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Independents' Day

'Make nine changes to improve your practice'

By Emma Wilkinson

GPs are being urged to make nine 'high impact changes' to the way they work to improve patient care and make their practices more efficient.

The recommendations from the Improvement Foundation and the NHS Institute for Innovation and Improvement are based on 'best practice' and have been endorsed by the RCGP.

The changes include promoting patient self-management, improving patient access, redesigning clinical roles and systematic review of patient feedback (see right).

Sir John Oldham, head of the Improvement Foundation and a GP in Glossop, Derbyshire, said the ideas were not new but very few practices were implementing them all to their full potential.

He said: 'Some of it may be going into more depth than practices already do. For example, is self-management as systematic as it could be?

'The world moves forward and none of us can stay still. What's most important is what practices perceive they need to do more of, and that will be different in different areas.'

In a document to be sent to all GP surgeries in England, each recommendation is supported by an example of good practice.

But GPs said they had little time to implement recommendations largely aimed at helping promote service redesign.

Dr John Pittard, a GP in Staines, Middlesex, said: 'There's been so much change already and none of it really follows professional medical guidelines.

'It's about consumerism. It's management speak and I'm unimpressed. Policies like this come and go, but what doesn't come and go is clinical need.'

Dr Rubin Minhas, a GP in Gillingham, Kent, said the list appeared to be generated from a political standpoint. 'Some of it does make sense but GPs and primary care teams are also busy seeing patients rather than redesigning services.

'The biggest improvement to primary care would be to reduce the amount of wastage and inefficiency in the NHS and target that to front-line care.'

The nine 'high impact' changes

• Promote patient self-care and self-management

• Improve the management of patients with long-term conditions

• Improve patient access

• Improve care for patients by redesigning roles in general practice

• Use data and information to drive improvement

• Improve care through systematic review of patient feedback

• Avoid unnecessary follow-ups in primary and secondary care

• Provide services closer to patients

• Maximise use of practice- based commissioning

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