Has our wellbeing taken a backseat during this crisis?

24 April 2020

COVID-19 and the ways we are living during this pandemic will undoubtedly have an impact on our patients’ mental health, particularly our vulnerable patients who are on the NHS shielding list.

Earlier this week I conducted several routine telephone consultations for patients on our practice shielded list and all of them were physically well but bored out of their minds.

With the enormous pressure we’re under, this pandemic’s impact on mental health and wellbeing isn’t reserved for our patients – it can extend to us as well. It’s true what Ian Wood, First5 Committee Chair, said in his interview in the latest GP Frontline magazine: “healthy doctors equals healthy patients”.

With this in mind, I wonder if our wellbeing has taken a backseat during this crisis? Caring for patients will forever be our priority but isn’t the best way to do so to also care for ourselves?

The practicalities of taking care of ourselves at the moment are tough, which is why we’ve developed several Wellbeing Resources within our COVID-19 Hub and we continually build on these resources so do try to regularly check in.

RCGP wellbeing campaign

We’ve also launched #RCGPTogether, led by Vice Chair Mike Holmes, a campaign aiming to promote and celebrate wellbeing for members, colleagues across the NHS and patients.

This is difficult time for everyone, and a sense of togetherness will help us all get through it.

#RCGPTogether focuses on appreciating colleagues. I’d encourage everyone to share stories of the great work being done in general practice. This is such a unique time and raising awareness of general practice’s amazing response to this pandemic will be key to uplifting all our moods.

It encourages us to consider and talk about our own wellbeing. We encourage our patients all the time to talk about how they feel and take steps to look after themselves, and #RCGPTogether aims to support us to do the same. 

It also aims to foster a sense of community across social media using the #RCGPTogether hashtag. Now more than ever I’m thankful to have so many levels of community, whether that’s across the wider NHS, general practice or with our College members.

In a similar vein, yesterday an individual coaching support for primary care was launched and the hashtag #LookingAfterYouToo is being used to connect us all. We’re proud to have contributed to this project which was led by NHS England.

End of life care lobbying

Elsewhere, you might have also seen that we’ve been lobbying the Home Secretary Priti Patel this week, urging her to relax some of the laws around controlled drugs so that we can make more efficient use of drugs, such as morphine, at this time of high demand to allow our patients at or nearing the end of their lives during this pandemic the dignity and care they deserve.

Read our letter, which was covered by Channel 4 News and the Financial Times. I’m very grateful for the expertise of our Palliative and End of Life Care Lead Catherine Millington-Sanders for raising this issue and advising us throughout this important piece of work.

I’d also like to draw attention to the new Guidance for Remote Verification of Expected Death (VoED) out of hospital, developed with colleagues at the BMA, which is now up on our COVID-19 Hub. While some of the media has seen the complexities around this topic as controversial, we all know that death is simply is a part of our role. The guidance is a sensible move aimed at reducing delays and distress for families, as well as minimising risk of infection for doctors. Thank you to Joint Hon Sec Victoria Tzortziou-Brown for leading this work.

Free COVID-19 webinars

As well as resources on our website, we are also beginning to hold a series of free webinars. Our first one is titled COVID-19: Patient Assessment the role of physiology and oximetry and is next Wednesday, 29 April 2020, 13:30 – 14:30. It’s being hosted by Joint Hon Sec Jonathan Leach, Clinical Lead for Acute Deterioration and Sepsis, Simon Stockley, and Alison Tavare of the West of England AHSN who will be doing a Q&A after their presentation. Find out more.

Resources for locums

Our COVID-19 resource hub is being updated regularly and we’re keen to ensure it includes information, advice and guidance for all our members. I’ve had several queries from locum GPs about guidance specific to them – and whilst most of our existing guidance is relevant, we’re looking for opportunities to create content that will be unique to locums. If you have any ideas, get in touch. Locums fulfil an important role as part of the general practice workforce and they are contributing to addressing the COVID crisis in a number of ways, including working in the hot hubs.

Supporting trainees

In my last blog I spoke about another vital cohort of our membership, our trainees, some of whom are going through a particularly tough time at the moment with uncertainty as to where they stand with their training programmes.

As I wrote last week, the College Officers and I are in daily dialogue with the many organisations involved in the delivery and assessment of GP training to try and reach a speedy solution that will support our trainees without compromising patient safety.

I wrote to all trainees with an update yesterday and this afternoon, we took part in a meeting of the key stakeholders including HEE, the Devolved Nations, the GMC, DHSC and the BMA.  Anthony James, Chair of the College’s AIT Committee, was also there to represent trainees. We are working collaboratively to find a solution and were able to identify a number of options which will enable trainees to be assessed and to meet the necessary regulatory requirements, and which we will now develop further.

We appreciate that this is a hugely worrying, and frustrating time, particularly for our ST3s who were due to get CCT over the next couple of months.

Unfortunately, many of the decisions that need to be made are completely out of the College’s hands, but the concerns of our trainees are paramount, and we are doing everything we can to resolve this complex situation as soon as is possible.

Face masks and the media

Finally, I’d like to clarify my comments on Radio 4's Today Programme yesterday about the public use of face masks. Official guidance still suggests that there is little benefit of mask wearing amongst the general public and that research shows that people wearing masks do reduce their compliance with other hygiene measures over time. As an academic body, we are of course happy to be persuaded by emerging research and evidence. However, we still believe that the use of face masks - and the right type - should be reserved for frontline health workers.

It’s quite a challenge to get simple messages out through the media about complex issues and I’m sorry if I caused any consternation amongst those with strong views for or against the use of masks by the public. It isn’t always easy to get it right in the heat of the moment!

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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