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Au contraire, it reduces demand

Dr Hutton seems to have missed the main point of my letter amidst his incorrect assertion of how I have done it! Good access cuts patient demand.

Total surgery consultations have fallen since we joined the collaborative two years ago. For doctors they have fallen from 3.9 per patient per year to 2.9 and nurse consultations have fallen from 1.1 to 0.6 per patient per year. This has 'saved' our small practice 4,000 appointments over a year and was achieved in a practice that already had very good access.

We don't have any formal triage, but we are all much more available on the telephone than we were. We all do chronic disease management but within our normal appointment system so we haven't had to invest in extra nurses.

My accountant thinks we are a very profitable practice. Perhaps Dr Hutton would like to visit us and see for himself that it is not a fantasy. It might even help him understand capacity and demand concepts better.

Dr Nigel Wood

Stratford-upon-Avon

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