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GPs forced to undertake training in 'motivational interviewing'

Exclusive GPs must undergo compulsory training in motivating patients to take their prescribed medicines, as part of a CCG scheme aimed at reducing hospital admissions from improper medication use.

NHS Lambeth CCG has told practices that all prescribers, including non-medical prescribers, must undergo a two week course on motivational interview techniques for medicines adherence before December.

But GPs have said they are being treated like ‘children’ and that compulsory training was ‘a further nail in the coffin’ of GP professionalism, and takes up appointment time that should be spent with patients discussing alternatives to prescribing.

The email, circulated to practices by the medicines optimisation team at Lambeth CCG, states: ‘As part of the 2014-15 Medicines Optimisation Plan, all prescribers are required to undertake motivational interview technique training on Medicines Adherence as offered by Future Learn/Kings College London.’

It adds: ‘Please circulate this message to all prescribers (including non-medical prescribers) in your practice to ensure they have access to the training.’

The CCG says that GPs must register before the end of August or inform the medicines optimisation team who will arrange alternative training ‘as all prescribers need to undertake training’.

The online course, run by Kings College London’s Institute of Pharmaceutical Science, requires two hours of GP time per week in order to ‘enhance’ GP understanding of medicine adherence.

It states GPs will ‘gain increasing awareness of where in your own day-to-day consultations you can apply these techniques and approaches to better support patient self-management of medicines and effect behaviour change’.

Former RCGP chair Professor Clare Gerada, whose Hurley Group practice received the communication from Lambeth CCG, told Pulse: ‘It’s a further nail in the coffin of professionalisation, being a professional means being able to determine your learning needs.’

Dr Gerada added: ‘To insist that every GP does it - albeit only a two-hour  [a week] online programme - goes with the information governance, the hand-washing governance, all of the stuff now which is two to three hours of online trainin. It’s a further nail in the coffin.’

‘It’s more work, for what benefit? Actually, what we should be doing is spending more time with our patients to make sure that we don’t prescribe medicines, not that we make them take medicines, but that we don’t prescribe.’

‘And a motivational interview is a good technique, but only if you choose to want to do it, also insisting on the format of how you learn: it’s something you do to children.’

Pulse reported in May that, as part of the same medicines optimisation scheme, Lambeth CCG would be investigating practices who went over their prescribing budget, particularly those who overspent on care home prescribing.

A spokesperson for NHS Lambeth CCG told Pulse: ‘As with other healthcare professionals, prescribers are required to participate in  continued professional development  to maintain high quality care for patients.’

‘As medicines adherence is a priority in NHS Lambeth CCG, the Lambeth Borough Prescribing Committee took the decision to include training as part of the medicines optimisation plan for all prescribers,  to support  them in identifying and addressing  medicines adherence issues and to put patients at the heart of the decision-making process around medication. GPs sit on the Committee alongside medicines colleagues.’


Readers' comments (26)

  • As a self-confessed MI enthusiast I was pleasantly surprised to see Stephen Rollnick contribute this thread.
    He rightly points to the irony of coercing GPs into using a non-coercive method.

    In any case - as above - the article and headline need to be taken with a pinch of salt.

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  • There isnt any motivational interviewing training!! the course webiste states:
    "This two week course is designed for pharmacists, doctors, nurses and other healthcare professionals with a role or interest in supporting patients with long-term conditions. We’ve invited a range of inspirational healthcare professionals. researchers and clinical academics from across King’s college London’s Institute of Pharmaceutical Science and the Pharmaceutical Clinical Academic Group at King’s Health Partners to contribute to this course. You will be able to immerse yourself in our engaging video material, scenarios and discussions to explore the challenges of medicines non-adherence, factors that may influence patient medicines use and approaches that can be used to effectively engage patients in patient-centred consultations about self-managing medicines.

    Delivered in bite-sized sections, you will be able to enhance your own understanding of medicines adherence and, importantly, gain increasing awareness of where in your own day-to-day consultations you can apply these techniques and approaches to better support patient self-management of medicines and effect behaviour change. We look forward to walking you through this important and challenging area of healthcare provision.

    By the end of this two week course, learners will have developed their understanding, and reflected upon their own clinical practice and consultation skills, in order to:

    1) Identify patients at risk of medicines non-adherence

    2) Employ strategies to support these patients with the use of their medicines."

    Come on Pulse Magazine, you can do better than that!

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  • "must undergo a two week course" - no.

    Have been given the option to undergo a 4 hour course staged over 2 weeks to be completed in a 4 month window, for which it appears they will paid and which will add to individuals' mandated CPD.

    Story out of nothing.

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  • Stupid idea that rather ignores the fact that a high (and rising) proportion of A&E admissions are down to *proper* medication use. Agree with comments above. This is all getting rather sinister. Am also reminded of the plans (not yet that strongly rejected) to force people to have mental health treatment (unspecified as to what, exactly) on pain of having their benefits removed.

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  • Its those badass pigs on two legs again.

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  • Azeem Majeed

    There has been some previous research on the effectiveness of interventions to improve medication use among patients, including some systematic reviews. It would be helpful to know if the Lambeth CCG team looked at this evidence before planning their own medicines optimisation programme. Although the CPD element of this programme is described as ‘free’, it is not actually free in that it requires around fours of GP time to complete (which is time I could spend on another professional activity). I am a Lambeth GP and I did receive a letter from the CCG about this programme yesterday. However, the letter did not address the concerns that I and some other Lambeth GPs have about the programme and in particular, the CPD element.

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