Historically, wellbeing has perhaps not had the priority it needs

22 January 2021

Next week it will be exactly one year since the first cases of coronavirus in the UK were identified in my home town of York. Since then the virus has been at the forefront of our minds - our concerns have been about our patients but also about the wellbeing of our profession.

Throughout, the College in all four devolved nations, alongside many other organisations, has recognised wellbeing as a priority. We have worked with our wellbeing committee to ensure we are providing what our members need; we have formed key partnerships and lobbied policymakers to ensure that wellbeing is not forgotten.

We have signposted to self-help materials, support for group work and access to one to one interventions: each designed to provide a mechanism for colleagues to maintain their wellbeing. Of course, links to services such as the Practitioner Health Programme are also important for the increasing number of colleagues that need them.

So many issues contribute to this - the perceived value of GPs and general practice, our seemingly unending workload and the workforce challenges we face daily, being a few.

Historically, wellbeing has perhaps not had the priority it needs. Our lived experience tells us that our culture must change so that we take a proactive, positive and supportive approach to wellbeing. This must not stop when the current crisis improves.

As a four nation College we will continue to use our influence to ensure the wellbeing of GPs and our teams remains a priority, that it is central to our work as clinicians, and that there are adequate resources invested in it.

Post written by

Professor Mike Holmes, RCGP Vice Chair for Membership and International

Mike is a GP in Yorkshire and Vice Chair of the Royal College of GPs with responsibility for Membership and the International work of the College.

He has been a Partner with Haxby Group since 2002 caring for 50,000 patients in the cities of York and Hull and part of At Scale Collaborative. Mike is a Director of Nimbus Care Ltd caring for 130,000 patients in York and is working with all the practices to develop a Primary Care Home model of care.

Mike is also a GPSI in vasectomy although half his practice time is in a leadership role developing a multi-professional workforce.

He is a board member of the North LETB and leads development of Advanced Clinical Practitioners and Physicians Associates for the Local Workforce Action Board. He is also RCGP Clinical Lead for their General Practice 'At Scale' Programme.

Latest updates from College Chair Martin Marshall

COVID vaccination programme - tell us your experiences

There is still only one real story in town: the COVID vaccination programme (CVP).

You’re all doing amazing work rolling this out alongside everything else you need to do in general practice, and we’re hearing more than 5m patients have now been protected from this terrible virus.

We want to hear about your experiences on the frontline of the CVP - what’s going well, but also what’s not, so that we can identify key issues impacting on the smooth running of the programme and represent your views to policymakers.

We’ve put together this survey which closes at 23:59 this Sunday, 24 January, and shouldn’t take more than 5-10 minutes to complete.

One issue we are hearing about - although we don’t know how widespread - is supply. And we’ve heard over the last couple of days that some PCNs that have finished vaccinating their most vulnerable groups are unlikely to receive deliveries next week, while supply is focussed on areas that haven’t.

While we understand the rationale for this, we know it will be hugely frustrating for practices that just want to get on with it and protect as many of their patients as possible. What we continue to call for is clear, reliable and timely communication with practices, so you know what to expect and aren’t put in a position where you have to make last minute changes.

On Wednesday, I met with the Vaccines Minister Nadhim Zahawi to discuss the CVP, and Jo Churchill, Minister for Primary Care, also attended.

We discussed the prospect of 24/7 vaccinations - questioning whether there is a genuine demand for this, particularly when we’re focussing on elderly patients, never mind the sufficient staffing and vaccine supply. We also stressing the importance of ensuring vaccine supply and emphasised our desire to be closely involved in phase 2 rollout as we reach different population groups.

We believe that GPs are best to make decisions about how they meet patient demand in their communities. GPs should be trusted to assess public appetite for extended vaccination clinics and our initial perception is that there is unlikely to be great demand.

We’re in regular contact with Minister Churchill, as well as key people involved in the delivery of the CVP at NHS England, so please do fill out our survey. This is a four nation survey and our Devolved Nation Chairs are also having high level meetings with politicians and stakeholders in their own countries so that the views of GPs are represented right across the UK.

IT systems and the CVP

We know that the smooth running of IT systems is critical in the delivery of the Covid vaccination programme, and as such we’re working closely with NHSX and NHS Digital to ensure that the voice of general practice is taken into account as systems develop, and that issues are fixed as quickly as possible.

Work to equip core GP IT systems to manage both bookings and point of care for the vaccine is progressing well with some systems expected to launch in the coming weeks.

We're also discussing ways data flows can be improved to avoid confusion between mass vaccination centres and PCN sites. Necessary search and reporting functions will be key, especially with second doses not far away now, and work in this area is ongoing. We’ll update you as we hear more details.

Vaccine up-take in Black, Asian and minority ethnic communities

The College is concerned about recent reports which suggest that projected take-up of the COVID vaccine is lower amongst Black, Asian and minority ethnic communities - particularly as evidence shows these groups are disproportionately impacted by the virus - and as such, we’ve called for tailored communications and public health messaging to different communities to assure people that the vaccine is safe and effective.

It’s important we start to understand the reasons behind these findings, so that we can address the issue and we’re working closely with relevant bodies to ensure that the right messages are being delivered by the right people to all communities across the country. The last thing we want to see are pockets of communities who end up declining the vaccine once offered it and therefore continuing to be adversely affected by the pandemic.

You many have seen this week that our call for tailored communications and public health messaging around the vaccine featured in numerous media outlets including on the front page of The Guardian, and I spoke to ITV London about it yesterday.

Brexit and the health service

Vice Chair Gary Howsam hosted our latest RCGP LIVE panel event. We focussed on what one of our panellists described as the biggest public policy issue of the last two years, other than COVID: Brexit.

On the same day the Astra Zeneca vaccine was approved, the Brexit deal passed through Parliament. The true implications for the health service it seems haven’t been felt yet, but our panel were on hand to talk through what it could mean for the social care workforce, our trainees and recently qualified doctors and colleagues in Northern Ireland.

We were lucky enough to be joined by: Chair of the Cavendish Coalition Danny Mortimer; Head of Graduate Entry Medicine at Swansea University (and former College Vice Chair) Kamila Hawthorne; Associate Director of Career Development at Northern Irish Medical and Dental Training Agency Louise Sands; RCGP Joint Honorary Secretary Victoria Tzortziou Brown and RCGP Head of Campaigns and Public Affairs David Knowles.

This is an issue that will affect how we work in the future and you can catch up with what members asked and what the panel thought via Youtube.

WHO webinar

In a major coup for the College, we will be hosting a free webinar in collaboration with the World Health Organisation on 'Global Lessons Learnt from the COVID-19 Pandemic' on Wednesday 3 February.

It will explore challenges experienced at the start of the crisis, ways in which health services adapted at speed to manage increasing demands and the epidemiological and global public health lessons learnt during the pandemic.

Joining me on the speaker panel will be: Dr Jim Campbell, Director of Health Workforce at WHO; Professor Yuanli Liu, Founding Dean, School of Health Policy and Management at Peking Union Medical College, and Dr Lola Dare, President of the Centre for Health Sciences Training, Research and Development in Nigeria. It will be chaired by RCGP Chief Operating Officer, Dr Valerie Vaughan-Dick.

It’s a Zoom event but we’re expecting it to be very popular so please register now.

Due to different time zones, it will be held from 12:00 - 13:15 GMT when I realise a lot of you will be in practice, so it will be recorded for the College’s YouTube channel and the video and presentations will be uploaded to our COVID-19 Resources Hub.

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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