NHS must get smarter at spreading clinical knowledge, says Dr Ben Goldacre

Conventional academic papers are not the answer to improving patient care and the NHS needs to develop new 'structured machines' for disseminating and implementing knowledge, Dr Ben Goldacre told the RCGP conference.

Dr Ben Goldacre (Photo: Pete Hill)
Dr Ben Goldacre (Photo: Pete Hill)

Dr Goldacre, who has been appointed by health secretary Matt Hancock to head up a new tech advisory board, said there was often ‘unwarranted variation’ in the way drugs were prescribed.

He said his work developing the Openprescribing.net website, which allows users to see what GPs, practices and CCGs are prescribing, had showed ‘interesting patterns in the dissemination of knowledge in the medical profession’.

He cited examples relating to drug switches to either a better or generic treatment, which showed variations in when and how quickly CCGs had switched.

‘This is not about bad doctors, it’s about bad knowledge structures,’ he said. ‘We need a coordinated machine for disseminating knowledge to frontline decision makers that goes well beyond [medical optimisation] teams that are sometimes great, but can be variable, with variable skills in different places.’

Pharmacists, doctors, software engineers, epidemiologists, patients, writers and editors need to be involved if you are to disseminate knowledge to people, Dr Goldacre argued.

‘It’s not enough to do clinical trials and then publish it in a journal read by absolutely nobody – nobody cares. You need to get knowledge into action. You get knowledge into action by paying people salaries, to go out there and get knowledge into action,’ he said.

‘That is not to say that academics are of no consequence or value. These problems all require deep knowledge of data analysis, epidemiology, statistics, research methods, clinical trials and patient care.

‘What they require is that funders and universities pay people who have those skills to analyse data, to spot problems, to fix them. But not with the goal being to produce an academic paper, but with the goal being to produce an amazing machine that disseminates knowledge and finds the best way of disseminating knowledge. A machine that looks for practice variation, not just in prescribing.’

Dr Goldacre said that there was no one currently funding ‘that kind of thing’, which he said was ‘utterly deranged’.

‘We need patients and coal face clinicians to tell funders and universities that we don’t care how many papers they publish in obscure, paywalled, low impact journals,’ he concluded. ‘We demand better service.’

Read more from the RCGP annual conference

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register

Already registered?

Sign in

Just published

GP Job of the Week: Lead GP, urgent care centre, east London

GP Job of the Week: Lead GP, urgent care centre, east London

Greenbrook Healthcare is looking to appoint a lead GP to its clinical leadership...

NHS England says it will avoid top-down approach to PCNs

NHS England says it will avoid top-down approach to PCNs

NHS England will not issue national guidance to primary care networks (PCNs) about...

Capita admits to further cervical screening administration errors

Capita admits to further cervical screening administration errors

The BMA has again demanded that Capita be stripped of its contract to provide GP...

GPC Wales appoints new chair

GPC Wales appoints new chair

Dr Phil White has been appointed the new chair of GPC Wales.

Nine in 10 GPs say appraisal improves patient care

Nine in 10 GPs say appraisal improves patient care

The vast majority of GPs believe annual appraisal helps to improve patient care and...

GPs have a key role to play in helping people back into work

GPs have a key role to play in helping people back into work

Brief interventions by health professionals can help people to achieve their working...