Evidence from Royal College of General Practitioners – MT 6

Inquiry into access to medical technologies in Wales

The Royal College of General Practitioners is the largest membership organisation in the United Kingdom solely for GPs. It aims to encourage and maintain the highest standards of general medical practice and to act as the ‘voice’ of GPs on issues concerned with education, training, research, and clinical standards. Founded in 1952, the RCGP has over 49,000 members, 1,932 in Wales, who are committed to improving patient care, developing their own skills and promoting general practice as a discipline.

RCGP Wales welcomes the opportunity to respond to this consultation, and would base its response around its response to the earlier consultation in the autumn of 2012, which is included with this correspondence.

RCGP Wales considers that the most important area at present to develop is integration of IT through secondary care, community and primary care systems. Currently, hospital systems are often bespoke and do not fit well with GP systems. Although there are increasing efforts to develop portals for results etc., there is no way to access actual imaging for example. There are a number of fixes in place to allow e-mail communication but so far no patient integration for things such as appointments.

RCGP Wales believes that the future for general practice is about near patient testing and would potentially give this the main priority.

The falling cost and increasing availability of new technologies is one of the most exciting developments in primary care.

Many practices have spirometry, sats measurement etc. (some even have a 24-hour ECG monitor which costs a few hundred pounds) but desktop testing for D-dimer and troponins for example, is now available at a modest cost. In the next few years more and more equipment will become available. Items that cost thousands of pounds only a few years ago are now available for tens of pounds with no loss of reliability

Handheld diagnostic ultrasound and echocardiogram equipment is also now available and the cost is falling. Were these technologies and others to become routinely available, additional training for practitioners in their use would be necessary.

The primary care division at NWIS has been a key factor in the organised development of IT systems in general practice. It will be important to continue to ensure the systematic and integrated development of IM&T.

Given the likely effect of new technologies on the delivery of clinical care in general practice, Local Health Boards will need to be sensitive and flexible to funding priorities especially where low cost may introduce changes to extant clinical care pathways.