Published: 06/05/2004, Volume II4, No. 5904 Page 27

Practice round-up

Direct marketing smoking-cessation services

North Birmingham primary care trust sent 3,000 letters to local smokers inviting them to contact the smoking-cessation service if they wanted to give up. It received 222 self-referrals from November 2003 to January 2004. Two practices participated in the scheme and the total cost was£885, that is£4 per referral. The initiative started in September 2003 in recognition that current quit rates were not high enough to meet targets.

An internal survey had revealed that 43 per cent of self-referring smokers would reach the four-week quit period, up from about a quarter for referral by a doctor or nurse. The PCT carefully considered the ethical issues around direct marketing and ensured that letters were not sent to patients with serious illnesses. Other areas, such as medicine management, diabetes patient education and immunisation, could also benefit from the direct mail approach.

jammi. rao@northbirminghampct. nhs. uk

Prescription dispensing offers greater choice

Chesterfield and North Derbyshire Royal Hospital trust's new local pharmaceutical service has dispensed GP prescriptions to patients and staff at the hospital since April 2003.

The pilot was implemented after discussions with Chesterfield primary care trust about a service to give patients and hospital staff a greater choice in where to get their prescription, in and out of working hours.

Current arrangements for the provision of community pharmacy do not allow hospital pharmacies to dispense GP prescriptions. But under the terms of the local service provider arrangements, primary care trusts can contract for new services to be delivered through a community pharmacy alongside a traditional dispensing service.

A satisfaction survey has revealed that 43 per cent of respondents were aware that the hospital pharmacy was now able to dispense GPs' prescriptions and all of them found the service useful.

martin. shepherd@chesterfieldroyal. nhs. uk

Pain management triage

To cut waiting times and meet rising demand, Craven, Harrogate and Rural District primary care trust reviewed its chronic-pain service, including a targeted audit of patients. Ideas included strengthening patient support through the establishment of a local branch of the charity Action on Pain and using experienced chronic pain patients, with training and back-up to provide one-to-one support.

Over 30 per cent of patients reviewed did not require assessment by the full team and could have been treated effectively by a modified service.As a result new patients will continue to be triaged by the therapists and, depending on the outcome, there would be a range of assessment and treatment options. This would more than double the capacity of the service and reduce the average cost per patient.

The audit had shown that the needs of many patients could be met by specialist physiotherapy and occupational therapy skills alone. The project board recommended that this intermediate service should be provided in community settings, preferably GP practices.

The cost of the intermediate service is estimated to be 16 per cent of the average original service cost per patient. This is expected to rise to around 30 per cent if the service is extended across all localities.

andrew. bannister@chrd-pct. nhs. uk