Author Archives: Martin Roland

Trouble getting an appointment at your GP surgery? Findings from an evaluation of a ‘telephone first’ approach to demand management in general practice

Martin Roland and Jenny Newbould, Cambridge Centre for Health Services Research It’s certainly an increasingly common problem.  You spend ages trying to get through to your GP surgery, only to be told there is not an appointment for a week or two; maybe even six weeks if you want to see Dr Popular.  So, why …read more

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For the NHS, it’s likely that history will keep repeating itself

Professor Martin Roland reflects on the NHS – past, present, and future – following his CCHSR Annual Lecture on the subject on 6th December 2016 at the University of Cambridge

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Is this the rescue package general practice needs?

Two big new reports – NHS England’s General Practice Forward View, and the House of Commons Health Committee’s Report on Primary Care – set out the extent of the crisis in general practice. But, as Prof Martin Roland argues, perhaps they also do offer some really good solutions.

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Who should have PSA testing for prostate cancer?

Doctors and patients are confused by PSA testing. In January 2016, the UK National Screening Committee recommendation concluded that “Evidence shows a benefit of prostate screening to reduce prostate cancer deaths by 21%. Despite this significant reduction, the major harms of treating men who incorrectly test positive still outweigh the benefits. A systematic population screening …read more

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Changing how GPs practice – it really can work

When we produced our report “The Future of Primary Care: Creating Teams for Tomorrow” in the summer (1), the little negative comment there was arose from the idea of larger multi-disciplinary teams, including pharmacists and new roles such as physician associates. GPs worried about what they’d find for these people to do, how they’d train …read more

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“We torture them before they die”

This telling phrase comes from a paper by Liz Dzeng and colleagues (1) which describes the distress felt by young American doctors who feel obliged to deliver futile treatments to patients at the end of life. In part this comes from an excessive move away from paternalism (‘let the doctor decide’) to prioritise patient autonomy …read more

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High users don’t always stay high users (again)

OK, so maybe this is labouring the point as we’ve gone on about this out before – e.g. see our previous papers on the subject (here and here). Nevertheless, it’s nice to find that someone else agrees. This time it’s a study from the US. They call their frequent flyers ‘super-utilizers’ but it’s the same …read more

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Why don’t care coordination interventions work?

Trials of care coordination are often disappointing. Well, they quite often show improved quality of care and improved patient experience but they rarely seem to save money. Which is a pity because that’s often why they’re set up. Or at least the mantra is “Fragmented care is wasteful, so if we get it better coordinated, …read more

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Wrong kind of care plans?

Doctors are pretty sceptical about care plans. No less so since the government started providing incentives for patients with long term conditions to have care plans. Yet a published Cochrane Review suggests that care plans can improve physical and mental health and improve people’s confidence in managing their own conditions [1]. So what’s the reason …read more

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So will pharmacists save the NHS?

Well maybe, but we shouldn’t get too carried away. The RCGP and RPS have produced a joint statement of how pharmacists and GPs could work better together and the news media today are talking about an ‘army’ of pharmacists coming to the rescue of general practice. Should we be greeting the cavalry with open arms? …read more

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  • The Cambridge Centre for Health Services Research (CCHSR) is a thriving collaboration between the University of Cambridge and RAND Europe. We aim to inform health policy and practice by conducting research and evaluation studies of organisation and delivery of healthcare, including safety, effectiveness, efficiency and patient experience.