The climate emergency is a public health emergency

5 November 2021

By the time you read this, COP26 - the United Nations Climate Change Conference in Glasgow - will have reached the halfway mark. Worryingly, before it even started it seems our expectations were being managed downwards by the assembled world leaders.

Climate change not only impacts on our health directly, but also indirectly through altering detrimentally the wider determinants of health. As ever there will be marked inequality in the distribution of those most negatively affected, with the world’s least advantaged people suffering most.

We all have a part to play as individuals, but understanding that the climate emergency is also a public health emergency focuses our minds on what we could be doing in our professional roles as GPs. As trusted members of our communities we must leverage our opportunity to be positive role models for change.

Prevention, waste reduction, prescribing low carbon medicines and avoiding unnecessary travel are simple measures we have in our gift to advocate for, and enact.

The first step to effecting change is often the hardest. What will be your first step?  If you aren’t sure, please check out the RCGP Sustainability and Climate Change web page.

The promises and pledges of the powerful few gathered in Glasgow will set the policy and planning direction, but it is the cumulative small actions of the many that will create the change we need.

Post written by

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

Speaking out for general practice

After the past few months in which criticism of hardworking GPs seems to have become a national sport, we hoped that the tide was finally starting to turn and the attitude towards general practice was becoming slightly more positive.

So, we were dismayed at the media coverage of English Health and Social Care Secretary Sajid Javid’s appearance at a Health Select Committee on NHS backlogs on Tuesday, which suggested that lack of face-to-face GP appointments was placing additional strain on Accident and Emergency departments.

To be fair, he also acknowledged the immense pressures GPs were under, but of course these comments were completely lost in the media coverage and GPs became the target yet again. I have written to Mr Javid challenging the figures he cited and also reiterating the need for a comprehensive workforce solution, particularly in light of his public admission that the target of 6000 additional GPs promised by the Government will be missed. I will share the letter and the Health Secretary’s response when we receive it.

I have also written formally to NHS England Chief Executive Amanda Pritchard with our response to the ‘rescue’ package for general practice that was launched ahead of our annual conference in Liverpool.

Our media reaction has already been well documented, but I felt it was important that NHS England leaders heard directly from the College about how demoralised and worn down GPs are feeling.

In the letter, I have raised concerns about the poor timing of the announcement and our disappointment over the content, particularly given the low morale in the profession due to our overstretched and underfunded service and being on the receiving end of constant media criticism. I have set the record straight about access to GP appointments, challenging the narrative about the proportion of face-to-face appointments and refuting claims that remote care is substandard.

I have also reiterated that GPs can’t rely on a pool of locums to help deliver patient care because there simply isn’t the workforce available. Instead, we need action to reduce bureaucracy, including the suspension of QOF, as well as schemes to keep experienced GPs in the workforce. I have requested an urgent meeting with Amanda and will keep you updated.

Learning together about Post-Covid Syndrome (Long Covid)

We have learned so much about COVID-19 and how to manage it but are now facing the many emerging challenges of managing Post-Covid Syndrome. Our journal the BJGP has produced an excellent edition focusing on this and to help all GPs improve their care for patients with Post-Covid Syndrome, the College is hosting a monthly series of free, interactive educational sessions for GPs across the UK.

During the sessions, we hear from experts on an aspect of the disease alongside a patient. As a group we then discuss learning points and how they impact on our individual practices and unique patient populations. Last night we heard from Professor Terence Stevenson and Dr Liz Whittaker on how Post-Covid Syndrome affects children. Our next monthly meeting is on 2 December and we will be discussing the revised NICE/SIGN guidelines co-written with the College.

We will also discuss the management of Postural Orthostatic Tachycardia with renowned expert Dr Lesley Kavi so please register for free.

Support for veterans

As Remembrance Day approaches, we’d like to remind GP practices of our Veteran Friendly accreditation scheme that supports GP teams to support patients who have served in the Armed Forces.

More than 1,000 practices have already signed up to access tailored training and information. It’s a straightforward process and you can find out more.

Appraisal roundtable

We hosted a roundtable this week to explore GPs’ experiences of the medical appraisal process and consider how it can be improved. This was a direct result of a previous College Council motion and it was a highly constructive discussion during which we identified several themes for further work. The College successfully campaigned for the temporary suspension of appraisal and CQC inspections of practices in England during the first wave of COVID and we’ve welcomed the introduction of a lighter touch approach to appraisal.

But we know that many GPs have concerns around the process and we will continue to do everything we can to reduce overall regulatory burdens for GPs, especially when GP workload is at record levels. My thanks to our outgoing Medical Director for Revalidation Susi Caesar for her commitment and hard work in this area. Susi also chairs the Academy of Royal College’s Professional Development Committee and has consistently championed the views of GPs.

If you require any support for your appraisal or revalidation, the RCGP Professional Standards Team may be able to help.

AGM and James Mackenzie Lecture

The Annual General Meeting of the College takes place on Friday 19 November 2021 at the College’s London headquarters 30 Euston Square at 14:00. Notice and papers for the AGM will be available via the website.

The James Mackenzie Lecture will also take place on that day at 16:00. This year’s lecture will be delivered by Professor Maureen Baker, former Chair of the College and a driving force for patient safety. To register for one or both events, please email

Both will be hybrid events that you can join in person or virtually.

Kieran Sweeney Prize 2021

Re-invigorating relationship-based care is a priority of mine as Chair, so I was delighted to hear this would be the topic of the Tamar Faculty’s Kieran Sweeney Prize this year. This is a national UK prize for medical writing by GPs, in honour of the memory of Dr Kieran Sweeney, with a prize of £1,000 for the best original piece submitted by a practising GP in answer to the question 'What does the future hold for the relationship between a patient and their GP in the UK?'.

Deadline for entries is 13 December 2021.

Please email to receive the entry form and rule and entry criteria.


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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