Helping shape the future of general practice

3 July 2020

This week has seen a lot of discussion regarding the future shape of general practice in Wales.

Mair and I have spoken with the National Director & Strategic Programme Lead for Primary Care and the Chair of the General Practitioners Committee, Wales to ensure the College is at the forefront of the debate.

We also had the opportunity to meet with Vaughan Gething, the Minister for Health and Social Care, this week and I’d like to update you on what we talked about.

Ministerial meetings

The College meets with the health minister on a six-monthly basis.

Rarely though has there been quite so much change in between our meetings. Sitting down with Vaughan Gething MS in January now feels a world away.

We identified four priority topics we wanted to discuss during this meeting and I’ll address each one in turn.

Unscheduled care

At the start of the pandemic, in this country there was very much a UK government-led approach, but as the lockdown period has continued, we have increasingly seen marked variation in approaches, between the four nations.

Each reader will come to their own conclusions on which approach is the most effective, but at the College we have adapted to the changing landscape.

One area where there does appear to be a different debate in each nation is over the model to be adopted to account for unscheduled care post-COVID-19.

In England there has been talk about an enhanced 111 telephone service and we were keen to learn more about the approach to be taken in Wales and the impact it would have on the workload of GPs.

While not entirely ruling out a similar path in Wales, it was clear that it was not the minister’s preference.

He is keen that any solution in Wales is fit for the future, and not just the immediate challenges of winter pressures, and a possible second wave, and that the focus should be on the existing NHS 111 service, which has proved that it can expand to meet clinical need.

Technology

The Welsh Government must be tired of hearing us talking about e-prescribing. It has been on our meeting agendas for some time.

I regret to inform it that this will stay on the agenda until we see progress. It was encouraging that the minister indicated this was a priority and invited us to discuss it further with the Deputy Director of Primary Care.

We will continue to push for a clear timeframe for the roll-out. The College believes this is deliverable by mid-2021.

Few aspects of the change over the last six months has been as marked as the roll-out of remote consulting. On balance this has been very successful and for some GPs it has opened up new ways of working they will be keen to maintain post-COVID-19.

However, one issue I do hear regularly from our members, is a concern that remote consulting must be seen as an option alongside traditional face-to-face consultations and not as a replacement.

Such technology is not appropriate for every consultation or every patient and it is important that we keep a range of consultation methods available.

The minister took this point on board and appeared to understand our concerns over the limitations of placing too much emphasis on the remote option.

Inequalities

Mair addressed our concerns about the exacerbation of inequalities due to the pandemic and this led to a wide-ranging discussion over both health and non-health contributory factors to the wellbeing of our patients.

To GPs, these issues are second nature and it is important to place the work of GPs and their teams in this broad context in the eyes of government, rather than simply allowing ministers to see us as only a provider of care at the point of need.

We can play a huge role in the overall aspirations for a healthier society.

Reconfiguration of general practice

On the topic of the reconfiguration of general practice, we were keen to get across the importance of continuity of care.

This is an issue which can sometimes lack the prominence it deserves in the rush to achieve access targets but is hugely beneficial to the patient.

Mair also explained how valuable professional and practice development was for GPs and their teams. We believe there is a need to provide protected time for this development.

Our next scheduled meeting with the minister is in January 2021, I wonder how the world will look then?

Needless to say, we’ll be in very regular contact with the Welsh Government in the meantime to help shape the future of general practice in a way which works for our members and our patients.


Post written by

Dr Peter Saul, Joint Chair of RCGP Wales

Dr Peter Saul qualified in 1985 and currently is a partner in Rhosllanerchrugog near Wrexham. He combines his work in the practice with his other professional passion of medical education, in the role of Associate Postgraduate Dean in the Wales Deanery. He also works one session a week running the Paediatric Allergy Clinic at Chester Hospital.

Peter has been an active member of his local RCGP faculty, serving as Chair and as Treasurer. He is also actively involved with the media, with a medical column in the local newspaper and as a regular radio contributor.

For fun he rides a bike (his favourite being his red Brompton), and when in need of a loftier perspective he flies his part owned light aircraft from Welshpool Airport. He lives on a smallholding and has three grown up children, one of whom is a junior doctor in London.

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