GP practices in Camden: a study in variation

Healthwatch Camden offers a constructive contribution to discussions about primary care, highlighting some of the variability of service across the borough. This report explores the variation in performance across Camden’s 36 GP practices through the lens of a selection of indicators and themes that are important to patients. 

Key findings

Analysis of patient experience and clinical performance data reveals wide variation across GP services in Camden. 

No single GP practice can be described as the best or worst across the whole range of indicators. 

By presenting publicly available data in a clear comparative format, Healthwatch Camden reveals a patchwork quilt of variation and tells thirty six different stories — one for every GP practice in Camden. 

Data on clinical performance show a generally high standard across all the GP practices in Camden. Nevertheless, the data reveal variation. For example the percentage of patients on the diabetes disease register who have a record of an albumin-creatinine ratio test in the preceding 12 months ranges from 100% at one practice to less than 10% at others. 

The data suggest that the practices located in the less deprived areas of the borough perform better but some practices in deprived areas are doing better than their neighbours. 

Numerous contextual factors, such as the differing social and economic circumstances of the patients registered at the practice, may contribute to variation in performance. However, no single factor appears to fully explain the differences in scores between the 36 GP practices in Camden.

 There is a good level of carer-awareness at all the GP practices but many fall short in efforts to formally identify patients who are unpaid carers and add them to the carer register. People with sensory impairments face barriers in many practices, most commonly related to communication challenges. 

Health advocates based in GP practices report variation in types of non-medical support sought by different patient groups. Patients from black, minority and ethnic groups are more likely to seek help with housing or benefits while white British patients are more likely to seek support around healthy living. 

Asking why the different practices perform well in some areas but show room for improvement in others could assist efforts to reducing variability of quality and improving equity of GP services for people across the borough. 

Healthwatch Camden wants to see all those individuals and different organisations that have an interest in commissioning and providing primary care services in Camden working towards addressing variations in quality so that every patient, wherever they live in the borough, can enjoy the best possible services.