GPs and patients must be at the centre of health reforms

12 February 2021

They say that come the day of the nuclear apocalypse only three things will remain: cockroaches, tax inspectors and the middle tier of the NHS.

All four nations in the UK have their own manifestation of the middle tier. In England we’ve had Sustainability and Transformation Partnerships (STPs) since 2016. I’m sure STPs have an important role to play in enabling a more integrated health and care system but they don’t set my pulse racing.

This might be a reflection of the monotony of lockdown, but I admit I do get excited about service integration at a local level, driven by frontline health and care professionals, focused on designing and delivering seamless pathways of care with patients.

And that’s fundamentally what the new Health Bill for England aims to achieve. The headlines are about ministers taking back control of the NHS - and hopefully accountability for it too, I assume. But really it’s about the reintroduction of local collaboration and an acceptance (implicit, of course) that over the last decade, competition hasn’t worked terribly well in the English NHS.

'Bravo' and 'at last', I say. And if general practitioners and patients are supported to be at the centre of the reforms, they might just make a difference.

Latest updates from your College

Vaccine update

You and your teams have done a stunning job, and we're well on our way to meeting the target of giving all patients in the top four priority groups the opportunity to have their first vaccine dose by mid-February. This is an exceptional achievement and I've been blown away by your resilience to 'get the job done' in such innovative and pragmatic ways.

We remain concerned about uptake among patients from Black, Asian, and Minority Ethnic groups. Our analysis highlighting the scale of the issue and our call for a high-profile national campaign, supported by faith leaders and popular figures from BAME communities, to tackle misinformation and increase confidence in the vaccine featured heavily in the media last weekend.

I was interviewed by Sky News, and our research featured on the front page of The Telegraph, The Sunday Times, Mail Online, and Sky's Sophy Ridge on Sunday. You can read our full release.

Thank you again for all the work you and your teams are doing, managing the many challenges associated with such a complex programme in such a professional way. It truly is lifesaving work.

Fresh Approach to General Practice

Yesterday I had the pleasure of addressing many of you at the College's Fresh Approach to General Practice online conference.

It was firstly an opportunity for me to celebrate the role you've played throughout the pandemic - not least in rolling out the COVID vaccination programme.  

But the other focus of my speech was on the importance and benefits of relationship-based care in general practice: its value for GPs and patients; the barriers to delivering it; how these can be overcome.  

I personally believe that RBC is vital for truly person-centred general practice and must be factored into any future model of healthcare. From the feedback I received yesterday, I think many of you agree - we now need to make the case to politicians and decision makers. This is why I made it a policy priority when I became College Chair.

You can read my full speech on our website.

The conference was full of thought-provoking speakers. Mark Britnell, head of Global Health at KPMG, delivered a fascinating address looking at the global healthcare workforce, and this afternoon we've just heard an inspiring speech by Harvard Professor of American and African American Studies, David Williams. I was also delighted to join an invigorating panel for this year's RCGP Question Time - if you've been to conference before, you'll know I usually chair this session, so it was slightly daunting to be at the receiving end of the questions! Honorary Treasurer Steve Mowle did an excellent job as Chair.

If you missed the conference, full content is available to purchase on-demand until 12 August so you can watch and digest in your own time. Register for access.

New Appraisal Toolkit

Our new Appraisal Toolkit, delivered in partnership with Fourteen Fish, went live on Monday and all College members are entitled to a 30% discount, bringing the price down from £42 per year to £29.40 (inc VAT).

We hope that this offer will be a welcome boost when the pandemic is creating even greater pressures for GPs. It will particularly benefit and strengthen the support we can offer our First5s as all GP trainees who gain their CCT will be given a free subscription for the duration of their First5, provided they maintain their RCGP membership.

The new Appraisal Toolkit partnership builds on our successful development of a new more intuitive Trainee Portfolio, also in partnership with FourteenFish, that improves our support for trainees. Following the successful migration of 25,000 active users and almost 3 million portfolio data items, all trainees across the UK are now using this new Trainee Portfolio, and we have been receiving positive feedback from users. Now, as trainees complete their training, they will be able to seamlessly transfer from their Trainee Portfolio to the Appraisal Toolkit.

Our work to reduce the overall bureaucratic burden for GPs continues and we will continue to build on our good progress so far in making the appraisal process less arduous and more supportive for GPs.

You can find our more on the FourteenFish website, or please contact if you have any questions.

I must also point out that your choice of appraisal toolkit is up to you (subject to the requirements of your primary care organisation) and that there are other options available for you.

Tier 2 Visa letter

We've been contacted by several GP trainees, about to achieve CCT, who are concerned about securing employment once they complete their training and are subsequently at risk of deportation. Some have taken non-GP roles in order to secure a visa.

As we did last summer, we've written to the Home Secretary, Priti Patel, to urgently allow Health Education England to extend visa sponsorship during the COVID-19 pandemic, so trainees have more time to secure employment. You can read our letter in full.

To lose a single qualified GP due to administrative barriers is unacceptable given the workforce pressures the profession continues to face. This issue keeps arising so we need long-term solutions in place. We've suggested to the Home Secretary that NHS England become sponsors for GPs, taking the onus off small practices who at the moment don't have the administrative capacity or resources to offer Tier 2 sponsorship.

Introducing RCGP Mentorship

In the coming months we're launching RCGP Mentoring, a platform designed so that we can connect and support each other in our career growth and development.

The peer support platform will allow future or current GP mentees to match with mentors with their desired interests, skills and expertise, as well as offering a range of resources to help you navigate the mentoring process, supporting you in your role as a mentee or mentor and ensuring that your mentoring relationships are enjoyable and productive.

We're currently looking for members to join the platform as RCGP mentors. Whether you are just starting training or approaching retirement, you can share valuable perspective, knowledge and skills with your peers. Find out more and sign up as a mentor or watch this video for further information.

Centre for Perioperative Care

The Centre for Perioperative Care (CPOC), of which the RCGP is a partner, has launched a new project aimed at producing the UK’s first ever perioperative care Green Paper. The project will examine the short-term challenges and long-term opportunities facing perioperative care in the wake of the COVID-19 pandemic. It will also advance a vision for the future of the surgical pathway and the perioperative team. CPOC is offering members the opportunity to support the project by helping shape its recommendations. Learn more about the project’s aims, how to get involved and how to stay informed.

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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