Learning from the consequences of tough decisions

17 July 2020

We all know that the UK’s response to COVID-19 does not compare well with that of other countries.

We’ve not fared poorly because of lack of commitment or effort on anyone’s part, but let’s not allow anyone to pretend that we’re in a good place.

There are many questions to which we don’t yet know the answer.

  • Is it likely that if we’d introduced lockdown a week earlier we would have seen half the number of COVID-related deaths?
  • Was the early confusion between containment and suppression of the infection the problem?
  • Was the shortage of PPE for clinical staff and the ongoing delay in introducing a robust test and trace system the main issue?
  • Is it true that the British public would only tolerate a low level of lock down for a limited period of time?
  • Would the outcome have been different if we’d moved early to protect those at greatest risk from the virus – members of Black, Asian and Ethnic Minority (BAME) groups, and older people, particularly those living in care homes?
  • Was the under-funding of our public health services over the last decade a key factor, or an over-confidence that the private sector had the answers?
  • Or perhaps it was the preoccupation with a centralised response, which marginalised local community assets, not least the power of general practice?

Leaving these questions unanswered is not just unsettling for all of us, it’s unacceptable.

We all need to learn from the consequences of the decisions that have been taken, acknowledging that they were tough decisions made at pace with the best of intentions.

As a College, we recognise that there were some things we could have done better and we’ve learnt for the future.

Now it’s time for government to do so, to ensure that we manage the local spikes and second wave more effectively.

We’re asking members about their experiences of working in general practice during the COVID-19 pandemic. Take our short survey.

COVID-19 update from your College

The mask debate

Face coverings are one area where the College was sceptical at the start of the pandemic.

We were unconvinced by the evidence that they are an effective way of helping to stop the spread of COVID-19, but growing evidence of air transmission has shifted our position.

The Government has now announced that face coverings will be mandatory in shops from 24 July and we have supported this through our membership of the Academy of Medical Royal Colleges.

We recognise that not everyone will agree with this position but we feel it’s the right thing to do, for now at least.

What we now need is clear guidance for people who might be exempt from wearing face masks, and how they are expected to prove this, if challenged.

What we don’t want is an influx of patients requesting exemption forms on health grounds: this would not be a good use of our time, especially when we are now seeing routine consultation rates rising to near normal levels.

We also need to see clear public messaging that wearing a mask is not an alternative to other measures, such as appropriate social distancing and hygiene measures.

The College has collated UK-wide guidance for GPs and our teams on the use of masks and face coverings in primary care settings (397 KB PDF).

Supporting BAME colleagues

This week we had another instalment of our #RCGPTogetherLIVE series. Chaired by our Humber and the Ridings Faculty Chair, Margaret Ikpoh, it discussed how the College can support our BAME members in general practice.

The panel talked about:

  • leadership
  • outreach to international medical graduates
  • how white doctors can support their colleagues
  • risk assessment tools for practices.

College President Amanda Howe also spoke about our forthcoming BAME action plan.

I’m grateful to the panel, which, as well as Margaret and Amanda, included:

  • former President Mayur Lakhani
  • former Vice Chair for Professional Development Kamila Hawthorne
  • Vice Chair for Membership Mike Holmes
  • RCGP Scotland Executive Officer for Professional Development Sigi Joseph
  • GP F1 Shamarah Mathurin-Charles.  

More than 300 people joined the discussion and if you weren’t able to, it is available on our Youtube channel.

Stand for RCGP Council

There is still time to stand as a Nationally-Elected Council Member for RCGP Council from November 2020-November 2023.

Being on RCGP Council is your chance to represent colleagues, draw attention to the issues you have noticed are impacting on the profession and patient care, and ultimately influence College policy and the wider work we do.

We hope to see as diverse a group of applicants as possible.

Please visit our dedicated RCGP Election website for more details about the role and the online nomination form.

The nomination period will close at 12 noon on Friday 24 July 2020.


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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