GPs need to play a stronger role in co-ordinating care for people with long-term or chronic conditions, according to a new report from The King’s Fund.

Co-ordinated Care for People with Complex Chronic Conditions, funded by Aetna and the Aetna Foundation in the United States, compares five UK-based case studies with a proven track-record in providing care co-ordination in primary and community care settings. It identifies the critical success factors that enable effective care co-ordination and how these might be transferrable to different settings, in the United Kingdom and elsewhere.

Across all of the five case study sites, limited engagement from GPs reduced both the effectiveness of care co-ordination and the number of referrals into the programmes. Despite attempts to address this, including financial incentives and information sessions, only one of the sites had managed to achieve the desired level of engagement with GPs.

The findings follow recent calls by the Health Secretary for general practice to improve the co-ordination of care for vulnerable older people, including proposals to allocate a named clinician to oversee their care.

The report concluded that the primary purpose of good care co-ordination should be to improve quality of care, rather than just to reduce costs, and that good care co-ordination should be driven at a local, rather than a system, level. The report also found a chronic lack of evaluation on which to judge the performance of care co-ordination programmes and recommended that there should be more measurement, evaluation, and reflection on performance.