1. Interspecialty Learning: Breaking the Barriers between Primary and Secondary Care Saif Ahmad, Prit Chahal, Jane Little

2. Introduction An effective primary-secondary care interface is of growing significance to professionals and patients An understanding of commissioning and NHS management is important for doctors

3. Interspecialty learning Parallels with interprofessional learning Evidence- surprisingly scarce

4. Aims Evaluate a novel interspecialty learning exercise designed to educate GP and medical trainees on NHS management and commissioning

5. What was done 74 GP and medical trainees attended “NHS Management Structures and Service Re- Design” Whole day (not on hospital site)

6. The Intervention 6 mixed, randomly allocated groups Asked to re-design a service – E.g. Heart failure, diabetes Internet, consultants and expert patients

7. The Intervention Each group then pitched their business case to a commissioning panel – Dragons’ Den

8. “Dragons’ Den”

9. Questionnaires Pre- and post event (100% compliance) Assessed – 1) Perceived knowledge and skills – 2) Attitudes

10. Results...

11. Multiple variables pre- and post A- Combined teaching helpful Understanding of B- Patient centred approach to service design C- Evidence based approach D- Primary-secondary care interface E- NHS management structures Likert score

12. Would recommend to colleague

13. Comments “Revolutionary way of learning”. “An excellent approach to teaching a relatively unfamiliar, drab subject” “...helped me to understand how both primary and secondary care can be integrated for the interest of the patient”.

14. Comments “Secondary care physicians seemed to blame problems on inappropriate GP referrals ie its all the GPs fault. Felt that day was focused on sorting out inadequacies in primary care. It was quite demoralising spending time working out ideas for them to be completely ripped apart”

15. Potential Partners Medics with A&E doctors Surgeons with anaesthetists GPs with anyone List is endless.... Ken Currie, Three Oncologists Scottish National Portrait Gallery © KEN CURRIE

16. Conclusion Interspecialty learning may modify trainees’ knowledge, skills and attitudes Regular exercises are likely to reinforce these benefits Potentially improve collaboration and patient care

17. Acknowledgements Mrs Karen Montrose Mrs Jane Hind Dr Nohaid Ilyas Dr Jonathan Corne

18. References 1.Lingard, L., et al., The rules of the game: interprofessional collaboration on the intensive care unit team. Crit Care, 2004. 8(6): p. R403-8. 2.Pollard, L.C., et al., Perceived barriers to integrated care in rheumatoid arthritis: views of recipients and providers of care in an inner- city setting. BMC Musculoskelet Disord, 2011. 12: p. 19.