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NHS tsar calls on clinicians to reassess clinical practice

Published on 11/07/05 at 11:11am

The NHS tsar for primary care has called on clinicians to challenge the way they undertake clinical practice in order to improve efficiency.

Dr David Colin-Thome urged clinicians to question the efficiency of accepted practice within the health service, like levels of outpatient appointments, the provision of diagnostic treatment and length of hospital stays.

"There is a whole area of clinical challenge beyond what most lay people would have knowledge that we have a duty to spend money in a more appropriate way," he said.

He flagged up the example of patient follow-up appointments, which number around 30 million a year, representing around two-thirds of total outpatient appointments a year.

"Is this the most appropriate way of delivering care?" he said.

Speaking at the NHS Alliance PCTs: Fit for purpose conference, Dr Colin-Thome called on clinicians to look at ways of improving efficiency, citing the example of increasing diagnostic treatment in primary care to reduce the 9.5 million new GP appointments a year,

Clinicians, he said, should also look to evidence which suggests that 20% of X-rays represent no clinical value and look at reducing hospital stays, which he said most patients wanted.

He said the introduction of practice based commissioning would improve some efficiencies, commenting that more diagnostic treatment at primary care level could keep people out of hospital but stressed that commissioners and the PCTs had to work together in reshaping healthcare.

"This is not a battle between primary and secondary care. It is where the care is undertaken which is important."

Other reforms, like the new pharmacy contract, also needed to be utilised, with GPs working with pharmacists in providing care for long-term conditions.

Meanwhile, Dr Colin-Thome said the public engagement at the heart of the government's forthcoming white paper on primary care was unique and represented a culture change.

He said healthcare professionals could not postulate on what the changes to the policy would be because it might result in different ideas than the usual policy makers.

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