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  • Principal Investigator: Jack O'Sullivan
  • 1 October 2017 to 1 October 2018
  • Project No: 386.
  • Funding round: FR 14

Over the last decade, the workload for General Practitioners in the UK has increased significantly (1). From 2007 to 2014, the number and length of primary care consultations has increased by 11% and 7% respectively (1). Over a similar time period, the NHS has experienced an unprecedented rise in spending, an 80% rise (10). Rising workload and spending has left UK primary care overstretched and at ‘saturation point’ (1). Given 90% of all NHS care occurs in primary care, increasing workload threatens the ability of the NHS to provide effective healthcare. It remains unclear if other aspects of primary care workload, most significantly, test ordering, have seen similar changes. This needs to be addressed ‘urgently’.   

We will determine the change in total test use in UK primary care from 2000 to 2015, the change in ordering of 25 common tests over the same time period, any differences in total test use across the UK test, and any differences in ordering of 25 specific tests across the UK.

To achieve our aims, we will use a large dataset of primary care records to analyse tests ordered for patients from UK primary care.

An understanding of total changes in test use over time will identify whether primary care test use has increased in line with other aspects of primary care workload and inform future primary care resource requirements. The identification of specific tests that have significantly increased or decreased in use over time will serve as a basis to explore whether these changes are appropriate or not. Similarly, identification of regions that use tests at higher or lower rates than other regions around the UK can lead to further investigation to see if reasonable explanations exist for these differences. Ultimately, this study will serve as a foundation for a series of studies aiming to reduce inappropriate test use to help contribute to the changes required to ensure UK primary care sustainability.

Evidence synthesis working group

The collaboration will be conducting 18 high impact systematic reviews, under four workstreams.

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