The Royal College of General Practitioners Interview Rosie Benneyworth

Dr Rosie Benneyworth, Managing Director of South West Academic Health Science Network and Non-Executive Director of the NICE board

The Royal College of General Practitioners ask Rosie about her professional history, and how Science Networks can make life better for GPs.

Tell us why you joined the NICE Board and what you hope your background as a GP can bring to the organisation.

I have been involved with NICE for several years, initially in a guideline development group, and more recently as a NICE Fellow. I am constantly impressed with NICE’s commitment to improving quality of care, openness and transparency in decision making, and patient involvement in all their work.

I was a GP partner for 12 years and currently work as an out-of-hours GP in Somerset. More recently with my Academic Health Science Network (AHSN) role I have been working with GPs across the South west. This has given me an excellent understanding of both the opportunities and challenges that GPs manage. I am keen to use this experience to support NICE in developing its role in primary care, especially at a time where we know there are significant challenges facing the profession.

Do AHSNs have an important role to play in spreading best practice, innovation and translational research?

I have been with the South West AHSN for a year, which is one of 15 AHSNs across the country, whose role is to spread the adoption of innovation. We know that there are many examples where there is a really good idea, which is benefitting patients in one practice, but is not known about in a practice a few miles down the road. It has been stated that, on average, it can take 17 years for research that has proven beneficial to patients to reach all patients in the NHS. I see our role in the AHSNs as accelerating this process so that patients are not disadvantaged.

By working with a broad range of partners across many sectors such as academia and industry, we can find solutions to some of the difficult problems in the NHS. For example, there is a need to find new ways of managing increased demand in times of workforce and financial pressures, and AHSNs are playing a key role in supporting their regions with this.

How do you think this could benefit GPs?

We need to find ways to share information between GPs about things that are working well, will improve care for patients and make their demanding roles easier. We know that there are many new models of care emerging in primary care and different professions working in the sector (e.g. pharmacists). By helping GPs to understand what works and what doesn’t work, and to learn from each other, new ways of working can more quickly emerge to manage demand and the workforce crisis we are in. Also, by giving GPs tools to undertake quality improvement work and to understand whether it is having a positive effect on patient care, we are more likely to achieve sustainable change.

What would you tell any new GPs about the importance of innovation and adopting new practice?

Einstein said ‘Insanity is doing the same thing over and over again and expecting different results’. We know there are huge pressures on the system and if we continue to work in the same way we will just work harder and harder which is unsustainable. The technology is available to completely transform the way we work, we need to find mechanisms of getting this embedded in our daily practice to both improve patient care and reduce pressure on the workforce. Most importantly, patients can be disadvantaged if they do not have access to new drugs or diagnostic tests and their outcomes may be poorer as a result.

I think we also need to innovate in how we change our relationships with patients to empower them in all aspects of their care and the design of services which they use. Patient centred care is something that is talked about widely but I feel we have a long way to go to get there.

Over-diagnosis and over-treatment are major issues for GPs at the moment. How do you think NICE guidance and the work of the AHSN can address this?

This is a key issue which we need to address and goes back to my previous comment about empowering people in their health and wellbeing. We need to be able to have the time with people to enable them to make decisions about their care, and activate them on a much greater scale than we are seeing at present. This includes all aspects of care including diagnostic tests and treatments.

In my opinion, NICE guidance gives clinicians and patients a synopsis of the best available evidence which should be used to inform these discussions, but not as a paternalistic tool to tell patients what to do. We also need to support clinicians in understanding what does not add any benefit to patients – often practice has emerged because ‘that’s how it’s always been done’ rather than it having any evidence that it adds value to someone’s care. AHSNs can support with innovations such as digital apps for patients to use with long term conditions, which can enable self-management. Or they can support service models that have a more holistic approach, bringing together other agencies such as the voluntary sector who can provide a less ‘medical-model’ of care.

What do you think the priorities of NICE should be for primary care over the coming period?

NICE understands the pressure that primary care is under and I know that they are working with GPs to find new ways to ensure their guidance and standards are produced in a way that meets their needs.

Information needs to be easy to digest, as GPs deal with increasing complexity, for example, managing multi-morbidity, which links to the question above about over treatment. I think NICE needs to be looking at its work with primary care as part of the wider health and care system to support the work that many areas are undertaking in trying to break down the ‘silos’ that exist at the moment. In line with this, we need to be finding systems and technology that support clinicians giving the best possible care to enable the best outcomes for patients.