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Taking the lead in fundholding

Cowton, Christopher J. and Drake, Julie E. (1999) Taking the lead in fundholding. Journal of Management in Medicine, 13 (4). pp. 218-233. ISSN 0268-9235

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Abstract

The prevalence of rather negative, or at best mixed, attitudes of doctors towards participation in management has been reported in several previous research studies. This paper adds to that growing empirical literature, but complements most of the previous studies by focusing on general medical practitioners in primary care rather than on doctors in secondary care settings. The focus for the study were doctors who had agreed to undertake the lead partner role in the now-defunct general practitioner fundholding initiative within the UK National Health Service. The findings indicate widespread reluctance but the presence of a minority of enthusiasts, which resonates with previous studies of secondary care settings. A finding of potential significance for future research and practice was that some doctors who were initially reluctant became more keen on undertaking a management role once they had experienced it.

Item Type: Article
Subjects: R Medicine > R Medicine (General)
R Medicine > RA Public aspects of medicine
Schools: The Business School
The Business School > Financial Ethics and Governance Research Group
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References:

1. Beginning on 1st April 1991, the implementation of fundholding proceeded in a series of
annual ``waves''. The first wave set a minimum patient list size for fundholding applicants
of 9,000, but subsequent waves gradually reduced that requirement.
2. It has not yet been possible to interview the lead partner, but the PIQ and fund/practice
manager's interview have been completed and provide some useful insights. The difficulty
of gaining access to the lead partner also says something about how the practice is run.Brazell, H. (1987), ``Doctors as managers'', Management Education and Development, Vol. 18 No. 2,
pp. 95-102.
Britten, N. and Fisher, B. (1993), ``Qualitative research and general practice'', British Journal of
General Practice, Vol. 43 No. 372, pp. 270-1.
Buchanan, D., Jordan, S., Preston, D. and Smith, A. (1997), ``Doctor in the process: the engagement
of clinical directors in hospital management'', Journal of Management in Medicine, Vol. 11
No. 3, pp. 132-56.
Chambers, R. and Belcher, J. (1993), ``Work patterns of general practitioners before and after the
introduction of the 1990 contract'', British Journal of General Practice, Vol. 43 No. 375,
pp. 410-12.
Coulter, A. (1995), ``General practice fundholding: time for a cool appraisal'', British Journal of
General Practice, Vol. 45 No. 392, pp. 119-20.
Cowton, C.J. and Drake, J.E. (1999), ``Went fundholding, going commissioning? Some evidencebased
reflections on the prospects for primary care groups'', Public Money and
Management, Vol. 19 No. 2, pp. 33-7.
Dopson, S. (1994), ``Management: the one disease consultants did not think existed'', Journal of
Management in Medicine, Vol. 8 No. 5, pp. 25-36.
Dopson, S. (1996), ``Doctors in management: a challenge to established debates'', in Leopold, J.,
Glover, I. and Hughes, M. (Eds), Beyond Reason? The National Health Service and the
Limits of Management, Avebury, Aldershot, pp. 173-88.
Ennew, C., Whynes, D., Jolleys, J. and Robinson, P. (1998), ``Entrepreneurship and innovation
among GP fundholders'', Public Money and Management, Vol. 18 No. 1, pp. 59-64.
Fitzgerald, L. (1994), ``Moving clinicians into management: a professional challenge or threat?'',
Journal of Management in Medicine, Vol. 8 No. 6, pp. 32-44.
FitzGerald, L. (1996), ``Clinical management: the impact of a changing context on a changing
profession'', in Leopold, J., Glover, I. and Hughes, M. (Eds), Beyond Reason? The National
Health Service and the Limits of Management, Avebury, Aldershot, pp. 189-203.
Glennerster, H., Matsaganis, M. and Owens, P. (1992), A Foothold for Fundholding, Research
Report No. 12, King's Fund Institute, London.
Glennerster, H., Matsaganis, M., Owens, P. and Hancock, S. (1994), Implementing GP
Fundholding: Wild Card or Winning Hand, Open University Press, Buckingham.
Glynn, J.J., Murphy, M.P. and Perkins, D.A. (1992), ``GP practice budgets: an evaluation of the
financial risks and rewards'', Financial Accountability and Management, Vol. 8 No. 2,
pp. 149-61.
Greenfield, S. and Nayak, A. (1996), ``A management role for the general practitioner?'', in
Leopold, J., Glover, I. and Hughes, M. (Eds), Beyond Reason? The National Health Service
and the Limits of Management, Avebury, Aldershot, pp. 59-80.
Hunter, D.J. (1994), ``From tribalism to corporatism: the managerial challenge to medical
dominance'', in Gabe, J., Kelleher, D. and Williams, G. (Eds), Challenging Medicine,
Routledge, London, pp. 1-22.
Kelleher, D., Gabe, J. and Williams, G. (1994), ``Understanding medical dominance in the modern
world'', in Gabe, J., Kelleher, D. and Williams, G. (Eds), Challenging Medicine, Routledge,
London, pp. xi-xxix.
Laughlin, R., Broadbent, J. and Shearn, D. (1992), ``Recent financial and accountability changes in
general practice: an unhealthy intrusion into medical autonomy?'', Financial Accountability
and Management, Vol. 8 No. 2, pp. 129-49.Laughlin, R., Broadbent, J., Shearn, D. and Willig-Atherton, H. (1994), ``Recent financial and
administrative changes in GP practices: initial experiences and effects'', Accounting,
Auditing & Accountability Journal, Vol. 7 No. 3, pp. 96-124.
Llewellyn, S. and Grant, J. (1996), ``The impact of fundholding on primary health care: accounts
from Scottish GPs'', Financial Accountability and Management, Vol. 12 No. 2, pp. 125-40.
Mark, A. (1991), ``Where are the medical managers?'', Journal of Management in Medicine, Vol. 5
No. 4, pp. 6-12.
Mark, A. and Scott, H. (1992), ``Management in the National Health Service'', in Willcocks, L. and
Harrow, J. (Eds), Rediscovering Public Services Management, McGraw-Hill, London,
pp. 197-234.
Murphy, E., Spiegal, N. and Kinmonth, A-L. (1992), ```Will you help me with my research? Gaining
access to primary care settings and subjects'', British Journal of General Practice, Vol. 42
No. 357, pp. 162-5.
Ong, B.N. (1998), ``Evolving perceptions of clinical management in acute hospitals in England'',
British Journal of Management, Vol. 9 No. 3, pp. 199-210.
Willcocks, S. (1998), ``The development of clinical management at an NHS Trust hospital: a case
study example'', Journal of Management in Medicine, Vol. 12 No. 3, pp. 168-77.

Depositing User: Sara Taylor
Date Deposited: 15 Feb 2008 14:49
Last Modified: 22 Oct 2008 13:30
URI: http://eprints.hud.ac.uk/id/eprint/530

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