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‘Box ticking’ fears over NHS mandate changes


20 February 2013

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Making ‘every contact count’ is set to be cemented into the GP mandate, amid concerns from GP leaders that it will lead to increased “box ticking”. 

On February 14 the government released a report which proposed NHS staff should be responsible for “improving [patients] health and wellbeing” at every consultation. 

Making ‘every contact count’ is set to be cemented into the GP mandate, amid concerns from GP leaders that it will lead to increased “box ticking”. 

On February 14 the government released a report which proposed NHS staff should be responsible for “improving [patients] health and wellbeing” at every consultation. 

“Health professionals are very well placed to support patients with wider support around their health and wellbeing,” the Department of Health (DH) document said. 
‘No need for targets’
But deputy chair of BMA’s GP committee, Dr Richard Vautrey believes GPs do not need to be driven by targets. 
He said: “Addressing the patient’s ideas, concerns and expectations should come first, rather than what the government or others suggest might be good to include.
“Every GP will provide appropriate advice on diet, exercise or smoking whenever it’s appropriate to do so, and if they have the time within an already packed consultation to do that.”
The government report on “strengthening” the NHS mandate said many healthcare professionals support the proposals. 
Enforcement
However, the document noted a significant number of respondents were concerned about “practical implementation and enforcement”. 
Dr Michael Dixon, chair of the NHS Alliance said it would be “the worst thing” if GPs had to start doing “consultations by numbers”. 
He said: “If someone comes in to say that their husband has just died, it would be absolutely trite to tick a box and say I’ve given ‘lifestyle advice’.”
Yet Dr Dixon said in general the idea is “absolutely fair and reasonable,” and that “general practice should take a far greater role in local health”.  
DH said it would welcome a “more holistic approach which maximises opportunities for each contact” in the NHS Constitution.

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