Hein Le Roux and his wife Emma and family have recently returned from a stint in Grafton to work as GPs in the England.
While here, Hein was a collaborative star, presenting his change ideas at a number of workshops.
In the UK, as well as general practice, he will also be doing ‘stuff’ with the NHS Institute for Innovation and Improvement.
This is the first in what we hope will be a series of ‘Postcards from UK’. The UK experience in ‘commissioning’ may be invaluable to us as we enter the new world of Medicare Locals. There is nothing like having a gude to walk in front – and fall into all the hidden traps before we do. GP Commissioning sounds like a particularly perilous trek.
Lots on changes to the way we work aiming to reduce health inequality, improve care quality and control costs – all of which they call ‘GP led Commissioning’.
It is about getting clinical engagement to improve service commissioning (eg hospital services) and greater GP accountability for the health care budget – what is spent and the outcomes achieved.
At present we do what we like (referrals, prescribing etc) with little accountability. As a result there are many ways of doing things and care quality is variable whilst health care costs are out of control.
Although I can see the merits in some of this, there will need to be a massive cultural change in how we GPs think. All the practices in an area (consortium) will be paid part of their income based on a ‘quality premium’ determined by how we all do. In our area that is 85 practices covering 600 000 people – is quite scary. Like a super-collaborative with big teeth. Needless to say collaboration will be the key to success.
Your comments welcome.