I believe wholeheartedly in consultation, engagement, empowerment, and ownership.
But not as just buzz words to drop into meetings. Rather, I believe in what these words stand for at their best: genuine conversations between practitioners, partners, patients, policy makers and even politicians; shared insights into what works and what needs work; and a commitment to agreeing and delivering change, and all that that entails.
We recently worked with Imperial HealthCare Partners on a crowdsourced consultation exercise amongst GPs in North West London to understand what tasks, demands and issues most impacted them and took them away from patient care. The results were fascinating - if not surprising. Filling in care plans, writing sickness certificates for schools, chasing payments, writing letters to housing departments, chasing hospital results and following up on in-hospital referrals from hospital staff, chasing discharge summaries, manually entering data, constantly adapting to one new NHS initiative after another.... the list goes on. Over and above the problems raised, we were taken aback by the desire to address them. With over 100 ideas and nearly 200 suggestions and comments, there is a real will amongst London's GP community to help refocus work back onto patient care.
But we're not the only ones consulting London GPs. News organisations are out there too. Polling and surveying practitioners for their thoughts and experiences on workload, well-being and retirement plans. Recently the BMJs "Unheard Voices" feature has provided a channel for clinicians to talk first-hand about their experiences, whilst the HSJ are crowdsourcing views on primary care policy and practices to great success.
Which make it all the more galling that government appears to be moving in the opposite direction. Away from consultation. And away from input from those at the frontline of primary care.
At present, the law says that "affected persons" must be consulted on proposed changes to primary care activities. That means the doctors and nurses working in general practice, the patients who may have reduced or changed services, and the myriad of other providers. Complementing the in-community care provided by district nurses, social workers and mental health services whose service can, and generally do, integrate with GP activities.
Under new proposals recently issued by the Department of Health, there is no need to consult or engage "affected persons". No empowerment of local providers or communities. No ownership of the "what", "where" or "how" of new services in a particular locale, beyond the views of the commissioners and policy makers who, inevitably, will be looking at the bottom line.
Londonwide LMCs has responded to the formal consultation from the Department of Health. For whatever good it will do. The whole process (with its abbreviated, 4 week, consultation period) is clearly a fait accompli. Which is sad because as the Chief Executive of the NHS talks about patients becoming more involved in managing their own care and services, it seems that the system is making it harder and harder for their voices to be heard. You can see the consultation here - https://www.gov.uk/government/consultations/partnership-arrangements-between-nhs-bodies-and-local-authorities (closes on 8th March 2015).
My Londonwide LMCs team work for London's 6000 GPs and practice staff. Every day we are out and about across the capital on the frontline: meeting with the unheard majority of practicing GPs; listening to their concerns and sharing information with them. Finding out what truly matters to them and their practices day in and day out.
I wish we weren't the only ones!