Silo Thinking at the NHS, Despite ‘Reforms’

05th July 2014

NHS GP, Peezy inventor and Forte Medical co-founder, Dr Vincent Forte, wrote to the Financial Times following the recent debate on antibiotic resistance. Transcript below or on the Financial Times website here.


Government-sponsored research into pharmaceutical solutions to reduce antibiotic prescribing is all very well, but without a belt-and-braces philosophy of bacteriology sampling accuracy, and appropriate antibiotic prescribing, the same problem will keep recurring.

I am an NHS GP and have been in practice for 22 years. A little over a decade ago I questioned why female patients returned often more than once for the same urinary tract infection. I had treated them with a broad-spectrum antibiotic and expected their problem to subside. Closer investigation led me to understand that the specimens they were providing for diagnosis were often contaminated. It transpired that up to 30% of urine specimens are contaminated – that’s up to 22m specimens each year that cannot be read, wasting lab and clinician time and money and a whole pile of antibiotics that need not be prescribed with the consequent issues of fuelling the problem of antibiotic resistance.

I invented a low-tech but perfectly targeted specimen collection system, which has won an NHS and other Awards for its efficacy, hygiene and long-term cost savings. This system is not only low-tech but low cost at around 95p per patient. Its many benefits include right-first-time treatment, implicitly precluding the over prescribing of antibiotics. It has proven, peer reviewed and published clinical evidence.

The company I co-founded has been knocking on NHS doors for the last few years demonstrating the long term benefits and cost savings of our specimen collection system. Apart from some enlightened champions who understand the diagnostic implications of a clean specimen, we are met with negativity by a procurement body that refuses to countenance additional expenditure on a basic but critical process they hitherto have not invested in. Silo thinking remains alive and kicking in the NHS, notwithstanding “reforms”.

This intransigence is costing the healthcare system time, money and the serious matter of antibiotic overprescribing.


Dr Vincent Forte
Forte Medical Limited
London EC2