Total purchasing in primary care: three case studies

Stephen Abbott; Stephen Harrison; Nicola Walsh

doi:10.1108/02689239910299812

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Journal of Management in Medicine

ISSN: 0268-9235
Currently published as: Journal of Health Organization and Management
Incorporates: Health Manpower Management

Online from: 1986

Subject Area: Health Care Management/Healthcare

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Total purchasing in primary care: three case studies

Document Information:
Title:	Total purchasing in primary care: three case studies
Author(s):	Stephen Abbott, (Senior Research Fellow, Health and Community Care Research Unit, University of Liverpool, Liverpool, UK), Stephen Harrison, (Professor of Health Policy and Politics, Nuffield Institute for Health, University of Leeds, Leeds, UK, and), Nicola Walsh, (Fellow, Health Services Management Centre, University of Birmingham, Birmingham, UK)
Citation:	Stephen Abbott, Stephen Harrison, Nicola Walsh, (1999) "Total purchasing in primary care: three case studies", Journal of Management in Medicine, Vol. 13 Iss: 6, pp.365 - 372
Keywords:	General practice, Health care, Purchasing, United Kingdom
Article type:	Case study
DOI:	10.1108/02689239910299812 (Permanent URL)
Publisher:	MCB UP Ltd
Abstract:	Total purchasing in primary care (TPPC) was piloted in the mid-1990s, first by four “pioneer sites”, and later by over 80 first and second waves of “pilot sites”. Separate evaluations of three of the pioneers show that they faced challenges similar to those experienced by the pilot sites, namely: the need to develop organisations which were effective both internally and, in their relationships with other health-care agencies, externally; and the difficulties encountered when attempting to change the behaviour of local acute care providers. Although GP fund holding and/or TPPC have had some successes in influencing the pattern of delivery for some elective and community services, the challenge of reducing hospital admissions and lengths of stay remains formidable.