How could we possibly take on lead responsibility for delivering the anticipated COVID vaccine as well? But how could we refuse to do so?

13 November 2020 

How can general practice possibly take on more work? We’re busier than ever; consulting with more patients, dealing with more complex problems, arranging and rearranging more investigations and referrals, delivering the biggest flu vaccination programme ever. 
 
How could we possibly take on lead responsibility for delivering the anticipated COVID vaccine as well?
 
But how could we refuse to do so? 
 
General practice has the experience and expertise, the infrastructure and, most importantly, the trust of the public, to deliver a mass vaccination programme of unprecedented scale. And unlike other contenders, we have a track record of success because we understand the system and understand our patients. 
 
It goes without saying that we need to be properly resourced, both financially and by recruiting an army of staff drawn from out-patient departments, community services, dentists, medical students and others, as well as from our own extended primary care teams.

We also need to be clear which parts of our usual work must continue and we need support from the centre as well as from our patients to stop doing non-essential work.

We need to be clear that not all practices and not all practitioners will be able to take on the extra work and, where this is the case, working in networks will fill the gaps. We need to ensure that committed, hard-working staff aren’t driven into the ground.

And we need a straight-talking public information campaign which describes the risks and the uncertainties inevitably associated with a new vaccine developed at pace. 
 
The coming winter was always going to be tough for general practice and now it looks like it’s going to be tougher. But I think most general practices are up for the challenge because we want to do our best for our patients and communities.

Latest updates from your College

COVID-19 vaccination programme (CVP)

We heard the excellent news on Monday that the first COVID-19 vaccination, developed by Pfizer/BioNTech, has been found to be effective in 90% of people.
    
The College responded positively, and linked to my 'Just Saying' above, made clear that involving general practice in delivery of the vaccine makes sense given our experience in delivering mass vaccinations within communities, and the trust our patients have in us.

We were, however, clear that this will be an enormous challenge for general practice, particularly given the workload and workforce challenges we are working under, and that we’ll need support from colleagues across the health service.
    
We also called for clarity around which work could be scaled back to create capacity to deliver the COVID vaccination programme, alongside the expanded flu vaccination programme, and all the other vital care we deliver to patients every day that we simply must not stop.

I said on BBC Radio 4’s Today Programme that unnecessary bureaucracy would be a good place to start. I also spoke to Radio 4’s World at One, Times Radio and the BBC News Channel, as well as several newspapers.

You’ll be aware that an agreement has been negotiated between the GP Committee of the BMA and NHS England for GP practices to opt in to, in order to play a key role in the forthcoming vaccination programme. The GPC has issued preliminary guidance about what this means and how to get involved - and it will be updated as more details about the programme become available.

Hot-off-the-press is the College’s new eLearning, launched today to support members in England with the delivery of the COVID-19 vaccination programme.

Updates for Scotland, Wales and Northern Ireland will follow shortly and we’ll continue to keep you informed as we find out more.

COVID-19 guidance and resources

We’re continuing to update our website with the latest guidance around COVID-19, and our COVID-19 Resource Hub.

We've developed this joint guidance (357 KB PDF) with the BMA to help practices across the UK to prioritise the clinical and non-clinical workload in general practice.

We’re also soon to publish a paper looking at the nature and range of acute COVID-19 symptoms in adults, while recognising the current case definition. This is an important piece of work and has the potential to be significant in supporting GPs in caring for patients with COVID-19 by forming the basis of educational resources. 

The College’s Clinical Policy Advisory Group is also currently overseeing a number of resources relating to post COVID syndrome and are planning a webinar for early December.

It should be an engaging and informative learning opportunity, so we hope as many of you as possible sign up to join - more details to follow. 
 
I spoke to the Economist’s 'Babbage' podcast this week about long COVID - now clinically know as post COVID syndrome - which is  available to listen to.

Access to diagnostic services

The College is keen to better understand practices' experiences of accessing diagnostic services for patients.

We would also like to know whether practices have access to community diagnostics without referral to secondary care, and whether such services would be of value to clinicians.

We would like to invite you to participate in a short, anonymous survey taking no more than five minutes to complete. The results will inform our lobbying to ensure that general practice has the resources it needs to respond to COVID-19.

Annual General Meeting

There is still time to book to attend this year’s Annual General Meeting, which will take place virtually via Zoom next Friday 20 November, 12:30 - 13:30.

Register online for the AGM by sending an email to secretariat@rcgp.org.uk stating your full name and membership number or GMC number for voting purposes. Details of the Zoom meeting will be emailed to you. Find out more.

Virtual Wards

Many GPs are operating 'virtual ward rounds' allowing for regular virtual contact with certain COVID-19 patients using pulse oximeters to monitor patients’ oxygen levels virtually. 

The College recently published this paper on Virtual Wards, Silent Hypoxia and improving COVID outcomes (771 KB PDF) which sets out the known evidence for the concept of virtual wards and outlines the role GPs play in delivering and supporting it.

It supports further development of access to virtual wards for patients who currently have COVID-19 and calls for more research in this area to ensure best practice.

Hearing loss toolkit

The College has collaborated with The Royal National Institute for Deaf People (RNID) and NHS England and Improvement to develop an educational toolkit to support GPs and trainees deliver care to patients with hearing difficulties.

It covers how to recognise the early symptoms of hearing loss, when to refer patients for hearing assessments, and aims to give GPs the confidence to innovate and make changes to primary care policy and practice to ensure patients who are deaf or have hearing loss receive the best possible care. 

The toolkit is part of the College’s Deafness and Hearing Loss Spotlight Project, which also aims to support GPs to implement the latest NICE Guidelines and NHS Accessibility Quality Standard and Guidance across the UK.

Thank you to Devina Maru, Clinical Champion for the project, for her work and leadership in this area.

Self-Care Week - 16-22 November

Monday marks the start of self care week - organised by the charity Self Care Forum since 2011. Encouraging patients to self care when appropriate is essential in alleviating pressures across the health service, and it increases our patients’ health literacy. Our representative on the Forum, Dominic Horne, explains more.

We’ve also worked with Andrew Boyd, RCGP Clinical Champion for Physical Activity and Lifestyle and Faraz Mughal, RCGP Clinical Lead for Young People’s Mental Health, to put together tips for maintaining physical and mental health during second lockdown, which we hope will be picked up by the media in the coming days.


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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