GPs are not the only players in commissioning

The government announced GP commissioning with great panache earlier this year as only a seasoned master of ceremonies could, writes Dr Anil Mehta, clinical director of the Fairlop Polysystem, Redbridge, north east London.

Dr Anil Mehta: 'I remember seeing my first PCT finance report and thinking it would be easier to read hieroglyphics'

It duly exited stage left leaving the new players of primary care blinking under the spotlight in front of an expectant audience.

No one would blame GPs for a serious case of stage fright given the speed with which we have been propelled centre stage but it would be a mistake to take it upon ourselves to be an all singing, all dancing bandwagon.

Nothing exists in isolation and commissioning is no exception. Indeed, a newcomer to healthcare would be forgiven in recent months for thinking that GPs were primary care.

In reality, commissioning is only going to work if we genuinely pool our skills and experience with fellow professionals.

In my opinion, nurses are vital to the commissioning process. They see more patients then GPs and are often local residents themselves with a real understanding about what’s happening in the community.

A lot of changes that can improve patient experience don’t require huge sums of money but are about thinking smarter and unlocking bottle necks of bureaucracy and poor practice that nurses are often aware of.

For example, we have a 15-week wait for a physio appointment, non-district nurses and GPs aren’t allowed to syringe ears during home visits and our local hospital’s anti-coagulation unit won’t manage patients’ INR unless their blood is taken on site.

A one-stop shop service for COPD patients, a neighbourhood blood testing service and more hospital outpatient appointments in a community setting are further examples of positive change.

In turn, nurses shouldn’t be shy in coming forward. GPs have long held the belief that they can do a better job than PCTs and have been given the Christmas present early.

Likewise, nurses need to be more vocal and willing to get involved in the whole process because they have a valuable contribution to make at what is a historic turning point in the NHS.

I can hear nurses say they know nothing about commissioning, finance or any other number of duties stacking up outside our door.

Well, I’ll let you into a secret. Neither did I until I took the plunge. I remember seeing my first PCT finance report and thinking it would be easier to read hieroglyphics.

We all have something to bring to the table and that combination of knowledge is formidable if we find time to share it.

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