My license is an inclusive one. That’s why I’m called a general practitioner.

9 October 2020

GPs should 'work to the top of their license'. That’s the phrase used by people who have a good understanding of GCSE economics but have little understanding of what expert medical generalists do. Working as a general medical physician (yes, the ones who were unhelpfully removed from the hospital consultant workforce years ago) is the role that most people suggest is the top of a GP’s license. That sounds attractive to some doctors - no more annoying sore throats or back aches - but it leaves me cold.

When I see a patient who I know, who presents with a simple viral sore throat, I address it in a couple of minutes before moving onto the next concern that the patient wants to share with me. If our receptionist triages that patient to our brilliant practice nurse, they receive a 15-minute appointment to deal with the problem. Do the sums.

But it’s about more than economics. GPs know that sore throats or backaches (the bottom of our license?) can be opening gambits from patients who want to know whether we’re interested in their need to talk about self-harm or in the bruises that they sustain every Friday night when their partner returns from the pub.

My license is an inclusive one. That’s why I’m called a general practitioner.

Latest updates from your College

COVID update

It’s clear that the second wave of COVID-19 is upon us and getting worse with escalating numbers of cases, hospital admissions and sadly, deaths. As GPs, we continue to be at the forefront of tackling this disease. Many of you will be working in lockdown areas, and I can only imagine how challenging the situation is for you right now. We’re here to support you and will advocate on your behalf at the highest levels - we also continue to develop our COVID-19 Resource Hub, which we hope you find helpful.

The situation is clearly serious and it’s vital people continue to maintain hygiene measures and follow official advice on social distancing. As such, we are in support of this statement made by the Academy of Medical Royal Colleges earlier this week - however, as a College, we won’t be getting involved in political decisions, such as whether to impose lockdowns or curfews.

Long COVID developments

There’s been some really encouraging news around so-called 'long COVID' this week - an issue I know is increasingly affecting our day to day work in general practice, and is dreadful for those patients suffering from it.

On Tuesday, NICE and SIGN, the equivalent body in Scotland, announced that they would be working with the College to develop guidance for GPs on how to deliver care to patients suffering with prolonged effects of COVID-19, which we know affects a small but significant number of people. This is excellent news and comes off the back of a letter we wrote to NHS England asking them to commission such guidance, and we’re delighted to be involved. Our aim is to produce guidance, based on the latest evidence, to help patients to self-care where appropriate and to support our teams to manage the care and rehabilitation of patients with long-COVID as best we can. Many thanks to Gail Allsopp, Clinical Policy Lead, for her leadership in this area.

We also heard a number of measures announced by NHS England to address long-COVID on Wednesday. These are all incredibly welcome, in particular the announcement of investment into 'long-COVID clinics' which is something the College has called for. You can find out more on the NHS England website.

Calling for clarity on flu vaccine supplies

Last week I mentioned that I had written to Health and Social Care Secretary for England Matt Hancock seeking assurances on flu vaccine supplies following reports from College members about shortages and your concerns about being able to vaccinate at risk groups. Read our letter (81 KB PDF) - it attracted major media coverage including The Guardian, 5 News, GP Online and iNews.

I have had two conversations with the Secretary of State this week on COVID-related issues and an announcement on flu vaccine supplies is apparently imminent, along with clarity on anticipated timeframes. We will continue to monitor the situation closely as the flu vaccine is one of our most important forms of defence against the winter pressures that will be even greater this year with the second wave of COVID.

NHS England's 'Help us, help you' campaign

One of the most worrying side-effects of the pandemic has been the fall in people seeking medical attention when they have concerns about their health, particularly if those concerns are potential signs of serious illness, such as cancer.

While data from our Research Surveillance Centre shows that demand for routine consultations is back to near normal levels, the people who potentially did not come forward at the peak of lockdown are a cause for concern. As we know, a timely diagnosis of cancer, can lead to better outcomes for patients.

NHS England has today launched their 'Help us, Help you' campaign, with an initial focus on cancer, to encourage those with potential signs of cancer to get them checked out. The campaign is set to be featured on TV and social media, so look out for it.

New book on doctors with mental illness

We’re all super-busy but please try and find some time to read a fascinating new book on doctors with mental illness, by co-Chair of the NHS Assembly, former College Chair and current RCGP Council member Clare Gerada.

Clare is the Medical Director of the Practitioner Health Programme, which she started from her practice in London in response to a worrying rise in mental health problems and suicide amongst doctors.

The scheme is now nationwide and supports thousands of doctors every year - including GPs who are struggling - by providing timely, 'no blame, no shame' interventions.

Clare is renowned for her foresight and energy, and also her willingness to tackle difficult and 'taboo' subjects. As GPs, we are very good at caring for our patients but not always as good at looking after ourselves and Clare’s phenomenal work makes it acceptable for us to admit that sometimes we’re 'not ok' and to seek help. Find out more about the book.

Profits are going to the charity Doctors in Distress.

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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