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A different view

Our editor finds herself talking shop at a Christmas do

I met John the other night at a Christmas party.

As we tucked into our Christmas turkey I asked him what he did.

Turns out he works in a big acute trust hospital.

And we're off, for the next half hour we put the NHS to rights.

John tells me three things that give me a different perspective on things.

1. He doesn't think the NHS is sustainable in its current form and patients will have to take out private insurance in future

2. He genuinely wonders what it's like to work for a lean, efficient private organisation as the message from above is always that the way he and his colleagues work is inefficient

3. He's been told for so long that they have to do things more efficiently, or indeed have had changes to try and achieve efficiency, that it's something of a broken record

I hope GP commissioners are mindful of John and his colleagues and how they're feeling right now.

GP commissioners will need to do more than tune up the tariff or get alternative providers in if the NHS is to be transformed.

The National Prescribing Centre recently published an excellent document on Payment by Results which says up to 60 per cent of medicines used by providers of secondary and tertiary care may be associated with medicines which fall outside the scope of PbR. 60 per cent! Some scope there for GP commissioners?

GP commissioning will have failed if it just nibbles at the edges of acute trusts as commissioners. It needs to effect change throughout the pathway – and engage John et al in that process.

Susan McNulty


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