What is the role of doctors in managing demand on the NHS?

BMJ 2017; 356 doi: https://doi.org/10.1136/bmj.j1269 (Published 16 March 2017) Cite this as: BMJ 2017;356:j1269
  1. Gareth Iacobucci, senior news reporter, The BMJ
  1. giacobucci{at}bmj.com

As the NHS strains under pressure from rising patient activity, an ageing population, and financial constraints, The BMJ hosted a discussion on how clinicians should be helping to manage demand at last week’s Nuffield Trust health policy summit. Gareth Iacobucci reports


Jeremy Taylor, chief executive of the charities’ coalition National Voices, kicked off the debate by questioning the use of the term “managing demand.”

“It sets up an unhelpful dynamic in which people with healthcare needs go to clinicians and their stance is, “how can we minimise their use of my service,” he said.

“Yes, money is tight, but people will get ill and will need access to healthcare.”

Ashok Soni, chair of NHS England’s local professional network for pharmacy in London, said clinicians could do more to engage with patients about using medicines more appropriately and effectively.

“We know that between 30% and 50% [of medicines] are not used the way they are designed. Pharmacists have worked with care homes, and we’ve demonstrated quite significant savings in terms of better use of medicines there,” he said.

Martin Marshall, vice chair of the Royal College of General Practitioners and professor of healthcare improvement at University College London, spoke about the importance of strong relationships between GPs, consultants, and patients.

“We need to go back to reminding ourselves about relationships and continuity,” he said.

“I'm very comfortable having conversations with the patients I know about what is appropriate and what might be less appropriate. When …

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