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surpluses of £200,000. On the other hand, the
Sheffield Far Lane Medical Centre was stripped of fundholding status after running up a £100,000 deficit and placing a block on the referral of patients with non-urgent conditions. The Commission wanted to see commissioning organised more cost-effectively by district and family health service authorities carrying out joint commissioning, but involving GPs in decision-making.
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The Audit
Commission claimed in 1993 that the pendulum had swung too far in favour of GPs who wished to pursue their own interests as there was no mechanism to get them to support national objectives. Some of the first wave of fundholders ended the year with surpluses in excess of £100,000. Five had
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says "We rarely allow enough time to evaluate pilot, let alone national, policies". but it enabled the incoming government to introduce primary care groups — "thereby universalising fundholding while repudiating the concept."
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were given control over some of the budgets for hospital care for their patients. This enabled them to change hospital practices by, in some cases, getting hospital consultants to run sessions outside hospital.
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32:
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162:"GP fundholding system 'should be phased out': Changes in family doctor practices fail to deliver promised benefits and undermine national health strategy, say reports"
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Government in 1997/8 because of concerns that it helped to foster a two-tier health service. The scheme did not survive long enough to permit proper evaluation. As
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250:"The King's Fund Library Catalog › Details for: Learning from the NHS internal market : A review of the evidence"
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Research by Dr
Russell Mannion at the University of York identified some benefits of the scheme:
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185:"The abolition of the GP fundholding scheme: a lesson in evidence-based policy making"
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Reduced coordination between organisations, with reduction in shared care delivery
113:"Clinical commissioning: what can we learn from previous commissioning models?"
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137:"CCGS will disappear like fundholding, top manager warns | GPonline"
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Better co-ordination between primary and community support services
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Reduced rates of referrals to hospitals for electives
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National Health
Service and Community Care Act 1990
75:More GP engagement in developing care pathways
86:Greater costs for management and transactions
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345:1998 disestablishments in the United Kingdom
69:Quicker waiting time for emergency treatment
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340:1991 establishments in the United Kingdom
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230:. University of York. 27 September 2005
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19:was created in 1991 as part of the
276:"Markets, politicians, and the NHS"
274:Klein, Rudolf (27 November 1999).
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47:Fundholding was abolished by the
66:Fewer emergency-related bed days
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228:"GP fundholding - the facts"
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164:. Independent. 26 May 1993
292:10.1136/bmj.319.7222.1383
83:Less patient satisfaction
79:and some disadvantages:
330:National Health Service
280:British Medical Journal
25:National Health Service
37:general practices
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335:General practice
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286:(7222): 1383–4.
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252:. Archived from
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139:. Archived from
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195:(475): 141–4.
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17:GP Fundholding
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35:. Individual
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258:. Retrieved
254:the original
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232:. Retrieved
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166:. Retrieved
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145:. Retrieved
141:the original
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120:. Retrieved
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53:Rudolf Klein
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21:quasi-market
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15:
324:Categories
260:2014-10-08
147:2014-10-08
122:2017-01-11
94:References
234:8 October
168:8 October
310:10574834
211:11885824
29:Thatcher
301:1117121
202:1314221
27:by the
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49:Labour
306:PMID
236:2014
207:PMID
170:2014
296:PMC
288:doi
284:319
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