Results from an evaluation of a London primary care service: limitations to throughput Available to Purchase

This paper looks at ISIS, the primary care service that was set up in the London borough of Islington to improve throughput into GP prescribing services from the drug‐using population. ISIS is a service developed from a statutory and voluntary sector initiative that was developed with a GP shared‐care model in its design. It is led by a GP and two non‐medical prescribing nurses to service a population that would not stay with the service but would be managed through the project to GP prescribing services.Over the course of the first year, however, while throughput to GP services improved, the numbers were still too low for the model to work effectively. Just under half of GPs were not offering services to this population, and there were a number of more complex patients who needed to be referred to a specialist drug agency.Results from the annual audit showed that there was a population of clients who were responding well to treatment but did not have a prescribing GP to be referred on to. This paper highlights these stable patients and argues that this population can be managed in a GP‐led service such as ISIS. Revisions to service design and commissioning objectives may be required, but should be easy to implement.