If we aspire to health care that is accessible to all, based on clinical need rather than ability to pay, the NHS is a robust model

9 July 2021

I was honoured to be invited to represent general practice at last Monday’s commemoration and thanksgiving for the 73rd anniversary of the NHS. The multidenominational service at St Paul’s Cathedral was a moving occasion, full of pomp, ceremony and decorated with a few Very Important People.

Sir Simon Stevens referred to the founding need for a post-war national health service, quoting Nye Bevan’s autobiography, In Place of Fear. Imam Yunus Dudhwala talked about the selflessness of NHS staff. Rabbi Jonathan Wittenberg spoke about how we are at our best in the service of others.

It was inspiring at a time that we need inspiration. As we emerge from the worst (maybe) of the pandemic, a small but influential group of politicians and journalists are asking whether the NHS has a future. This happens periodically, fuelled by ill-informed views that there’s a better model out there somewhere. There isn’t. If we aspire to health care that is accessible to all, based on clinical need rather than ability to pay, the NHS is a robust model. Of course it needs to adapt to the changing needs of society, of course it isn’t perfect, of course it needs to be better resourced, but it’s an achievement we should all celebrate with pride.

Latest updates from your College

Easing restrictions

The Prime Minister’s announcement on Monday that the current restrictions will be relaxed on 19 July has been welcomed by some and met with serious concern by others.

Of course, we understand the desire to open up society and get back to normal. But the pandemic isn’t over, case rates - particularly of the Delta variant - are soaring, and we are feeling the impact in our surgeries, as are our colleagues in secondary care. The Health Secretary, on Tuesday, said he expects 100,000 cases a day by next month.

There is a difference between something being mandated and recommended. Our view is that some of the measures we have seen implemented over the last year - such as mask wearing to keep ourselves and others safer - should continue to be recommended, particularly in healthcare environments and crowded public spaces.

We have issued a statement today, calling for caution - and for some infection control measures, such as the wearing of masks, to remain in GP practices. We are also asking for clarity as to how we should manage inevitably rising workloads in general practice, what infection control measures should remain, and what is being done to advise patients what they should do if they have potential signs of COVID-19.

We have also signed up to a statement from the Academy of Medical Royal Colleges, showing that there is a united front from professions across the NHS.

NHS Bill

The government introduced the Health and Care Bill into the House of Commons on Tuesday, initiating its parliamentary journey to legislation.

The Bill will introduce legislative changes that aim to restructure parts of the NHS in England and create a 'truly integrated' healthcare system with less bureaucracy. We all say 'yes' to that.

Among several significant changes, the Bill is expected to place integrated care systems (ICSs) on a statutory footing to make them accountable for commissioning and delivering services to the patients in their footprint.

MPs will get the chance to debate the Bill for the first time next Wednesday during its Second Reading.

Our focus is on ensuring a strong GP voice and influence in ICSs. You can read our response to the First Reading and find out how we are working to influence the Bill.

This was also the topic of our latest RCGP Live webinar, chaired by College Vice Chair for External Affairs, Gary Howsam, with representatives from NHS Confederation and the BMA. You can watch it back now.

GP Patient Survey

The latest GP patient survey results were published yesterday and reveal patient satisfaction with general practice has hit its highest point in three years despite the pressure of the pandemic. Over the past year, access to and quality of general practice appointments has improved, in the context of generally high satisfaction and confidence and trust in the profession.

This is remarkable given the year we’ve had and testament to your hard work and dedication to delivering the best possible care for your patients. It shows how much general practice is valued by patients - and just how important it is to protect our service. I hope the results provide food for thought for those who have criticised general practice during the pandemic.

You can read our full response.

GP Data update

Since the delay to the GP Data for Planning and Research (GPDPR) programme was announced, following our calls for more time to allow NHS Digital to properly engage with the public and the profession, we have continued to push for improvements to the programme. Most recently we have set out the areas that we believe must be addressed prior to data being collected under GPDPR, including increased communication and engagement, improvements to opt-out processes, and greater safeguards for the data collected, such as 100% use of trusted research environments.

We will keep you updated as discussions continue.

Revalidation roundtable

As one of several actions resulting from a College Council motion, we are hosting a roundtable discussion to explore GPs' experiences of appraisal and revalidation and consider how the system can be improved.  

I’m conscious you might be experiencing survey fatigue, but we’d be grateful to hear about your experiences of appraisal and revalidation, whether positive, negative, or somewhere in between.

If you would like to share your experiences, please email our Revalidation Team by 15 August 2021.

Inspire Awards

Nominations for the College’s 2021 Inspire Awards are open and will run until 31 August.

These awards celebrate our dedicated Member volunteers across the country, and the work you do in the best interests of patient care. This year we pay special attention to all your outstanding contributions during what has been the most challenging year many of us have ever faced.

You can find out more and nominate a colleague you find inspirational.

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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