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GPs buried under trusts' workload dump

Patients feeling supported by GP as important as medication for diabetes control

The relationship between GP practices and patients with diabetes is ‘potentially as important’ as medication is for managing the disease, research has shown.

Ensuring patients feel 'listened to, involved and cared for’ is a 'realistic way to make a difference to their clinical outcome' according to the study, which compared data from the National Diabetes Audit with GP survey data on the attitudes of patients with long-term conditions.

Researchers found practices in England that scored more poorly in a survey question asking whether patients had enough support in managing their long-term condition also had a higher proportion of patients at high glycaemic risk and fewer patients hitting targets for controlling the disease.

'GP practices engaging more effectively with their patients have a higher proportion of people on target HBbA1C,' said the paper, published in the Primary Care Diabetes journal.

Researchers found several aspects of care could account for variation in diabetes contro,l including practice demographics and how well services were organised.

But the they also showed that medication and whether patients felt supported in managing their long-term condition had the same level of influence over whether patients were hitting glycaemic control targets.

The paper concluded: 'The relation between the person with diabetes and clinician in primary care shown to be quantitatively potentially as important in influencing glycaemic outcome as the services provided and medication provided.'

Study leader Dr Adrian Heald, diabetes consultant and researcher at the University of Manchester, said the results show GP practices engaging more effectively with their patients have a higher proportion of people on target HbA1C.

He said: ‘The analysis that we report here combines two completely independent data sets, the GP practice patient survey and National Diabetes Audit, to demonstrate clearly and quantifiably that to support and inform patients with [long-term conditions] and ensure they are engaged, is just as important a function of primary care staff as keeping medication reviews up to date and completing the required checks.’

He added: ‘This will pay off in longer term, reduced healthcare costs.’

Dr Andrew Green, BMA GP committee clinical and prescribing lead, said: ‘It is always reassuring to get the results of a study confirm what we have believed for years.’

He added there was more to successful treatment than performing tests and prescribing based on protocols.

‘Modern management of chronic disease is complex and relies on trust and relationships built up over time. In the rush to improve access and address workforce problems we forget the role of a trusted personal doctor at our peril.’

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