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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.’