The prevention clinic nobody could measure

Ronan Whitlow has not had a cardiac event, which is the entire result, and also the reason it is nearly impossible to demonstrate.

The referral letter was rewritten to lead with the question rather than the history, which cut a round of clarification out of most onward pathways.

Six months later

The practice runs a flag on anyone presenting three times with the same complaint and no diagnosis, regardless of what was concluded each time.

You cannot photograph the thing that didn’t happen. That’s the whole problem with funding prevention.

Ines Cardoso, nurse practitioner

Pattern, not presentation

Continuity was measured for a year: what proportion of appointments a patient had with the clinician who knew them. It had fallen to under a third.

“I don’t feel any different,” he says. “Apparently that’s the point.”