I was never much good at audit. It’s not that I can’t see the point of it (‘research shows us the right thing to do, audit shows us it’s being done right’), and indeed I have started a few projects in my time. But I’ve never got round to completing the cycle.
Unearthing the current state of play in the treatment of leg ulcers on your patch, comparing it with best practice, then tactfully telling everyone what they should be doing takes it out of you. Going back at a later date to check that your staff and partners have taken any notice of you is more than I have ever managed.
Fortunately, the winners at this year’s Guidelines in Practice Awards are made of sterner stuff. Of the 90 or so entrants, those who walked away with the fat cheques and accolades had the stamina to finish what they’d started. Where most of us manage just an audit squiggle, they’d completed the full cycle. So if you fancy some money, some praise and a fab night out at a posh London hotel next year, you’ll have to go the whole way.
The highlight for me was that the top prize this year went to a singlehanded practice. According to the judges, the strategy offered by the small team led by Dr Geoff Rawes allowed them to offer "a truly patient-centred approach".
Now, putting patients at the centre of the NHS is one of New Labour’s mantras (and always puts me in mind of the middle drawer of the mortuary). But Dr Rawes and his practice manager, practice nurse and receptionists had really achieved it, with their one-stop clinics for CHD, hypertension and diabetes, which they set up to do all the checks for these conditions in a single appointment.
Add to that the fact that practising in the north-east of England, as Dr Rawes does, is hardly a picnic, and you get some measure of the achievement.
The team listened to what the patients had to say and involved them, making them far better informed and more likely to adhere to treatment, as well as willing to make lifestyle changes to improve their health. And they had done an audit to prove it.
Although I’m a cynic by nature, I found the Guidelines in Practice awards truly invigorating. Practices were clearly motivated by delivering the best evidence based practice.
We’re not terribly good at praising ourselves in medicine, but we need to learn to do it more. These awards were not easily won – a high calibre judging panel scrutinised them carefully – but I’d like to think that those who made the shortlist will attack their jobs with renewed vigour. Perhaps someone can do an audit to check.
I doubt that anyone entered the Awards for political motives, but in the NHS politics are always lurking behind the screen, not least in the threat to single-handed practices. But there are plenty of small businesses in the UK with excellent quality control which open their work up to scrutiny. Size isn’t the issue.
The achievements of Dr Rawes and his team show that a single-handed practice can deliver the NSFs and keep staff and patients happy. And if anyone tries to close down small practices, here’s some excellent evidence to defend the cause. How can you shut down something that wins an award based on its delivery of the Government’s health reforms?