NICE must be built into IT systems to work
I'm writing regarding your debate on NICE last week to give my own experience of working with the institute ('Does NICE listen to the views of GPs?', pulsetoday.co.uk/ debates).
In December I attended the NICE annual conference in Manchester and presented, with our PCT, a summary of our strategy for implementing NICE guidelines in primary care.
We were winners in our category and met and talked at length with a team from NICE. They were a delightful group of people doing a job that has to be done if we're to avoid healthcare being dominated by single-interest groups. But two things struck me at the conference.
First, GPs made up a tiny proportion of the delegates. Second, my impression was that the NICE team did not have general practice in its sights, did not really understand general practice and had no experience of our IT systems. Furthermore the challenge of incorporating one piece of guidance into a specialist team is quite unlike trying to change general practice behaviour with a flood of green booklets.
If NICE is here to stay we must strive to incorporate its guidance into our workflow or face the medicolegal and regulatory consequences.
I believe very strongly that the only way to bring about this change is to build user-friendly templates into our IT systems. If well-designed they will improve both the quality and speed of consultations, by allowing us to display relevant information from the patient database, print pre-constructed blood test forms and information for the patient, highlight age-related guidance, perform single-click data input and aid us with prescribing.
Such IT systems will bear little resemblance to NICE paper summaries which are unusable in the consultation and have little impact on the behaviour of general practice teams.
I agree with both Dr Rubin Minhas and Dr Simon Bradley that GPs need to get involved in this important process to tease out what behaviour needs to be changed by the guidance and to work out how to encourage that change. We have begun this process and by working with NICE and IT suppliers, we can develop it further.
From Dr Alan Fisher, BournemouthShould GPs build user-friendly NICE templates into their systems?