Monday, 5 January 2009

COPD - commissioning innovation in Easington

Innovation - butterfly leaps from hands.  Image borrowed from nextup
Does Practice-Based Commissioning (PBC, asking the GPs and GP surgeries to decide what their patients need, then providing the funding to pay for it) work?
Many erudite commentators say that GPs aren't getting engaged, aren't bothered to come up with good ideas.  Is this because the GPs have tired of coming forwards with ideas, or because they are too greedy and can't see where to make a profit?
Obviously it is easy to find any number of cases to support each point of view, but http://www.pulsetoday.co.uk/story.asp?sectioncode=40&storycode=4121538 (you will have to register for Pulse before they let you view the page) illustrates clearly that GPs do understand their patients and their patient needs, and with no benefit at all to the GP (because Co Durham PCT has phased out the 70% of savings going to the GP surgery) are fully prepared to step in and defend the patient's right to dignity and the best possible life.  In this case, GP practices in Easington, in combination with community staff, PCT and social services, created a simple to follow chart which relieves anxiety during a COPD attack and in many cases means the patients choose not to go to hospital.

I've written about this before. http://benefits.minney.org/2008/07/commissioning-for-innovation.html.  Without someone prepared to take a gamble we'd never move forwards.  So many management consultants explain how you can shave 5% off here, and 2% off there, always working within the bounds of what is already known, asking each organisation to do the same as the best organisations.  Where's the innovation?  How will we find anything new?  
Patients aren't widgets to be processed as quickly as possible.  If we don't get it right, sickness has a nasty habit of getting worse, finding another way to pop up both in terms of time and use of resources, and in terms of pain and incapacity.  If we do get it right, happy people live active and fulfilling lives.  Innovation is important!


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