The maxim that success is the sum of small efforts, repeated day in and day out has never been more apt

29 January 2021

We’re told that dealing with COVID is a marathon, not a sprint. It feels like both to me.

Like so many general practice vaccination centres across the country, my practice in East London has been sprinting to get a slick process up and running and is now working at a steadier pace of delivery, constrained only by limited supplies. And while it’s been tough, it does feel like a joyous experience. Our older patients are grateful and excited, craving social contact. And I’ve found the opportunity to work with colleagues across our borough, meeting old friends and making new ones, massively energising.

But we all know there are big challenges ahead. Such as vaccine supplies in an increasingly competitive and fractious international market. Such as recognising that staff can’t sprint for long when they are running a marathon or they won’t finish the race. Such as the complexity of taking ethnicity, occupation and deprivation into account as we move into phase 2 of prioritisation. Such as dealing with the anger and frustration that even rapid uptake of the vaccine isn’t going to release lock down anytime soon. Such as dealing with the inevitable criticisms that general practice isn’t doing its usual day job, alongside our new day, night and weekend jobs.

I could go on but I won’t. General practice is doing a stunning job, we’re showing our colours. Our success is rightly being lauded by politicians, by the media and, mostly importantly, by our patients. We can expect a lot of noise in coming months but general practices will get on with the job of vaccinating their communities.

The maxim that success is the sum of small efforts, repeated day in and day out has never been more apt.


Latest updates from your College

COVID vaccination programme update

General practice is really leading the way in the COVID vaccination programme, with community sites, so far, delivering an estimated three quarters of all COVID jabs. That wouldn’t be possible without the expertise and dedication of you and your teams - once again, thank you.

I know what meticulous planning goes into running vaccination clinics: not just in terms of getting as many patients through the doors as possible but doing so in a safe way in line with social distancing measures. And then trying to get patients to maintain social distancing, when for many this trip to the surgery might be the most contact they’ve had with people for months. It’s certainly a challenge - waiting rooms can’t always be constantly monitored - but we’ve published some useful tips on the COVID-19 Resource Hub on ways to help keep patients and staff safe when working or visiting practices.

You've undoubtedly seen reports about German authorities questioning the efficacy of the Oxford/AstraZeneca - and the ludicrous misreporting that it only has 8% efficacy in over-65s. We are clear that this vaccine, and the Pfizer/BioNTech one, have both been rigorously tested by the MHRA and are both safe and effective. Whether subsequently dismissed, or not, these reports threaten the trust and confidence people have in the vaccine, and risk uptake at a time when we need as many people coming forward as possible. You can read my comments about this in The Guardian.

We're particularly concerned about low uptake amongst Black, Asian and ethnic minority patients. This week we've continued our calls for tailored public health campaigns, where appropriate, to assure patients, regardless of their ethnicity or background, that the vaccine is safe. This week the Government announced £23 million of funding to boost vaccine uptake in communities most at-risk from the virus. Read my comments in The Financial Times, The New York Times, and The Times.

PRINCIPLE Trial

Since early on in the pandemic, the RCGP Research and Surveillance Centre has been working in collaboration with the University of Oxford on the PRINCIPLE trial, studies conducted at a primary care level to investigate potential treatments for COVID-19 and prevent hospitalisations. As part of this, two antibiotics were investigated as possible treatments: Azithromycin and Doxycycline.

This week, the study concluded that these antibiotics show no effect of treating COVID-19 or reducing the longevity of the virus in patients. It’s not the positive outcome we were all hoping for, but it is still an important finding, that will help guide prescribing decisions, and reduce the use of ineffective treatments.

The PRINCIPLE trial is ongoing, and recruitment for the investigation into inhaled Budesonide as a possible treatment has begun. For these studies to be as successful as possible, we need large cohorts of participants. If not already involved, I would encourage practices to sign up to the RSC network to partake in the study and help monitor the prevalence of COVID-19 in the community. To register practice interest, please email practiceenquiries@phc.ox.ac.uk.

New 'Daffodil Standards' for care homes

Delivering care to patients at the end of their lives is a challenging but rewarding area of general practice. This is a time when patients are at their most vulnerable, and this can be even more distinct for patients living in care homes.

In partnership with the end-of-life charity Marie Curie we’ve launched a new set of 'Daffodil Standards’ to support GPs and their teams in providing consistently high-quality palliative and end of life care specifically focusing on elderly patients living in care homes.

The new guidance, specifically relating to elderly people living in care homes, has been co-developed with frontline GPs, members of the multi-disciplinary practice team and relevant care providers. The guidance is free and has been designed with busy GP teams in mind, in the form of bitesize QI activities for practices to undertake. The care home standards were already in development before the outbreak of COVID-19 and their use is not limited to the care of patients during the pandemic.

This new standard complements the original programme but is standalone and so engagement with the original standards is not a prerequisite to signing up. You can read more on our website and in GP Online, as well as an Opinion piece by RCGP Clinical Lead for End of Life Care Catherine Millington-Saunders on why practices should sign up.

More information on the new Daffodil Standard and how practices can sign up is available on the RCGP website.

Meeting with Health Minister Edward Argar

On Wednesday, I met with the Health Minister Edward Argar, to discuss the UK’s future relationship with the EU.

The College has always been clear that healthcare must be protected in any Brexit deal, so we are encouraged that the final deal appears to provide the foundations for ongoing close collaboration, with minimal disruption to areas such as medicines supply and research collaboration.

I was also able to raise important issues for ensuring the sustainability of the general practice workforce, including extending GP training and mutual recognition of professional qualifications. The Minister was receptive and agreed to take these matters forward. I look forward to continuing to work with the Minister and his colleagues.

AKT exam update

On Wednesday, despite the national lockdown and adverse weather conditions in some areas of the country, tests centres across the UK were open to welcome the 1670 trainees sitting their AKT exam. This year's turnout is just shy of our record number of 1681 trainees, who sat the exam in October 2012. I'm pleased to report that the exam was delivered without any problems.

A huge thank you to the RCGP exams team - and all other colleagues who've supported them - for their work to make this important exam go ahead, and for providing assurance to trainees and answering their questions in the lead up to the exam.

The best of luck to all trainees who sat the exam, and are working very hard to complete their training, in exceptionally difficult circumstances.

RCGP Research Paper of the Year award 2020 - Open for submissions

We’re delighted to announce that we’re accepting submissions for the RCGP Research Paper of the Year Award 2020 - to be awarded in 2021. The Awards recognise individuals or teams of GP researchers who have undertaken and published exceptional research relating to general practice or primary care.

Deadline for submissions: 28 February 2021

Read more.


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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