The courage of the non-combatant

13 May 2022

What a great expression, one that increasingly reflects my conversations with some non-clinician managers, policy makers and commentators who, judging from places of comfort, are convinced that our model of general practice is broken. Their solutions are radical, transformative, apparently inspired by Mark Zuckerberg’s motto ‘move fast and break things’.

We do need to embrace change and innovative ideas and most general practices are doing so. But I want innovation to come from the combatants, the people on the front line of care who understand the consequences of breaking things and who are there to pick up the pieces.

If innovation is to make a difference then it needs to be evolutionary in nature, building on the strengths of our established model of general practice and properly resourced.

Latest updates from your College

New GP Frontline: Read Now

Your latest edition of GP Frontline is out now. Read our Big Interview with Chair of the Health Select Committee, Jeremy Hunt, who discusses his ups and downs as the country’s longest serving Health Secretary, what he thinks needs to be done to build the GP workforce, and why he’s on a mission to safeguard continuity of care in the NHS. We also speak to Scottish Cabinet Secretary for Health and Social Care Humza Yousaf about his first year in the role.

In this edition we also pay homage to the College in its 70th year and hear from Vice Chair Margaret Ikpoh about her plans for the MRCGP. You can read about how the College is representing your interests to politicians and in the media.

Our Opinion: Why we need to vaccinate the world piece comes from Cornwall GP Kath Browne. And we profile the only GP on the Government’s SAGE committee, the GP who also works as a coroner, the GP working to support medically trained refugees and the GP who went from couch to 70k in the Sahara Desert in our GP Lives section.

Highlighting GP pressures

On Monday the Daily Express ran a front-page story highlighting the pressures facing general practice and the impact this is having on patients. It was based on an OpEd I wrote for the paper, as well as interviews with a number of GPs, including Vice Chair Gary Howsam.

In the double-page splash I made it clear that workload and workforce pressures in general practice are at unsafe and unsustainable levels – and that every effort must be made, not just to recruit new GPs to the profession but retain existing ones. It must have hit a nerve with the editors of the Express, which is influential amongst Government, as the editorial stated: “Losing yet more burnt out GPs from the profession can only make a dire situation worse. This health emergency needs to be sorted out – and quickly – because GPs are suffering, and patients too.”

I also had a letter published in the Telegraph combating recent comments about general practice adding further pressure to A&E services. I highlighted that the latest evidence suggested that the numbers and type of patients accessing emergency care are largely unchanged – and that general practice alleviates pressures across the health service, including Emergency Departments, it doesn’t add to them.

Menopause Statement

Following on from our statement last week regarding the HRT supply shortages currently being experienced across the system, we have finalised our College position statement on the menopause.

It is co-badged and supported by the Royal College of Obstetricians and Gynaecologists and the British Menopause Society and is in response to the growing media, political and patient interest in this area. The statement shares information and links around current clinical guidance, suggestions for improved care, discussions around new prescription durations, working with secondary care, testosterone prescribing, and available education materials and resources.

We recognise that much of the discussions around the areas included in the statement are still under discussion at a national level and so we will update our statement as and when anything changes.

Refugee and asylum-seeking doctors

I was pleased to be part of a contingent of health and charity leaders to meet Prince Charles for a discussion on refugee and asylum-seeking doctors.

He’s keen to see a more joined-up approach across sectors to support this growing number of health professionals who find themselves displaced from their home countries, be it through war or for other reasons, and seemed genuinely interested in the work going on in general practice.

While it’s easy to question the involvement of the Royal Family in these issues, it’s important that the voice of GPs is represented and I hope that the meeting will result in better alignment of the various strands of work being done by several organisations.

Meanwhile, the plight of the Ukranian people continues to shock and move us all. Doctors of the World is doing some excellent work and you can donate here.

Veteran Friendly Accreditation

In partnership with NHS England, our Veteran Friendly accreditation programme enables GP practices to provide the best medical care and treatment for former members of the armed services. We’re looking for a Clinical Champion for one session per week, who will take a lead on developing strategic relationships with key stakeholders and providing support and guidance for primary care teams. The role is initially offered for six months, pending a programme extension to 2024. Closing date for applications: 20 May.

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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