Implementing a national clinical effectiveness policy: developing relationships between purchasers and clinicians

Abstract

The NHS Executive expects purchasers and providers to base their agreed patterns of care on evidence of clinical effectiveness. If this approach is to be successful it is necessary to reconcile conflicting published information about effectiveness and local professional opinion. In this study we have identified the type of interactions that occur when purchasers and providers were brought together to discuss how this policy could be implemented locally. Three geographically‐based multidisciplinary workshops were structured around three case studies: coronary artery disease, diabetes, and the management of clinical depression in general practice. The proceedings were transcribed and analysed using content analysis methods. Structured observation techniques were used to examine the interaction between providers and purchasers in the three groups that discussed coronary artery disease. While the overall pattern of interactions between purchasers and providers was similar among the workshops, there were significant differences within them. In two of the workshops providers dominated the discussions on clinical effectiveness, which may affect the purchaser's ability to implement a policy of clinical effectiveness. If a local policy of clinical effectiveness is to be successful there is a need to strengthen purchasers' ability to match the provider's knowledge and enthusiasm.

Citation

Littlejohns, P., Dumelow, C. and Griffiths, S. (1996), "Implementing a national clinical effectiveness policy: developing relationships between purchasers and clinicians", Journal of Clinical Effectiveness, Vol. 1 No. 4, pp. 124-128. https://doi.org/10.1108/eb020848