Strategic Change In The Uk National Health Service: The Views Of Some General Practitioners

The NHS White paper (The new NHS modern dependable) was published in December 1997. This strategic document, endorsed by a new Government, promotes integrated care, national standards of care and easier and swifter access to the NHS, in a ten year programme which proposes that local doctors and nurses will shape local primary and secondary care services. The opinions of a small group of General Practitioners were surveyed from a structured questionnaire as part of a seminar / discussion session. The GPs' knowledge and views of the White Paper were obtained, together with data on their own practices' clinical performance, their priorities and their use of information. The differences between their views and experience and the national strategy identify constraints to change in the extent of collaboration, of clinical consistency, and of information use. The findings are important because an effective national health strategy relies on full support from those whose work is affected, especially general practitioners, and these proposals will involve them in more planning and management than is currently the case. The currently little collaboration reported between GPs and other care agencies conflicts with the Government proposals. GPs also said that they did not use information much in planning and delivering services. They were not confident in accessing, analysing and understanding information, and felt that there was insufficient relevant information to help them plan and deliver services to major patient care groups. It is hoped that exposure to, and support with, information management methods should increase the amount of shared relevant information, and the use to which it is put. GPs' current focus on their individual practice, rather than on the envisaged larger, multiprofessional PCGs, may limit the preparation of agreed rational plans and the introduction of effective collaboration.