the best way to get guidelines from NICE introduced would be to financially 
penalise thos ewho don't follow them! one never sees GPs move faster than if 
our walet is filched.

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From: 	[log in to unmask] on behalf of John Sanfey
Sent: 	08 March 1998 23:11
To: 	[log in to unmask]
Subject: 	Re: Re:RCGP. Time to be NICE?


Dear Sirs,
                The proposed new  body, the National Institute for Clinical
Effectiveness (NICE) is potentially very powerful, with a remit to produce
guidelines on practice, audit and clinical development. It will try to
influence every aspect of the 8000 or so consultations that each of us has
every year.

Clinical guidelines are of very little use, as shown by a recent review in
Evidence Based Medicine (Worrall G et al Jan/Feb 1998). If NICE is to have
any positive effect at all, it is vital that it should be peer- led, i.e.
by practising clinicians. If the new term 'clinical governance' means
anything it should be that the NHS is driven by clinical need, (with
evidence appraisal by clinicians).  If the concept of a primary care led
NHS is not a cynical joke then NICE must be chaired by practising GPs. 

I propose that the RCGP should be offered the chair of NICE.  

As a council member I am aware of the criticisms levelled at the RCGP. Our
college began as a populist wave of professional self-development, but is
now often accused of being out of touch, and too centrally orientated. It
is my personal view that the only problem with the RCGP is that the whole
profession is depressed, and over-loaded, with low self-esteem. We are
sleep walking into the control of Health Authorities, resigned to let go
our long cherished professional self-governance.

There is little sense of peer led professional development taking place
these days. At the last count there were only 50 GPS in the UK undergoing
masters training. The numbers who have taken Fellowship By Assessment are
only about 120 by now. Anyone organising meetings at present knows that
there are not enough GPS willing to engage in the proper scientific
development of our practice. 

The RCGP remains a forum to facilitate people to think collectively and to
organise an intelligent neural network of colleagues. I am proposing an
increase in collegiate activity. Lets find ways to get our heads together,
not just to let off steam but to formulate proper scientific development.  

Too many people see the College as an institution, and not as a tool. 
There is no reason on earth why a resurgence of scientific enthusiasm among
"real GPS" would not transform the college back into a thriving hotbed of
exciting development. A buzzing network of collegiate intelligence. For
goodness sake! What is the alternative? 

These are my personal views.

John Sanfey. FRCGP
RCGP council rep. (Vale of Trent).  Full Time GP (why do I feel I have to
add this when defending the RCGP?)
Alvaston Med. Centre & Derby MSc GPM Group
http://www-hcs.derby.ac.uk/postgrad_courses/mscgp.html
Tel.  01332 571322   




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From: Howard Griffiths <[log in to unmask]>
To: INTERNET:[log in to unmask]
Subject: Re:RCGP. Time to be NICE?
Date: 06 March 1998 12:41

Dear Dr Sanfey,

Would you be prepared to re-write this posting as a letter to the editor of
Pulse, please? We feel that the arguments contained would prove of interest
to all GPs.

We look forward to hearing from you.

Yours sincerely,

Howard Griffiths,
Editor, 
Pulse
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