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Family Practice Vol. 21, No. 4, 458-468
Family Practice Vol. 21, No. 4 © Oxford University Press 2004, all rights reserved.

Quality, core values and the general practice consultation: issues of definition, measurement and delivery

JGR Howiea, D Heaneyb and M Maxwellc

a Professor Emeritus, University of Edinburgh, b Department of General Practice and Primary Care, University of Aberdeen, c Department of Community Health Sciences—General Practice, University of Edinburgh, 4 Ravelrig Park, Balerno, Edinburgh EH14 7DL

E-mail: John.Howie2@btopenworld.com

Received 20 November 2003; Accepted 10 March 2004.

Howie JGR, Heaney D and Maxwell M. Quality, and core values and the general practice consultation: issues of definition, measurement and delivery. Family Practice 2004; 21: 458–468.

The first 150 words of the full text of this article appear below.


   Introduction
 
Doctors working in any branch of medicine aim to provide and to improve quality on a continuous basis. Teaching and research are intended to underpin these processes. Quality measurement attempts to check that these aims are being met. In the UK, for general practice, within-profession initiatives served the public adequately until well into the 1980s, as testified by the founding of the College of General Practitioners in 1952, the establishment of Departments of General Practice throughout the 1960s and 1970s, and the ‘GP Charter’ of 1966—all of which were responses to the ground-breaking exposure of the state of UK general practice of the early NHS years in the Collings Report of 1950.1

The discipline's ill-considered rejection of the government's ‘good practice allowance’ initiative in 1985 marked its failure to recognize the growing wish of public and government for more explicit quality accountability and the guaranteeing of minimum standards of care . . . [Full Text of this Article]


   The discipline of general practice
 

   The core values: definition and measurement
 
Patient-centredness
Patient-centred consulting skills. Patient priorities. Sharing decision making between patients and doctors. Overview (patient-centredness)
Holism
Summary (core values)

   Quality at consultations—a research programme
 

   The Consultation Quality Index (CQI)
 

   Applications of the CQI
 
Clinical governance
Doctors. Practices. Research and development
Ethnicity. Practice size.
   Discussion
 
Doctors or consultations?
The CQI as a measure of core values
Empathy
The ‘context’ of consultations

   Summary
 

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