The geography of fundholding in southwest England: implications for the evolution of primary care groups

Using postcode-ED linkage to calculate patient-weighted deprivation indices for 330 general practices in southwest England, this study examines whether the populations served by fundholding and non-fundholding practices varied with respect to socio-economic status. Little evidence is found of systematic socio-economic bias in the uptake of fundholding. However, a distinct spatial pattern to the distribution of fundholding is revealed in this article, urban practices having adopted the scheme more readily than their rural and mixed rural/urban counterparts. As practice-level fundholding is replaced by commissioning at the locality level, such geographical variation is likely to be expressed in the way in which primary care groups evolve, (C) 1999 Elsevier Science Ltd. All rights reserved.