Now Alison, I heard you mention education and the pharmaceutical industry. Can you tell me a little bit more about your thinking here.
We were criticised for always telling people what not to do and that hurt. I have had a hard look at our previous communications and I can see what they mean. So I have tried to change this impression big time.
Was that the only driver?
No. The consultants had a dig also – they said that in some situations we divided doctors and did little to drive integration. Actually I think that they have that spot on. Quite a few systems have been developed to be competitive and combative and ‘integration’ has been a key theme for us.
So what are the goals?
The aim is to improve the standard of care in general practice. We want to empower GPs to do more for patients, avoiding errors and reducing referrals.
What does that mean?
We have developed a program for education in two simple stages. GPs log into our information portal and link the clinical guideline to the local patient pathway and additional information about the medicines. They simply tick a button to say that they have completed this and we know where they are up to.
And what then – isn’t it open to abuse?
Yes of course it is. It is a high trust process – we are all adults. The next stage is planned meetings at lunchtime and evening where the local consultant talks about it all again and answers any questions.
This sounds a lot of work?
Not really. We have a small contract with a company to run the Internet platform. Most is built on national guidelines with some local interpretation and some education about medicines. Several of the programs are sponsored by the pharmaceutical industry. They have most of the training material anyway and we allow them to provide information on their products to GPs.
Doesn’t this encourage GPs to prescribe the wrong medicines?
No. All of the information is within the licensed indications and fully referenced. The industry is great at that. And, in a way, we need to give the GPs more information and allow them greater flexibility to make an appropriate choice.
Is there not a risk to the prescribing budget?
It is all one allocation. We spend lots on referrals and un-planned admissions. If we improve the quality of care the total costs go down. In most situations the actual prescribing costs go down also. After all they are responsible for the prescribing budget. There are two phrases that I try to use. ‘Do the right thing first time’ and ‘improve the quality and the costs will contain themselves’. These are two phrases that I actually believe in and so far they seem to be true.
Well Alison, I have found our chat very interesting. I hope to repeat this at Christmas 2013. I am looking forward to seeing your success.