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Long-term conditions scheme 'doomed to fail'

By Nigel Praities

A flagship Government scheme to issue 15 million patients with advice about long-term conditions this year is in crisis, after experts warned GPs would not support it without more resources.

The scheme aims to provide so called information prescriptions, containing personalised information about a patient's condition, potential treatments and signpost them towards relevant care services and support groups in their area.

It was supposed to be in place for all patients with long-term conditions by the end of 2008 under plans revealed in the Our Health, Our Care, Our Say white paper and reiterated in Lord Darzi's next stage review.

But Pulse can reveal limited progress has been made on the roll-out of the scheme, with top Government advisers admitting it is destined for failure.

A new evaluation of pilots of the project showed GPs were the ‘least positive' about information prescriptions, were sceptical about their worth and reluctant to issue them because of workload concerns.

An adviser to the Department of Health, who did not want to be named, said rolling out the scheme by the end of the year was now ‘completely off the cards' as it was not backed by any extra resources.

‘Part of the problem is the GPs. Why should they spend another two minutes if they are not going to be paid any more for it?' the advisor said.

A Department of Health spokesperson confirmed the roll-out of the scheme would now extend into 2009 and beyond, with the only progress so far to place outline documents for six diseases on the NHS Choices website.

Dr Helen Hosker, a GPSI in elderly people's care in Manchester, said patients needed more personalised information, rather than a generic download from a website.

‘The Government has really set itself up for a fall. This is something GPs should be doing in conjunction with community services. It needs to be done carefully and with a lot of thought,' she said.

Dr Hunaid Rashiq, a GPSI in COPD in Birmingham, said older patients and those from ethnic minorities would struggle with large amounts of information and the idea could prove ‘counterproductive'.

‘You can overload patients with information. Unless you are really interested in it will end up in the bin like junk mail.

‘I would worry that what would happen is that we have given you your information prescription so now we don't need to worry. But the relationship with your GP or your nurse should be your information prescription,' he said.

What is an 'information prescription'?

- The Government released plans in its Our Health, Our Care Our Say white paper in January 2006 for all patients with long-term conditions to receive an ‘information prescription' from a health or social care professional by the end of 2008

- The prescription would ensure that all patients ‘routinely receive information about their condition and, where they can, to receive peer and other self-care support through networks

- NHS Choices has information prescriptions for dementia, depression, diabetes, asthma, stroke, and coronary heart disease on the website. They include advice on living with the particular condition the patient has, what to do if there any complications and useful websites for more information

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