General practice needs to be supported right now. Not demoralised. Not vilified.

18 September 2020

Monday wasn’t a good day for GPs. Waking up with a tough week ahead, and then seeing the headlines.

The letter from NHS England aside, the communications around it were ill-judged and insulting to the profession. It was also frankly incorrect: data from the College’s Research Surveillance Centre shows that the week preceding the letter was the busiest this year for GP practices, with a 25% rise in face to face appointments on any other week since lockdown.

General practice has been open throughout the pandemic, mainly remotely, but in person if necessary. It’s frustrating to be told otherwise, without evidence to back it up, and when we’re working in such a way because we’re following national guidance - from NHS England.

The irony of Monday’s headlines coming just weeks after Health Secretary Matt Hancock told us that all GP consultations should be remote by default (something the College doesn’t agree with) is not lost on me.

I hope you think our response was strong and countered some of the media vitriol aimed at the profession. It featured in the Telegraph, The Times, the Mail and BBC, and I was interviewed on Radio 4’s Today Programme (2h 53 minutes in). I’ve also made the case in this BMJ column.

General practice needs to be supported right now. Not demoralised. Not vilified.

We’ve had several conversations with NHS England since Monday - and I appreciate Nikki Kanani’s apology for the hurt caused. I was also sad to read about the personal attacks she received. They know we’re angry. They know the profession is angry. But we need to work together to get through the next few months and ensure general practice is on a sustainable footing for the future.

You are doing a fantastic job. What I said in my message last week stands: you are 'just getting on with it' in the face of enormous challenges ahead. Thanks again.

Latest updates from your College

RCGP intervenes on testing chaos

Another big issue this week has been COVID-19 testing. I’m sure you’ve all seen reports on  the chaos, and all of you will have taken calls from frustrated patients trying to get tests.

The Test and Trace system clearly needs sorting out. Both in terms of increasing capacity, but also by optimising its logistics, so that the tests and ability to process them are where they need to be. A lot of work will need to be done to restore public and professional confidence in the system, when it is finally rectified.

I appeared on BBC Newsnight on Tuesday making the case that GPs and our teams need to be prioritised for testing. If they’re not, they’ll need to isolate, and that will impact on the capacity they have to do our jobs. I also said GPs need access to tests for patients who we think clinically needs one, in particular to help differentiate between COVID-19 and other, potentially serious, conditions.

Having access to tests and having the ability to do tests for patients who present to us in surgery and we think would benefit from one is a far cry from GPs becoming 'gatekeepers' for testing. General practice must not become a replacement for a centralised system - this is what I told The Times yesterday, and you can see our full statement. I’ve also written to Baroness Dido Harding, head of NHS Test and Trace, outlining our position.

Personalised Care Institute launches

And now positive news. I mentioned last week that the College was hosting the launch of the Personalised Care Institute (PCI) - a virtual organisation promoting evidence-based, personalised care training to all health and care professionals. I’m pleased to report that the launch on Tuesday was a huge success.

Just under 300 delegates attended and since the event the College has received good feedback. The new 'Core Skills for Personalised Care eLearning module', which was specifically created for the PCI, is now live and accessible to all on the website. New courses, such as the eLearning module 'Shared Decision Making and Risk Communication', are set to be added in the coming months.

Thank you to the College team, led by Pauline Foreman, who have worked hard to get the institute up and running.

For further information and to keep up to date with developments you can register via the PCI website in order to be added to the mailing list and receive monthly newsletters.

World Patient Safety Day

"One key to keeping patients safe is keeping health workers safe." Those are the words of Dr Tedros Adhanom Ghebreyesus, Director General of the World Health Organization yesterday, on World Patient Safety Day.

As GPs, our patients' safety is always at the forefront of our minds when we’re caring for them. The COVID-19 pandemic has highlighted the challenges and difficulties that doctors, nurses and other health workers face in providing safe patient care. It has shown how the safety of health workers is paramount in ensuring patient safety.

GPs and family doctors across the world have been on the front lines of tackling the pandemic. It’s vital that we’re working in conditions that are as safe as possible, for our benefit, as well as for our patients - we’ll do what we can to speak up on behalf of our members, and we’re pleased to support this WHO initiative.

Find out more about World Patient Safety Day, including details of a draft Health Worker Safety Charter and a set of World Patient Safety Day 2020 Goals.

Letters to make a difference

The College has signed two joint letters this week to Matt Hancock, Secretary of State for Health and Social Care in England, on pharmacy-related issues.

The first is calling for pharmacists to be able to make limited adjustments to patients' prescriptions in the case of drug shortages, without the patient having to go back and forth between the GP and pharmacist.

The second (267 KB PDF) is calling for the Health Secretary to intervene in the Priadel brand of lithium being withdrawn by the manufacturer and the price of the alternative Camcolit being increased.

Both are very important issues, with implications for GP workload and the care we deliver to patients. Thank you to joint Hon Sec Jonathan Leach and Vice Chair Gary Howsam for leading on these issues respectively, as well as to our colleagues at the Royal Pharmaceutical Society for their collaborative approach.


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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