Trusting relationships are the essence of our speciality, the tools of our trade

2 July 2021

Imagine a radiologist being put in a position where they couldn’t use an MRI scanner. Or a physician their stethoscope, or a surgeon their scalpel. What a crazy situation, I hear you say.

And yet, that’s what’s happening to general practice as our workload increases. We need time and space to build trusting relationships with those patients who will benefit from the investment. Trusting relationships are the essence of our speciality, the tools of our trade. They are interventions which are central to our effectiveness as expert medical generalists.

Of course, some of what we do is straightforward and transactional, but more is complex and interpersonal. The research evidence is clear that trusting relationships are associated with better experiences, processes and outcomes for patients, GPs and the NHS as a whole. This is true of sustained relationships built over time, but also, most likely, of 'speed relationships' developed within single or a small number of consultations by highly trained clinicians.

So I’m not surprised by the enthusiastic response of many to the College’s latest report, The power of relationships. A time of crisis is a time to remind ourselves and others what really matters. The College’s advocacy of relationship-based care isn’t a yearning for a long-lost past, it’s the present and the future of our specialty. Patients and clinicians know that - now, we need to persuade policy makers and that’s what your College is doing.

Latest updates from your College

An update from Council

Our Governing Council meeting was as energising as they come last Saturday. We discussed three substantial policy issues, and to say the debate was rich would be an understatement.

Council members from right across the UK spoke fervently about their experiences working as members of multi-disciplinary teams and remote working, touching on how these newer ways of working impact on both day to day general practice, and the patient care they are able to provide. All the feedback will be taken on board as we move forward with our work on these issues, advocating to decision-makers at the highest levels on your behalf.

The highlight of the day for me was an inspiring debate on what we need to be doing to reinvigorate relationship-based care. This was one of my top priorities when I became Chair (before the pandemic derailed plans somewhat) and, as you can see from my Just Saying above, is a genuine passion of mine. It was clear from Council that there is appetite to push forward with this.

As ever, you can get a sense of the discussions by searching #RCGPCouncil on Twitter.

RCGP Council shapes the policy of the entire College - and you are all represented by its members. The elections for six nationally elected Council members are now open, and this is your chance to vote for who you want to represent you to shape the debate. 13 excellent candidates are standing, from all different walks of general practice. You can read about them all and cast your votes.

Voting closes at 12 noon on Friday 30 July 2021.

Latest with the COVID-19 vaccination programme

You’ll have seen the news from the Department of Health and Social Care on Wednesday evening that a COVID-19 booster vaccine campaign is being planned for this autumn and will run alongside the flu vaccine programme. NHS England have sent this letter on COVID-19 Vaccination Autumn/Winter (Phase 3) planning.

It's good to see we're starting to get some clarity following the media work we did with NHS Providers last week, which attracted coverage on Radio 4’s Today Programme, the Times and elsewhere.

But we’re still waiting for full details about how this will work in practice, and the full involvement of general practice. We have had initial discussions with Vaccines Minister Nadhim Zahawi on how things might work. What we do know is that the success of both last year’s expanded flu vaccine programme and the COVID vaccination programme, with 66% delivered by GP-led teams, has been down to the hard work and dedication of you and your teams.

We need to continue being central to the vaccination effort, but ahead of what is set to be a very busy winter, the workload and workforce pressures we are working under must be taken into account.

New Health Secretary

I’ve written to Sajid Javid following his appointment as the new Secretary of State for Health and Social Care in England, highlighting the crucial workforce and workload challenges facing our profession, and emphasising our most recent data showing that GPs are seeing more patients now than pre-pandemic, while playing a leading role in delivering the COVID-19 vaccination programme.

He brings a wide range of experience to the post, with this being his sixth senior cabinet member appointment, following roles including Culture Secretary, Business Secretary, Housing Secretary, Home Secretary and most recently, Chancellor of the Exchequer.

As ever, the College will continue working to further engage with the new Secretary of State (and the equivalent ministers in Scotland, Wales and NI) in the best interests of the profession and the patient care we provide.

John Fry award winner

Many congratulations to Greg Irving at Edge Hill University who has won this year’s illustrious John Fry Award.

The John Fry Award is an award by nomination presented each year by the College in consultation with the Society of Academic Primary Care. It is presented to a Member or Fellow of the College who has promoted the discipline of general practice through research and publishing. The award is intended to encourage GPs to undertake research early in their career and within 20 years of qualification as a GP.

Greg won against stiff competition based on his substantial and productive research career to date - and also on the evidence of his contributions as a developing leader and contributor to national and international initiatives. He will receive his award at the Spring General Meeting next year.

Conversion therapy

RCGP Northern Ireland Chair Laurence Dorman and colleagues are doing some sterling work which they hope will lead to the country’s banning of conversion therapy.

The College signed up to a joint Memorandum of Understanding against conversion therapy with other health bodies in 2015, subsequently updated in 2017, but Laurence has taken up the campaign in NI after learning of the lived experiences of GP colleagues.

One of them, Gareth Patterson, has made this fantastic TED Talk in which he mentions the College’s evidence being used as part of an important debate at Stormont.

The College also arranged a meeting between Gareth and the NI Communities Minister so we hope all these efforts will lead to an important change in policy.

WONCA Europe

Next week sees our Dutch colleagues hosting the 2021 WONCA Europe conference. It's a virtual conference, so RCGP members can access it wherever they are.

This is an excellent opportunity to enhance your knowledge and nurture collaborations with Europe's family physicians community.

You can find out more.

NHS birthday

Monday marks 73 years since the NHS was founded, and never has it shown its worth more, or been more challenged, than in the last 18 months. This isn’t so much a celebration of the institution of the NHS itself - although the founding principle that healthcare should be free at the point of need irrespective of someone’s ability to pay is certainly worth celebrating - but of the million plus people working within it, protecting patients from becoming ill, and caring for them when they are.

There are a number of events being run by NHS England, and across the UK, many virtual, over the weekend, and I’ll be representing general practice at a special celebration at St Paul’s Cathedral on Monday before my afternoon surgery.

General practice is the foundation of the NHS. Without our service, it would not be sustainable - and it’s important that everyone remembers that.

Post written by

Professor Martin Marshall, Chair of RCGP Council

Professor Martin Marshall is Chair of the Royal College of General Practitioners and a GP in Newham, East London. He is also Professor of Healthcare Improvement at UCL in the Department of Primary Care and Population Health. Previously he was Programme Director for Population Health and Primary Care at UCLPartners (2014-2019), Director of Research & Development at the Health Foundation (2007-2012), Deputy Chief Medical Officer for England and Director General in the Department of Health (2006-2007), Professor of General Practice at the University of Manchester (2000-2006) and a Harkness Fellow in Healthcare Policy. 

He is a Fellow of the Royal College of Physicians of London and of the Faculty of Public Health Medicine and was a non-executive director of the Care Quality Commission until 2012. He has advised governments in Singapore, Egypt, Canada and New Zealand, has over 230 publications in the field of quality improvement and health service redesign and his primary academic interest is in maximising the impact of research on practice. In 2005 he was awarded a CBE in the Queen’s Birthday Honours for Services to Health Care. 

A co-founder and driving force of the Rethinking Medicine movement, Martin has a passionate commitment to the values of the NHS, patient care and ensuring the GP voice is central in a time of great change. When he’s not working, he likes being outside, preferably on a mountain or a coastal path with his wife Sue and their puppy. 

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