]
  19. Luxton D. E. Fundholding practices get preference. BMJ. 1993 Jan 16;306(6871):206–207. doi: 10.1136/bmj.306.6871.206-c. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Matsaganis M., Glennerster H. The threat of 'cream skimming' in the post-reform NHS. J Health Econ. 1994 Mar;13(1):31–60. doi: 10.1016/0167-6296(94)90003-5. [DOI] [PubMed] [Google Scholar]
  21. Maxwell M., Heaney D., Howie J. G., Noble S. General practice fundholding: observations on prescribing patterns and costs using the defined daily dose method. BMJ. 1993 Nov 6;307(6913):1190–1194. doi: 10.1136/bmj.307.6913.1190. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. McAvoy B. R. Heartsink hotel revisited. BMJ. 1993 Mar 13;306(6879):694–695. doi: 10.1136/bmj.306.6879.694. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. McCullough C. J. Fundholding practices get preference. BMJ. 1993 Jan 9;306(6870):141–141. doi: 10.1136/bmj.306.6870.141-b. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. Moore L., Dalziel M. Making the internal market work: a case for managed change. BMJ. 1993 Nov 13;307(6914):1270–1272. doi: 10.1136/bmj.307.6914.1270. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Newton J., Fraser M., Robinson J., Wainwright D. Fundholding in northern region: the first year. BMJ. 1993 Feb 6;306(6874):375–378. doi: 10.1136/bmj.306.6874.375. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Roland M. Fundholding and cash limits in primary care: blight or blessing? BMJ. 1991 Jul 20;303(6795):171–172. doi: 10.1136/bmj.303.6795.171. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Sheldon T. A., Smith P., Borowitz M., Martin S., Hill R. C. Attempt at deriving a formula for setting general practitioner fundholding budgets. BMJ. 1994 Oct 22;309(6961):1059–1064. doi: 10.1136/bmj.309.6961.1059. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Whynes D. K., Reed G. Fundholders' referral patterns and perceptions of service quality in hospital provision of elective general surgery. Br J Gen Pract. 1994 Dec;44(389):557–560. [PMC free article] [PubMed] [Google Scholar]

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