Empowering and caring for patients

6 November 2020

Media mayhem

Wednesday was a mad one in surgery. Like many of you, I am concerned about the rising COVID-19 infection rates in our communities and so I joined forces with Mark Taylor from the Royal College of Surgeons and Hamish Courtney from the Royal College of Physicians of Edinburgh to issue a joint statement.

Once the statement went out, there was huge media interest in what we had to say. For the first time ever I think, three medical Colleges went on the Stephen Nolan show, which is a difficult gig, particularly when I managed to do it during morning surgery!

The main messages we wished to convey were the rising cases, limited capacity for critical care beds and for the public to work with us and help protect Health & Social Care services this winter. 

You may be aware of Dr Tom Black’s comments on BBC Newsline this week, suggesting that the hospitality industry should not return on 14 November.

The debate about lockdown and its risks and harms to the economy will continue for many months to come. Difficult decisions will have to be made and as a College, we believe that these decisions need to be made by politicians.

When it comes to lockdown and debates about the economy, we therefore have a neutral position. Instead, our messages and calls are aimed at ensuring political decision makers prioritise health and social care in the interests of patients and staff and do all they can to ensure they keep patients safe and protect our GPs and health service staff.

Furthermore, I was personally shocked and saddened by personal attacks on Tom by some of our politicians and it is very important that medical leaders are supported to make brave, reasoned arguments and recommendations without being subject to personal abuse.

Empowering and caring for patients

The rest of my day was incredibly busy but enormously professionally satisfying. I ended up performing four home visits and supported many families who were in great need.

My consultations were a typical range of cases we see in general practice:

  • A man living alone in his 90s with advancing heart failure and a falling renal function.
  • A frail lady with terminal renal cancer where her cancer is well controlled, but one of her daughters has had to reduce her caring commitment due to her progressing interstitial lung disease.
  • A man with rapidly advancing pancreatic cancer quickly trying to put in place measures to support his intelligent and active wife who’s early onset Alzheimer’s disease will make it impossible for her to live alone unsupported after he dies.
  • A family who want to take their mother home from a care home as they can’t get to see her.

We see all these stories unfold in our surgeries and it is a true honour to be able to offer medical and human skills to help our patients navigate our sometimes-complicated health system and empower them to make the right choices for themselves and their families.

Supporting our LGBTQ colleagues

I was incredibly moved and proud to catch up on a BBC Spotlight programme this week on conversion therapy in Northern Ireland. The programme featured two of our GP colleagues, Dr Gareth Patterson and Dr Gary Adair-Gilliland, and I was so proud to see them stand up against conversion therapy and be so public about their personal lives.

RCGP is firmly against conversion therapy and is signed up to this memorandum of understanding (1.26 MB PDF) which was updated last year in line with changes suggested by the College.

Under the leadership of our colleague Dr Mark Holloway, RCGPNI also issued helpful guidelines on the treatment of patients from the Lesbian, Gay, Bisexual and Transgender communities.
In August this year, for the first time, RCGPNI was due to host a joint stand at Belfast Pride with the British Medical Association.

Ursula Mason and I were all set to take part in the parade to show our solidarity with colleagues from the LGBTQ community. Unfortunately, due to COVID-19, the parade was cancelled. But rest assured we will participate in this event as soon as it is reorganised.
I am immensely proud to be Gary and Gareth’s colleague and it is appalling that GPs still face additional challenges and barriers in life, based on their sexuality or gender.

I cannot imagine the difficulties some of our colleagues have faced over the years in revealing issues about their personal life, so if you identify yourself as a member of the LGBTQ community and are working as a GP in Northern Ireland please get in touch with me.

I would love to connect and see how we can help support you as a community of likeminded professionals. This invite is warmly extended to GPs who are not members of our College.

If these issues are important to you, then they are important to us, and we genuinely want to help, so please share this message with any GPs you know would benefit from our support.

COVID Centres

The regional COVID-19 Assessment Centres Board is due to meet next week, so if you have queries or issues you would like to flag about COVID centres please get in touch with me or your RCGP locality representative.

Data from the centres shows they are getting busier and, more worryingly, anecdotal evidence is highlighting that approximately 50% of patients referred to the centres are COVID-19 positive.

I feel this is a chilling statistic and highlights the importance of having a safe environment to accurately examine patients and to be able to offer basic treatments which they can take home, such as courses of antibiotics and steroids, to avoid a second journey to a community pharmacist.

The rotas continue to be as low as possible and we are indebted to our colleagues who work tirelessly as leads for these centres. 

Our practices have all been hit in one way or another by either GPs or their staff having to self-isolate or take time off for illness.

It is vital we make our teams as flexible as possible so please take time to talk to your team about what you would do if someone had to go off.

The College has some good resources including a Business Continuity Template which is worth looking at.

COVID-19 infection has huge implications when treated alongside other conditions and these resources on specific clinical management are helpful, with conditions such as Addison’s Disease and Asthma now covered.

RCGPNI team update

It is brilliant this week to welcome back from furlough our highly valued team of Michelle Newell (Membership & Events Manager), Fiona Monaghan (Membership & Events Coordinator) and Yvette Triggs (Office & Governance Coordinator) to our virtual office.

For too long, it has just been Jill Brennan (NI Manager), Clare Higgins (Policy & Public Affairs Officer) and I, so we are delighted to have the full team back in action!

I will be working hard with them to ensure you have full knowledge of, and access to, RCGP learning resources.

If you have any questions or suggestions, please don’t hesitate to get in touch with members of the team.

Assisted dying 

Last month, the Dignity in Dying Bill 2020 (581 KB PDF) passed through the second reading in the Dail Eireann in the Republic of Ireland, and has now moved to the committee stage.

Of note, the Bill on page five makes provision for any person over the age of 18 who lives on the island of Ireland and has done so for the past year. As it deals with broader social and legal issues, the Bill has gone to the Justice Committee as opposed to Health Committee.

The Bill, if passed, could have huge implications for GPs working in Northern Ireland, as our patients could drive a short journey to avail of these services.

This week, we linked in with Provost of RCGP ROI Faculty, Dr Diarmuid Quinlan, to learn more. The process of any change in the law is in the early stages, but I will keep you informed of further developments.

Post written by

Dr Laurence Dorman, Chair of RCGP Northern Ireland

Dr Laurence Dorman took office in November 2019 after three years as Deputy Chair of Policy for RCGPNI. A GP principal in Mourne Family Surgery, Kilkeel, Co Down, since 2007, he is the fourth generation of GPs in his family. He was also, until recently, the Chair of Newry and District GP Federation. 

Laurence has particular interests in new ways of working in primary care, cancer care, and inspiring the next generation of GPs. He set up the successful Dear Colleague initiative to improve the interface between primary and secondary care and has been a strategic advocate for interface and communication since September 2017.

During his time as Chair, he wants to support College members to ensure that the future of GP services is protected, supported and sustainable.

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