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Herefordshire – frustrated by approval process

Compared with some of the other counties in the West Midlands, the way healthcare is organised in Herefordshire is relatively simple.

Compared with some of the other counties in the West Midlands, the way healthcare is organised in Herefordshire is relatively simple.



The county has one local authority, one PCT, one main hospital and all 24 practices are signed up to a single PBC group which covers 180,000 patients.

Dr Andrew Watts, GP chair of the Practice Based Commissioning Group, Herefordshire, says getting all 24 practices to commit to working together was a real plus: ‘It meant we could support each other. And hospital doctors have also been supportive.'

PCT assistance came in the form of a ‘reasonably good incentive scheme', and financial backing to help practices progress PBC has been ‘fair across the board'.

Success stories include a DVT pathway with near patient D-dimer testing and an insulin LES. The group's next ‘big hope' is to develop integrated care teams, which has already met with ‘enthusiasm' from the PCT.

Getting the green light for small projects is a relatively simple process, he says.

But a major concern is that medium-sized schemes must go through the ‘same unwieldy approval process as a major business case'.

He adds: ‘It's frustrating because as GPs we're used to identifying a problem in the morning, and by the evening being well on the way to solving it. But those rules don't apply in the PBC world.'

Herefordshire

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