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18 November 2019

GPs that receive more capitation funding get high Care Quality ratings, study finds

Research finds that higher capitation funding was consistently associated with higher quality ratings across all Care Quality Commission (CQC) categories.

doctor checking blood pressure

A team of researchers led by Dr Veline L’Esperance, School of Population Health & Environmental Sciences, have found that increased funding per patient is significantly associated with higher CQC ratings in each of five domains of quality: caring, effective, responsive, safe and well-led, together with the overall practice rating.

Since October 2014, all GPs have been subjected to inspections by the CQC where they report on the extent to which practices are performing in the domains of caring and combine to produce an overall practice rating. These domains incorporate components of clinical achievement, patient experience and patient safety

In research published in BMJ Open, the team carried out a cross-sectional study covering 3 years of primary care data from over 7000 practises. They investigated the association between the achievement of quality ratings and practice capitation funding and adjusted for known confounders.

Their findings demonstrated that higher capitation funding is associated with significantly higher ratings across all individual domains.

Our findings suggest that revisions to the primary care capitation formula are necessary to ensure that additional funding is provided in urban areas of high deprivation and ethnic minority populations to address quality of care inequalities

Dr Veline L’Esperance.

Capitation (or core) funding accounts for just over half of the overall funding that practices receive. It is calculated from the total number of patients on the practice’s list, adjusted to reflect factors affecting GPs’ workload (patients’ age and sex, numbers of patients in nursing and residential homes, and small area census and socioeconomic morbidity data), rurality, and an index of local staff costs that affect the cost of providing services.

These findings suggest that measured dimensions of the quality of care are related to the underlying funding of primary care. Less well-funded practices achieve lower quality ratings, implying that additional capitation funding may be associated with higher levels of primary care quality.