Healthy Skepticism Library item: 5644

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Publication type: Journal Article

White C.
Chief medical officer calls for rewards to improve clinical practice
BMJ 2006 Jul 29; 33:(7561):216
http://bmj.bmjjournals.com/cgi/content/short/333/7561/216-a?etoc%3e

Abstract:

The chief medical officer for England, Liam Donaldson, has said that financial rewards and penalties could be introduced in a bid to root out unacceptable regional variations in clinical practice.

Professor Donaldson was speaking last week at the launch of the latest issue of his annual report on the state of public health, which draws on data for 2005 from the former 28 strategic health authorities.

He said that despite great improvements in medical education and the growth of an evidence base to inform practice “there is still far too much clinical variation” that cannot be justified by medical need and that is “not acceptable.”

Not only do such discrepancies result in inappropriate care and health inequalities, they also expose patients to unnecessary risk and cost the NHS “billions” every year, he added, citing as one example the use of 574 different hip joint and socket combinations for broadly similar . . .