NHS Tameside and Glossop launched a project to provide lifestyle advice to people identified using GP practice systems. The pilot was run as part of the DH’s integrated care pilots.
Patients found to be at 20% or greater risk of developing cardiovascular disease were invited to attend advice sessions either at a pharmacy or their local GP practice.
A report evaluating the integrated care pilot projects for the DH revealed that patients were unwilling to attend sessions at a community pharmacy.
‘The focus of the pilot changed from pharmacies to GP surgeries during the course of the pilot because of people’s reluctance to attend these services at pharmacies,’ the report said.
‘This highlighted that the presumed patient preference may not have been correct or may not have been strong enough to change behaviour.’
The report also warns against basing service decisions on presumptions about what patients will prefer and stresses the importance of basing service redesign on evidence.
‘The focus on the needs and preferences of end users can easily be lost in the challenging task of building the organisational platform for integration and in organising new methods of delivering professional care,’ it said. ‘Using performance metrics focused on the end user and strengthening the user voice in the platform for integration might avoid this.’
NHS Tameside and Glossop had ‘reported learning from the experience’, the report said.
GPC deputy chairman Dr Richard Vautrey said the decision to scrap pharmacy-based screening services was ‘not a surprise’. ‘In reality, there was a lot of duplication,’ he said.
‘What this demonstrates is the importance of well structured screening based on the GP practice list,’ he added. ‘This is the most effective and cost effective way to deliver such screening.’
Dr Vautrey said that he would expect such decisions to become more common as clinical commissioning groups (CCGs) look to make evidence-based decisions on services.
‘I would expect CCGs to be more tough on non-cost effective treatment,’ he said. ‘If [introducing CCGs] is going to do anything, it is going to bring clinical understanding to decisions.’