In his insightful overview of what he refers to as ‘the non-principal phenomenon’, Peter Davies asks if this poses a threat to patient enablement.1 He cites Howie et al2 who previously found that length of consultation and knowing the doctor well were positively correlated with patient enablement.
It may provide some reassurance that in this area the local non-principal (sessional) group has undertaken a survey of patient enablement and, in fact, reported results better than those of local principals surveyed as part of GPASS. The two sets of results are not directly comparable as the sessional group is a voluntary one and so not all sessional GPs participate, whereas over 90% of principals participated in GPASS. Principals were reimbursed for this activity: sessional GPs were not. Nevertheless the results do indicate that sessional GPs can obtain high levels of patient enablement. In addition, where sessional GPs undertake to work regularly in the same practice or practices — which is very much the case in this area — there are considerable opportunities to get to know individual patients well.
In the light of this and the continuing exodus of principals, some of whom are dissatisfied with partnership, the sessional phenomenon may not actually represent a threat at all, but rather an opportunity for motivated GPs who enjoy their work and are committed to patient enablement to deliver high quality clinical care.
- © British Journal of General Practice, 2004.
