The British Medical Association’s (BMA) General Practitioners Committee (GPC) has written to the Department of Health (DH) with an analysis of the results of a consultation exercise and the surveying it has done to assess GPs’ views on the effect the forthcoming changes to their contract will have on their services. The relevant points for people who wish to promote telehealth remote monitoring are paragraphs 47 – 55, starting on page 13 of the BMA’s letter to DH. (PDF) Basically they are saying ‘It’s too difficult; we don’t believe it helps ease our work or that patients like it; so we can’t be bothered and please re-think making us do it.”
However, this reaction has to be seen in the context of the response as a whole. The BMA (as the doctors’ ‘union’), has a particular need to spin the results in the most negative way and the survey was undertaken at a time when GPs’ morale has been low and, on page 1, the BMA summarises the complete findings as:
“An overwhelming 88% of GPs responding to our survey with some awareness of the proposed contract imposition agreed with the statement that they personally will be less able to offer good quality care to their patients as a result of this imposition. Of the 58% of GPs who said they were prepared to take action and who expected to make changes as a result of the imposition:
54% said they expected their practice to have to reduce access to patients.
– 91% of these said that GPs would not be able to see patients for routine appointments as quickly as they currently do
– 72% thought they would have to reduce the number of consultations offered to free up time for the new workload
– 75% expected to reduce the range of services offered to patients.
82% expected to have to make changes to staff working hours or employment
52% expected to reduce their use of locums
Heads-up thanks to Mike Burton.
Why is that that Policy-Makers and Doctors appear to conduct all their discussion using mega-phones; just shouting and posturing? You wonder if GPs understand the Hippocratic oath. We need a sensible, low key, grown-up discussion between all parties to work through the issues – we as citizens deserve it. We all know that telecare remote monitoring must play a part in keeping people healthy and their conditions more stable, delivering care closer to home where people want it, reducing unplanned admissions and allowing more proactive interventions (oh and therefore controlling costs). However it is obvious that it cannot be delivered within the existing healthcare set-up and with existing IT systems. There has to be changes in clinical workflow and some re-configuration in the way healthcare services are delivered and the provision of extra IT systems to not only support this extra data capture but to intelligently integrate it across the patient journey. With the changes in Healthcare in England – funding moving to GPs. the creation of Clinical Support Units and Clinical Commissioning Groups you’d think there are organisations who have some ability to start small and innovate and try things out and see what works. Instead we are destined to fail as the BMAs’ minds are completely closed to the bigger picture and policy-makers don’t know how to engage. encourage and cajole. Why should we be surprised? Policy-makers appear to see telecare remote monitoring as a technical silver-bullet and the BMJ don’t have a track record in innovation – after all it was the BMJ who have just about killed Summary Care Record by putting the frighteners on people around privacy, which has been successfully worked through in so many other countries around the world. In the words of Private Frazer, “We’re all doomed”.