Trainees determination and willingness to contribute to the COVID-19 effort is shining through

17 April 2020

I'd like to start this week by acknowledging the efforts - and the predicament - of our trainees in this COVID-19 world.

Embarking on a career in general practice is always daunting (as well as challenging, stimulating and exciting) but having to do this in the middle of a pandemic is hugely intimidating.

A lot is expected of our trainees as they transform into 'expert medical generalists' but never more so than now.

Even with my years of experience, I am finding constant remote consultations a challenge, but our next generation of GPs are having to grapple with this before they are totally comfortable with face-to-face appointments. They are dealing with even greater levels of risk and uncertainty and being asked to do more, sometimes with less supervision, in an environment where continuity of care - one of the main reasons why many of us go into general practice - is much reduced.

One of the best things about GP training is being able to build close, sometimes lifelong, networks of friends and colleagues but the current situation means they are losing out on these valuable connections when they perhaps need them most, particularly our ST1 colleagues who are just finding their feet.

Despite the odds, their determination and willingness to contribute to the COVID-19 effort is shining through.

As well as directly supporting general practice and working in COVID hubs, they are working right across acute medicine and intensive care. I know that many of our more experienced GPs have also been very grateful for the tech support they've received from their trainees in the switch to new ways of working!

They are very much on the frontline and I would like to thank them on behalf of the entire College for everything they are doing. We are very lucky to have them as part of our speciality and I hope they can stay strong and steadfast over the next challenging weeks and months.

AKT and CSA exams

I would like to address the particular concerns of our ST3 colleagues who were due to complete their training in August but for whom the future is now looking very uncertain, following the necessary postponement of the AKT and CSA exams.

I appreciate how nerve-racking this must be, especially for those with jobs to go to, and at a time of other major life changes such as taking on mortgages and having children.

This is very complex territory but please be assured that we are in discussions with Health Education England and the Department of Health and Social Care to try and reach a speedy decision on how we can offer greater flexibility to help ST3s.

Michael Mulholland, Vice Chair for Professional Development, and Anthony James, Chair of the AiT committee, have filmed a vlog with more information and we have also made significant changes to the Workplace Based Assessment requirements to reduce the assessment burden. I will also be sending out much more regular communication to all our trainees to keep everyone updated.

What impact is COVID-19 having on trainee GPs? - 9 April 2020

Whilst I am not going to offer false hope as this decision is not in the College's hands, I can guarantee that this is a top priority and I will not rest until this issue is resolved. In the meantime, I would like to give a special thanks to Anthony and the reps on our AiT Committee for everything they are doing to support individual trainees, and for the intelligence and counsel they are providing to College Officers and staff to inform our work on these difficult matters.

GP contribution during the pandemic

Elsewhere, whilst media attention has focussed on the truly remarkable work in ITUs, general practice is making its equally important contribution to the crisis. Gail Allsop, one of our clinical leads, has recorded a video diary for the BBC, which is due to be aired at some point over the next few days.

The contribution of general practice during the pandemic is massive. We’re looking after the majority of patients with COVID-19 in the community, especially the more vulnerable in their homes and care homes. We're looking after people with non-COVID illnesses (they don't go away just because we’re in a pandemic) and providing acute, long term and preventative care. We’re gearing up for the inevitable psychological and social fall out of this terrible pandemic for our patients and communities, especially people who have lost loved ones and haven’t been able to grieve, people who have lost their livelihoods, and NHS and care staff who have selflessly given their all and will inevitably need our help as adrenalin levels drop off. And we're leading massive transformation of how we provide care, some of which needs to be embedded into new ways of working and some will need to be pushed back on when the crisis is over.

The ability of general practice to take on and address big challenges never ceases to amaze me.

I mentioned last week that some GPs had reported to me that workload was more doable as a consequence of cutting down on unnecessary admin work and reduced non-COVID demand. I’ve heard similar reports from colleagues across the NHS, except for ITUs.

My experience in my practice in East London is that routine work is coming back, albeit we're doing it differently.

Nevertheless, it's important that we use the short period of space that some practices are experiencing to plan for the future. Our collective task is to ensure that general practice emerges stronger from the crisis and that everyone continues to support the objective of creating a truly general practice-led NHS. I’m confident that we will achieve this.

Important updates to the RCGP website

We continue to update our website to ensure you have access to high-quality resources designed to support you through this crisis. Key developments this week include our updated evidence summary on the clinical management of COVID-19 including how NEWS2 should only be used alongside a wider clinical assessment, more content has been added to our section for returners and students; and we've updated our FAQ on the use of NSAIDs based upon new MHRA guidance.

Massive thanks to everyone – clinicians, administrative staff, GPs coming out of retirement and our colleagues who are also working under the greatest of pressure in national organisations - for your remarkable efforts during this challenging time.


Post written by

Professor Martin Marshall, Chair of RCGP Council

Martin Marshall is a GP in Newham East London and Professor of Healthcare Improvement at UCL, Programme Director for Primary Care at UCLP Partners. He leads Improvement Science London, an initiative to promote and embed the science of improvement across the health service and academic sectors. He is immediate past Vice Chair (External Affairs) of the RCGP.

Previously he was Director of R&D at the Health Foundation, Deputy Chief Medical Officer for England and Director General in the Department of Health, a clinical academic at the University of Manchester and a Harkness Fellow in Healthcare Policy.

He has been a GP for 28 years. He is a fellow of the RCP and FPHM, and was a non-executive director of the Care Quality Commission until 2012.

He has over 200 publications in the field of quality of care and in 2005 he was awarded a CBE in the Queen's Birthday Honours for Services to Health Care.


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