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We need to reduce rules and restrictions for commissioners and GPs, Dr Michael Dixon tells CCGs

Dr Michael Dixon

At a meeting between Ashford and Canterbury and Coastal CCGs in Kent, Dr Michael Dixon said: ‘If we want to bring back personal doctoring and continuity to our frail patients and those with complex diseases, we need to free up our clinicians to do this, and not restrict them with an over-prescriptive model of how to do it.’

Posted: 9 April 2014

During his speech, which was part of an education afternoon for GPs, he said that: ‘”Tick-box medicine” or “medicine by numbers” is not patient centred medicine. We must free clinical commissioning from rules, regulations, competition restrictions and conflict of interest issues so commissioners and their constituent practices can plan and implement ‘general practice at scale’. This will then allow them to take on the “out of hospitals services” agenda that we have all been talking about for so long.

‘For general practice, it is essential that we restore the element of professionalism and goodwill, which comes from treating GPs with respect, and enabling general practice to get on with the job. This was very much the intention behind the drive for personal care and continuity of treatment for the vulnerable elderly and those with complex disease.

‘Unfortunately, the good of all this is in danger of being “lost in translation”. The recently published DES on avoiding hospital admissions for the over 75s seems to be all about filling in forms, rather than relating and talking to our vulnerable elderly. When it comes to personal care and continuity it is often the un-measurables that are the most important things. And, having got rid of 40% of the QoF because it was over bureaucratic, we are in danger of replacing it with an even more bureaucratic process in the name of something that is entirely appropriate and laudable.

‘Consequently, in the same way as we must give clinical commissioners greater headroom to do what is right, we must also give frontline GPs and general practices greater headroom to make a real difference. That means less rules and restrictions, not more. It also means handing more decision making powers to local clinical commissioners working with local offices, who know the realities of everyday general practice, and the detrimental and demoralising effect that stifling bureaucracy can have on GPs trying to do their best for patients.’