In the curious acoustic of the BMA’s magnificent round Prince’s Room, where one can hear a conversation on the other side of the room as if it were at one’s own table, TFPL held a meeting of their Health Special Interest Group on the information needs of GPs. Commissioning needs dominated, hardly surprisingly. This is a partial account, based on my notes and tweets. There’s a TwapperKeeper archive of tweets at the #tfplsig hashtag, and the presentations and questions and notes from the group tasks, are online. There’s also a TFPL blog report.
Welcoming us, Vivienne Winterson of TFPL introduced the chair for the evening, Sue Lacey Bryant, who, Vivienne observed was ideally suited to lead our discussions, having an unique awareness through her role as Associate Director of GP Consortia Development at NHS Milton Keynes and her involvement in evidence-based practice. Where will we be in 9-18 months time, Sue asked? What products should we be developing to meet commissioners’ need? She mentioned work-life balance as a key issue, as commissioners face huge workloads.
Anita Jolly, Clinical Specialist with BMJ Learning, took us through the commissioning continuum, from the micro level of one doctor commissioning services for one patient, through the meso level, commissioning for localities, to the macro level, commissioning for communities. There will still be some national commissioning, for example for rare conditions. Commissioners will have to carry out population needs analysis, service analysis and must set priorities setting. They must procure services that are the best fit, shape provider structure, plan capacity and evaluate outcomes. The patient experience will be at the heart of everything.
Knowledge needs will be heaviest at the strategic planning stage, with a great deal of epidemiological data and information to be processed. I’ve put here in bullet form the knowledge needs she identified:
• National drivers
• Financial drivers
• Service design
• Evidence based models
• Organisational research
• Health economics
• Market intelligence
• Other providers (cf ‘any willing provider’)
• Capacity management
• Policies and guidelines
Commissioners will need skills in strategic planning, procurement (including information management). They will need to promote an evidence-base culture and continuous quality improvement.
Then Anne Gray of Quality:MK took us through her experience of commissioners’ knowledge needs. They want to know about:
• Service specifications
• Business cases
• Models used elsewhere (with contact names if possible)
• Will it work here?
• Summaries of evidence
• Impact analysis
Quality:MK offers a hot topics page, updated with the issues of most concern to commissioners. At the moment self care and urgent care are riding high Probably the most important point Anne made is that references are not enough. Commissioners need a much more tailored and active service. She also mentioned the Commissioning Handbook for Librarians, a wiki-based resource for librarians supporting commissioning, the Ask an Expert service and a paper,
Gkeredakis, E and Roginski, C
The need for clarity in evidence based commissioning.
HSJ 26 May 2011 p23-25.
The final speaker was Sarah Panzetta, who described the development of the GP Camden website. Development started in 2008 and the site launched in 2010. Camden has a large number of locum or salaried GPs, with high levels of information need unmet by a complex landscape of disparate organisation-based websites and intranets. Sarah told us that getting content right for the incredibly complicated world of GPs takes time. Compatible referral forms were very popular with users. The presence of Dr Poppy Freeman, the GP lead for the project, was crucial to its success. Developing the site required the core skills of a librarian: gathering, organising, describing. Obsessive tendencies needed to be curbed; the best was often the enemy of the good.
In discussion, we were given eight minutes (which seems to be a new magic number for group tasks), to answer a series of questions:
• What kinds of IM skills does a CCG need as it moves forward into commissioning?
• Who do we need to liaise, partner, network with to meet these information needs (as a virtual team)?
• How to identify models of care?
• What do we need to learn and improve?
• What tools and rules are required for commissioning?
I was in the final group, on tools and rules. I fear we didn’t think of much in the way of rules, but perhaps some of the tools might be useful. In the report-backs, I was struck by comments from the Models of Care group, who came up with some interesting ideas for sharing information in the NHS. In general, there is a considerable need for knowledge to be shared by GP commissioners. What worries me is how far market pressures will militate against this.