BECOME ACCOUNTABLE TO THE WHOLE POPULATION

Clinicians and health services need to be accountable to and for the whole population in need and not just for those people who have been referred. 

The focus of medical services hitherto has been on the patients referred to a service, either self referred or referred by another clinician.  The focus of value improvement has to be on the population served, including those people with a condition who are not yet in contact with the service. In England, general practitioners have had responsibility for populations since 1948 but those who work in specialised services (i.e. in hospitals or psychiatric services) have not. Of course there are exceptions, for example the excellent book Mental Illness in the Community: the Pathway to Psychiatric Care by David Goldberg and Peter Huxley, published in 1980(1), shows how at least one mental health service was based on the principles of population psychiatry.

Without diluting the clinician’s traditional commitment to the individual patient it is clear that they also have broader responsibilities to the community that  provides the resources for health services. The new responsibilities of the clinician and the service in which they work in the 21st Century are for Productivity, Efficiency, Value, Sustainability, and Equity.

Health services must account fo all the patients in the population served with the particular need that is the service’s special interest and not just those who happen to have been referred. 

BVHC Resources

BVHC recognizes that to practise Population Medicine the clinician needs a new skill set; they need to know how to:

  • Develop systems
  • Build networks of clinicians and patients
  • Design pathways
  • Manage knowledge
  • Harness the Internet’s potential
  • Engage patients
  • Create and manage programme budgets
  • Develop the right culture

BVHC has several resources that will directly address these needs:

The Population Medicine Development Programme: The Population Medicine Programme draws on our Systems and Culture Programmes and provides the knowledge, skills and insights that specialists need to move from a primary focus on the referred population to thinking of the whole population. It is also relevant to general practitioners shifting their thinking from small populations to a larger one. The Programme is delivered through ten interactive modules, complemented by a workbook called How To Practise Population Medicine.

Developing Integrated Systems of Care: The clinician in their consulting room can deliver an excellent service to the individual patients they consult but to deliver a service to a population requires systems that integrate all relevant disciplines and organisations.  

Exploit the Internet and the Smartphone: Much of what we do has changed little since the introduction of the landline telephone, but the technological developments of the last decade offer completely new ways of relating to and interacting with patients and the public through the media of the internet and, in particular, the smartphone.

References

1. Mental Illness in the Community: the Pathway to Psychiatric Care by David Goldberg and Peter Huxley (1980) ; Tavistock