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Nurturing ideas for productivity

13 January 2012

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It was, as one of the winners said, “a night I won’t forget in a hurry, that’s for sure”. As those who attended will understand, I’m referring to the General Practice Awards 2011 ceremony on 16 November, an evening that toasted the hard work, dedication and innovation of GP surgeries across the UK.

As the dynamic Practice Manager of the Year Valerie Denton said, the lavish occasion at the London Lancaster Hotel, hosted by TV’s Dr Phil Hammond, felt “just like the Oscars” – although the assembled guests were, in my opinion, far more deserving than the pampered celebrities we normally see receiving onstage plaudits. Huge congratulations to all the winners and the nominees – for all achievements were uniformly outstanding – whom I enjoyed speaking to in my ignoble attempts to bask in their reflected glory.

This was the first time this publication joined forces with sister publications Nursing in Practice and GP Business to celebrate general practice in its totality, a move that makes perfect sense in view of the multidisciplinary nature of GP surgeries.
Details of the many winners can be found at but I would like to pay special tribute here to Practice Administration Team of the Year Garswood Surgery in Wigan, who were deserving victors for their work managing patient recalls.

The surgery’s receptionists perform a daily search of the clinical system’s diary and report any entries made for that day. This simple action is the first step of a robust practice-wide quality protocol that ensures proactive patient follow-up, resulting in fewer hospital admissions. “The system means that patients whose condition worsens are quickly identified and they are seen promptly,” said Practice Manager Sharon Greenwood.

It was pleasing to see that practice receptionists’ crucial role received further attention recently when a British Medical Journal study lauded their “complex prescribing role” (see News Digest). In a finding that might not surprise practice managers, academics from the universities of London and Nottingham reported that reception staff often use “practical judgements to help bridge the gap between formal prescribing protocols and the complex reality of the repeat prescribing process”.  This work is creative and demands both explicit and tacit knowledge, the authors went on to say, adding that clinicians are often unaware of this input.

I do hope those clinicians are in a minority. The work of a collaborative practice team using its staff and resources effectively to provide good patient care, as evidenced by the work of Garswood Surgery and others, will need to be clearly understood if practices are to deliver the QIPP (Quality, Innovation, Productivity and Prevention) agenda to enhance value for money while maintaining or improving quality.

Dr James Kingsland sums up this mighty challenge in our interview this issue when he says practices will have to become “more productive with what is protected”. This is the essential gauntlet thrust upon practices, and will surely be the dominant goal over the next few years, as the NHS seeks to make £20bn of efficiency savings by 2015.

In our feature report this issue, Peter Rowe, the government’s QIPP lead for medicines use and procurement, doesn’t pull his punches when he says: “Practices have to grasp the fact that others are already making changes – and if they don’t keep up, they will have to justify why not”. The report looks at potential changes alluded to, including the use of telehealth, risk profiling, collaboration with pharmacists and even encouraging patients to self-care.

Steve Martin’s (no, not that one) article this issue follows up on the latter point, suggesting how ‘influencing’ measures can reduce those dreaded ‘did not attends’ (DNAs). This is also discussed as part of a look at the recently piloted Productive General Practice programme, focusing on QIPP. What’s striking is how important the team effort has been to the success of these case studies.

It seems that while QIPP is a difficult and dominant challenge, it is not unsurpassable – especially when faced collectively. On that note of solidarity, I’d like to wish all readers a happy start to 2012.