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The role of performance indicators in changing the autonomy of the general practice profession in the UK

The role of performance indicators in changing the autonomy of the general practice profession in the UK
The role of performance indicators in changing the autonomy of the general practice profession in the UK
Performance indicators (PIs) are widely used across the UK public sector, but they have only recently been applied to clinical care. In doing so, they challenge a previously guarded aspect of clinical autonomy—the assessment of work performance. This "challenge" is specific to a primary care setting and in the general practice profession. This paper reviews the qualitative findings from an empirical study within one English primary care group on the response to a set of clinical PIs relating to general practitioners (GPs) in terms of the effect upon their clinical autonomy. Prior to interviews with GPs, primary care teams received feedback on their clinical performance as judged by indicators. Five themes were crucial in understanding GPs responses: the credibility of PIs, the growing need to demonstrate competence, perceptions of autonomy, the ulterior purpose of PIs, and the identity of the assessor of their performance. PIs are playing a key role in changing the locus of performance assessment along two dimensions: location and expertise. As the locus helps to determine the nature of clinical autonomy, it is likely to have implications for the nature of the general practice profession.
general practitioners, performance indicators, profession, managerialism, autonomy, uk
0277-9536
1493-1504
Exworthy, M.
08248153-7746-4437-abf7-1b4170478289
Wilkinson, E.K.
83a43191-8586-4c95-9499-690e7c6cb5fa
McColl, A.
246d333b-6d5b-4a34-9022-c9db56b042e0
Moore, M.
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Roderick, P.
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Smith, H.
cc42a332-71ec-436f-8207-9151275a92d8
Gabbay, J.
d779b76c-febe-461b-b3bb-e110163f114a
Exworthy, M.
08248153-7746-4437-abf7-1b4170478289
Wilkinson, E.K.
83a43191-8586-4c95-9499-690e7c6cb5fa
McColl, A.
246d333b-6d5b-4a34-9022-c9db56b042e0
Moore, M.
1be81dad-7120-45f0-bbed-f3b0cc0cfe99
Roderick, P.
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Smith, H.
cc42a332-71ec-436f-8207-9151275a92d8
Gabbay, J.
d779b76c-febe-461b-b3bb-e110163f114a

Exworthy, M., Wilkinson, E.K., McColl, A., Moore, M., Roderick, P., Smith, H. and Gabbay, J. (2003) The role of performance indicators in changing the autonomy of the general practice profession in the UK. Social Science & Medicine, 56 (7), 1493-1504. (doi:10.1016/S0277-9536(02)00151-X).

Record type: Article

Abstract

Performance indicators (PIs) are widely used across the UK public sector, but they have only recently been applied to clinical care. In doing so, they challenge a previously guarded aspect of clinical autonomy—the assessment of work performance. This "challenge" is specific to a primary care setting and in the general practice profession. This paper reviews the qualitative findings from an empirical study within one English primary care group on the response to a set of clinical PIs relating to general practitioners (GPs) in terms of the effect upon their clinical autonomy. Prior to interviews with GPs, primary care teams received feedback on their clinical performance as judged by indicators. Five themes were crucial in understanding GPs responses: the credibility of PIs, the growing need to demonstrate competence, perceptions of autonomy, the ulterior purpose of PIs, and the identity of the assessor of their performance. PIs are playing a key role in changing the locus of performance assessment along two dimensions: location and expertise. As the locus helps to determine the nature of clinical autonomy, it is likely to have implications for the nature of the general practice profession.

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More information

Published date: April 2003
Keywords: general practitioners, performance indicators, profession, managerialism, autonomy, uk

Identifiers

Local EPrints ID: 24331
URI: http://eprints.soton.ac.uk/id/eprint/24331
ISSN: 0277-9536
PURE UUID: 288a4cd2-a94e-475a-856d-91a1c425f167
ORCID for M. Moore: ORCID iD orcid.org/0000-0002-5127-4509
ORCID for P. Roderick: ORCID iD orcid.org/0000-0001-9475-6850

Catalogue record

Date deposited: 30 Mar 2006
Last modified: 09 Jan 2022 03:17

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Contributors

Author: M. Exworthy
Author: E.K. Wilkinson
Author: A. McColl
Author: M. Moore ORCID iD
Author: P. Roderick ORCID iD
Author: H. Smith
Author: J. Gabbay

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