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RCGP IN THE NEWS

Thu, 23 May 2013 00:00:00 +0100

RCGP IN THE NEWS

Our spokespeople are in demand daily to provide comment on a wide variety of national media stories.

Here is a digest of the most recent stories

'Stop attacking GPs. We don't deserve it' - The Independent 23/5/13

RCGP Chair, Dr Clare Gerada wrote an opinion piece in The Independent saying 'GPs are used to being scapegoated, but I cannot sit back and allow my profession to be held responsible for the problems in A&E.'

Click here to read the article (external link)

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GPs accuse Hunt of risking patients' health with cuts - The Times 23/5/13

The RCGP accused the Government of putting patients at risk by slashing funding for primary care. Budgets are set to fall by nearly £200m over the next three years. Dr Clare Gerada said a whole day’s care in general practice costs one tenth of a day in hospital but GPs are facing increasing workloads, with real consequences for patient care.

The RCGP press release is available here

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A&E Crisis/GP out of hours services - BBC Newsnight 21/5/13

Dr Clare Gerada was on BBC Newsnight last night (22/5/13) defending GPs against the current criticism over rising A&E attendance and the provision of GP out of hours services. Watch again at

http://www.bbc.co.uk/iplayer/episode/b01sl8pw/Newsnight_21_05_2013/

(external link - available until 28/5/13)

Spending on patient care set to plummet by millions, warn GP leaders

Thu, 23 May 2013 00:00:00 +0100

The amount of money allocated to GPs to care for their patients is set to fall by nearly £200m over the next three years- equivalent to the current funding for 1.2 million patients, according to predictions from GP leaders.

The stark warning comes from the Royal College of General Practitioners who say that the proportion of NHS funding being spent on general practice has been falling for successive years, with GP practices being starved of the resources they need to meet the growing needs of patients and to safeguard the future of patient care.

The predictions are based on RCGP calculations for the time period 2011/12 to 2015/16, at 2011/2012 prices.

Only 9% of the NHS budget in England was spent on general practice in 2010/11, even though GPs see over 1 million patients per day and 90% of all NHS activity takes place in general practice.

The breakdown of NHS spending for 2010/11 for A&E and acute care was 47%, and a further 19% was spent on other secondary care such as maternity and mental health, with 10% spent on community care.

The College is worried that if funding and resources continue to be stretched, this will seriously impact on the ability of GPs to continue to provide timely access to high quality care and services for their patients.

RCGP Chair Dr Clare Gerada, said: “General practice is the most effective and cost-effective way of providing patient care - a whole day's care in general practice costs one tenth of a day in hospital. But funding and resources for our services is being stretched to the limits, with family doctors facing ballooning workloads, record hours being worked in surgery and real consequences for patient care.

“Personalised continuous and integrated care are the cornerstones of general practice - something that the Health Secretary himself has acknowledged this week based on his visits to GP surgeries.

“GPs want to be able to do more for their patients and deliver the care that they deserve. General practice is becoming increasingly challenging and complex – with an ageing population and more patients presenting with obesity and more complex and multiple conditions - and the funding we receive to provide services must reflect this.

“GPs have seen consultation rates explode in recent years. We now routinely see up to 60 patients on a daily basis whereas even 10 years ago this would happen only in exceptional circumstances such as a flu outbreak.

“Most GPs want to help alleviate pressure on hospitals, including on A&E, with a shift in care back to the community, but this must be matched with adequate resourcing and we cannot continue to juggle an ever-increasing workload with a decreasing workforce.

“On the day that the Health Secretary is outlining his aspirations for the future of GP care, we hope that he will heed our warnings. We want the Government to invest in GPs and patients to the necessary levels that will guarantee safe and effective care for our patients today and in the future.”

ENDS

RCGP launches membership consultation on assisted dying

Wed, 22 May 2013 00:00:00 +0100

The RCGP has today announced a consultation with its members on the College's collective position on a change in the law on assisted dying.

The College’s position on assisted dying since 2005 has been that, with good palliative care, a change in legislation is not required. However, many clinicians and patients feel strongly about this complex and emotive subject, and high profile cases such as Paul Lamb and Tony Nicklinson have brought it to the forefront once again.

As the largest membership organisation in the UK solely for GPs, with over 46,000 members, the RCGP is the most representative voice in the UK for GPs. The College believes that the time is now right to review the practical and ethical issues involved and to give its members the opportunity to debate what the RCGP's collective position should be.

The membership consultation will consider whether the College should adopt a position of support, opposition or neutrality on a change in the law - and the potential implications of each of these positions.
The College has taken the decision to run the consultation for a number of reasons. It recognises that there are compelling arguments on both sides of the debate and that some members’ views may have changed over the past eight years. It has also welcomed many new members since 2005 and it is important that their views are taken into account.

The GP-patient relationship, with GPs often attending patients in the final days and hours of their lives, puts GPs in a unique position to offer insights into the arguments for and against a change in the law on this profoundly important issue and the College anticipates that the outcome of the consultation on assisted dying will be viewed as significant.

The consultation will run until 9 October 2013, with a debate by the RCGP's governing Council expected in early 2014.

ENDS

Latest update to RCGP trainee ePortfolio

Tue, 21 May 2013 00:00:00 +0100

A new-look ePortfolio for trainee GPs will be launched in August by the Royal College of General Practitioners (RCGP).

The redevelopment is part of an ongoing improvement process to make the ePortfolio more user friendly for GPs in training. The Trainee ePortfolio is an essential tool for GP trainees as they complete their training programme and is in line with General Medical Council guidelines.

Following extensive consultation and feedback from users, features of the Trainee ePortfolio now include cutting edge coding language, ASP.NET, which is compliant and compatible with most current user platforms.

The new-look also incorporates:

• a new dashboard feature for easy navigation
• the capacity for trainees and supervisors to link directly to evidence in Educational Supervisor Reports (ESRs) and an email feature allowing users to request that evidence is reviewed
• the opportunity to directly transfer information from Trainee ePortfolio to Revalidation ePortfolio once MRCGP has been achieved
• mechanisms to allow the College’s dedicated ePortfolio team to easily implement new updates

All current and new Trainee ePortfolio users will receive access to an online guide explaining the new navigational features and functions offered by the update.

In order to implement these substantial improvements, the Trainee ePortfolio website will be taken offline from 5pm on Friday 2nd August 2013 until the morning of Wednesday 7th August 2013. This will ensure that the update is ready for the start of the next training year.

Dr Jenny Fox, Chair of the ePortfolio Development Group said: "We have listened to feedback from our trainees and made a number of slight modifications that we think will make a big difference to users. We will continue to review the system so that it continues to deliver what our trainees need as they record their progress towards becoming GPs."

ENDS

RCGP reaction to Health Secretarys speech on primary care

Tue, 21 May 2013 00:00:00 +0100

RCGP reaction to Health Secretary's speech on primary care

The Health Secretary's keynote speech on the role of general practice is being used by the media as another excuse to attack GPs, says RCGP Chair Dr Clare Gerada.

Dr Gerada said: "It is a pity that this opportunity to be positive about the role of general practice in the NHS has been turned into yet another attack in the media on hardworking GPs and the care we provide for our patients.

"Family doctors are working ever longer hours in surgery as they struggle to cope with ballooning workloads, at a time when the Government is diverting more and more funding and resources away from general practice.

"Quite rightly there has been a lot of attention on the serious problems in A&E but we must also recognise that there is a growing crisis in general practice."

On the issue of inspection for primary care, she said: "We support anything that will promote quality in general practice and are open to working with the Government and the Care Quality Commission to devise a system that is going to create the right incentives to improve standards, including whether there is a case for introducing a Chief Inspector of Primary Care. But this must be done without adding to bureaucracy or creating a crude system of overall ratings for GP practices.

"We need to be clear that any new system of inspection for primary care would be proportionate, supportive, influenced by the profession, and that it will add value to what the CQC is already doing. Rumours of Ofsted-style inspections and tougher regulation are unhelpful and extremely demoralising, especially at a time when GPs are already heaving under the pressure of a bureaucratic and stifling tick box culture.

"What is required from Government is a proportionate and tailored approach to examine any issues or concerns with the current system for regulating primary care, what is needed to remedy these and how inspections will work for different health and social care services. The same system that is used to inspect hospitals cannot simply be extended to 8,500 GP surgeries and community services in England.

"The College had hoped that the Secretary of State's speech would mark a turning point for general practice. It acknowledges the value of general practice as the cornerstone of patient care across the entire NHS - based on what Mr Hunt has seen for himself during his visits to GP surgeries.

"We particularly welcome his focus on personalised, continuous and integrated care - the key strengths of general practice - and on reducing bureaucracy so that GPs can provide the levels of care they want to deliver and which our patients deserve.

"But we need to change the narrative from attacking GPs and focus on ensuring that primary care is properly resourced, thus relieving pressure on other parts of the health services, particularly A&E.

"GPs work exceptionally hard for our patients. We are the solution to problems in the NHS, not the cause."

ENDS

Social Workers join GPs in unique collaboration

Fri, 17 May 2013 00:00:00 +0100

The Royal College of General Practitioners and The College of Social Work (TCSW) have announced a unique partnership that will encourage closer links between health and social care to improve and integrate care and services for patients.

The collaboration will include The College of Social Work relocating from its current premises, shared with the Social Care Institute, to the RCGP’s landmark headquarters at 30 Euston Square in Central London on Monday 20th May.

As well as providing a new opportunity for co-working, the move fits well with the RCGP’s aspiration to be the centre for global primary care. The prime location of 30 Euston Square and its proximity to the British Medical Association, The Wellcome Trust, and other related organisations is already creating a ‘health hub’ and raising awareness of the work being done to improve and integrate patient care.

TCSW Chair Jo Cleary said: “We are delighted to be moving in with the Royal College of General Practitioners. We are both professional colleges and have a shared interest in supporting and promoting our respective professions.

“At The College of Social Work we see this as a fantastic opportunity to collaborate with the Royal College of GPs and contribute to the development of fully integrated health and social care across the country. We are very much looking forward to exploring opportunities for sharing expertise.”

RCGP Chair, Dr Clare Gerada, said: "Our move to 30 Euston Square has led to a lot of interest from organisations specialising in health and social care. Providing accommodation for allied health organisations fits well with our ethos of improving care for patients, as well as with our aspirations to create a centre for global primary care.

"GPs are at the interface between health and social care so we are delighted to be welcoming The College of Social Work to our College premises. We hope it will provide further opportunities for us to blur the boundaries between primary, secondary and social care to create truly integrated services for our patients and service users."

ENDS

Notes to Editors:

The College of Social Work is the centre of excellence for social work, upholding and strengthening professional standards to the benefit of the public. We are an independent membership organisation that aims to provide a strong, unified voice for social workers and play a leading role in the development of social policy. Our new address is 30 Euston Square, London, NW1 2FB. Telephone: 020 8453 2929.

The office move is the latest in a series of positive developments for The College of Social Work, including recruiting new Chief Executive Annie Hudson, Strategic Director for Children, Young People and Skills at Bristol City Council, who worked with the BBC on the acclaimed documentary ‘Protecting our Children’. Our membership has expanded to 6,100 members and continues to grow rapidly, and we recently held our first elections for the Board and Professional Assembly as an important step towards becoming a fully democratic college.

The Royal College of General Practitioners is the largest Medical Royal College in the UK and represents over 46,000 GP members, dedicated to promoting excellence in patient care.

Media contacts

Jane McCormick - Jane.McCormick@tcsw.org.uk 07939 592965

Mark Ivory – Mark.Ivory@tcsw.org.uk 07906 893109

National Council Member Ballot

Thu, 16 May 2013 00:00:00 +0100

National Council Member Ballot 2013

The National RCGP Council Member Ballot opened on 13 May and will close on Friday 31 May at noon.

A national ballot is held each year, with nationally elected Council members usually serve a three year term, with six places coming up for election at a time.

Details of this year's candidates are on the Council section of the website here

All RCGP members and fellows in good standing are entitled to vote but honorary fellows, ‘Fellows ad eundem’ or Associates in Training (AiTs) are not. Voting is overseen by our electoral agents, Electoral Reform Services (ERS).

All those eligible to vote should have been sent voting information, if this has not been received they should please contact schinery@rcgp.org.uk

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Dementia diagnosis must be in line with patient wishes says RCGP

Wed, 15 May 2013 00:00:00 +0100

Dementia diagnosis must be in line with patients' wishes, says RCGP

The Royal College of General Practitioners has welcomed the Prime Minister's call for a sharp rise in diagnosis rates for dementia by 2015 - but says it must be backed by appropriate funding and that patients' wishes should be paramount.

RCGP Chair Dr Clare Gerada said:

"As GPs responsible for a growing number of patients with dementia, their families and their carers, we welcome the personal commitment of the Prime Minister and the Health Secretary on this crucial issue. We hope that today's announcement will now translate into proper funding and resources, directed where they are most desperately needed.

"GPs are committed to improving the care we provide to patients with dementia - and we acknowledge that earlier and more accurate diagnosis can enable people with dementia and their families to make more informed choices and decisions about their future care, whilst they still have the capacity to do so.

"Appropriate diagnosis is one of the biggest challenges currently facing GPs and the NHS, and distinguishing between dementia and age related memory loss only adds to the complexity.

"Approaches to diagnosis and treatment must be shaped first and foremost by the needs and expressed wishes of the individual patient, their families and carers. Any interventions to improve the accuracy and timeliness of diagnosis, particularly in the early stages of the disease, must be based upon the best possible evidence.

"Not every person with dementia will find the advantages of an early diagnosis outweigh the possible disadvantages and evidence shows that if a person’s wellbeing is not enhanced by receiving a diagnosis, then it should not be forced upon them. In many areas, the local availability of assessment and support services is also insufficient to meet demand.

"The College has designated dementia as one of our clinical priorities and appointed two 'dementia champions' to lead a programme in association with the Alzheimer's Society. We are developing a 'roadmap' for dementia as a navigational aid for what to do at different points during the course of a patient’s pathway through dementia, and to assist primary care with the management of dementia for patients, family and carers.

"We need better co-ordination of approaches for referral, assessment, and treatment across the boundaries of primary, secondary and social care. We also believe that our plans for enhancing and extending GP training will improve the detection and management of chronic conditions such as dementia.

"Every day in our surgeries, GPs are witnessing the devastating impact of dementia on patients and their families . We are keen to work with the Prime Minister and the Government to improve the services and access to services that will really make a difference to people with dementia and help them live healthy, independent and productive lives for as long as possible."

ENDS

Creating better access for patients needing scans

Tue, 14 May 2013 00:00:00 +0100

Patients needing diagnostic imaging on the NHS should receive better, more efficient access after being referred by their GP, according to new guidance launched this week.

The new recommendations, published by the Royal College of General Practitioners, the Royal College of Radiologists and the Society and College of Radiographers, have outlined improvements for patients by ensuring that timely and appropriate medical imaging services such as scans are provided to them and their referring doctors.

Boosting communication through the open sharing of images and reports across local and regional healthcare networks, as well as making previous imaging history reports available to all providers, is also recommended to ensure patients receive the fastest possible diagnosis.

Patients needing urgent scans on the NHS should be seen within a week of being referred by their GP and routine screenings should be carried out within two weeks of a GP referral. Patients in rural areas would also have improved access under the recommendations.

The guide - Quality Imaging Services for Primary care: A Good Practice Guide – sets out what needs to change to make a ‘tremendous difference’ to the care of patients requiring an NHS scan and aims to reinforce the links between local NHS clinical imaging departments and the new Clinical Commissioning Groups (CCGs).

Underpinning the recommendations is the need to improve the clinical relationship and dialogue between primary care and radiology clinicians.

If used correctly, the guide should significantly improve patient care, increase efficiency and shorten waiting times, as well as cutting NHS costs.

RCGP Chair Dr Clare Gerada, said: “By working together and using this guidance, GPs, radiologists and radiographers can really make a difference to patients needing scans, be it urgent or routine. It will help Clinical Commissioning Groups to highlight where current services need to change and where they could become more localised.

“Making the process more straightforward, and ultimately quicker, will also lead to greater peace of mind for patients as it will take away a lot of the anxiety and uncertainty that waiting times can cause.”

RCR Vice-President Dr Pete Cavanagh said: “Diagnostic radiology is at the heart of most patient pathways and it is important that those commissioning and providing such services have a clear, shared understanding of what needs to be in place for patient safety and to ensure the effective use of healthcare resources. It is essential that such services are commissioned in a way that ensures that the patient and referring doctor have access not only to an image and a report but the medical expertise of a clinical radiologist as well as other members of the radiology team.

“The shared goal of providing the highest quality, seamless care to patients is what has driven the work of the colleges and is why this guide is an important step in this aim.”

Director of Professional Policy at the Society and College of Radiographers, Prof Audrey Paterson, commented: “This guide provides a real opportunity to embed best practice for GPs and their patients in clinical radiology departments across the country. Services may well find aspects of the guide challenging but their well established principles of effective team working and skills mix will enable them to more than rise to them, developing strong and effective partnerships with GPs and the Clinical Commissioning Groups as they do so.”

Quality Imaging Services for Primary care: A Good Practice Guide can be found on the www.rcgp.org.uk/commissioning, www.rcr.ac.uk and www.sor.org websites.

ENDS

RCGP comment on review of care for elderly patients

Mon, 13 May 2013 00:00:00 +0100

The RCGP is calling for general practice to be at the heart of the Government's forthcoming review on care for elderly patients, announced today.

RCGP Chair Dr Clare Gerada said:

“Our ageing population and the growing funding crisis in social care are presenting the health service with one of its biggest dilemmas. We therefore welcome the decision to review how we can develop a truly 'whole system' approach to care for vulnerable elderly patients.

“We were pleased to hear the Secretary of State acknowledge that GPs play a crucial role in proactively managing the health of vulnerable older people. For too long this issue has been focused on hospital care when it is GPs who often provide the vital link between health, secondary care and social care. We make the NHS fair and accessible and are the best value for money in the health service.

“However, to achieve meaningful change the review must look at the huge workload challenges facing GPs and ensure that the right investment is in place to enable primary care to deliver for elderly patients.

“If properly resourced, better joined-up working between general practice, secondary care and social care can deliver better health and wellbeing for our elderly patients, as well as helping to identify and support those most at risk of ill health.

“There are some excellent examples of where this is happening already and we hope that the Government will use the skills and expertise of GPs wisely to deliver truly coordinated and quality care for our elderly and vulnerable.”

Ends

New Chair-elect for RCGP

Fri, 10 May 2013 00:00:00 +0100

Dr Maureen Baker CBE is the new Chair-elect of the Royal College of General Practitioners (RCGP). She will succeed the current Chair Dr Clare Gerada in November 2013.

In the election, conducted by Electoral Reform Services, Dr Baker received 37 votes and Dr Steve Mowle 21 votes, out of a possible 67 votes.

Dr Baker has been a GP since 1985 and currently practises in Lincoln. She has substantial leadership experience within the RCGP where she served as Honorary Secretary from 1999-2009. She is currently a member of the RCGP Trustee Board, a nationally elected member of College Council, and RCGP Lead for Emergency Planning and Preparedness.

She formerly chaired the RCGP/GPC Emergency Planning Group and led efforts by the College and the GP profession in preparing for and dealing with the 2009 Influenza Pandemic.

She was previously Director of Primary Care at the National Patient Safety Agency and is currently Clinical Director for Patient Safety at the Health and Social Care Information Centre

In 2004, Dr Baker received a CBE for services to medicine and, in 2009, the RCGP Foundation Council Award for meritorious services to general practice.

She has also had an illustrious academic career and has contributed to over 50 journal and book publications.

She said: "I am delighted and honoured to be elected to such an important role at the RCGP. Later this year the NHS will celebrate its 65th anniversary in a landscape of financial austerity and an environment more complex and challenging than at any time in its history. This very week, news of the serious problems facing A&E units only serves to underline the desperate need for adequately resourced and properly integrated GP services.

“I am more convinced than ever that GPs, and their professional body, have a crucial role to play in helping the NHS tackle the challenges of the years ahead. I look forward to playing my part in meeting these challenges.”

Dr Baker will take up the role of Chair Elect following the next Council meeting in June and will formally become the next Chair of College Council at the November meeting.

ENDS

RCGP criticises patchwork quilt of patient care caused by NHS 111

Fri, 10 May 2013 00:00:00 +0100

RCGP criticises "patchwork quilt" of patient care caused by NHS 111

The Royal College of General Practitioners is calling for urgent action to protect patients in the rollout of the new system.

RCGP Chair, Dr Clare Gerada, said:
"The concept of a unified number to support 999 is a sound one but the implementation of NHS 111 has been significantly problematic. Questions also need to be asked about why a completely new system was rolled out on Easter Bank Holiday at the same time as the NHS was getting to grips with the biggest ever top-down reorganisation in its history.

"We now have a 'patchwork quilt' of services, with NHS 111 working well in some areas, the system seriously flawed in other parts of the country, and patients left in a situation of not knowing where to turn for help or facing long delays in trying to access the service.

"Once again, GPs are bearing the brunt of the criticism when it is GPs who came to the rescue to protect patients and save the system from total collapse over Easter, and who are continuing to shore it up.

"NHS 111 was rolled out far too early, with unnecessary pressure placed on some sites to go live before they were ready. We are also concerned about how the service itself is being run - some areas seem to be properly resourced with well-trained clinical staff whilst in other areas it is struggling to cope with insufficient numbers of 'call centre' handlers, some of whom have received only a few weeks training. This is having a significant impact, not just on emergency care but on GP surgeries, walk in centres and urgent care centres.

"We would welcome any promise of new funding in A&E services but it is vital that this does not come at the expense of general practice. Today, over one million patients will see their GP. We see and deal with the vast majority of patient contacts within the NHS and the most effective way of protecting hospitals and patients is by investing in general practice and having more GPs spending longer with their patients and in their communities.

"We now have a situation where patients have lost confidence in the new NHS 111 service before it is even fully up and running. The responsibility for this lies at the door of the Government and it is unacceptable to carry on blaming GPs for what is going wrong with the system.

"Decisive action is needed so that patients - and health professionals - are reassured about the effectiveness and ability of NHS 111 to deliver the service right across England.

"There is too much at stake to put these failures down to teething problems and just hope for the best."

ENDS

GPs must not be the new border agency in policing access to the NHS: RCGP reaction to Queen's speech

Wed, 08 May 2013 00:00:00 +0100

The Royal College of General Practitioners (RCGP) has today warned against the danger of turning GPs into a form of immigration control - and cautioned the Government against plugging the social care funding gap by raiding the NHS budget, in its reaction to the Queen's speech.

RCGP Chair Dr Clare Gerada said:

"GPs must not be a new 'border agency' in policing access to the NHS. Whilst the health system must not be abused and we must bring an end to health tourism, it is important that we do not overestimate the problem and that GPs are not placed in the invidious position of being the new border agency.

"General Practice must remain the main access to health care within the NHS. GPs have a duty of care to all people seeking healthcare, and should not be expected to police access to healthcare and turn people away when they are at their most vulnerable. It is important to protect individuals and public health."

NHS funding

"The NHS ring-fence must not be broken up to plug the gaps between health and social care, the Royal College of General Practitioners (RCGP) warns today in the wake of the Queen's speech.

“We support greater integration between health and social care, but we have already seen a real terms decrease in funding for general practice in the past two years. If we are to make integration work for patients we must rebalance funding towards primary care and focus on new ways of working together.

“We support many of the measures the new Care and Support Bill will introduce, such as enhanced legal rights for carers, we urge the Government to clarify that it does not intend to use funding from the ring-fenced NHS budget to plug gaps in social care provision.

“Whilst pooling budgets at a local level may enhance patient care where robust joint agreements are in place, simply taking money from the NHS and throwing it at social care won’t deliver the improved care we all want to achieve.”

Care and Support Bill

“The Care and Support Bill is an important opportunity to promote greater joint working between health and social care, and GPs can play a central role in this.

“However, we feel that some aspects of the Bill – such as ensuring hospital discharges happen in a more integrated way – need to be strengthened in line with the recommendations made earlier this year by the Joint Scrutiny Committee which looked at the legislation. We look forward to working with the Government on this.”

Public health

“It was hoped that the Government would take forward bold measures to tackle alcohol and smoking – two of the biggest challenges facing the NHS in the coming years. That the Government has backed down on both of these issues is disappointing, and we urge Ministers to reconsider the weight of evidence suggesting that action is needed.”

ENDS

New e-learning course for GPs to help patients with alcohol problems

Fri, 03 May 2013 00:00:00 +0100

New guidance to help GPs support their patients with alcohol problems is launched today by the Royal College of General Practitioners (RCGP).

The e-learning course focuses on both physical and mental health issues associated with alcohol, as well as raising awareness of how the families of patients with alcohol problems can also be affected.

It covers:

• identification of patients with alcohol problems and brief advice
• medical aspects: physical health
• medical aspects: mental health
• dependency and medically assisted withdrawal
• alcohol and the family
• aftercare, recovery and relapse prevention

The course builds on the successful introductory level ‘Alcohol: Identification and Brief Advice’ course released last year, which raised awareness to a general audience. It is freely available as part of the RCGP’s Online Learning Environment (OLE).

The course uses case studies, videos of simulated consultations, and written assessments based on up-to-date research to provide healthcare professionals with a comprehensive understanding of the negative effects of alcohol in their patients, methods of measuring alcohol consumption and available interventions.

Completion of this e-learning course is the first step in achieving the RCGP Certificate in the Management of Alcohol Problems in Primary Care- Level 1. The second step entails participation in a face-to-face training course run by the RCGP’s Substance Misuse and Associated Health team.

The RCGP runs the courses regularly and they are also available to external course organisers for local delivery. They aim to equip participants with:

• an understanding of the models of behavioural change
• an awareness and knowledge of categories of problem drinking and screening tools
• the ability to identify the skills needed to deliver brief interventions
• the ability to carry out safe alcohol detoxification
• an insight into the role of primary care in aftercare
• an overview of complementary approaches, such as Alcoholics Anonymous

Dr Clare Gerada, Chair of RCGP, said: "Alcohol has the potential to cause a wide range of medical and social problems so it is important for GPs to be able to recognise the symptoms of alcohol abuse in their patients and to know how to deal with them.

“These excellent resources will really enhance the knowledge and handling strategies of healthcare professionals dealing with alcohol issues in primary care, as well as benefiting patients, their families and the wider community. They are also valuable tools for continued professional development, which is essential for GP revalidation.”

ENDS

New framework to support and develop General Practice Nurses launched

Fri, 03 May 2013 00:00:00 +0100

A new framework to support general practice nurses in achieving and maintaining the necessary levels of competency across all areas of their generalist role has been published by the General Practice Foundation of the Royal College of General Practitioners, with contributions from the Royal College of Nursing (RCN) Practice Nurse Forum Steering Committee.

The General Practice Nurse Competencies are aligned with the NHS Knowledge and Skills Framework 2004 and informed by a wide range of national documents. This new guidance is also aligned with the General Practice Nursing Standards published by the RCGP in 2012. The intention of the document is to ensure that a standard level of competency is achieved by all General Practice Nurses (GPNs) working in primary care teams within 18 months of starting employment.

This current edition of the framework is an update of the 2006 Working in Partnership Programme (WiPP) General Practice Nurse Toolkit, which was archived from the RCN’s website in 2012. Revisions have been made by experts at the University of Plymouth General Practice Unit and reviewed by leading GPNs from across the UK and the RCN.

The framework provides a detailed picture of the role of the GPN. It can be used:

as an initial self-assessment tool to help individuals recognise their current level of competence and identify specific areas for continued professional development (CPD).
as a tool to review, demonstrate and record CPD, recognise the acquisition of specific skills and knowledge, and provide evidence of assessment of safe clinical practice.
to provide a benchmark when reviewing, demonstrating and measuring progress.
to inform and support the commissioning process through the design and delivery of education, training and workforce planning, including job design, recruitment and retention.

Professor Mike Pringle, RCGP President, said: ‘"I am proud that the RCGP is associated, through our General Practice Foundation, with this important initiative. General Practice Nurses are essential members of effective primary care teams and these competencies show the way forward."

Jenny Aston, Chair of the RCGP General Practice Foundation Nursing Group and Former Chair RCN Advanced Nurse Practitioner Forum, said: “I am really pleased that we now have the General Practice Nurse Competencies to accompany the Nursing Standards. Both provide very useful guidance for GPs, practice managers, and nurses starting out in General Practice. They will also provide Local Education and Training Boards (LETBs), CCGs and education providers with information to support the development of nursing excellence in General Practice.”

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RCGP comment on NHS111

Fri, 03 May 2013 00:00:00 +0100

Commenting on NHS 111, Dr Clare Gerada, Chair of the Royal College of General Practitioners (RCGP), said:

“The RCGP believes NHS 111 must be more effectively supported if it is going to properly direct patients to the most appropriate form of urgent NHS care.

“It is extremely worrying that there is still so much uncertainty around the delivery and reliability of the advice provided by NHS 111 in some areas.

“We are also concerned that patients are losing confidence in the new service before it is even fully up and running. We call on NHS England to provide more reassurance about its effectiveness and ability to deliver the necessary standards of care for all patients using the service, right across England.”

ENDS

GP trainees gain new influence in College work

Thu, 02 May 2013 00:00:00 +0100

Trainee GPs have been reviewing fees associated with the range of benefits and services included with their RCGP membership.

The work is part of a wider move to strengthen the involvement and participation of future GPs in all aspects of the College’s work. In November 2012, RCGP Council widened its membership to include two trainee representatives with full voting rights for the first time in College history.

Now members of the College's Associates in Training Committee, which includes representatives from the BMA’s GP trainee committee, have been working with new RCGP Honorary Treasurer Dr Helen Stokes-Lampard to look at how the College attributes its fees between trainee membership benefits and examination costs of the MRCGP.

Dr Stokes-Lampard undertook an in-depth analysis of the finances associated with AiT benefits and services. In a break with College tradition, members of the Associates in Training Committee and the BMA trainee committee were the first to be presented with her findings, prior to their progression through the usual College channels.

The Committee was given the opportunity to review the data, which highlighted that the overall package of AiT benefits are subsidised by ‘central’ RCGP. Committee members noted the distribution of fees between membership and MRCGP examinations may no longer accurately reflect their direct costs, and the difficult financial position of Less than Full Time Trainees.

The College will now do further work to address how the fees can be re-aligned for AiTs, whilst maintaining fairness to all RCGP members. The outcome of the work is expected to benefit AiTs by reducing the costs of some individual examinations to more accurately represent their on-the-day costs, and increasing the proportion of fees eligible for tax relief.

Dr Stokes-Lampard said: “College fees are set annually and Members of the AiT committee have, until now, not had the opportunity to contribute extensively to those discussions. But the College greatly values all its trainees and wants to encourage their involvement in every aspect of College life and work.

“I was keen that the AiT Committee should be the first to hear about this work and its members have already made an invaluable contribution in reviewing what is on offer to them and how much it costs.

“It is vital that we support our next generation of GPs, whilst maintaining fairness to all our members."

Dr Ben Brown, Chair of the AiT Committee, said: "The Associates in Training Committee was established to ensure that the 12,000 AiTs – around a quarter of the RCGP membership – have strong representation within the College on all matters related to GP training.

“Membership and exam fees are an important issue for us as they are a significant financial burden to AiTs. So ensuring my committee does all we can to make them as fair as possible is a top priority.

“We welcome the opportunity to work closely with the new Honorary Treasurer, which is reflective of the whole culture at the College – one that values the voice of trainee and early-career members.”

ENDS

BJGP editorial suggests it may be time for a re-think on depression

Tue, 30 Apr 2013 00:00:00 +0100

Time for a re-think on depression?

Western society may soon need to re-think what it calls ‘depression’ and how it is treated, suggest researchers in the British Journal of General Practice this month, in a special focus on mental health.

In an editorial¹, Professor Chris Dowrick from the University of Liverpool predicts that as China, India and the Middle East become politically and economically dominant in the next 20-30 years, this will create very different cultural norms and understandings of health and illness, with ‘unity’ of mind and body becoming more accepted in western medicine and society.

He looks at existing evidence and new research suggesting depression could be a shifting concept and a culture-dependent diagnosis.

Professor Dowrick said: “The World Health Organisation predicts that by 2020, depression will be the second most important global health problem.

“Our perception of what is currently labelled ‘depression’ may eventually change, with different understanding of certain frames of mind and how we respond to them.”

Ends

Please mention the British Journal of General Practice in any news stories.
1. Depression as a culture-bound syndrome: implications for primary care. Dowrick C. Br J Gen Pract 2013 DOI: 10.3399/bjgp13X665189

All press-released BJGP stories are now freely available on the BJGP website at

www.rcgp.org.uk/bjgp

The BJGP is the leading journal of family medicine in Europe and is distributed free of charge every month to over 46,000 GPs.

Although it is published by the RCGP, it has complete editorial independence. Opinions expressed in the BJGP should not be taken to represent the policy of the RCGP unless this is specifically stated.

New guidance lights a path for commissioners of child health services

Tue, 30 Apr 2013 00:00:00 +0100

An intercollegiate approach to improving local provision of child health services by placing GPs at their hub has been published today (30/4/13).

Commissioning a Good Child Health Service is the result of close collaboration between the Royal College of General Practitioners (RCGP) and the Royal College of Paediatrics and Child Health (RCPCH), with the support of the Royal College of Nursing (RCN) and the Department of Health.

Around a quarter of a GP’s patients are under 19 years of age, with this group representing more than 20% of the UK population. The document provides a shared vision of what a good children’s health service looks like from a primary care perspective, with input from GPs, paediatricians and children’s nurses. It argues that GPs should be placed firmly at the centre of a multidisciplinary team, collaborating with local voluntary and authority partners as well as community and acute care services.

The working party which developed the guidance has aimed to ‘light a path for commissioners’ promoting key areas for them to address as local strategies are developed and services commissioned, including: inappropriate A&E attendances; prenatal and adolescent mental health issues; neonatal feeding problems; children with chronic and long term illness; school issues; and safeguarding and the needs of looked after children.

The document also places strong emphasis on accountability, encouraging all stakeholders to take responsibility for local care through an agreed annual delivery plan within key delivery areas. It includes ideas for Advance Care Plans for those with life-threatening conditions, and targets those who are most vulnerable and socially excluded. The document recommends not only a strong multi-professional approach, but also a systems overhaul, including IT systems, to ensure all aspects of a child’s ‘journey’ are as efficient and effective as possible.

Dr Clare Gerada, Chair of the RCGP, said: “GPs are ready to take on this role. Commissioning of services within this area presents us with many challenges but also crucially many golden opportunities to get it right for these patients and to really make every contact count. We need to ensure these patients receive the best possible care, at whichever point they access the NHS and for however long. It is a role we are ready to take on.

“There is an increasing perception that GPs are spending less time looking after children. Significant numbers of children are also living poverty and experience poor access to good health care. Providing trainee GPs with more experience of paediatric and child health is one of the tenets on which the RCGP’s current case for extended and enhanced GP training is built.”

Dr Hilary Cass, President of the Royal College of Paediatrics and Child Health, said: “There is much that is good about the health care we provide for our children – but we have considerable room for improvement.

“For the majority of children who fall ill, their first contact with a healthcare professional is with their GP. So it’s crucial that GPs are equipped with the knowledge and tools to treat children and refer them onwards if needed to get the most appropriate care.

“GPs need to be bold in their commissioning decisions and work with colleagues across the healthcare profession to transform care delivery services and outcomes. If we can get things right for children then we’ll reap our reward in a healthier nation.”

Professor Nigel Mathers, Chair of the Guideline Working Party, said: “This report is not intended to be a detailed guide for commissioners but one that introduces the key principles that need to be considered when developing and improving child health services. We have tried to produce a ‘reader-friendly’ document based on sound evidence for the members of our three Colleges who may be involved in commissioning child health services.”

The guidance – Commissioning a Good Child Health Service – will be freely available online at www.rcgp.org.uk/child-health. A review copy is attached for media.

Ends

A new model for general practice?

Mon, 29 Apr 2013 00:00:00 +0100

The traditional role of the GP is being challenged as the role has broadened from that centred on a ‘helping model’ in doctor-patient consultations to a role that also emphasises a ‘business model’ whereby GPs are increasingly required to consider how their work impacts local communities and wider health systems, reports this month’s British Journal of General Practice (BJGP).

Whilst good communication skills, empathy towards patients and professional integrity - along with clinical knowledge and expertise - will remain the most important attributes for a GP to have both now and in the future, they will need an additional set of skills if they are to meet the challenges of the NHS of the future and deliver on patient expectations.

The additional skill set – or “competencies” – will be necessary to cover the increasing need for GPs to work outside of their practices, embrace community involvement and take on tasks involving leadership and financial acumen, alongside their continued commitment to quality improvement in care.

Organisational, resource management skills and effective teamwork were also seen as important in the future of general practice. However, it was noted that these skills should be concentrated on during training , rather than at point of entry to a GP training scheme.

Overall, in the first job analysis study of its kind for 12 years, 11 competency domains were identified by Professor Fiona Patterson of Work Psychology Group, and senior representatives from the Royal College of General Practitioners (RCGP) and COGPED. It was found that whilst the skills and experience necessary to be a GP in the UK are still aligned with those in 2005, the domains have broadened considerably to include new responsibilities associated with balancing multiple agendas, including commissioning.

The study suggests that the challenge for GPs will be the ability to balance and maintain patient care and trust and professional integrity with resource management. It also warns against negative effects that this potential conflict might have on doctors and promotes the idea that high levels of self-efficacy will be a necessary trait for GPs of the future.

The study also questions whether current GP training will adequately prepare GPs to deal with increased psychosocial issues facing patients as well as non-clinical duties. The RCGP has already had its educational case for extended and enhanced GP training accepted by Medical Education England. This will enhance GP training to four years with a special emphasis on GP placements in the areas of child health and mental health.

The multisource, multi-method study, involved over 1200 participants. It used a mix of stakeholder interviews, questionnaires and an expert panel review to assess the skills and competencies a GP should be able to demonstrate now, in the future and at point of training. The stakeholders interviewed included representatives of COGPED and the British International Doctors Association (BIDA) as well as patient groups and trainee GPs.

RCGP Honorary Secretary and workforce lead Professor Amanda Howe said: “This is a far reaching study with far-reaching implications for the future of the profession. It reinforces everything that the RCGP has been saying through our work on the Commission on Generalism and other initiatives.

“Many of our members working in general practice today are already demonstrating the broader breadth of skills outlined in the study, particularly with the introduction of the new commissioning agenda.

“But we must acknowledge that most GPs entered general practice to care for patients. This vital relationship is the cornerstone of the NHS and it must not be lost or downgraded as we take on additional roles and responsibilities.”

Professor Fiona Patterson, the lead author of the report said: “Our study provides evidence that there is now a pressing need to determine how the greater breadth of capabilities required can be addressed during education and training to support and equip GPs in the future”.

ENDS

Please mention that this study was printed in the British Journal of General Practice in any news stories. Authors: Fiona Patterson, Abdol Tavabie, MeiLing Denney, Maire Kerrin, Vicki Ashworth, Anna Koczwara and Sheona MacLeod. This article can be cited as Br J Gen Pract 2013; DOI: 10.3399/bjgp13X667196

All press-released BJGP stories are now freely available on the BJGP website.

RCGP responds to Secretary of State comment on access to out of hours care

Mon, 29 Apr 2013 00:00:00 +0100

Dr Clare Gerada, Chair of the RCGP said: “Once again, GPs are being used as a scapegoat and it is not acceptable.

"It is not true that the rise in demand on A&E services is due to a reduction in out of hours provision by GPs - and there is no evidence to prove that the increase is due to the GP contractual changes in 2004. We acknowledge that there has been a gradual rise in the numbers of patients attending A&E since 2004, but the numbers are calculated differently to a decade ago and now take into account attendance at Walk in Centres and Minor Injury Units.

"There are numerous reasons why our colleagues working in A&E departments are under pressure. As well as a serious shortage of A&E consultants, the lack of co-ordination between health, community and social care - particularly in the care of frail elderly patients - leads to a myriad of problems including unnecessary admissions, breaches in the four-hour target and delays in ambulance turnaround.

"We must stop assuming that the health service starts and ends with hospitals. Nor should we assume that increased demand equates to bad outcomes. Over the last decade, a number of initiatives have been put in place to improve access to timely and appropriate care.

"We are one NHS with patients accessing different services at different times - be it their GP surgery, walk-in clinics, pharmacy, NHS 111, or minor injury units, as well as hospitals. Focussing on A&E departments misses the bigger picture and does great disservice to the people working across the NHS who are trying to do their best for all their patients.

"These are tough times for us all and one of the issues Mr Hunt should be addressing is the shortage of 10,000+ GPs across all services, not just out-of-hours.

“As a National Health Service we should all be working together with Government to improve patient care, not blaming GPs for perceived 'inadequacies' in patient care."

ENDS

RCGP response to Caldicott Review into information governance in health and social care

Fri, 26 Apr 2013 00:00:00 +0100

RCGP responds to the Caldicott Review on information governance in health and social care - ‘Information: To share or not to share’

RCGP Chair Dr Clare Gerada, said: "Better sharing of information – providing the right safeguards are in place – has the potential to deliver better outcomes for patients, and GPs can play a central role in developing more joined up ways of working across primary, secondary and social care.

"We agree therefore with the report’s conclusion that action is needed to tackle the ‘culture of anxiety’ around sharing information that can create unnecessary barriers to closer working between health professionals.

"However, it is vital that patients are informed about and engaged in how information about their care is used, and we agree that patients should have ‘no surprises’ about the use of their data. We are therefore especially pleased that the report has recognised that where patients object to their data being shared for use by researchers and commissioners, this should be respected. This is something that the RCGP in particular has called for very strongly.

"We also particularly support the recommendation that registered and regulated social workers should be considered part of the ‘care team’. This has the potential to foster greater joint working between GPs and social care professionals, with significant benefits for the growing number of patients whose needs cut across the boundaries of health and social care.

"The report also highlights the importance of patients being able to access their own records. The RCGP has been working hard to support GP practices in providing patients with electronic access to their records by 2015, and last month we published our Roadmap to Patient Online Access. This work is part of the College’s commitment to improving patient involvement in care and enhancing their experience of and engagement with their practice."

ENDS

The Caldicott Review – To share or not to share – is online here https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/192572/2900774_InfoGovernance_accv2.pdf

RCGP response to MMR catch-up campaign

Wed, 24 Apr 2013 00:00:00 +0100

Dr Clare Gerada, Chair of the RCGP said:

"The catch-up programme is a wise and necessary move, but it is very distressing for patients and for those of us working in the NHS to find ourselves in this position when, a few years ago, we were almost at the point of eradicating the disease and the present situation could have been avoided.

"The recent outbreak across Wales and parts of England has shown what a serious condition measles is and the terrible consequences it can have.

"GPs have never stopped promoting the MMR vaccine or discussing the benefits of vaccinations with patients, even at the times of severe adverse media publicity. We urge all parents of small children and the young people who have previously missed out on their MMR vaccine to come forward as a priority. Primary care staff can talk through any concerns that patients might have.

"The RCGP is pleased to support Public Health England in this catch-up programme. The sterling work of GPs and practice staff in Wales over the past week shows that they are already stepping up to the plate. We must restore MMR vaccination rates to pre-Wakefield levels if we are to protect future generations."

ENDS

STIs in Primary Care

Thu, 18 Apr 2013 00:00:00 +0100

Sexually Transmitted Infections in Primary Care – updated guidance for 2013

With growing numbers of sexually transmitted infections (STIs) including HIV, being diagnosed in general practice in the UK, the Royal College of General Practitioners (RCGP) and the British Association for Sexual Health and HIV (BASHH) have updated their popular UK national guidelines on the management of STIs and related conditions in general practice.

The booklet Sexually Transmitted Infections in Primary Care was originally published in 2006 and was an instant success with health professionals. It covered the management of all STIs relevant to primary care and was written in concise format, providing background information, management options, tests and treatments.

The updated 2013 guideline is an easy to use PDF document with links within the text allowing quick navigation. Charts and tables compliment bullet-point advice and newly written algorithms help with management options. It can be downloaded for free from both the RCGP and BASHH websites.

Author Dr Neil Lazaro, a member of the Clinical Effectiveness Group of BASHH and the RCGP Sex, Drugs, HIV and Viral Hepatitis Group, said:

“This booklet has been written in an informal and shorthand way, designed to be quick to use during a GP consultation. It provides GPs with pragmatic management options for the ‘Friday afternoon consultation’ and will also alert clinicians to the possibility that they may actually be dealing with a patient with an STI. Dysuria in a male, for example, is often a symptom of sexually acquired urethritis rather than a UTI.”

Dr Clare Gerada, Chair of the RCGP, said:

“This booklet will be very helpful in managing patients appropriately. It is a readable, comprehensive and very practical “coal-face” guide of what to do in General Practice. It will also be useful for contraceptive clinics, prisons, HM Forces and A&E teams.”

Dr Janet Wilson, President of BASHH, said: “This booklet provides accurate and relevant information, is easily accessible and definitely useful to all working in general practice and other non-specialist settings.”

Sexually Transmitted Infections in Primary care 2013 is available in PDF format and may be downloaded for free from the RCGP and BASHH websites.

Ends

A six-step guide to commissioning end of life care

Tue, 16 Apr 2013 00:00:00 +0100

The complexities of commissioning local services to improve end of life care are addressed in useful guidance launched today by the Royal College of General Practitioners (RCGP).

RCGP Commissioning Guidance in End of Life Care provides GPs and Clinical Commissioning Groups (CCGs) with a logical, six-step framework and overview to support their work in delivering practical improvements across the health, social care and voluntary and independent sectors.

The guidance has been produced to ensure that the needs of dying patients and those closest to them are paramount whilst services are commissioned and developed around them.

It advocates a broad approach that is locally tailored but based on national policy, guidance and current expert thinking. It cautions that improvements in treating long term conditions, dementia, frailty and reducing hospitalisation cannot be achieved unless end of life care is seriously considered and integrated.

RCGP Chair Dr Clare Gerada said:

“The UK has a strong tradition of excellence in palliative care and referral to palliative care services, particularly for people with cancer, is greatly valued.

“The challenge we face as GP providers and commissioners is to move beyond this to the greater population who need our help. The importance of making improvements in end of life care cannot be emphasised enough and primary care is central to this challenge.

“This guidance will support GPs and commissioners in ensuring that the right care is consistently delivered for patients, at the right time and in the place of their choosing.”

The guidance is written by Professor Keri Thomas, RCGP Clinical Lead for End of Life Care, and Dr David Paynton, RCGP National Clinical Lead for Commissioning.

It provides case histories of good practice and signposts to existing resources and documents including the RCGP End of Life Care Strategy, RCGP/RCN Patient Charter and a variety of palliative care resources.

ENDS

RCGP comment on MMR vaccine

Tue, 16 Apr 2013 00:00:00 +0100

Commenting on the MMR vaccine, Dr George Kassianos, Immunisation Lead for the Royal College of General Practitioners (RCGP), said:

"The RCGP fully supports the childhood immunisation campaign using the MMR vaccine and would encourage parents to have their children vaccinated.

"We cannot allow outbreaks of measles, or mumps, or rubella infection when we have a vaccine with an excellent record in safety, requiring only two doses: the MMR vaccine.

"The RCGP certainly sees no reason to justify the introduction of single antigen vaccines in parallel to the MMR vaccine and there are good examples for why single antigen vaccines should not be made available on the NHS: the MMR is one of the safest and most scrutinised vaccines we have ever had; there is no scientific evidence that single vaccines provide any more of an advantage to children; and single vaccines can mean that children require six injections, two for each antigen, measles, mumps and rubella instead of two MMR injections meaning many children can end up not having completed their six-injection courses placing them at higher risk of measles, mumps, or rubella.

"The RCGP urges all parents whose children have not had two doses of the MMR vaccine, or had single antigen vaccines in the past, to contact their GP practice in order to complete their immunisations with two doses of the MMR vaccine."

ENDS

Notice of Spring General Meeting 17 May 2013

Thu, 04 Apr 2013 00:00:00 +0100

THE ROYAL COLLEGE OF GENERAL PRACTITIONERS' SPRING GENERAL MEETING

17 MAY 2013

Notice is hereby given that the Spring General Meeting of the Royal College of General Practitioners will be held at RCGP Headquarters, 30 Euston Square, London, NW1 2FB
on Friday 17 May at 14.00

The President, Professor Mike Pringle CBE MD FRCP PRCGP
will be in the Chair.

The agenda can be viewed here

RCGP announces new Clinical Champions

Thu, 04 Apr 2013 00:00:00 +0100

The RCGP has announced the ‘Clinical Champions’ who will take forward the College’s clinical priorities for the period 2013-2016.

Dr Kathryn Griffith is RCGP Clinical Champion for Chronic Kidney Disease
Dr Griffith is a GP in York. She is primary care representative on the Renal Advisory Group at the Department of Health; was involved in the development of the 18-week pathway for CKD; and was on the NICE Quality Standard for CKD. She is also currently the only general practitioner on the NICE panel for the Update of the CKD Guideline.

Her published work includes Ten steps before you refer for CKD¹ and The 18-week pathway for chronic kidney disease².

Dr Jane Roberts is RCGP Clinical Champion for Youth Mental Health
Dr Roberts is Clinical Senior Lecturer in General Practice at the University of Sunderland and a salaried GP. She is Chair of the RCGP Adolescent Health Group; the RCGP representative on the Children and Young People Improving Access to Psychological Therapies Programme Expert Reference Group; and a NICE Guideline Development Group Member on Social Anxiety Disorder.

Dr Roberts was also the RCGP representative on the Intercollegiate Working Party to end the administrative detention of children and young people in immigration centres.

As part of her work at University of Sunderland, Dr Roberts has been involved in research into community mental health initiatives lead as a priority and helped identify adolescent mental health as a neglected area of research and practice. In parallel with this project, she also worked on developing a clinical in-house service to offer bio-psycho-social assessments of 5-19 year olds presenting with emotional or behavioural difficulties in general practice.

Dr Waqaar Shah is RCGP Clinical Champion for Eye Health With a Focus on Ageing
Dr Shah is already the RCGP Eye Care representative providing advice and strategic direction to the RCGP. Prior to general practice, he spent five years working in Ophthalmology. He sits on the Department of Health Eye Care Strategy Group; is a trustee and executive board member of Vision 2020; and has played a significant role in the development of GP Commissioning Guidance for Eye Care.

Dr Shah contributed significantly to the Department of Health GOS18 review process, and to the DH Workforce Development Consensus for Ophthalmology. He also provides expert evidence to the All Party Parliamentary Group on Eye Care

Dr Greg Rogers is Clinical Champion for Epilepsy Care
Dr Rogers is the current Chair of the UK GP Epilepsy Society; the International League Against Epilepsy; and scientific advisor to both Epilepsy Action and Epilepsy Bereaved. He is also a national adviser to NICE and has sat on a number of guideline development groups.

He has published several research papers and chapters into the role of GPs in caring for patients with epilepsy, is on the Editorial Board of Practical Neurology at the BMA, and also sits on the Personal Health Budget RCGP/DH task group.

ENDS

FURTHER INFORMATION

RCGP Press office – 020 3188 7574/7575/7576
Out of hours: 0203 188 7659
press@rcgp.org.uk

NOTES TO EDITORS
1. 10 Steps before you refer for CKD. Griffith KE, Kalra P. British Journal of Cardiology 2010; 17: 81-84
2. Griffith KE The 18-week pathway for chronic kidney disease. Journal of Renal Nursing 2009; 180-183

Full details of the RCGP’s clinical priorities can be found at www.rcgp.org.uk/circ

Essential commissioning guidance launched on working with local communities

Tue, 02 Apr 2013 00:00:00 +0100

Working with Communities, Developing Communities

New guidance for Clinical Commissioning Groups (CCGs) on how to work within communities rather than imposing top-down decisions is launched today by the Royal College of General Practitioners.

Working with Communities, Developing Communities is the latest resource produced by the RCGP Centre for Commissioning, set up in 2010 to support GPs with the commissioning and delivery of healthcare and services. The publication coincides with the introduction of Clinical Commissioning Groups (CCGs) across England on 1 April.

The guide puts forward both a financial case and health case as to why investing resources in Community Development is beneficial for local populations, primary care practitioners and CCGs.

It emphasises that local populations must be seen as assets, not burdens, in order to make CCGs strong and successful. It also focuses on the need for CCGs to work together and build partnerships within their communities between health, education, housing and other services including policing.

Community Development comes in many forms but all focus on maximising the potential of local individuals and community groups in shaping how public services develop, creating opportunities and solving problems. It uses two main case studies to illustrate these along with numerous other examples, including Time Banks which use participants’ time and skills as currency instead of money.

Community Development professionals will work with residents to identify key, local issues and set agendas important to local people. Local authorities and public service organisations, such as NHS groups, will be involved in making decisions but fundamentally this should be an inclusive process.

Health benefits from effective Community Development include:

improved social integration which evidence has shown to increase resilience against physical and mental health problems; promoting social networking which has been shown to tackle health inequalities and promoting wider societal benefits; and sustainability in terms of the impact on health services, employment opportunities, education, housing and policing.

Financial rewards associated include those seen by the Health Empowerment Leverage Project (HELP) in Devon- one of the principle case studies in the report. It saw an NHS saving of £558,714 over 3 years and estimated annual wider societal savings across England of £130 million. HELP focuses on building links between local populations and frontline services.

Another example is the Healthy Communities Collaborative which targeted reducing falls in older people and saw a saving of £1.2 million in hospital costs, £2.75 million in residential care costs and £120,000 in ambulance costs over three years.

Dr Clare Gerada, Chair of the RCGP said: “We need to engage with the people we have been commissioned to serve. The people within the community should have their say in what they think will make their society, their lives, better; be it health or education or housing. They should have a role in making these things happen. As leaders, we need to listen to them and develop lasting relationships between services, concentrating on the things that our local populations really want and need.

“We must trust our communities to work proactively with us for the greater good of society, inclusive of healthcare as well as other essential services. We need to believe that people want to look after themselves and work towards a better, healthier, life for themselves, their families and their communities.”

Dr David Paynton, National Clinical Lead for the RCGP Centre for Commissioning said: “Community Development promotes simple ideas that produce multi-faceted benefits to everyone involved. CCGs must be strong and deliver sustainable outcomes in order to be successful and to do this we must utilise our most important resource- our communities- not fritter away another important resource -money- by outsourcing to contractors and paying inflated and unnecessary prices.

“This guidance gives an excellent overview of how primary care practitioners can work with- not against- their local population.”

ENDS

Comment on NHS 111

Thu, 28 Mar 2013 00:00:00 Z

Commenting on NHS 111, RCGP Chair Dr Clare Gerada, said:

"The RCGP is becoming increasingly concerned by reports of serious issues with the delivery of NHS111 services in Manchester, South London and the Midlands. Patients and health professionals need to have confidence in the new system and how it works, and be assured that the health service will be there for them should they need it. We need urgent reassurance that patients and GPs will be able to rely on a fully functioning service from Monday, wherever they live and work.

"Many GPs in affected areas are stepping into the breach to protect vulnerable and worried patients and the RCGP will continue to monitor the situation."

Ends

eLearning to help GPs recognise early symptoms of ovarian cancer

Wed, 27 Mar 2013 00:00:00 Z

eLearning to help GPs recognise early symptoms of ovarian cancer

An online learning module for GPs to assist them in identifying ovarian cancer in its early stages has been produced with the RCGP in partnership with Target Ovarian Cancer.

There are around 7,000 diagnoses of ovarian cancer each year in the UK1 and the average woman has an approximately 2% lifetime risk of ovarian cancer. Most women are still diagnosed when they have advanced disease, with only around 30% diagnosed at the earliest stage.

Ovarian cancer still has the worst prognosis of all the gynaecological cancers, with a one year survival rate of 73% and a five year survival rate of 44%. Contrary to popular belief, it is not a silent killer - most women have symptoms from it, regardless of the stage at which they are diagnosed.

The eLearning module is designed to help GPs establish the duration of symptoms, their impact on the patient’s life and help them ascertain their own ideas and concerns about the diagnosis, such as being able to confidently differentiate the cancer from other conditions, such as IBS. It also covers NICE guidance and recommendations around appropriate CA-125 testing.

Dr Dirk Pilat, Medical Director of the RCGP Online Learning Environment, said: “Most women have had symptoms for months before presentation and there are often delays between presentation and specialist referral. Around one third of ovarian cancers are actually diagnosed following an admission to A&E.

"Ovarian cancer is not a silent killer, although early symptoms are often vague. The vast majority of women diagnosed with ovarian cancer at all clinical disease stages do have symptoms. However, the problem is that the positive predictive value (PPV) for each individual symptom is low. A woman who has a symptom associated with ovarian cancer usually does not have ovarian cancer. However, women with multiple symptoms are more likely to have ovarian cancer than women with only a single symptom.”

Dr Sharon Tate, Public Affairs Manager, Target Ovarian Cancer, said “The symptoms of ovarian cancer are commonly seen in GP practice and can be easily mistaken for those caused by more common conditions. We are delighted to have worked with RCGP eLearning on this new online module and are confident that it will give many more GPs the opportunity to update their knowledge of ovarian cancer symptoms, and in particular support them in recognising ovarian cancer among the more common conditions. This is crucial if women are to be diagnosed in a timely manner and their survival chances improved.”

The module is entitled “Bloating and Other Abdominal Symptoms: Could it be Ovarian Cancer?”. It takes around 30 minutes to complete and is freely available on the RCGP Online Learning Environment at www.elearning.rcgp.org.uk.

ENDS

FURTHER INFORMATION

RCGP Press office – 020 3188 7574/7575/7576
Out of hours: 0203 188 7659
press@rcgp.org.uk

NOTES TO EDITORS
1. Cancer Research UK 2010 statistic http://www.cancerresearchuk.org/cancer-info/cancerstats/types/ovary/. Over 80% of ovarian cancer deaths are in women aged 60 or over. During the last decade, survival rates following a diagnosis of ovarian cancer have improved in England overall, especially in younger women. Despite this however, ovarian cancer still has the worst prognosis of all the gynaecological cancers, with a one year survival rate of 73% and a five year survival rate of 36% (International Cancer Benchmarking Partnership (ICBP) study).

2. Known associated symptoms of ovarian cancer include:
Abdominal, pelvic or low back pain
Early satiety
Urinary urgency/frequency
Change in bowel habit
Weight loss (although, some women may actually have weight gain due to ascites)
Fatigue
Dyspareunia
Postmenopausal or irregular vaginal bleeding (more uncommon presenting feature)

3. The RCGP Revalidation ePortfolio automatically records learning completed in the RCGP Online Learning Environment OLE to help GPs record and plan their CPD for appraisal and revalidation.
Other new courses planned for 2013 include Substance Misuse and Prostate Cancer.

To access the free e-learning visit www.elearning.rcgp.org.uk

The Royal College of General Practitioners is a network of more than 46,000 family doctors working to improve care for patients. We work to encourage and maintain the highest standards of general medical practice and act as the voice of GPs on education, training, research and clinical standards.

RCGP comment on Government Response to Francis Inquiry

Tue, 26 Mar 2013 00:00:00 Z

RCGP Chair Dr Clare Gerada said:

"High quality patient care is at the heart of what the RCGP does. We are open to working with the Government and the Care Quality Commission to examine how the system for regulation of primary care could be improved to make it more effective, including whether there is a case for introducing a Chief Inspector of Primary Care.

"We support the development of good quality information systems for health and social care. But we believe that a single summary score for each general practice would mislead patients, rather than helping them to assess the quality of GP practices in their area. A single summary score is unlikely to take into account the age of the practice population, deprivation, or a whole host of other factors, and will therefore be unable to offer meaningful comparisons.

"The College recognises that the Government has taken some positive initial steps towards supporting NHS whistle blowers, but much more is needed to achieve meaningful change in this area. In particular, we urge the Government to publish a comprehensive plan of action explaining how it intends to enforce the ban on ‘gagging clauses’ in the NHS, and consider what measures are needed to ensure NHS whistle blowers are better able to access practical and financial support."

RCGP response to Patients Association report

Fri, 22 Mar 2013 00:00:00 Z

RCGP response to Patients Association report on GP appointments

RCGP Chair Dr Clare Gerada said:

"This is another disappointing and extremely demoralising report from the Patients Association. There are over a million consultations in primary care every day and GPs are working extremely hard to deliver the best care they can for their patients against a backdrop of NHS upheaval and increasingly limited resources.

"Being ill outside normal hours can be a very frightening experience for patients and they should be able to rely on the same level of care and services as they would receive in hours. Patients in all areas of England can still access their GP Out of Hours Service by phoning their GP surgery and being directly transferred to their out of hours provider or given a number to ring.

"Since 2004, the majority of GP Out of Hours services have been commissioned, funded and monitored by local Primary Care Trusts and this has inevitably led to some variation. But contrary to anecdotal opinion, GP out of hours services have been generally good in PCTs where there has been appropriate funding and monitoring, and GP out of hours services have performed consistently better against national quality standards and targets than A&E departments that are considerably better funded.

"The different NHS services available can be confusing to patients and we hope that the new Clinical Commissioning Groups who will be taking on responsibility for commissioning and providing out of hours services will make it easier for patients to navigate the system and obtain the appropriate care they need.

"On the issue of GP appointments, we are not denying that some patients have difficulty in booking. Most GP surgeries operate independently and have their own booking routines and it can be difficult to know how your own practice operates, especially if you do not consult the GP very regularly.

"Most surgeries will allocate some slots for patients who need to see a GP that same day and patients can also ask to see a nurse or another health professional. Other alternatives such as the local pharmacist are also worth considering.

"GPs are there to care for people when they are ill and we can understand patients' frustrations, but general practice is changing beyond recognition. Factors such as the ageing population and the rising numbers of people presenting with multiple, complex and long-term conditions, including mental health issues, mean that patients are booking more frequent - often multiple - appointments, well in advance, and this obviously reduces the availability for others.

"If we are to meet patients' needs and expectations, today and in the future, we must have more GPs. The RCGP is calling for at least 10,000 additional GPs, as well as longer appointment times so that GPs can spend more time with their patients.

"The relationship between GP and patient is unique in the NHS and we take patients' concerns and complaints very seriously, but these sporadic reports from the Patients Association are ill founded and damaging.

"As we have said many times before, we would prefer the Patients Association to work with us to find ways of supporting GPs to make improvements in patient care, rather than producing sensationalist surveys that repeatedly and unfairly criticise GPs and their teams."

ENDS

Doctors in the fast lane on social media guidance

Mon, 18 Mar 2013 00:00:00 Z

The first-ever practical guide to help UK doctors navigate their way around the ethical and confidentiality dilemmas of social media is published today by the Royal College of General Practitioners (RCGP) in collaboration with Doctors.net.uk and LimeGreen Media.

The Social Media Highway Code is a collation of practical and supportive advice based around a 10-point plan. The advice was provided by a range of people with an interest in social media, including doctors, nurses, journalists, lawyers, students and patients.

It is intended to help and encourage healthcare professionals to communicate effectively using various social media channels, whilst adhering to the conventions that their patients, their colleagues and the public might reasonably expect.

The points in the Code include:

Recognise that the personal and professional can’t always be separated
Engage with the public but be cautious of giving personal advice
Respect the privacy of all patients, especially the vulnerable
Show your human side, but maintain professional boundaries

A first draft of the guide was launched at the RCGP annual conference last October and prompted an exciting online debate joined by doctors across the UK, Europe and Australia, which trended No.1 in the UK on Twitter.

Since then, healthcare professionals from all over the world have been providing feedback on the Code through Twitter, Facebook and the online forums on Doctors.net.uk. The feedback has now been reviewed and the themes incorporated into the Code, which was given an official stamp of approval by RCGP Council in February.

Changes added include more information for GPs working in the Armed Forces and in controlled environments, more on the extra responsibilities that doctors can hold as ‘data controllers’, and more tips and advice on communicating with the public and with colleagues.

Whilst primarily aimed at healthcare professionals, the comprehensive and common-sense Code is transferable to other professional spheres. There has been interest in adapting the content for education professionals, with the potential to extend this to legal and political spheres and other professions where ethics and client safety are paramount.

The co-authors of the Code – enthusiastic Twitter users Dr Ben Riley [@drbenriley] and Dr Clare Gerada [@clarercgp] – will be participating in a lunchtime Twitter debate on Friday 22nd March. The discussion will cover how social media effects healthcare professionals and patients, and how the benefits could be rolled out to wider society. They invite anyone with an interest in social media and healthcare to take part using the Twitter hashtag #RCGPSoMe.

Dr Riley, lead-author of the Code and Curriculum Director for the RCGP said:

“The interest and feedback we have received from healthcare professionals across the globe has been fantastic. There are many opportunities for GPs and other healthcare professionals to take the lead in developing how social media can be used to improve healthcare. At the same time healthcare professionals need to protect their patients and support each other with using these new ways of communicating. The Code has a practical focus and addresses a number of the challenging areas that GPs and other healthcare professionals have been asking about for some time.”

Dr Gerada, Chair of the RCGP said:

“I am proud to lead a College that consistently puts patient care at the heart of what we do. We were the first Medical Royal College to have an active patient group, the first to trend in the UK on Twitter, and now we are the first to produce positive, practical guidance on Social Media usage in order to protect the interests of both patients and healthcare professionals.”

Harvey Ward, Chair of the RCGP Patient Partnership Group said:

“The 1931 Highway Code was created to ‘educate all road users about their duties and obligations to each other and the whole community’ and similarly the College’s 2013 Social Media Highway Code can be described as ‘a code of good manners to be observed by all courteous and considerate persons’.

“Using the Code’s advice, social media offers great potential benefits to all patients and hard to reach groups by, for example, improving access to information about healthcare services. Additionally, the Code is a wonderful step in the right direction for heightening patient safety online, where some patients can be vulnerable.”

Dr James Quekett from Doctors.net.uk said:

“The Code is about helping individuals navigate social media and attempts to highlight where doctors need to exercise caution based on past experience. It is not about imposing rules on their online behaviour.”

ENDS

RCGP response to BMJ investigation into conflicts of interest on commissioning boards

Thu, 14 Mar 2013 00:00:00 Z

RCGP comment on the findings of the BMJ investigation into GP conflicts of interest on commissioning boards

Dr Clare Gerada, Chair of the Royal College of General Practitioners, said: "This is what the College warned about as far back as September 2011 when we issued guidance around the ethics of commissioning.

"Maintaining the highest ethical standards in all our activities is fundamental for all GPs and we are fully aware of our responsibilities in declaring any conflicts of interest. But this is a new marketised system that GPs are rapidly having to get used to, in particular how we operate fairly, ethically and effectively within it.

"GPs are usually appointed to Clinical Commissioning Groups because of their experience in holding other positions, not always paid or private, but even here, the potential for conflict of interest is always present.

"Members of Clinical Commissioning Groups should be expected to disclose information about conflicts of interest and to exclude themselves from decision making where a conflict of interest exists . But there should be prompts and checks to reinforce this and rules to ensure that decision making is efficient, transparent and fair, without being overly complex or slow.

"Clinically-led commissioning on this scale is unchartered territory and GPs are being presented with a tremendous range of new challenges. If conflicts of interest in clinical commissioning groups are not managed effectively, the consequences could badly undermine the confidence of regulators, providers and, most importantly, patients, in the system."

ENDS

In 2011 the RCGP Centre for Commissioning produced guidance on Managing conflicts of interest in clinical commissioning groups.

The BMJ report is available on the BMJ website

RCGP response to new regulations laid in Parliament on choice and competition

Tue, 12 Mar 2013 00:00:00 Z

RCGP Chair Dr Clare Gerada said: "This is a step in the right direction but the revised regulations do not go far enough in ensuring that commissioners are genuinely free to decide whether or not to expose services to competition. There is a big difference between the previous procurement guidelines and these regulations, which will have statutory force.

"It should be up to commissioners to do what they feel is best for their patients, using their professional and clinical judgment. Despite the revisions, they will still be required to show that there is only one capable provider in order to avoid having to put a service out to tender."

ENDS

Recent RCGP comments on this issue:

RCGP response to news that Regulation 75 of the Health and Social Care Act is to be re-written

RCGP Chair Dr Clare Gerada has sent a letter to Earl Howe regarding section 75 of the Health and Social Care Act procurement regulations currently before Parliament

RCGP response to Chief Medical Officer report on antibiotic resistance

Mon, 11 Mar 2013 00:00:00 Z

Responding to the CMO’s report on antibiotic resistance, RCGP Chair Dr Clare Gerada, said:

"Patients have come to rely on - and expect - antibiotics for common colds and infections that will get better naturally or respond better to other treatments and this can make it difficult for GPs to prescribe appropriately.

"The College has been working for some time to reduce the unnecessary prescribing of antibiotics. Prescribing has been designated a clinical priority and we have already produced a wide range of resources, including a toolkit with the Health Protection Agency and free online learning - to support GPs in this area.

"The Chief Medical Officer's report and recommendations will help this work and we particularly welcome the emphasis on training and continuing professional development for health professionals.

"Antibiotics can achieve excellent results if prescribed and used appropriately but patients need to be more aware of their drawbacks and this report will help GPs to get this message across."

RCGP and Arthritis Research UK launch new e-learning module on MSK

Thu, 07 Mar 2013 00:00:00 Z

Musculoskeletal Care (MSK) is the focus of a new e-learning course launched this week by the Royal College of General Practitioners (RCGP) in collaboration with the charity Arthritis Research UK.

The module is the latest addition to the RCGP’s rapidly-expanding Online Learning Environment (OLE) and it is free to all healthcare professionals - not just members of the College. It aims to improve GPs’ and GP trainees' core skills in diagnosing and managing MSK conditions.

MSK conditions are the fourth largest area of spending in the NHS. There are 100,000 MSK consultations in England every day with 20% of the UK population consulting a GP with an MSK problem annually.

The comprehensive module - developed for GPs by GPs - includes a number of lessons and assessments using clinical examples to demonstrate different aspects of care for MSK conditions, with advice for users on how to deal with each:

Inflammatory Arthritis – long-term condition management and co-morbidity
Gout and Polygmyalgia Rheumatica (PMR)
Osteoarthritis (OA) – supported self-management and behaviour change
Fibromyalgia Syndrome (FMS) – explanation and signposting
Common Upper and Lower Limb conditions
Spinal conditions – biopsychosocial approach, discussions around work

The module, based on up to date research in the area, takes 4.5 hours and offers CPD credits - essential for revalidation.

The e-learning tool is being accompanied by a pilot series of one-day workshops allowing participants to get to grips with the practical aspects of MSK core skills. Exceptional demand for places has led to these becoming fully booked but feedback will be analysed with the view to hold further workshops later this year. A MSK impact toolkit is also planned.

Arthritis Research UK funded the project as well as helping to develop it, with further contributions from the Arthritis Research UK Primary Care Centre at Keele University.

Dr Clare Gerada, Chair of RCGP, said:

"MSK conditions are notoriously difficult to manage as they don’t fit the neat model of disease-diagnosis-treatment-cure. However, patients with MSK conditions rely on their GP for diagnosis and management of their problem.

"This fantastic resource will benefit GPs and those patients. The fact that it is free for all healthcare professionals emphasises the work the College does to promote continued professional development.

Dr Tom Margham, primary care lead at Arthritis Research UK and a practising GP in East London said:

“Many GPs may not have received any formal MSK training in primary care. We hope that the core skills project will help to increase their confidence levels in managing musculoskeletal conditions, enabling them to deliver better care and treatment to the millions of people living with pain and disability.”

ENDS

The e-learning module is available through the RCGP's Online Learning Environment

For more information on the work that RCGP is doing on MSK and rheumatology visit the Clinical Innovation and Research Centre section of our website

Anyone who is interested in future MSK workshops run by the RCGP can email Expressions of interest to msk@rcgp.org.uk.

Patient Online launch with Secretary of State

Wed, 06 Mar 2013 00:00:00 Z

(Left-right) Dr Peter Short, GP; Chris Ghush, Head of RCGP CIRC; Dr Imran Rafi, Chair of CIRC, who led the programme; Jeremy Hunt, Secretary of State for Health; Dr Clare Gerada, Chair of RCGP; and Dr Arvind Madan, GP

Patient Online: the route to electronic access

New guidance to support GP practices in providing online access for patients is launched today by the Royal College of General Practitioners.

Patient Online: a Roadmap covers transactional services such as the booking and cancelling of GP appointments and the ordering of repeat prescriptions, secure online communication with the practice and access to online records. It is a means by which patients can improve engagement with their GP practice and become more involved in choices about their own healthcare.

The guidance looks at the principles of online access to records by patients, steps to offering access, and the principles around training, education and support for practices. Issues around information governance, including third party data and GP workload are taken into account.

It acknowledges that some GPs are already providing various forms of online access and is meant to supplement current working practices. Clinical Commissioning Groups are also invited to use the guidance to consider how they best support their GP practices.

Options for what can realistically be offered to patients now and what might be offered in the future are set out under four classifications, taking into account the differences in capacity of GP practices:

A - functionality that is already present in current systems and that many practices are already using or considering implementing as a first step in offering online access. Resources, such as password management, will need to be identified to enable practices to take on new work processes.

B - many practices will have standard functionality to be able to offer these items for patients. They bring additional workload, and therefore any implementation will require negotiations with the profession.

C - items specified will present practices with ethical and/or implementation challenges, with potential risks to confidentiality and/or patient safety or with significant workload implications, and would be seen as an enhanced practice offering. They are only likely to be provided by general practices with a strong interest in access to records, and after the risks have been mitigated.

D - items that may be desirable, but should only be considered once the preliminary items (e.g. A and B) have been achieved, again subject to negotiation.

The guidance also explores the different elements within a clinical record that could be made available for access, assessing the potential benefits and risks of making these elements accessible. It addresses the distinction between online services such as appointment booking and online records.

By 2015, the NHS Commissioning Board expects all GP practices in England to offer patients online access to their records and transactional services.

The Government asked the RCGP to lead on development of guidance and the College accepted on the grounds that, with 46,000 GP members, it was best placed to provide the professional leadership, training and support that GP practices will need to deliver access in a way that is appropriate, workable, realistic and safe for all parties.

Over the past six months, the College has worked in partnership with a wide cross-section of patient groups and professional organisations. The principles and messages of Patient Online have been produced through consensus within the seven working groups and through wider stakeholder engagement.

Patient Online has been produced by the RCGP to support and inform GPs and their practices. It is intended to be taken up voluntarily and willingly by practices and patients. The number of practices offering online services and access to records is expected to rise steadily and progressively as the 2015 deadline approaches.

The information technology (IT) to provide Patient Online will need to be mandated through the GP Systems of Choice (GPSoC) and local service providers (LSP) contract processes. It is a possibility that the NHS Commissioning Board will set up an enhanced service agreement which will contain the requirement for some aspects of online functionality. The guidance produced through the College could be used to assist practices through any such process but contract negotiations around General Medical Services remain with the BMA's General Practitioners Committee.

RCGP Chair Dr Clare Gerada said: "Patients gaining access to their own records presents us with great opportunities - and major challenges, not only for GPs, but also for patients themselves and their carers.
"From the outset, our focus has been on the practical steps needed for GP practices to deliver patient online access by 2015 and we believe that the Roadmap is an appropriate, workable and realistic way forward for all those involved. This could not have been achieved without the hard work and commitment of the many organisations and individuals involved."

Dr Imran Rafi, Chair of the RCGP Clinical Innovation and Research Centre, who led the Patient Online programme, said: "The UK is a leader in primary care services and general practice, as a specialty, is a leader in the use of IT systems to support quality electronic healthcare records. The challenge is for each GP surgery to consider what the implications of online access are likely to be on the delivery of their high quality services.

"We can use IT to deliver quality accessible care that addresses health inequalities, to reduce fragmentation of care and provide coordinated care for people with multiple morbidities, and to involve patients and carers more in decisions about their health. But when considering the value of IT, we must also take into account the unintended consequences of the use of health IT, such as exacerbating the digital divide."

Health Secretary Jeremy Hunt said: “I have set a challenge to the NHS to go paperless by 2018. That means embracing the many benefits that technology can bring so NHS staff spend time with patients not paperwork, and patients get the 21st century services they expect.

"I am delighted that the Royal College of General Practitioners has led this work to help give patients better electronic access to GP services. Appointments, prescriptions and test results can and should be only a click away. Records - which help patients work in partnership with their doctor to manage their care - also need to be easily accessible.

“This roadmap is a fantastic guide to how we are going to make this happen and I applaud the professional and patient groups that have been involved in putting it together.”

ENDS

www.rcgp.org.uk/patientonline

RCGP response to news around Regulation 75

Tue, 05 Mar 2013 00:00:00 Z

RCGP response to news that Regulation 75 of the Health and Social Care Act is to be re-written

RCGP Chair, Dr Clare Gerada, said:

"We are delighted - and relieved - that the Government has listened to us and responded so quickly and positively.

"We are also grateful to the many individuals and organisations who rallied to support the College after we raised our concerns last week.

"We now urge the Government to work with us to develop an acceptable set of replacement regulations that will ensure GP commissioners have the freedom to make decisions in the best interests of our patients and in line with the values that have underpinned the NHS for the past 65 years."

ENDS

The RCGP wrote to Earl Howe last week raising concerns about the wording of Regulation 75. The full letter can be viewed here

RCGP response to Living Well for Longer

Tue, 05 Mar 2013 00:00:00 Z

RCGP Chair of Council, Dr Clare Gerada, said:

"People are living much longer - but not necessarily living healthier - and the challenge is to find ways of achieving both.

"We welcome the Secretary of State's report and are pleased that many of the issues raised are what the College and GPs have been working to address for some time.

"With over one million consultations every day, GPs are at the front line of their communities and have the potential to develop services that will improve the quality of life for patients with cancer, stroke, respiratory problems, dementia and liver disease - as well as working with those most at risk to prevent such conditions happening in the first place. We are already working with our colleagues in secondary and social care and with the third sector to make improvements

"GPs need and want to do more, but as people live longer, general practice is becoming more complex and patients are increasingly presenting with multiple conditions, including mental health issues. If we are to meet the needs and expectations of patients today and in the future, we need more support and resources.

"Over the next 10 years, we need an increase of at least 10,000 more GPs, particularly in those areas that are currently under-doctored but have the greatest health inequalities. We also need longer and enhanced training for GPs entering the profession.

"We need to encourage more patients to work with their GPs in planning and managing their own care to achieve the best outcomes possible, as well as bringing about societal changes, such as a minimum pricing for alcohol, that will undoubtedly help people live longer, healthier and more fulfilling lives in the long run."

ENDS

Letter to Earl Howe regarding Section 75

Fri, 01 Mar 2013 00:00:00 Z

RCGP Chair Dr Clare Gerada has sent a letter to Earl Howe regarding section 75 of the Health and Social Care Act procurement regulations currently before Parliament.

The letter sets out the RCGP's serious concerns that, in contradiction to assurances given by Ministers during the Act's passage through Parliament, the regulations will severely restrict CCGs' freedom to decide not to expose services to competition.

The letter can be viewed here and accompanying case studies are here.

ENDS

Study puts patients in control of GP consultation times

Wed, 20 Feb 2013 00:00:00 Z

Asking patients to choose their preferred length of consultation time when booking a GP appointment may increase satisfaction levels for patients and doctors, suggests a study¹ in the March issue of the British Journal of General Practice (BJGP).

Dr Rod Sampson and colleagues from the Cairn Medical Practice in Inverness conducted an experiment in which 174 patients visiting the surgery over a five week period were invited to choose between 5, 10, 15 or 20 minute consultations when making their appointment. The patients and their GPs gave feedback on how positively or negatively the length of their consultation impacted on patient care.

Both doctors and patients reported an increase in patient empowerment and improved time management in the consultation, although there were some concerns about the accuracy of the choice of timing in particular cases and it was suggested that patient education in this area might be beneficial.

Commenting on his research, Dr Rod Sampson said: “Choice is an important issue for patients and they can usually assess accurately how long a consultation they need. The results of this study suggest that there may be a number of benefits to be gained by giving patients greater responsibility for choosing the length of their appointments. It is important to be aware that this may not meet all the needs of doctors or patients. Educating doctors, reception staff and patients on how best to use such a system, for the benefit of both doctors and patients would seem necessary.”

Professor Roger Jones, Editor of the British Journal of General Practice said: “This research has real potential to shake up what we perceive as patient choice. This was not a large study and we would be interested in seeing whether the findings would be similar over a large number of GP practices, and over a longer period.”

ENDS

Please mention that this study was printed in the British Journal of General Practice in any news stories.

1. Sharing control of appointment length with patients in general practice: a qualitative study. Authors: Rod Sampson, Jeremiah O’Rourke, Ross Hendry, David Heaney, Samantha Holden, Alex Thain and Ronald MacVicar Please cite this article as:

Br J Gen Pract 2013; DOI: 10.3399/bjgp13X664234

All press-released BJGP stories are now made available on an ‘open access’ basis on the BJGP website.

RCGP Response to Francis Report

Wed, 06 Feb 2013 00:00:00 Z

The RCGP has responded to Sir Robert Francis QC's Public Inquiry report into Mid Staffs NHS Foundation Trust, published today (6/2/13).

RCGP Chair, Dr Clare Gerada said:

"What happened at Mid Staffordshire NHS Foundation Trust was system failure of the highest order and we are deeply saddened that so many patients and their families were let down, with such tragic results.

"Unfortunately, it demonstrates the extreme consequences of what can happen when the NHS loses sight of patient care on the ground in the scramble to balance budgets and achieve targets.

"Hospitals should be places where people feel safe and where they can trust the staff looking after them to deliver the care and kindness they deserve. They should not be institutions that strike fear and dread into the hearts of patients, in many cases even before they are admitted.

"While the Francis report focuses on failings in secondary care, it has implications for the whole of the NHS, including general practice. At a time when the NHS is under greater than ever financial pressure, it is imperative that the needs of patients are put first, and that cuts are not made which could jeopardise the safety of patient care.

"Two major changes must happen in the wake of the Francis report if we are to provide the necessary reassurance that the lessons of Mid Staffs have been learnt and, most importantly, that the same mistakes will not be repeated elsewhere in future.

"Firstly, we need to refocus and restore patient care back to its rightful place at the heart of everything we do, across the entire health service from the most junior healthcare assistant to the most senior consultant.

"Clinicians, including GPs and their teams, must be given the ability to do what is most important: listening to patients and caring for them.

"GPs have so far ridden the storm but financial constraints and top-down targets are starting to adversely affect the level of care we can deliver to our patients. We need to reverse this trend by increasing the number of GPs available to provide patient care, and by ensuring they are free to focus their attention on what matters most to patients.

"The second lesson we must take from the Francis report is the need to create an environment in which health professionals right across the NHS can raise concerns on behalf of their patients without fear of recrimination, and where concerns will be properly and thoroughly investigated. In anticipation of the report, the RCGP has produced a UK-wide position statement on raising concerns and whistle blowing in the NHS that we hope will prove invaluable for GPs, hospital staff and patients.

"The NHS was set up 65 years ago to provide fair and effective healthcare and to protect patients. If it is to continue doing this, the Government and all of us working in the NHS must stop underestimating the importance of kindness and compassion, the fundamentals of good patient care that cannot be budgeted for."

ENDS

Primary care predicts future of substance misuse recovery

Thu, 31 Jan 2013 00:00:00 Z

The Royal College of General Practitioners (RCGP) and Substance Misuse Management in General Practice (SMMGP) have issued a joint paper considering the future impact of the changing commissioning environment on primary care drug and alcohol treatment.

The paper explores how primary care can proactively contribute to the rapidly developing recovery systems of care, by building on its strong legacy of safe, holistic and clinically effective care closer to home. It also includes checklists on how to evidence that services are working towards these themes. The paper is being presented at a joint RCGP and National Treatment Agency conference in York this week to an audience of over 200 clinicians, commissioners and service providers.

Co-author and RCGP Substance Misuse and Associated Health Medical Director Dr Linda Harris, said

“This paper covers key themes of recovery-oriented treatment and illustrates the unique role that primary care plays in improving outcomes for individuals, families and the wider community. The paper emphasises the importance of locally designed and responsive services and the opportunities for primary healthcare teams, working with Clinical Commissioning Groups and their Local Health and Wellbeing Boards to improve outcomes for patients. The paper offers practical examples of how a practice or a shared care team can benchmark the quality of their systems, and thereby provide evidence to commissioners that they are working in a recovery focused way. It is essential reading for all those commissioning and providing recovery services within substance misuse.”

Co-author Kate Halliday, Policy and Development Manager at the SMMGP said:

“Primary care is ideally placed to provide treatment for people with drug and alcohol problems as part of a recovery focused system. In the new era of localism it is essential that primary care evidences its important role in reducing the harms associated with drugs and alcohol and also in achieving positive health outcomes. This paper will support practitioners and clinicians to evidence quality within primary care based drug and alcohol treatment. “

Ends

RCGP Press office – 020 3188 7574/7575/7576
Out of hours: 0203 188 7659
press@rcgp.org.uk

NOTES TO EDITORS

The joint paper can be found on the Policy section of the RCGP website

The paper will be presented at the NTA/RCGP Joint Northern Conference: Recovery in Primary Care – Shaping, Leading, Influencing on Thursday 31 January at the Royal Hotel in York.

Medical bodies unite to combat addiction to medicines

Wed, 16 Jan 2013 00:00:00 Z

The Royal College of General Practitioners (RCGP) and the Royal College of Psychiatrists (RCPsych) today publish a signed consensus statement aimed at reducing patient addiction to medicines such as tranquilisers and painkillers.

Supported by professional groups, specialist service providers and voluntary bodies representing 17 organisations, it cautions against long-term prescribing of medicines which carry a risk of addiction, except in exceptional circumstances, and recommends rigorous and holistic regular reviews by practitioners with suitable expertise and understanding.

The statement calls on health and social care professionals across the statutory and voluntary sectors, in partnership with service users, to work together to reduce the risk of patient addiction to medicines and to support those who are dependent.

The statement acknowledges the issues and challenges faced by some patients who have dependency to prescribed or over the counter medications. It highlights the extreme caution that must be taken when reducing and stopping any medication to avoid serious risks of withdrawal and the need to enlist specialist help and advice to manage the physical and psychological aspects of the conditions these patients experience.

Read the Consensus Statement [PDF]. Also available on the RCPsych website.

Professor Clare Gerada, Chair of the RCGP, said:

“Medicines such as tranquilisers do work for many patients but they need to fully understand the risks associated with these drugs and be in a position to make informed choices about their treatment and care plans, including seeking agreement on the duration and review of any proposed course of medication or treatment.

“GPs are well placed to work in partnership with other agencies including the voluntary and charitable sector many of whom offer advice and support including groups who can provide peer to peer support along with vital patient education and information.

"This approach has been shown to be successful in helping patients to slowly adjust their treatment and achieve their recovery goals, including providing them with more access to alternatives such as psychological therapies and physical rehabilitation for pain relief.

“GPs and health professionals are already helping these patients to reduce their medication and understand all the options – but there is general agreement that we all need to do more. We are very grateful to have had the support of the NTA and the Royal College of Psychiatrists in drawing up this statement and hope it will have a big impact on patient care in what can be a difficult area.”

Consultant psychiatrist Dr Emma Whicher, of the Royal College of Psychiatrists, said:

“Addiction psychiatrists are increasingly working with people who have developed dependence problems with prescribed or over the counter medication. Although these medications are beneficial to many people, awareness of the alternatives and risks is also important. This statement recognises the problem and supports people in their recovery. In addition treatment is available and effective for people who develop addiction to prescribed or over the counter medication.”

The RCGP has also developed factsheets for GPs and their teams which will be available shortly to be followed by an online learning module for GPs, to inform their own continuing professional development to ensure they are kept abreast of the latest treatments and developments in this area.

ENDS

Royal College of Psychiatrists
Royal College of General Practitioners
The British Pain Society
The National Treatment Agency for Substance Misuse
Faculty of Pain Medicine of the Royal College of Anaesthetists
Royal College of Nursing
Royal Pharmaceutical Society
National Pharmacy Association
Battle Against Tranquillisers
Bridge Benzodiazepine Withdrawal Project
MIND in Camden Tranquilliser Project
Centre for Pharmacy Postgraduate Education
Substance Misuse Management in General Practice
Codeine Free (www.Codienefree.info)
British Psychological Society
British Association of Social Workers
The College of Social Work

RCGP response to Alzheimer's Society report

Tue, 15 Jan 2013 00:00:00 Z

Professor Clare Gerada, Chair of the Royal College of GPs said

“The RCGP is committed to improving the care GPs provide to patients with dementia but diagnosing patients as having dementia is difficult, especially in the early stages when patients are likely to visit their GP with concerns.

"In an ideal world every patient would receive an equal level of and equal access to healthcare regardless of their individual circumstances or where they live. However, GPs currently face a number of obstacles that inhibit them from making this a reality for patients with dementia.

“GPs need to have access to a wide range of services and resources such as memory clinics so that they can properly support people beyond diagnosis and help them live healthy, independent and productive lives for as long as possible. Management works best with teams working together – supported by experts and generalists from the voluntary, hospital and community sectors. These services should be available to everyone who needs them and with an ageing population it is even more important that local Council or Government cuts do not adversely affect them.

"The College has named Dementia as one of our clinical priorities and appointed two 'clinical champions' to lead a programme in association with the Alzheimer's Society. We are developing a 'roadmap' for dementia as a navigational aid for what to do at different points during the course of a patient’s journey through dementia, and to assist primary care to assist with management of dementia for patients, family and carers.

"We also believe that our plans for enhancing and extending GP training will improve the detection and management of chronic conditions, like dementia. Addressing key training needs will be crucial to ensuring that future GPs will develop the skills required to fulfil their role in a complex and changing NHS environment.

“We welcome Health Secretary Jeremy Hunt’s personal interest in this issue and hope that this is channelled into sustaining and increasing services, such as memory clinics. We hope that his concern is backed up with support for GPs to deliver the resources necessary to improve timely diagnosis"

ENDS

RCGP seeks new Clinical Champions

Wed, 09 Jan 2013 00:00:00 Z

The RCGP is seeking to appoint Clinical Champions to lead on four new clinical priorities for the College.

The College is looking for RCGP members who can work collaboratively to raise the profile and awareness of Chronic Kidney Disease; Epilepsy Care; Eye Health, with a focus on ageing and sight loss; and Youth Mental Health.

Each year the College chooses four clinical areas and supports efforts to raise the profile and awareness of these areas both within general practice and across primary care. Each priority programme runs for three years and is led by a ‘Clinical Champion’. The role of the clinical champion is to work in partnership with key decision-makers and opinion-formers in each clinical area on projects that seek to improve the care provided and patient outcomes.

Dr Matt Hoghton, Medical Director of the RCGPs’ Clinical Innovation and Research Centre said:

“Being a clinical champion can be an extremely rewarding and stimulating experience, providing the opportunity to influence and shape the development and delivery of a range of initiatives within the College ranging from guidance to strategies and from audits to key reports.”

The closing date for all applications is Thursday 31 January at 17:00 with the roles starting in April following an induction day.

GPs can find out more about the application process by visiting the CIRC pages of the RCGP website

ENDS

NOTES TO EDITORS
The Clinical Priorities for April 2013-March 2016 are Chronic Kidney Disease; Epilepsy Care; Eye Health, with a focus on ageing and sight loss; and Youth Mental Health

Closing date for all applications: Thursday 31st January 2013, 5pm
Interviews: mid February 2013 (dates to be confirmed)
Role starts: Monday 1st April 2013 (an induction day will be held in March 2013)
Tenure and baseline time commitment: 3 years – 1 day per month
Funding: £1,500 budget per annum to cover travel and other related expenses

Personal Health Budgets: a guide for GPs

Tue, 08 Jan 2013 00:00:00 Z

A practical guide to personal health budgets (PHBs) for GPs in England has been published by the Royal College of General Practitioners.

In November following a three-year pilot programme, the Government confirmed that PHBs will be rolled out across England.

The easily accessible guide covers what PHBs are, which patients are eligible, and how they can be used effectively. It has been produced with input from GPs and PHB managers with first-hand experience of using PHBs at the pilot sites.

The PDF guide is available free of charge on the College’s website, it includes a useful FAQ section and decision tree for quick reference purposes. It uses case studies to bring scenarios to life.

PHBs will enable patients to choose treatments, including some that fall outside those traditionally funded by the NHS, to improve their health. They are based on a care planning approach and patients will agree chosen treatments that will then be signed off by the NHS.

Patients in England receiving NHS Continuing Healthcare will be eligible for a personal health budget and, by April 2014, all those with continuing health needs will have the right to ask for a PHB. Clinical Commissioning Groups will be able to offer them more widely to patients who they feel may benefit.

RCGP Chair Dr Clare Gerada said:

"This new guide is an excellent and easy reference tool for GPs and will help to make sure that personal health budgets are used in the most beneficial way for patients.

“The College previously published a position statement giving the proposals a ‘cautious amber’ carefully exploring the opportunities and risks involved and will continue to closely monitor the development of personal health budgets."

ENDS

The RCGP’s position statement can be viewed in full here [PDF]

RCGP inaugurates Companion of the College Award

Tue, 08 Jan 2013 00:00:00 Z

(L-R Dr Steve Mowle, Vice-Chair RCGP; Dr Helen Stokes-Lampard, Honorary Treasurer RCGP ; Prof. Clare Gerada, Chair of Council RCGP; His Majesty The Sultan of Brunei; Dr Iona Heath, Immediate past President RCGP; Prof. Nigel Mathers, Vice-Chair RCGP)
Photo by Justin Grainge Photography

His Majesty the Sultan of Brunei has become the first recipient of the new ‘Companion of the College’ Award, established to mark the RCGP’s 60th anniversary.

He received the award in a special ceremony at the RCGP’s new headquarters at 30 Euston Square.

The Award has been established to recognise the contribution of individuals of significant standing who have supported the College in furthering its charitable objectives. A Companion of the College will have demonstrated commitment to the development of the College and to primary care in the UK or worldwide.

His Majesty the Sultan was presented with the award for his longstanding support of the RCGP’s work to provide primary healthcare in Brunei.

He has championed improvements in healthcare both in Brunei and across the ASEAN region. His National Health Care Plan 2000-2010 gave the people of Brunei access to primary care through the development of a family medical service. This remains a priority in his Vision 2035 and Health Strategy, which focuses on promoting excellence in professional standards and continuing professional development, principles akin to those of the RCGP.

The College has been working in partnership with senior medical leaders in Brunei since 2003 to help develop and continuously improve family medicine examinations at the Universitii Brunei Darussalam (UBD).

Using the expertise of College members, the RCGP accredits the Family Medicine exam in Brunei and doctors who pass this exam are entitled to become international members of RCGP (MRCGP[INT]). This work is helping to build strong primary care systems in Brunei to improve outcomes for patients.

Brunei has pioneered the RCGP Sponsorship Scheme with the GMC using the Medical Training Initiative which is a Higher Specialist Training programme open to MRCGP[INT] members. Brunei sent the first two international members to undertake this additional training in the UK in 2011. There are currently four MRCGP[INT] Brunei colleagues in the UK.

His Majesty has also made a significant donation to the College’s fundraising appeal and the new 300 seater auditorium at 30 Euston Square, centrepiece of the College’s conference facilities has been named in his honour.

RCGP Immediate Past President Dr Iona Heath, who helped forge the College’s links with Brunei, said:

“Family medicine is at the heart of His Majesty’s vision, establishing it as a crucial resource for the frontline delivery of healthcare that echoes the role of general practice in the UK.”