Total purchasing in primary care: three case studies

S Abbott, S Harrison, Nicola Walsh

Research output: Contribution to journalArticle

3 Citations (Scopus)


Total purchasing in primary care (TPPC) was piloted in the mid-1990's, first by four "pioneer sites", and later by over 80 first and second waves of "pilot sites". Separate evaluations of three of the pioneers show that they faced challenges similar to those experienced by the pilot sites, namely: the need to develop organisations which were effective both internally and, in their relationships with other health-care agencies, externally; and the difficulties encountered when attempting to change the behaviour of local acute care providers. Although GP fund holding and/or TPPC have had some successes in influencing the pattern of delivery for some elective and community services, the challenge of reducing hospital admissions and lengths of stay remains formidable.
Original languageEnglish
Pages (from-to)365-372
Number of pages8
JournalJournal of Management in Medicine
Issue number6
Publication statusPublished - 1 Jan 1999


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