An update on the COVID-19 vaccination programme

4 December 2020 

Cardiac surgeons have agreed to be held to account for their individual post-operative mortality rates. It’s difficult to imagine GPs reaching a similar consensus about a single outcome measure for our speciality. Indeed, the very thought of attempting such a reductionist exercise would leave many apoplectic.

But that hasn’t stopped some thoughtful people from having a go, most notably John Howie and colleagues from Edinburgh who nearly 25 years ago developed the Patient Enablement Instrument. Howie defined enablement as the extent to which an interaction between a patient and a GP results in the patient having a better understanding of, and a better ability to cope with, their health and illness.

The PEI never took off but enablement does feel like an important outcome of our interaction with patients. So how disappointing is it to learn from last year’s patient survey in England that nearly 40% of people didn’t feel as involved as they wanted to be in decisions, 59% felt they didn't have enough support to manage their condition, and 60% felt that they didn't adequately discuss what was important to them to manage their condition.

GPs want to enable their patients but it’s very clear that we don’t have the time or space to do so. That’s why the College is persistent in our messaging that undoable workload is the greatest impediment to our ability to care for our patients.

Latest updates from your College

COVID-19 vaccine update

From what we know about the Pfizer/BioNTech vaccine, approved by the MHRA for use in the UK as early as next week, it will be a great logistical challenge to deliver in general practice, so at least initially we’re expecting the focus of delivery to be in hospital hubs.  We’re asking NHS England for more details about the roll out, particularly the role of general practice in it, and as soon as we hear anything, we’ll share it with you.
Ultimately, the vaccine approval is excellent news, and should assure us as health professionals, and our patients, that it is safe. I have spoken about it in recent media interviews on LBC, BBC News Channel and Times Radio.

NHS Resolution has produced a series of FAQs on indemnity arrangements related to the COVID-19 vaccination programme.

Letter regarding the JCVI priority list for the COVID-19 vaccine

The College has been raising concerns about the extent to which GPs, their practice staff, and patients from Black, Asian and minority ethnic communities are disproportionately affected by COVID-19 throughout the pandemic.

On Monday, I wrote to Secretary of State for Health and Social Care, Matt Hancock, asking for a detailed rationale on the decision not to include Black, Asian and minority ethnic communities on the Joint Committee on Vaccination and Immunisation’s prioritisation list for the COVID-19 vaccine.

This despite data showing that patients from these communities have a greater susceptibility to contracting and dying from the virus. Whilst this can partly be explained by co-morbidities - which would, therefore, be picked up by the current priority list - research from the ONS suggests this is not sufficient to fully explain the disparity.

We have also asked whether a risk assessment tool that takes into account socio-economic factors has been considered.

Read my letter, which was covered in The Times.

GP workload

Recent data from the RCGP Research and Surveillance Centre shows that workload in general practice is rising rapidly with consultation rates exceeding 2019 levels - and that doesn’t account for the expanded flu vaccination programme, and the work we’re doing to prepare for the COVID vaccination programme.

We’re also seeing a growing proportion of care being delivered face to face with more than 360,000 face-to-face appointments delivered every day in the last month.

This is why it’s so unfair to see articles criticising the sterling efforts of GPs during the pandemic in the media - as we saw in the Mail on Sunday last weekend. This kind of criticism by the media and armchair critics about the different - but necessary - ways we are working in unwarranted, and the College will continue to defend the profession against it. Read Vice Chair Gary Howsam’s response.

Transgender care

Congratulations to RCGP member Kamilla Kamaruddin, who has been awarded the Frontline Hero award at the PinkNews Awards 2020 for her work in recognising and addressing the health inequalities faced by transgender patients. See her accept the award.

The College has recently launched two eLearning modules on gender variance - the first focusing on adults, the second on children and young people. We have also developed a position statement on the GP’s role in delivering care to transgender and gender questioning patients.

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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