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At the heart of general practice since 1960

Army of GP nurses and receptionists to run CVD screening

The starting gun has been fired on a huge programme of cardiovascular screening in general practice, with PCTs to receive guidance on implementation as early as April.

A report submitted to the

Department of Health by the National Screening Committee formally proposes screening patients once they reach the ages of 40, 50 and 60.

An army of practice nurses, healthcare assistants and even receptionists are set to be trained up to conduct screening tests, after pilots of diabetes screening found minimal expertise was required.

But screening will still be a huge burden on practices in terms of resources and workload, with the experts responsible for the proposals admitting funding through the GP contract would be essential.

High-risk patients are set to get a battery of tests, including for blood glucose and cholesterol, although some patients may be screened by non-

invasive assessment.

Dr Elizabeth Goyder, principal investigator for evaluation of the eight diabetes screening pilots, told Pulse: 'Advice on where to start will come out in April, but realistically PCTs are unlikely to expect all practices to be doing this systematically.

'Although it's a huge amount of primary prevention and risk assessment, it's not something GPs will be expected to pay for. I suspect in two years or whenever, it will become part of the contract.'

Screening points are likely

to be top priority for the planned overhaul of the quality and outcomes framework in 2008.

Dr Goyder, who is a clinical senior lecturer at the University of Sheffield, said practices in the pilots had trained up healthcare assistants and receptionists, admitting it was 'probably not feasible' for GPs to take on the work themselves.

Data from the pilots was

included in the committee's

report, submitted to ministers last November.

A Department of Health spokesperson said: 'The report envisaged any such system of risk assessment could involve healthcare assistants working with the support of GP nurses. The department's vascular programme board is reviewing

the recommendations and will discuss them with stakeholders.'

Sir Muir Gray, director of the National Screening Committee, said practices would have flexibility in how they ran screening, with some doing it opportunistically, and others inviting high-risk patients in after preliminary screening of computer records.

But Dr Arnold Zermansky, a GP in Leeds, said screening would have to be resourced. 'Somebody's got to pay for the healthcare assistants and the follow-up healthcare, and that's where doctors come in.'

egoodman@cmpmedica.com

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