GP views on ESTEEM

Dr Phil Dommett, Trescobeas, Falmouth, writes..

The study is deeply flawed in many respects.
It is too small and too short.  It has run-in period of 4 weeks: how good or bad were pre-existing systems?  We have no idea what training they had. [Ed: a session given by Dr Steve Clay]  We have no idea what motivated them to join and whether they wanted change.  There is no indication as to whether it improved access as it was only based on people wanting same-day appts.  It had a very limited view on quality outcomes.  It did not address anything about quality of contact other than crude markers.  The length of consult was only crudely assessed.  The pricing aspects are deeply flawed.  Hardly even mentioned that it confirmed safety aspects, although there was evidence that there was some support for that benefit….
“Evidence” is what you choose to find.

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