Please use this identifier to cite or link to this item:
Title: Population health needs as predictors of variations in NHS practice payments: a cross-sectional study of English general practices in 2013-2014 and 2014-2015.
Authors: Levene, Louis S.
Baker, Richard
Wilson, Andrew
Walker, Nicola
Boomla, K.
Bankart, John
First Published: 22-Nov-2016
Publisher: Royal College of General Practitioners
Citation: British Journal of General Practice, 2016
Abstract: BACKGROUND: NHS general practice payments in England include pay for performance elements and a weighted component designed to compensate for workload, but without measures of specific deprivation or ethnic groups. AIM: To determine whether population factors related to health needs predicted variations in NHS payments to individual general practices in England. DESIGN AND SETTING: Cross-sectional study of all practices in England, in financial years 2013-2014 and 2014-2015. METHOD: Descriptive statistics, univariable analyses (examining correlations between payment and predictors), and multivariable analyses (undertaking multivariable linear regressions for each year, with logarithms of payments as the dependent variables, and with population, practice, and performance factors as independent variables) were undertaken. RESULTS: Several population variables predicted variations in adjusted total payments, but inconsistently. Higher payments were associated with increases in deprivation, patients of older age, African Caribbean ethnic group, and asthma prevalence. Lower payments were associated with an increase in smoking prevalence. Long-term health conditions, South Asian ethnic group, and diabetes prevalence were not predictive. The adjusted R(2) values were 0.359 (2013-2014) and 0.374 (2014-2015). A slightly different set of variables predicted variations in the payment component designed to compensate for workload. Lower payments were associated with increases in deprivation, patients of older age, and diabetes prevalence. Smoking prevalence was not predictive. There was a geographical differential. CONCLUSION: Population factors related to health needs were, overall, poor predictors of variations in adjusted total practice payments and in the payment component designed to compensate for workload. Revising the weighting formula and extending weighting to other payment components might better support practices to address these needs.
DOI Link: 10.3399/bjgp16X688345
ISSN: 0960-1643
eISSN: 1478-5242
Version: Publisher Version
Status: Peer-reviewed
Type: Journal Article
Rights: © British Journal of General Practice 2016 This is an OpenAccess article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Appears in Collections:Published Articles, Dept. of Health Sciences

Files in This Item:
File Description SizeFormat 
Levene_BJGP.pdfPublished (publisher PDF)144.98 kBAdobe PDFView/Open

Items in LRA are protected by copyright, with all rights reserved, unless otherwise indicated.