Small and simple changes in the more mundane, routine aspects of our practice can lead to significant carbon footprint reductions

5 March 2021

'An unprecedented challenge demands an unprecedented response'.

It’s a phrase we’ve heard many times over the past year in relation to the COVID-19 pandemic. But the 'unprecedented challenge' referred to in the quote above is not the pandemic, it is climate change.

Increasingly people are accepting that the climate and ecological crisis is the leading public health issue of our generation. So, what can we all do to understand and play our role in this crisis? The answer is not for a few people to do a lot, but with most of us doing every possible thing we can.

Small and simple changes in the more mundane, routine aspects of our practice can lead to significant carbon footprint reductions. A focus on prevention, active travel, 'lean' pathways and low carbon alternatives when prescribing is in the gift of all of us as GPs. Working alongside our patients, millions of small actions can have big impacts - but when asked, most people don’t know where to start and what they can do to help.

Ahead of the COP26 conference in Glasgow in November 2021, RCGP Chair Professor Martin Marshall will join the panel for a free webinar on Tuesday 16 March, 13:00 - 14:00. Jointly held by the RCGP, the BMJ and the UK Health Alliance on Climate Change, it will consider how GPs and their practices can individually and collectively take action on climate change - as well as highlighting what has been achieved by GP practices so far.

Might this be the beginning of yet another 'unprecedented response' from general practice?

Dr Gary Howsam, College Vice Chair for External Affairs

Gary is a GP Partner in a multi-site practice in Peterborough.

He was elected as Vice Chair (External Affairs) of RCGP in 2019. His College portfolio also includes being officer lead for Sustainability and the Climate Emergency, Research and Innovation, and Patient and Carer involvement.

Gary has been Chair of Cambridgeshire and Peterborough CCG's Governing Body since July 2016 and he is also Vice Chair of the Cambridgeshire and Peterborough Sustainability and Transformation Partnership (STP) Board, Vice Chair of the Peterborough Health and Wellbeing Board and a Senior Clinical Tutor at the University of Cambridge.

He initially trained as a dentist, but after completing a subsequent medical degree and basic surgical training, with a view to a career in maxillofacial surgery, he moved across to General Practice training in 2005. He has worked in salaried, partner, trainer and Out of Hours roles across Cambridgeshire since finishing his training in 2008.

Latest updates from College Chair Martin Marshall

Council update

Council last Friday was what RCGP Council is all about: rich, impassioned discussion and ideas from the frontline of general practice, being used to shape College policy.

As I mentioned last week, Council passed a motion from Sonali Kinra and Margaret Ikpoh to call on the CQC to take measures to assess the impact of its inspections on GPs from Black Asian and Minority Ethnic communities. It is something we’ll be speaking to representatives from the CQC about shortly. You can read our full statement.

There were also important discussions on integration of care, in particular in relation to the recent NHS White Paper for England. We also had an excellent discussion about the future of the MRCGP exam, and Council gave its go-ahead for an exam development group to be established. Contributions were insightful and will help to shape our work in both areas.

That is what Council is for: to shape College policy, and ensure it is reflective of the experiences of GPs on the ground. Nominations for national elections to stand as Council members, and College President, succeeding our excellent Amanda Howe, are currently open. This is your chance to have your voice heard. For more information, full details of the roles and responsibilities and to submit your nomination, please visit the election website.

Finally, it was our first Council meeting without Mike Holmes, whose three-year term as Vice Chair for Membership and International has come to an end. Huge thanks to Mike for all the work he’s done in the role, and best of luck for the future.

Vaccination update

As you continue your amazing efforts, vaccinating huge numbers of people on a daily basis to get through the complex Group 6 category as fairly and efficiently as possible, we’re hearing reports through members and the media of some groups complaining that they’re being ‘denied’ vaccines.

In many cases, it sounds as though these patients simply haven’t yet been called, but we understand these reports must be frustrating. We’re working hard to get the message across that Group 6 is large and complex, and that patients should wait for their invitation for vaccination instead of calling up if they think they’re eligible.

Something else making headlines is the idea of mandatory vaccinations for NHS staff. It’s a complex area and whilst we strongly encourage all GPs and their teams to get the vaccine - both for their protection and that of their patients - the College does not support compulsory vaccination, given the risk of counter-productive, unintended consequences. You can read my comments, which have featured in the Daily Mail and the Mirror.

Finally, on the vaccination, we’re following discussion about the introduction of vaccine passports, or certificates, closely. Our key concern is that if something is introduced, then it doesn’t fall to GPs and our teams to facilitate - it would not be a good use of our time, and we’ve said this publicly.

We’re not averse to a system using the NHS app, as long as appropriate safeguards to protect patient data confidentiality are in place, but we do have some concerns about how this may widen health inequalities by giving more freedom to people with smartphones, than those without. We will continue to push these messages hard with policy makers and we’ll be raising our concerns with Michael Gove, who is chairing a committee exploring this issue, in the coming weeks.

Budget 2021

Ahead of this week’s Budget, I wrote jointly with Richard Vautrey of the BMA’s GP Committee to the Chancellor calling for an extension of the COVID capacity fund, as well as investment in the general practice workforce. You may have seen coverage of it Pulse, Management in Practice and GP Online.  

Outside of commitments to continue funding the pandemic response, the Budget was surprisingly light on funding for the NHS and social care - and as subsequent analysis of the detail has been done, it looks like less day-to-day spending for the health service. This is cause for concern, and we’ll be raising this with our contacts at the DHSC at our next meeting. In particular, we were surprised not to see explicit funding provision for expanded GP education and training, which is obviously going to be essential.

New Chief Examiner

We are delighted to announce that Professor Rich Withnall will succeed Dr MeiLing Denney as Chief Examiner from 1 June this year.

Rich has been appointed following a competitive recruitment process and brings with him a wealth of assessment and leadership experience. He has been an MRCGP examiner since 2005, and has led the CSA/RCA Core Group since 2017; he has also supported the College’s work as a Medical Director of MRCGP (Int). In his work outside the College, Rich is an Honorary Surgeon to Her Majesty the Queen and is about to become the UK Ministry of Defence’s Director of Healthcare in the rank of Air Vice-Marshal, as well as remaining a Professor of General Practice with a research interest in mental health. We are entering an exciting period of development for the MRCGP and are confident that he will be able to lead the exam successfully through this and continue to ensure it is a fair and robust assessment that prepares trainees for a successful career in general practice.

We would also like to thank MeiLing for the huge contribution she has made to the MRCGP since she first joined the panel of examiners in 1996. She has acted as the Research and Development lead and was instrumental in the development of the ‘new’ MRCGP in 2007. She has been Chief Examiner since 2017 and has undertaken the role with great integrity and a commitment to fairness and upholding standards. As Chief Examiner she has implemented an extensive review of the examination and, most recently, has overseen the development of the Recorded Consultation Assessment, in record time, to support the needs of trainees who have been impacted by the COVID-19 pandemic.

We are grateful to MeiLing for her dedication and exemplary leadership of the examination for the past four years, and look forward to working with Rich to continue our work to develop and grow the MRCGP to meet the needs of general practice and our patients.

BJGP webinar: Health Inequalities

It is 50 years since the 'Inverse Care Law' was introduced by Dr Julian Tudor Hart and the issue of health inequalities is more pressing than ever. This free webinar on Health Inequalities will be introduced by Prof. Sir Michael Marmot. There will be recent research and analysis from leading primary care researchers, in the form of short presentations with time for your questions.

Register now.

Myanmar - solidarity with medics

Right across the world healthcare professionals, including many GPs, are putting their lives at risk by trying to help people living in conflict zones.

A few weeks ago, we expressed our support and concern for colleagues living and working in Myanmar - a country we’ve had strong links with as part of our work to further the development of family medicine and improve Universal Health Coverage.

On Wednesday, Myanmar had had its deadliest day so far as protests opposing the military coup were violently supressed. We were appalled to see reports that healthcare professionals, caring for those injured, were being targeted for trying to help.

We stand in solidarity with these brave people, trying to do their job, and putting their own health and lives at risk in the process.

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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