Committee
Audit Committee, 02 Sep 2003
02 Sep 2003 · S2 · Audit Committee
Item of business
“Supporting prescribing in general practice”
Barbara Hurst:
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I will have a go at those questions.As far as clinical audit is concerned, I should have mentioned in response to one of Margaret Jamieson's questions the role of prescribing advisers in the different health board areas. Although those advisers work closely with individual practitioner practices, they do different things—if you like, they offer a clinical audit, but in specific areas. That is good practice, and one of the reasons that we have published this weighty report is to highlight some of that good practice and ensure that it is shared more widely. Indeed, our report points out that there needs to be more of that kind of work.As for our wider links with clinical audit and particularly with NHS Quality Improvement Scotland, we have been invited to sit on a group that is examining this issue with a view to taking it forward. We would certainly be able to feed our evidence into that group. Indeed, we try to do so whenever we can to ensure that no duplication occurs.The challenge with influencing individual practitioners is that they are individuals, which is probably why we were so pleased to find such great improvement in this area. The matter is very difficult; after all, we are talking about individual GPs. However, the prescribing adviser's ability to work with individual practices is probably where their role has been most powerful at a local level. I am not sure that that has answered your question, but I think that it provides some background.
In the same item of business
The Convener:
Con
Agenda item 3 is on general practice prescribing. I invite the Auditor General and members of his team to brief the committee on "Supporting prescribing in g...
Mr Black:
I will introduce the report to the committee. I have with me colleagues from Audit Scotland who worked on the detail of the report, and who will answer any q...
Barbara Hurst (Audit Scotland):
The present report and the 1999 baseline report were both big pieces of work. We were careful about the choice of indicators because the issue is a clinical ...
Margaret Jamieson:
Lab
The report mentions the waste in prescribing, which was also touched on in the baseline report. However, it does not really mention the work that has been un...
Barbara Hurst:
A number of health boards have done quite a bit of work in that area. On the reuse of drugs that have been prescribed to other people, lack of knowledge of h...
Margaret Jamieson:
Lab
In future, I hope that people who are prescribed a new drug for their symptoms will be given the drug only for the trial period initially, as that will reduc...
Barbara Hurst:
We were speaking about cost-effectiveness in the widest sense, but I must add a caveat. We cannot tell whether people are being prescribed a drug for their d...
Margaret Jamieson:
Lab
The report mentions that transdermal oestrogen-only hormone replacement therapy patches are very expensive, but it does not expand on that comment in relatio...
Barbara Hurst:
That is a crucial point. That is why we have been quite conservative with the savings. Patient compliance is an issue, and some patients definitely need the ...
Mr Black:
The questions that we are being asked are highly relevant. When the committee decides whether to take evidence on the subject, it might want to bear in mind ...
Mr Kenny MacAskill (Lothians) (SNP):
SNP
My question is about computerisation. Government and agencies are attempting to make progress in that area, for example through digital Scotland and broadban...
Barbara Hurst:
That would be a massive study in its own right, so I will give you a partial answer. On prescribing, we found that many pilots go on and on, but we are not l...
Susan Deacon:
Lab
I found "Supporting prescribing in general practice—a progress report" interesting and informative, just as I found the baseline report interesting and infor...
The Convener:
Con
We will come back to those.
Mr Black:
I will respond first to the point on whether we could do more work on the effectiveness of implementation. We should take that issue on board. I give the com...
Barbara Hurst:
I agree entirely with Susan Deacon. The link between community pharmacists and GPs is the way forward. That takes us back to computerisation, which would off...
Susan Deacon:
Lab
I am grateful for that diplomatic response. I hope that we will have the opportunity to probe the matter further.The first of my two final questions concerns...
Barbara Hurst:
I will have a go at those questions.As far as clinical audit is concerned, I should have mentioned in response to one of Margaret Jamieson's questions the ro...
Susan Deacon:
Lab
What about the question of training?
Barbara Hurst:
The training of doctors has come up as an issue in a study that we have started on the use of medicines in hospitals. I think that you are right to highlight...
George Lyon (Argyll and Bute) (LD):
LD
Given the report's recommendations on prescribing and extracting better value, the issue of implementation seems to be pretty critical. Is the roll-out of im...
Barbara Hurst:
I am going to cop out, slightly, of answering that question until we do a bit more work. A lot of money is certainly going into the IT budget, but we need to...
The Convener:
Con
Okay?
George Lyon:
LD
That did not answer any of my questions.
Mr Black:
I apologise for repeating what I said a moment ago, but I should point out that we must always operate within the boundaries of the evidence that we find and...
The Convener:
Con
Obviously we can discuss the matter when it comes back on to the agenda.
Rhona Brankin (Midlothian) (Lab):
Lab
I wanted to pursue the issue of sharing good practice, which links into the business of information and communication technology and how people access what i...
Barbara Hurst:
The committee could certainly explore that area. The situation is fairly ad hoc at the moment; for example, good practice might not be universally shared eve...
The Convener:
Con
I think that we have exhausted our questions, but we will discuss later how the committee will approach the matter. I thank Barbara Hurst for answering the c...