Realising Realistic Medicine: Chief Medical Officer for Scotland annual report 2015-2016 appendix

NHS Dumfries and Galloway

Initial thoughts

NHS Dumfries and Galloway has taken a number of different actions in order to support the progression of Realistic Medicine at a local level.

What have we done so far?

We have appointed an Associate Medical Director with a specific responsibility to progress work on Realistic Medicine locally. We have established a Clinical Effectiveness Group that will oversee the work - prioritising initiatives, monitoring progress and refining activity.

We also aim to promote Realistic Medicine through the work done by GP clusters - aiming to address variation more effectively.

The Clinical effectiveness Group and Associate Medical Director will report to our Healthcare Governance Group and we hope that there will be opportunities to share ideas and work with other health board areas.

We have already had marked success in the separate Demand Optimisation Group - noting, and then reducing Sex hormone assays, TSH testing, Vitamin B12 testing, pre-op screening and Vitamin D tests - to encourage clinicians to think more carefully about the clinical picture: blood tests done on patients where there is a reasonably clear clinical picture of a problem can make the testing more specific and more sensitive.

What next?

The Clinical Effectiveness group is currently developing a work plan for the first year: This will include addressing unwarranted variation in both outcomes and intervention rates, and the consent process. The group will be multidisciplinary in approach and have a number of enthusiastic opinion leaders - including physicians, surgeons, anaesthetists, pharmacists, laboratory staff, public health consultants and some senior managers.

Final thoughts

These are a snapshot of the work currently being planned and undertaken in NHS Dumfries and Galloway. We hope to continue with support of and progression towards the aims of Realistic Medicine.