Headlines: November 23rd, 2005

Small medical practises have an important role to play in the modern health service according to two new papers, “People matter: doctors, patients and the NHS” and “Squaring the Circle” produced by the NHS Alliance and the Small Practices Association. They dismiss the suggestion that small practises are out-dated anachronisms.”People Matter” says that small practises provide continuity in the doctor-patient relationship, which can have a major impact on health and health care costs. It points to research that consistently confirms that this continuity is what all groups of patients prefer and says this is particularly important for those with serious health problems. People with long term conditions, carers and the elderly also value what is now called ‘relational continuity’, according to the authors of the report.

The paper argues that even though it is easier to deliver relational continuity in small practices, organisational improvements can also be made in large practices. The two are not mutually exclusive. It puts forward two possible models of how small practices can deliver benefits normally associated with size. One is the ‘nested’ practice where a number of independent practices operate from the same location. The other is the ‘virtual super surgery’, the benefits of which have already been demonstrated in a collaborative project in Nottinghamshire.

The issues raised in the paper are discussed in more detail in the longer document: “Squaring the Circle”. Dr Michael Taylor, chairman of the Small Practices Association, said: “For too long, we have focused on organisational issues at the expense of human contact. People matter. Patients, their doctors – and NHS managers too. We must not allow the modern NHS to be de-humanised. Healthcare is a human service, and neither patients nor their doctors are numbers.”