Characteristics of general practices involved in undergraduate medical teaching

Background: The movement of medical education into the community has accele rated the development of a new model of general practice in which core clin ical services are complemented by educational and research activities invol ving the whole primary care team. Aim: To compare quality indicators, workload characteristics, and health au thority income of general practices involved in undergraduate medical educa tion in east London with those of other practices in the area and national figures where available. Design of study: A comprehensive survey of undergraduate and postgraduate c linical placements and practice-based research activity within general prac tice. Setting: One-hundred and sixty-one practices based in East London and the C ity Health Authority (ELCHA). Method: Cross-sectional survey comparing routinely-collected information on practice resources, workload, income, and performance between teaching and non-teaching practices. Results: In east London, teaching practices are larger partnerships with sm aller list sizes, higher staff costs, and better quality premises than non- teaching practices. Teaching practices demonstrate significantly better per formance on quality indicators, such as cervical cytology coverage and pres cribing indicators. Patient-related health authority income per whole time equivalent (WTE) general practitioner (GP) is significantly lower among tea ching practices. A multiple regression analysis was used to explore the ass ociation between teaching status and income. Eighty-eight per cent of the v ariation in patient-related income could be explained by the combination of list size, list turnover, removals at doctor's request, quality of premise s, and immunisation and cytology rates. Conclusion: This study demonstrates that practice involvement in undergradu ate education in east London is associated with higher scores on a range of organisational and performance quality indicators. The lower patient-relat ed income of teaching practices is associated with smaller list sizes and m ay only be partially replaced by teaching practices are more attractive to doctors seeking partnership in east London.