Biography

I qualified from Sheffield Medical School in 1981 and trained initially in general medicine, followed by general practice. I have combined 35 years of clinical work with an academic career in GP education (as GP trainer and GP tutor), undergraduate medical education, and primary care research.

Career History

Current: General Practitioner at the Acle Medical Practice, Honorary Senior Fellow at Norwich Medical School

Past appointments:

1988-2010 GP, Coastal Villages Practice, Norfolk
1991-2000 GP Trainer, Eastern Deanery
1994-2010 GP Tutor, Eastern Deanery 
1997-2001 Clinical Governance Lead, Great Yarmouth PCT
2001-2010 Honorary Senior Lecturer, Norwich Medical School

2005-2009 Chair, Eastern Deanery Continuing Professional Development Management Group

2010-2016 Clinical lecturer in general practice at the Norwich Medical School

Professional Qualifications and professional memberships:

Member of the Royal College of Physicians
Fellow of the Royal College of General Practitioners
Fellow of the Higher Educational Academy

Post-nominals Mb ChB MSc [distinction] MD FRCGP MRCP DRCOG FHEA

Academic Background

1981 Mb ChB (Sheffield)
1986 Member of the Royal College of Physicians (MRCP)
1988 Member of the Royal College of General Practitioners (MRCGP)
1988 Diploma of the Royal College of Obstetricians and Gynaecologists (DRCOG)
2004 MSc in Health Sciences, University of East Anglia (with distinction)
2005 Fellow of the Royal College of General Practitioners (FRCGP)
2008 MD, Norwich Medical School (Quality and Costs in the New GMS Contract for Primary Care)

All Publications

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Wakelin, R., Howe, A., Fleetcroft, R.

(2017)

Tongue-tie and breastfeeding: Identifying problems in the diagnostic and treatment journey,

in British Journal of Midwifery

25

(9)

pp. 579-584

Full Text UEA Repository

(Article)

(Published)


Steel, N., Fleetcroft, B., Hassan, Y.

(2017)

Prescribing statins in general practice: who decides?,

in British Journal of General Practice

67

(659)

pp. 246-247

Full Text

(Editorial)

(Published)


Fleetcroft, R., Asaria, M., Ali, S., Cookson, R.

(2017)

Outcomes and inequalities in diabetes from 2004/5 to 2011/12: English longitudinal study,

in British Journal of General Practice

67

(654)

pp. e1-e9

Full Text UEA Repository

(Article)

(Published)


Hassan, Y., Ford, J., Steel, N., Sheldon, J., Fleetcroft, R.

(2016)

Why are statin prescribing guidelines for primary prevention not always followed in primary care?,

in British Journal of General Practice

66

(651)

pp. 536-537

Full Text

(Comment/debate)

(Published)


Fleetcroft, R., Noble, M., Martin, A., Coombes, E., Ford, J., Steel, N.

(2016)

Emergency hospital admissions for asthma and access to primary care: cross-sectional analysis,

in British Journal of General Practice

66

(650)

pp. e640-e646

Full Text UEA Repository

(Article)

(Published)


Cookson, R., Asaria, M., Ali, S., Ferguson, B., Fleetcroft, R., Goddard, M., Goldblatt, P., Laudicella, M., Raine, R.

(2016)

Health Equity Indicators for the English NHS: a longitudinal whole-population study at the small-area level,

in Health Services and Delivery Research

4

(26)

Full Text UEA Repository

(Article)

(Published)


Asaria, M., Ali, S., Doran, T., Ferguson, B., Fleetcroft, R., Goddard, M., Goldblatt, P., Laudicella, M., Raine, R., Cookson, R.

(2016)

How a universal health system reduces inequalities: Lessons from England,

in Journal of Epidemiology and Community Health

70

(7)

pp. 637-643

Full Text UEA Repository

(Article)

(Published)


Bhattacharya, D., Aldus, C., Barton, G., Bond, C., Boonyaprapa, S., Charles, I., Fleetcroft, R., Holland, R., Jerosch-Herold, C., Salter, C., Shepstone, L., Walton, C., Watson, S., Wright, D.

(2016)

The feasibility of determining the effectiveness and cost-effectiveness of medication organisation devices compared with usual care for older people in a community setting: systematic review, stakeholder focus groups and feasibility randomised controlled trial,

in Health Technology Assessment

20

(50)

Full Text UEA Repository

(Article)

(Published)


Fleetcroft, R., Hardcastle, A., Purdy, S., Lipp, A., Price, G., Steel, N., Myint, P., Howe, A.

(2016)

Which types of emergency medical admissions may be preventable? Analyses of 132 randomly selected cases,

(Abstract)

(Published)


Smith, T., Penny, F., Fleetcroft, R.

(2016)

Smoking and alcohol behaviours in people following hip and knee arthroplasty: data from the Osteoarthritis Initiative,

in Orthopaedics & Traumatology: Surgery & Research

102

(2)

pp. 239-245

Full Text UEA Repository

(Article)

(Published)


Asaria, M., Cookson, R., Fleetcroft, R., Ali, S.

(2016)

Unequal socioeconomic distribution of the primary care workforce: whole-population small area longitudinal study,

in BMJ Open

6

(1)

article no. e008783

Full Text UEA Repository

(Article)

(Published)


Smith, T., Penny, F., Fleetcroft, R.

(2016)

Medical morbidities in people following hip and knee arthroplasty: data from the Osteoarthritis Initiative,

in European Journal of Orthopaedic Surgery & Traumatology

26

(1)

pp. 99-106

Full Text UEA Repository

(Article)

(Published)


Zaman, M. J., Fleetcroft, R., Bachmann, M., Sarev, T., Stirling, S., Clark, A., Myint, P. K.

(2016)

Association of increasing age with receipt of specialist care and long-term mortality in patients with non-ST elevation myocardial infarction,

in Age and Ageing

45

(1)

pp. 96-103

Full Text UEA Repository

(Article)

(Published)


Fleetcroft, R., Ford, J., Gollop, N. D., MacKeith, P., Perera, K., Shafi, A. A., Sorefan, J., Thurlow, C., Wakelin, R., Cowie, M. R., Steel, N.

(2015)

Difficulty accessing data from randomised trials of drugs for heart failure: a call for action,

in British Medical Journal (BMJ)

351

article no. h5002

Full Text UEA Repository

(Article)

(Published)


Fleetcroft, R., Howe, A.

(2015)

Improving the quality of Significant Event Audit' (SEA) by involving the patients,

in British Journal of General Practice

65

(630)

pp. 30

Full Text UEA Repository

(Article)

(Published)


Fleetcroft, R.

(2015)

The mortality rate in England between 2007 and 2012 was not associated with the quality of primary care in an established pay for performance programme,

in Evidence-Based Medicine

20

(4)

article no. 149

Full Text UEA Repository

(Article)

(Published)


Steel, N., Abdelhamid, A., Stokes, T., Edwards, H., Fleetcroft, R., Howe, A., Qureshi, N.

(2014)

A review of clinical practice guidelines found that they were often based on evidence of uncertain relevance to primary care patients,

in Journal of Clinical Epidemiology

67

(11)

pp. 1251–1257

Full Text UEA Repository

(Article)

(Published)


Bhattacharya, D., Salter, C., Aldus, C., Barton, G., Bond (Aberdeen), C., Charles, I., Fleetcroft, R., Holland, R., Jerosch-Herold, C., Shepstone, L., Walton, C., Wright, D.

(2014)

Do not initiate medication organisation devices without prior detailed medication review and vigilant monitoring,

in British Medical Journal (BMJ)

UEA Repository

(Article)

(Published)


Fleetcroft, R., Schofield, P., Ashworth, M.

(2014)

Variations in statin prescribing for primary cardiovascular disease prevention: cross-sectional analysis,

in BMC Health Services Research

14

article no. 414

Full Text UEA Repository

(Article)

(Published)


Smith, T. O., Purdy, R., Lister, S., Salter, C., Fleetcroft, R., Conaghan, P. G.

(2014)

Attitudes of people with osteoarthritis towards their conservative management: a systematic review and meta-ethnography,

in Rheumatology International

34

(3)

pp. 299-313

Full Text UEA Repository

(Article)

(Published)


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Key Research Interests

Health care quality and costs, access and evaluation

The causes of variations in performance

Translational medicine, including the effectiveness of guidelines in practice

Effectiveness of pay for performance in primary care

Significant event audit

Research Keywords:

Health Care Quality, Access and Evaluation

Prescribing Quality

Delivery of Health Care

Cardiovascular disease

Health Services Research

Primary Care

Quality of Health Care

 

Patient Safety

 

Postgraduate Research Student Supervision:

Primary Care
Patient Safety
Guideline Development
Pharmacology

Selected Publications

Ashworth, M, Schofield, P, Doran, T, Cookson, R, Sutton, M, Seed, PT, Howe, A and Fleetcroft, R (2013) The Public Health Impact score: a new measure of public health effectiveness for general practices in England. British Journal of General Practice, 63 (609). pp. 291-299.

Fleetcroft, R, Schofield, P, Duerden, M and Ashworth, M (2012) Achievement of cholesterol targets and prescribing of higher-cost statins: a cross-sectional study in general practice. British Journal of General Practice, 62 (605). pp. 815-820.

Fleetcroft, R, Steel, N, Cookson, R, Walker, S and Howe, A (2012) Incentive payments are not related to expected health gain in the pay for performance scheme for UK primary care: cross-sectional analysis. BMC Health Services Research, 12 (1). p. 94. ISSN 1472-6963

Fleetcroft, R, Cookson, R, Steel, N and Howe, A (2011) Correlation between prescribing quality and pharmaceutical costs in English primary care: national cross-sectional analysis. British Journal of General Practice, 61 (590). pp. 556-564.

Fleetcroft, R, Parekh-Bhurke, S, Howe, AC, Cookson, RA, Swift, L and Steel, N (2010) The UK pay-for-performance programme in primary care: estimation of population mortality reduction. British Journal of General Practice, 60 (578). pp. 649-654.

Walker, S, Mason, A, Claxton, K, Cookson, R, Fenwick, E, Fleetcroft, R and Sculpher, M (2010) Value for Money and the Quality and Outcomes Framework in Primary Care in the UK NHS. British Journal of General Practice, 60 (574). e213-e220.

Fleetcroft, R, Steel, N, Cookson, RA and Howe, AC (2008) Mind the gap! Evaluation of the performance gap attributable to exception reporting and target thresholds in the new GMS contract: national database analysis. BMC Health Services Research, 8. p. 131.

Maisey, SP, Steel, N, Marsh, R, Gillam, S, Fleetcroft, R and Howe, AC (2008) Effects of payment for performance in primary care: qualitative interview study. Journal of Health Services Research and Policy, 13 (3). pp. 133-139.

Steel, N, Maisey, SP, Clark, AB, Fleetcroft, R and Howe, AC (2007) Quality of clinical primary care and targeted incentive payments: an observational study. British Journal of General Practice, 57. pp. 449-454.

Fleetcroft, R and Cookson, R (2006) The relationship between the quality and cost of prescribing: small-scale observational study of GP practices in East Anglia in 2002-3. British Journal of General Practice (529). pp. 613-619. Fleetcroft, R and Cookson, RA (2006) Do the incentive payments in the new NHS contract for primary care reflect likely population health gains? Journal of Health Services Research and Policy, 11 (1). pp. 27-31.

Current Research Projects and Grants 

  1. Research for Patient Benefit (RfPB) Programme: PB-PG-0212-27059 - Can a practice based approach using significant event audit indentify key factors that might reduce avoidable non-elective hospital admissions? A feasibility study.  Start date June 2014.  Principal investigator.  £228,223
  2. NIHR RfPB 2013 - Evaluation of the Bronchiectasis Empowerment Tool.  Jan 2013, Duraction.  Co applicant.  £173,019
  3. NIHR RfPB 2013 - SERVED Memory: Feasibility study of Screening & Enhanced Risk management for Vascular Event related Decline in Memory.  [Start date to be confirmed] Co-investigator £232,388
  4. Norfolk and Waveney PCT 2013. Academic development post. 01/08/2013 to 01/18/2014, duration 12 months. Lead applicant £33,015
  5. Norfolk and Waveney PCT 2013. Research Capacity Funding, Development of an NIHR RfPB grant proposal on statins and the primary prevention of cardiovascular illness. 01/07/2013 to 31/08/2013, duration 2 months. Principal Investigator £5,793
  6. NIHR (National Institute for Health Research, Health Services Delivery and Research Programme) 01/01/2013 t0 31/12/2015, Developing indicators of change in NHS equity performance. Duration 36 months. Co applicant. £493,638
  7. NIHR (National Institute for Health Research). Are NICE clinical guidelines for primary care based on evidence from primary care? 01/07/2011 to 01/07/2013, duration 2 years.Co applicant. £194,743.00
  8. NIHR RfPB 2010. Will a dedicated service improve medicine administration in older persons with dysphagia? 01/08/2009 to 01/06/2012, duration 34 months. Co applicant. £79,621.00
  9. DoH Policy Research Programme 2007. The potential health gain impact of the new GMS contract. 01/01/2007 to 01/07/2007, duration 6 months. Joint project with The Health Economics Unit at York University and the Department of General Practice at Manchester University. Principal investigator. £89,000
  10. Eastern Strategic Health Authority. NHS Research Enterprise Award 2000. (funding to support MSc.)1/04/2000 to 01/04/2003, duration 36 months. Principal Investigator £36,000.  

Teaching Interests

I have a wide range of teaching interests at both undergraduate and postgraduate levels. My main interest is in getting research into current practice. I currently teach medical students in primary care. I have previously been involved in a variety of teaching on the MBBS including lectures, examination, and student advising. I have supervised postgraduates including Masters Students, General Practice Research Fellows and Academic Foundation Doctors. I was lead for the Academic Clinical Fellows training programme and Academic Foundation programme in Primary Care between 2010 and 2016.

External Activities and Indicators of Esteem

  • Member of the RCGP ‘clinical advisors’ programme (2010 - current)
  • Expert Advisor, NICE methods review (2011)
  • Expert Reviewer, Norfolk and Suffolk Primary Care Research Management Team, Research Capacity Funding Programme (2011-present)
  • Peer reviewer, British Medical Journal (2012- present)
  • Reviewer, British Journal of General Practice (2011- present)

Professional Activities

General Practitioner, Acle Medical Practice

Key Responsibilities