Any form of abuse to health staff is unacceptable

10 September 2021

In a recent survey one fifth of GPs said that they had been personally threatened by patients and half had witnessed violence or abuse directed at their staff. If you want to know how it feels to be a GP receptionist watch the video ‘If I die it will be your fault’ produced by the Institute for General Practice Management.

It’s shocking. Even when I was a GP in a tough inner-city area in Manchester 20 years ago, practice staff were largely immune from the mostly drug-related violence that went on in the streets. More than that, we were even protected by the perpetrators of the violence because we were on the side of the angels.

What on earth is going on? Perhaps the answer lies in part elsewhere in the survey. GPs are nearly twice as likely as hospital doctors to have experienced abuse and most respondents claimed the abuse was the consequence of dissatisfaction with the service.

This is no excuse. Any form of abuse to health staff is unacceptable and it’s good to see the primary care leads at NHS England being explicit about that. Now the College, BMA and Institute for General Practice Management are demanding that politicians do the same.

Many of the toxic behaviours that we see in our practices are yet another manifestation of general practice under pressure. The solution lies with government.

Latest updates from your College

Defending GPs

We continue our retaliation against the unwarranted and demoralising attacks by certain sections of the media on GPs.

We’re outraged by some of the coverage today on remote consultations and HSJ have published my opinion piece hitting back at the media vitriol we are having to contend with.

It is largely as a result of remote consultations that GPs have been able to continue delivering essential care and services to patients throughout the pandemic when many other parts of the NHS closed down.

I’ll keep making the point that the real issue in general practice is not about face-to-face versus remote consultations, but about chronic GP shortages caused by more than a decade of under-investment.

Yesterday, I was interviewed on Good Morning Britain. I used the opportunity to highlight workforce shortages and the heavy toll that this is taking on GPs’ own health, as well as repeating our calls for urgent progress on the Government’s manifesto pledge of an additional 6,000 GPs and 26,000 members of the general practice team. This was picked up by the Guardian and we’re expecting a story on GP pressures this weekend.

We’ve also hit back in response to an article on remote care in last week’s Sunday Times that had such an inflammatory headline I refuse to repeat it here! We’ve been promised that our riposte will be published this coming Sunday.

Health and Care Bill

Yesterday, I presented evidence to MPs on the Health and Care Public Bill Committee where I set out the importance of a strong GP voice in any future NHS reforms, and emphasised the workforce and workload challenges facing general practice that have had a significant impact on the mental health of GPs. You can watch the full session or take a look at a summary of key points raised. We’ve also submitted a written response to the Committee’s call for evidence, outlining our position on the Bill. You can find out more about the RCGP’s work on the Health and Care Bill.

PM's announcements on NHS and social care

We started the week in optimistic anticipation of what the Prime Minister’s two announcements - on extra funding for the NHS to accelerate the ‘biggest catch-up in history’ and social care reform - might mean for general practice. We end the week disappointed on the former and with more questions than answers about the latter.

Typically, many media headlines focused on ‘speed of access’ to appointments and specialists and ‘digital innovation’ so doctors can monitor patients in their homes. A new system will also be introduced for patients and their carers to arrange follow-up appointments ‘as and when they need them’.

This is potentially good news for patients, but we need to see more detail about how this will actually work. As it stands, it’s hard to see where the GPs who’ll carry out these appointments and referrals are going to come from, without major investment in our service.

We’re already bearing the brunt of the pandemic backlog as we try to support patients on long hospital waiting lists and those who have been unable to get appropriate care from other parts of the health service.

We go into general practice to care for patients but that care needs to be safe and this is becoming increasingly difficult to guarantee. Our current workforce is simply not big enough take on more work and more GPs are going to burn out or leave the profession.

Additional investment in the NHS is always a good thing and the need for a fully functional social care system goes without saying. But when are politicians going to wake up to the fact that the pressures in the health service are not confined to hospitals and that a lot of the problems could be resolved with proper investment in general practice?

A College analysis a few years ago estimated that every £1 spent on general practice was worth £4 for the rest of the NHS. We cannot allow general practice to wither on the vine while more and more money disappears into other parts of the NHS.

The solutions are in our Action Plan and we won’t rest until they’re delivered.

Project ECHO on Post Covid-19 Syndrome (Long Covid)

We are delighted to announce that the College has received funding from the Health & Social Care Board NI to run a UK wide ECHO project on Post Covid-19 syndrome (Long Covid), starting Thursday 7 October 2021 at 19:00. The eight-week programme will cover a range of challenges this new condition presents, such as how children are affected and a review of the updated NICE guidelines when available in November.

You can register your interest and book a place now. Unlike traditional webinars and lectures, where an expert gives their views and opinions, Project ECHO is designed so we can share best practice from each other. The model of a Post Covid-19 clinic based in London may not work for a practice based in Bangor (either Northern Ireland or Wales) but hearing from a colleague about how care is delivered in rural Scotland might work well. The events will be very informal and provide a safe space to learn from GPs right across the country, so come along and we can learn together.

Flu vaccine delays

Just after last week’s message went out, reports emerged of the delay to deliveries of the Seqirus flu vaccine.

As we said in our media response, this was the news we really didn’t want to hear, and I know that many of you are already having to cancel clinics and manage the associated anxiety from patients, not helped by the current shortage of blood tubes.

We did the media rounds at the weekend - particular thanks to Vice Chair for External Affairs Gary Howsam and Honorary Treasurer Steve Mowle - and will keep up the pressure on Government to resolve this quickly and make sure it doesn’t happen again further down the line. The coming months are already going to be tough enough for everyone working in general practice.

Social prescribing and health inequalities

Join this interactive session to learn more about data on social prescribing, personalised care and health inequalities across England. You can register now.

Using recently published data from the RCGP Research and Surveillance Centre’s social prescribing observatory, we will explore national and local insights to understand unmet need, variation and uptake in social prescribing. North East London ICS will be presenting their approach to using social prescribing data, measuring impact and addressing health inequalities.

Cass review on gender identity services for CYP

The Independent Cass Review is looking to recruit around 30 GPs to participate in an online professionals’ panel exploring issues around gender identity services for children and young people.

This time-limited research will provide a baseline of current competency, capacity and confidence among clinicians and other professionals (beyond the specialist GIDS service), as well as any broader concerns about the work, providing an evidence base from which to develop recommendations for service development and improvement.

The research will be conducted over six weeks from late September. You will be invited to anonymously respond to questions and activities. These online surveys and activities should not take more than 20-30 minutes in total each week. A smaller number of panel participants will be invited to take part in one or two online discussion workshops during the six weeks. These will be optional and will require approximately two hours of your time.

Vist this Cass Review webpage for more information and a short expression of interest form. This should only take 5-10 minutes to complete. Please apply by 17 September 2021.

Personalised Care Institute first anniversary

The Personalised Care Institute (PCI) celebrates its first anniversary this month - and has thanked all GPs who have undertaken its free training.

The PCI’s online Core Skills module takes 60 minutes to complete, and all learners get a Certificate of Learning as proof of professional development.

As a member of the PCI’s Steering Group, the RCGP recommends the PCI’s eLearning hub, which nine out of ten healthcare professional learners say has helped their daily practice.

WISE GP academic resources

There are major new updates to the WISE GP resources developed by the Society of Academic Primary Care in partnership with the College and School for Primary Care Research.

WISE GP is a wealth of resources to support primary care teaching and research engagement - including a growing library which now includes ideas for how frontline clinicians can use research studies to inform QI projects in practice, information on how to get involved in clinical scholarship, and career opportunities.

Thank you to Joanne Reeve and her colleagues for their continued commitment and undimmed enthusiasm for primary care research.

Inspire Awards 2021

The shortlist of award nominees is now live and open for your votes. Congratulations to all. Please take a look at our shortlisters and read about some of the fantastic work that has been going on. You have until 30 September to cast your vote (voting is for College members only).

The Inspire Awards will be held in Liverpool as part of the RCGP Annual Conference from 18:00, Friday 15 October.

Members can register your place now.

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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