Patients and their GPs are natural allies

14 May 2021

The most recent survey of patient views about general practice confirms what we already know: the vast majority of patients value their general practice highly. 82% of patients highly rate their overall experience of their practice. 95% of patients said they had confidence and trust in the clinicians looking after them. These figures have hardly changed from pre-pandemic levels.

When I shared these stats with one of my sisters, who works in marketing, her response was "wow, most businesses would give their right arm for ratings like that".

So here’s the problem: the stats are positive but the media and political narrative is too often negative, focusing on a small number of examples where things have gone wrong. I don’t discount these examples for one second; some of them are harrowing. But they don’t reflect the reality that, despite the pandemic, despite the workload crisis, despite the shortage of GPs, most general practices are doing a truly remarkable job at meeting the needs of most of their patients.

The negative narrative is worrying because it risks creating public spats between anxious patients and stressed clinicians. Patients and their GPs are natural allies - we’re on the same side and want the same thing. A lobbying partnership made in heaven?

Latest updates from your College

Remote consultations and digital triage

NHS England's letter yesterday evening - flagging the updates we can expect in the imminent Standard Operating Procedure (SOP) - has caused widespread consternation, further exacerbated by the media using it as yet another opportunity to criticise GPs.

Claims that we are being 'forced' to open up our surgery doors and 'ordered' to see patients face to face are infuriating, especially when the latest statistics show that more than half of consultations in general practice are being conducted in person - and GPs have been available, and working harder than ever, throughout the pandemic.

While the tone and the wording of the NHSE letter has fuelled the anger of the profession, we need the SOP itself to offer detail and clarity on how consultations might be delivered as we emerge from the pandemic and move towards the delivery of more normal services. It is crucial that this done in a safe and realistic way, taking into account the pressures that general practices are operating under.

You can read our response in full.

What is encouraging is that our calls for shared decision making between GP and patient on the most appropriate method of consultation are seemingly being heard.  

The College's own report on the future of remote consultations and digital triage, launched on Tuesday, makes it clear that we don’t want to see general practice become a 'remote by default' service post-pandemic.

There is certainly a place for remote working - and our report calls for significant investment into this - but what we want to see after the pandemic is a mix of remote and face to face consulting, with the appropriate method being a shared decision between practice and patient.

You all deserve huge credit for the way you swiftly transformed the way you deliver care during the pandemic - but I know from speaking to many of you, and feedback you've sent in, that while you've understood the need for these new ways of working, they aren't the ways you want to work long-term.

We need to see an end to the unfair and thoroughly undeserved criticism GPs are currently receiving in the media. One of the main vessels for this has been the Mail on Sunday, and I spoke to them last week for their Medical Minefield podcast to put the GPs' point of view across. It’s very hard-hitting and difficult to listen to in parts, but please try and listen to the whole recording if you have the time, as it’s quite balanced overall and I get a lot of airtime for our messages.

Also, with so much attention on the return to 'normality' across the UK, the worrying spread of the Indian variant has come as a stark reminder that this pandemic is far from over.

Roundtable on impact of CQC inspections

We are hosting a roundtable with the Care Quality Commission (CQC) on the impact of its inspections on GPs from ethnic minority communities and want to hear your lived experience. The roundtable is a direct result of the recent College Council motion calling on the CQC for a series of measures to improve the inspection process for ethnic minority GPs.

We are collating written feedback to share with the CQC team as we look to explore any inequalities brought out by the inspection process, ratings, or enforcement action, as well as access to support before and after CQC inspections.  

This feedback will not be attributed to individuals but will be used to build a picture of CQC inspections from the perspective of ethnic minority frontline GPs.

If you would like to share your experiences, please email RCGP Policy and Research Officer Anique Liiv. If you would prefer to speak with a fellow GP, we can also put you in touch with the proposers of the Council motion who will be attending the roundtable. Please contact Anique by 21 May 2021.

Data (GPDPR)

NHS Digital has this week issued a Data Provision Notice (DPN) as part of the development of GP Data for Planning and Research (GPDPR) - a planned replacement for the GP Extraction Service (GPES) to collect data for planning and research from general practices in England.

The College and the BMA have been engaged with the planning of this through our joint IT committee, in particular making a strong case for secure sharing of data. You can read our joint statement.

Menopause documentary

I know many of you were disappointed and angry with the TV documentary on menopause presented by Davina McCall on Wednesday evening, questioning our care and treatment of menopausal women and calling for GPs to be given more specific training.

In fairness to the producers of the programme, the College was given the right of reply and our statement was read out in full.

As GPs, we recognise the huge impact the menopause can have and we strive to give all our patients the best care we possibly can, but additional GP training is always proposed as the great panacea when the reality is that mandatory training courses for specific areas of medicine and not others would simply be unworkable for general practice.

My thanks to Anne Connolly, the College’s clinical lead for women’s health for her valuable input to our media response, and to those of you who contributed to the inevitable Twitter debate that followed the programme to support the College’s position.

What GPs really need is more time with their patients and to achieve that, we need a much bigger workforce to help make our current workload doable. We will continue to keep up the pressure on the four governments of the UK until we achieve this.

eLearning upgrade

Thanks again for your patience while our Online Learning Environment was upgraded last weekend. I hope that you’re noticing the improvements to the navigation and menu, without losing any of the familiarity of our existing CPD provision. A new personal dashboard has been added to display your accessed courses and completions. There’s also a quick 'one-click' access to courses and a simplified, more accurate 'breadcrumb trail', as well as a new icon set and clearer link identification on our Clinical Content page. Watch out for more improvements over the coming months.

Heart failure awareness

The British Society for Heart Failure (BSH) has launched a new awareness campaign to encourage patients with symptoms to present earlier.

The Freedom from the symptoms of heart failure - The F Word campaign is based around the symptoms: fighting for breath, fatigue and fluid build-up.

BSH has free materials to share with colleagues and patients or you can download the app via Google Play or the Apple Store.

Veterans’ Health Awareness webinar

This webinar provides insight into some of the common physical, mental and psychosocial problems affecting the 2.4 million veterans in the UK. You will gain understanding of the Armed Forces Covenant and what this means in Primary Care. 

Find out how you can join the 800+ GP practices in England already signed-up to the RCGP veteran accreditation programme. You can register 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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