General practice in Norway

The background for quality development in Norwegian general practice may be summarised as follows:

A majority of practitioners have had exposure to peer groups, within the specialist training programme or in the CME programme. Many groups have tried evaluation of participants’ practice by analysing video recordings or other material. However, the methods have not been extensively developed.

Specialists of general practice must complete a recertification program every five years. This leads to a high CME activity. The encouragement of peer groups in the CME programme is considered a suitable strategy to build experience with quality development.

Computer-based record systems is in use by more than 80 % of general practitioners. Up to this point, however, the potential of these systems for decision support, research and quality development activity has not been widely used.

In 1992, the International Classification of Primary Health Care (ICPC) was introduced into general practice in Norway. As a common coding tool, it may facilitate comparison between practices and the setting of quality standards.

Clinical guidelines have been developed for a small number of fields by various working parties of the GP organisations. Among these, programs for hypertension (revised 1993) and diabetes (revised 1995) are probably best known. However, their status and implementation is unclear.

The Medical Association in 1992 adopted a strategy for all medical fields to develop systems for quality development. Designing of quality indicators and systems for their use is one central aspect. The association provided grants for a fund to support the development of systems and methods. The allocation of fund money is made by a board which also includes government representatives.

Every provider of health care is obliged by law to document that legal standards and regulations are implemented in practice. There is also an general obligation to comply with generally accepted professional standards.

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Department of Public Health and Primary Health Care, last updated 09.05.96