An opportunity for constructive and practical learning

3 July 2020

Last year we picked up a number of errors in our practice which resulted in one of our patients not receiving an urgent prescription over a weekend. Thankfully the patient was fine.

We responded by carrying out a structured significant learning analysis involving the whole of our team. We recognised the problem might happen again, we learned, we moved on but we didn’t forget. It felt like a positive experience.

Let’s replace 'prescription error' with 'the UK’s response to the Covid-19 crisis' and 'practice team' with 'policy makers and health and care leaders'.

Shouldn’t we learn in order to ensure that any errors aren’t repeated? Isn’t learning particularly important as we prepare for the post-lockdown peaks and the second wave of the pandemic expected in the winter?

No one should pretend that our country has managed this crisis well; we have much to learn,

That’s why I joined a group of health professional leaders last week in signing an open letter to the leaders of the main UK political parties asking for a review of learning so far. We identified key areas ripe for learning:

  • how to encourage better coordination between sectors
  • how to improve procurement of PPE and testing kits
  • how to reduce the impact of the virus on members of BAME communities
  • how to get a better balance between a centralised response and a local one
  • how we might learn from countries which seem to have handled the crisis more effectively than us.

We didn’t demand accountability, or try to apportion blame, or ask for a distracting bureaucratic inquiry. We just called for an opportunity for constructive, practical learning, to help everyone to do things better next time.

Some politicians responded positively but the initial government response was to reject our call. I’m proud of our long-established culture of learning in general practice and I’d like to believe that people will learn from us.

COVID-19 update from your College

Support for Leicester colleagues

We’ll all be following the events in Leicester closely as it’s likely it won’t be the last regional lockdown we see as a result of COVID-19.

This is one of the reasons we co-signed the letter to the political parties last week (see above) calling for a rapid review into the UK’s preparedness to deal with such local spikes and a potential national second wave of the virus.

You can hear more about this in my interview with CNN.

It is also the reason why we are pushing for better information for GPs via the NHS Test and Trace programme.

This is necessary to do our job well, and so that we can make necessary arrangements to enable us to deliver optimal patient care, should we find ourselves in lockdown again.

It seems clear that in Leicester, the people necessary did not receive the appropriate data quickly enough, and that isn’t acceptable.

On behalf of the College, I’ve sent a message of support to our Leicester colleagues and been in touch with Nigel Scarborough, Chair of Leicester Faculty.

Localised lockdowns are an inevitable part of wider restrictions being eased, but it will be a difficult time for our colleagues in Leicester and their patients.

It will certainly have implications for general practice - both in the ways we work, and the problems our patients present to us with - and the College is here to support you as best we can.

  • We’ve produced a suite of online resources covering a huge range of issues associated with COVID-19
  • we’ve launched a member forum, providing a space for members to share your experiences with peers
  • we’ve been advocating in the best interests of general practice on issues including PPE, testing and regulation to Government and decision-makers, and will continue to do so.

Council elections and diversity

RCGP National Council Member Elections are now open. We’re inviting nominees to stand for six national-elected Council Member posts to sit for three years from November 2020 to 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.

You may have read our statement of solidarity with Black, Asian and Minority Ethnic colleagues last week, and some details about our forthcoming Action Plan, which is being developed in consultation with our BAME members forum.

One of the things we are committed to is working to improve representation of members from BAME communities on College committees, including UK Council, and we would encourage any BAME colleagues who wish to stand for Council to do so.

Please visit our Council Elections 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-COVID future of general practice

Following a vibrant discussion at RCGP Council on what the future of general practice will look like post-COVID, we held the latest in our series of #RCGPTogether webinars on the topic last night.

I was pleased to join colleagues in the devolved nations - Mair Hopkin, Joint Chair of RCGP Wales, Laurence Dorman, RCGPNI Chair, and Alasdair Forbes, Deputy Chair of RCGP Scotland - on the panel, and huge thanks to Vice Chair Gary Howsam for his excellent hosting skills.

It was a fascinating discussion about how the new ways we’ve been working during the pandemic have impacted on the profession and patients and we covered technology, workload and the ways in which general practice is intertwined with public health.

Thank you for some interesting interaction. If you weren’t able to join, you can watch it back now.

We plan to publish our full paper 'General practice in the post-COVID world' next week. Do look out for it.

Mask advice

Many thanks to our Clinical Policy Lead Gail Allsopp for producing this useful mask advice document, which analyses all the existing guidance on the use of face masks in primary care.

It explores what patients and practice staff should do and makes comparisons across the devolved nations.

This has been a confusing area for GPs and our teams, and I hope this important work will provide some clarity.

Have your say on reducing red tape in General Practice

The College has long been calling for a reduction in bureaucracy to free up frontline GPs and practice staff to spend more time with patients.

Our new report out next week on general practice in the post-COVID world looks at this very issue.

NHS England and Improvement are doing a review and want to hear from practice staff and managers about the time-consuming tasks that could be streamlined or removed, including specific examples.

NHSE&I are looking for expressions of interest to participate in a series of virtual focus groups in the weeks commencing 20 and 27 July 2020.

If you wish your practice team to participate and find out more about the discussion topics, please contact the review team directly at england.gpbureaucracyreview@nhs.net.

They have asked for responses by close of play on 8 July.


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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