1. Prudent Health Workshop Clinical Overview Dr Kurt Burkhardt (GP Partner/ Locality Clinical Director)

2. What is Prudent Healthcare? Don’t harm patients Only do what’s necessary (patient needs) Ensure equity between patients and health professionals Ensure the maximum benefit for what we do…by.. stopping medicines with no benefit

3. We need to know: What are we doing that is causing harm or a waste of time and money? Can we do it cheaper? What would doing “just what’s needed” look like?

4. Why Prescribing? It something Drs do a lot of ! 74 million scripts were written by GPs in 2012- 2013, costing £514 million Cwm Taf was 7.9 million at a cost of £53 million Or £176 per resident per year Cwm Taf is one of the highest in Wales It’s getting more complicated..some patients on very few drugs, others on as much as 20

5. Challenges Ageing population (more complex care) More is expected (government and public) Variation in Care and Health Public Health Issues (e.g. smoking, obesity, exercise) Workload Communication Longer waiting times Rising complaints and litigation ££££££££ Treating populations NOT patients The void between “mangers and grass roots”, or “policy and practice”

6. Typical “GP” Day Morning surgery (8:30-12:30) Reading test results, letters (12:30-13:00) Morning house calls (13:15-13:45) Afternoon clinics/paperwork /on call (14:00-16:00) Evening surgery (16:00- 18:45) “lunch!” Keeping up to date ! (20:00- ??)

7. Cultural changes: Political support Professional desire Public education

8. “Your Medicines, Your Health” Improves patient understanding Empowers individuals Promotes trust between public and professionals Encourages community support e.g. voluntary sector Targets specific areas of concern e.g. stockpiling

9. Tell us if you can’t take them ! Promotes communication between public and professionals Improves patient compliance Enables early intervention to reduce harm and promote effective prescribing Results in better health outcomes

10. What does it feel like at the moment?

11. What should it look like?