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Frogs in a jam jar, 1997

We sit like frogs in a jam jar, ready to jump as the next bit of information, mostly paper, rains down on us, and agonising about when to jump, and how high. The average UK medical mortal spends about 30 minutes a week reading journals, so we are always terrified of being behind. Filtering the volume of paper (estimated at about 3 kilos/week for the average GP) itself takes up 30 minutes. The twin problems are how to get the right stuff (evidence on which we should act) and how do we get that evidence into practice.

The right stuff

Patients hear on TV that there is a new whizzo remedy for something. They hear it before you do and come and ask about it. You know nothing (just a few weeks behind with the reading and no time to watch TV). A document in the 3 kilos six months or a year from now is six months or a year too late!

The process of working out how the NHS will deal with this advance takes place in every health authority, Trust, or GP surgery. While Bandolier can understand the political imperative of devolving management decisions as much as possible, it makes little sense for every health authority, Trust, or GP to go through the same appraisal process, at huge cost. We need a new mechanism to help us. Perhaps this is at the heart of the implementation gap - what is stopping evidence getting into practice - spotted by Walshe & Ham (see next story).

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