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Teaching GPs to say ‘no’

I'd like to clarify a couple of points raised by your article about ‘agreeable' GPs being a problem. (‘Agreeable' GPs should face disciplinary action, says NHS watchdog)

The National Clinical Assessment Service is not a ‘watchdog', but exists to provide advice and support to healthcare managers, doctors and GPs who are concerned about the performance of a colleague. We provide a similar service for pharmacists and dentists.

Our new good practice guide Handling concerns about a practitioner's behaviour and conductis designed to assist this, and our advice is always to act quickly so that any problems can be addressed and resolved early on.

In regards to ‘agreeability', it's self-evidently a good thing for GPs to listen to patients carefully and treat them with respect and kindness. But, of course, that sometimes includes saying ‘no' to a patient's request if it's not in their best clinical interest.

In our experience, there's only a small number of doctors who won't say ‘no' because they dislike confrontation, but this can lead to problems – for example, the over-prescription of antibiotics. It's this kind of ‘agreeability' we want to help GPs avoid.

The starting point for our advice, which is free to the NHS, is always to support practitioners back to safe practice through training where possible.

Our 11 years of experience has shown that the overwhelming majority of GPs who get this help are able to make changes and provide better, safer services as a result.

From Dr Pauline McAvoy, Interim medical director, National Clinical Assessment Service