Is NHS England wasting £45Million?

On the face of it - the online consultations programme sounds like a good idea - improve access to GPs and help reduce their workload by utilising IT. Its normally something I’d be very enthusiastic about. The devils advocate in me wonders if it’s a good use of the money or is it a handing over of a lot of money to a range of small and not so small IT companies that they haven’t been able to convince the majority of GPs to buy their product in the first place?

There are roughly 8000 GP practices and that means its about £5K each or perhaps £2K for a small one and £10K for a large one. Or if you think in terms of a GP federation - mine has ~30 practices that’s £150K

Could the money be spent in a better way? Better is difficult to define but more locally determined according to local priorities might be one definition, on things that might have more effect on either access or productivity could be another.

Well its one off capital, which means lets start with things we could buy. New computers, ours are often 5 years old slow running 32 bit windows 7, with little memory. They crash all the time often in the middle of surgeries and replacing them might be  huge win, or replacing them with laptops as I do wonder if the future is mobile. This morning it took one of my admin staff 30 mins to log on - that’s 30 mins of her time lost - 30 mins of her salary I paid for where she was doing nothing.

Bigger screens or dual screens, we have bought some for our clinicians, often we have multiple windows open and we spend ages reading things on screen. A really decent huge monitor or one that you could rotate to portrait might ease eye strain and make life better.

OK neither of these improve access or patient care though having a happier GP isn’t a bad idea. So what about training or consultancy. I’m often surprised by how little training people get or how often its updated. Also there are lots of consultancy services around that will come in and improve and streamline internal processes or look at access. I saw one the other day who claimed to reduce waits to see a GP from 2 weeks to 2 days not with a fancy IT system but by just looking at smoothing capacity to match demand would this be a better spend?

one of the most successful things to my mind that NHS E has done is fund the pharmacists in practice scheme - could they not pump prime a physio first or mental health worker first scheme - both have lots of evidence they affect patient care in terms of less time off work, less prescribing, less referrals.

Which brings me to how are they going to evaluate the scheme? Just saying a number of people used it - isn’t enough - was it a good use of the money compared to alternatives? There are lots of concerns that all these initiatives just drive demand - do they really drive the self care agenda? I guess - as its one year funding - the number of practices that take on the costs themselves in year 2 might be a measure.