Objectives To identify and assess the barriers that health authorities face as they manage quality improvements in general practice in the context of the NHS reforms.
Setting Three UK health authorities :
A rural health authority in the south west a deprived inner city health authority in the north east, and an affluent suburban health authority in the south east Participants Senior and junior managers.
Main outcome measures Structure of strategic and organisational management, and barriers to the leadership and management of quality improvement in general practice.
Absence of an explicit strategic plan for general practice, competing priorities for attention of the health authority, sensitivity of health professionals, lack of information due to poor quality of clinical data, lack of authority to implement change, unclear roles and responsibilities of managers within the organisations, and isolation from other authorities or organisations facing similar challenges.
Conclusions The health authorities faced significant barriers that would impede their ability to fulfil their responsibilities in the new NHS and that would reduce their capacity to contribute to quality improvements in general practice.
Mots-clés Pascal : Médecin généraliste, Organisation santé, Qualité service, Amélioration, Barrière, Evaluation, Pratique professionnelle, Homme, Royaume Uni, Europe, National health service
Mots-clés Pascal anglais : General practitioner, Public health organization, Service quality, Improvement, Barrier, Evaluation, Professional practice, Human, United Kingdom, Europe
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0393983
Code Inist : 002B30A05. Création : 22/03/2000.