Undoable workload is the biggest impediment to our ability as GPs to provide care for our patients

28 May 2021

I’ve said it before and I’ll keep on saying it - undoable workload is the biggest impediment to our ability as GPs to provide care for our patients.

There are lots of small answers to the workload crisis that we’re all experiencing, viscerally, every day and we, GPC colleagues and others are working on them. But there’s only one big answer and that’s increasing the size of the general practice workforce. What can and needs to be done in general practice has increased exponentially in recent decades and the number of health professionals delivering care has failed to keep pace.

The College is grasping this nettle. On the recruitment side, we’re proud that as a result of our lobbying, the number of GP training places has increased to 4000 this year, a 15% increase in two years. The taps are on - not fully and the bath will take time to fill - but there’s light on the too-distant horizon.

But on the retention side, the plug is still out. Again, our lobbying resulted in the 2019 manifesto promise of 6000 more full-time equivalent GPs by 2024. NHS Digital data shows that so far only 400 additional qualified GPs have been added to the workforce since the government made its pledge.

The response is to recruit other health professionals to work in general practice and this helps greatly. Nevertheless, it’s difficult to judge where we are as anything other than a monumental failure of workforce planning, with practices and patients paying the price. That’s why your College is pushing for radical action from the centre.

Latest updates from your College

GP pressures

It’s often difficult to get across to policy makers and the media just how serious the pressures in general practice are because we don’t have patients lying on trolleys in corridors waiting to be seen.

So we were really pleased that the BBC decided to devote a whole day’s coverage to general practice yesterday.

It was the best portrayal of what it’s like to be a GP in today’s NHS that I’ve seen or heard in a long time and I’m sure it will have struck several chords with those of you who saw it.

Huge credit to Doncaster GP and College Fellow Dean Eggitt for his honest and eloquent account of the daily pressures. He skilfully conveyed the seriousness of the situation while also coming across a caring and compassionate GP who is very much on the side of his patients.

I appeared on Radio 4's Today Programme (1hr 4mins in) and the BBC News Channel where I made the point that we were already bearing the brunt of GP shortages and a long working hours culture before the pandemic, but that things had now reached crisis point. As well as calling for 'big ticket' items including the 6000 additional GPs pledged by the Government, I said we also needed reduced red tape and regulation and to streamline communication between secondary and primary care.

So far, we’ve had pick-up from over 200 media outlets, including the Times, the Telegraph and the Daily Mail. You can read our full statement. Thanks also to Vice Chair for Professional Development Michael Mulholland who appeared on Radio 5 Live and to all those members who gave up their time to be interviewed on their local TV and radio.

New Chair-elect and Vice Chair-elect for Wales

Congratulations to Rowena Christmas, who has been elected as the next Chair of RCGP Wales, and to new Vice Chair-elect Shanti Karupiah.

Rowena and Shanti will take over from current Joint Chairs Mair Hopkin and Peter Saul and Vice Chair Rob Morgan in November and will serve three-year terms. You can read more.

Roundtable with Care Quality Commission

The College hosted a 'listening' roundtable with ethnic minority members and senior leaders from the CQC on Wednesday.

The purpose was to create a forum for our ethnic minority colleagues to share their lived experiences of inspections and regulation directly with the CQC. Overall, it was a very insightful discussion and a valuable starting point for future work and discussion, within the College as well as CQC.

Before the meeting, we asked members from ethnic communities to share their lived experiences of CQC inspections with us. We received powerful feedback, which we were then able to discuss, without attributing these accounts to specific practices.

If you would like to share your experiences of CQC inspections from your perspective as an ethnic minority GP, you can still email Anique Liiv. We want to hear from you.

The CQC also launched its new strategy yesterday, looking to take a more proportionate view of regulation. We are pleased that our calls for a lighter touch seem to have been heard and we look forward to seeing the rapid implementation of the new model. We will continue to work to ensure our members are treated equitably within the system.

GP Data for Planning and Research

Two weeks ago, NHS Digital issued a Data Provision Notice (DPN) to all practices in England for their new data collection, GP Data for Planning and Research (GPDPR). It is a legal obligation - resulting from a direction from the Secretary of State - for you to comply with the DPN and you can find additional guidance and FAQs for GPs and patients on the NHS Digital website.

The College has engaged with the planning for this programme via our joint GP IT committee with the BMA and made representations to NHS Digital regarding the security and intended uses of the data collected.

We support the principle of improved sharing of data but have not endorsed the programme and will continue to hold NHS Digital to account over its development in order to ensure appropriate safeguards are in place and to represent your views and those of the wider profession.

Most recently we have lobbied NHS Digital over the lack of appropriate communications to the public about the new collection and pushed back against the wholly inappropriate implication that it is GPs' responsibility to inform patients. We have written to NHS Digital about this and will keep you informed.

Integrated Care Systems roundtable

Yesterday evening, College Vice Chair for Professional Development Gary Howsam hosted a workshop on GP influence in Integrated Care Systems. The aim was to explore potential policy solutions to make sure GPs are able to shape and influence patient care in their local communities and within their ICSs. We will continue to push for a strong GP voice at all levels of the system, as we wait for the legislation to be laid before Parliament.

If you are a GP interested in system working, or you have any concerns about the proposals for GPs in your area, we want to hear from you. You can contact the Policy Team for more information.

Fellowship update

Our new application process to become a Fellow of the RCGP is now live.

We've streamlined and simplified many of the application requirements to make it easier to apply, while retaining the key criteria and standards associated with this marker of significant achievement and contribution. The one-off fee has also been substantially reduced for UK-based candidates.

We believe achieving fellowship is within the reach of all our Members, regardless of your career path or destination. Visit our webpage to find out more and to download the forms and accompanying resources.

Volunteers' Week

Next week is National Volunteers’ Week and an opportunity to pay tribute to our volunteer Members, committees and community groups who have been an invaluable support to the College during the last 12 months. Thanks to you all. Look out on our social media channels for some of the personal stories we’ll be bringing you, as well as the different ways of getting involved.

Post-COVID syndrome - where are we now?

Join us for this free webinar on 8 June on understanding and managing the long-term effects of COVID-19. We will be joined by the Office of National Statistics, who will share new figures from June 2021 on those who are affected by the ongoing symptoms of COVID-19. There will be an opportunity to ask questions and hear about the launch of new RCGP resources to help you learn more and keep up to date with the evidence as it changes. Register now.

Ethical lessons learnt from COVID-19

This free webinar on 16 June is brought to you by the Leicester Faculty but is open to all. There will be a panel discussion on: health inequalities by a local MP, the impact of COVID-19 on homeless patients, the differential impact of race, and the ethical COVID-19 learning from the Leicester experience. 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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