Commissioning good for GI care

Practice-based commissioning (PBC) should be used to improve the management of dyspepsia and coeliac disease in primary care, the British Society of Gastroenterologists (BSG) and GP specialists have said.

A BSG report released last week claimed 80-90 per cent of all GI disease was managed in primary care, and called for more resources to be put into primary care GI services.

Oxford GP and Primary Care Society for Gastroenterology (PCSG) chairman Dr Richard Stevens said that he was disappointed that dyspepsia and coeliac disease had not been included in the revised quality framework.

'It is seems odd that a major speciality that takes up 10 per cent of GPs' time and an even bigger slice of the budget for primary care should be overlooked,' he said.

'They must be in there next time, and PBC should help.'

He said PBC could improve GI care because GPs would realise they could make savings through dyspepsia clinics. The PCSG is approaching commissioning group leaders to help them realise potential savings.

The BSG report said more gastroenterology GPSIs should be trained to take over management of chronic GI conditions and to perform endoscopy in the community.

Dr Stevens said PBC would help reverse the sliding numbers of gastroenterology GPSIs by providing opportunities, and a lot could be done by GPs without much extra training.

'We need more GPSIs, but improving care is not just a matter of creating more ring-fenced specialists. You can look after those with chronic disease or do endoscopy and still be a generalist,' he said.

A survey of 13,300 GPs commissioned by Reckitt Benckiser found that 33 per cent would be prepared to run a dyspepsia clinic in their practice.

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