Self care ‘does not cut GP work'

DoH figures showing the Expert Patient Programme (EPP) cut GP consultations by 7 per cent have been questioned by other DoH-funded researchers.

The EPP, which began in 2002, runs self-management courses for patients to help them manage their conditions.

Last year’s primary care White Paper promised to triple the scheme’s expenditure.

This month the DoH released ‘internal evaluation data’ about the EPP’s effectiveness.

The full research was unavailable from the DoH, but a spokesman said that data from approximately 1,000 EPP participants showed patients attended 7 per cent fewer GP consultations and had 16 per cent fewer attendances at A&E and 10 per cent fewer outpatient visits.

A total of 38 per cent felt that symptoms including depression were less severe up to six months after completing a course.

However experts from the National Primary Care Research and Development Centre at Manchester University believe that the programme will fail to deliver the expected results.

Professor Anne Rogers, who led the rival Manchester research, which was DoH funded, said: ‘There was no reduction in the number of healthcare visits as a result of this scheme.’

She suggested that data used by the DoH was flawed.

The Manchester team looked at two groups; one that was given access to the programme and a control group. It found the EPP boosted patients’ confidence and made them feel more energetic.

However, it failed to reduce the number of healthcare visits they made.

Professor Rogers said: ‘Initially we thought that the programme might reduce the number of days for which patients had to be admitted to hospital. But the differences were not statistically significant.’

She said the DoH’s study had looked at patients who volunteered to return to the centres to fill out questionnaires.

The study ignored those who had dropped out of the schemes or who had failed to complete the questionnaires.

Members of the Manchester team expressed surprise the DoH had relied on its internal research, rather than the ‘rigorously conducted  trial’ from Manchester.

Professor Rogers said: ‘EPP might be helpful for those who see themselves as good managers. But there might be good reasons for not wanting to engage with other patients. It’s not helpful and it doesn’t seem to reduce visits to GPs.’

What do you think? Email your comments to GPletters@haymarket.com

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