I wish you all as Whitty a Christmas as possible from all of us at the RCGP

18 December 2020 

Chris 'next slide please' Whitty has an admirable talent for puncturing political bombast. 

Speaking at a Downing Street briefing earlier this week the Chief Medical Officer for England delivered pragmatic advice about family gatherings over the Christmas period. Keep it small, short and local, he dryly advised the British public. 

I suspect many GPs breathed a collective sigh of relief at this display of common sense from the Centre. More than most parts of society, over the last year we have seen first-hand both the risks of unrestricted spread of the COVID virus and the risks of lockdown in our communities. We know it’s not easy but we know action is required.

General practice has acted thoughtfully and swiftly. We have radically changed our model of providing care in order to keep patients safe, prioritised our most vulnerable patients, managed an unprecedented level of ill-health and distress, and are now delivering not one but two large scale immunisation programmes. If all goes to plan, the COVID vaccination programme being led by general practices across the country will result in the return of some kind of normality to our communities by the spring.

For all of that, on behalf of the College, I want to thank you. You and your teams have been truly remarkable, a credit to your communities, the NHS, and to our specialty. 

And I wish you all as Whitty a Christmas as possible from all of us at the RCGP.

Latest updates from your College

COVID vaccination in general practice

It has been a momentous week for the profession, with the start of the roll out of the Pfizer/BioNTech COVID-19 vaccine in general practice on Monday - initially at 100 sites, and now thought to be about 250 sites across England. 
Thank you so much for your commitment and dedication to deliver the programme. I know some of you won’t have felt able to take part given other pressures. And I know that some of you who did volunteer have had frustrating experiences. But thank you for doing what you can and sticking with it - and please be assured we are conveying the issues you are raising with us to NHS England. This is an enormous challenge for the profession, particularly given the logistical issues associated with the Pfizer vaccine, but I have no doubt that our skills, experience, and resilience will prove invaluable to the success of the overall programme over the coming months.  
On Tuesday I did my first shift at my practice’s COVID vaccine clinic in East London, administering the vaccine to patients, as you can see in the Guardian from Wednesday. It really was amazing to see learning in action - of course, we started slowly and there were teething problems, but we adapted and gained pace as we went along. I know from social media other practices had similar experiences - do share yours using #GPCovidJab.
Overall, we’ve seen an encouraging start to the vaccination programme with 108,000 vulnerable patients vaccinated in England, and 138,897 across the UK - that’s not including the GP figures, which I hope we’ll start receiving soon, along with data on who has had it, how many vaccines have been 'wasted' - and news of when new supplies will be arriving.
It is so important that the COVID-19 vaccination programme works, and I’m so proud of the role general practice is playing and will continue to play. I’ve been flying the flag for the profession in the media this week, speaking to Sky News (twice), BBC, LBC and Times Radio - and featuring heavily in the national and international press. Read our full response to the rollout.

Long COVID guidance

The College has been collaborating with NICE and SIGN to develop clinical guidelines to help and support GPs and other healthcare professionals in caring for patients suffering with long term symptoms of COVID-19. These guidelines were published today - alongside an information booklet for patients to help them understand and manage the condition (504 KB PDF).

This has been a rapid but vital piece of work. We know from our practice just how pronounced an issue long-COVID is - and the Office for National Statistics this week published data showing around 186,000 people in England are living with prolonged symptoms of COVID-19.
The guidance separates 'long COVID' into those with 'ongoing symptomatic COVID-19' (those who have had symptoms for four weeks or more) and 'post COVID syndrome' (those who have had symptoms for 12 weeks or more). 
We’ve listened to both clinicians and patients, and developed this guidance based on what we know. But COVID-19 is a new virus, and long COVID a new illness, so there is still a lot we don’t know and as more research is done, these guidelines will need to be updated. Thank you so much to Gail Allsopp, clinical lead for policy, for her leadership on behalf of the College in this area.
I’ve been speaking about this on Sky News, BBC Breakfast and the BBC News Channel, and Gail has spoken to Times Radio.

Joint Committee on Vaccination and Immunisation letter

Several weeks ago, the College wrote to the Secretary of State and the JCVI asking why people from Black, Asian, and minority ethnic communities were not included on the COVID-19 vaccination priority list.
We have since received a response from the JCVI, stating that the list will remain under review - but also highlighting that the current priority list allows for GPs' own judgement when inviting patients for the vaccine.

It also acknowledges the importance of accounting for health inequalities during promotion of the COVID-19 vaccine - and we have added our weight to this, calling for public messages to be tailored to different communities, in order to encourage people to come forward for their vaccine when invited.

Daffodil Standards

I’m pleased to share an exciting development to our hugely successful Daffodil Standards programme launched last February in partnership with Marie Curie, which one in six practices are now signed up to. The aim is to provide a self-assessment framework to support GPs and their teams to provide the best possible palliative and end of life care to patients.
We’ve now enhanced this programme with a ninth standalone 'Daffodil Standard' to support GP teams when providing palliative and end of life care specifically to elderly patients living in care homes.

'Daffodil Standards for Elderly People Living in Care Homes' is a free quality improvement tool that has been co-developed with frontline GPs, patients and their families, members of the multi-disciplinary practice team and other relevant care providers. It consists of two levels - the first looking at processes in place and the second looking at whether these deliver what patients and their families want and need.
The Standards are free to sign up to and available as a downloadable self-assessment tool.

Integrated Care Systems survey

The College is collecting views from GPs to shape our response to the NHS England and Improvement consultation ahead of the forthcoming NHS Bill which will attempt to introduce a more integrated care system.

We know that you have been working hard to deliver the best care for your patients and community. For that to continue, as we move away from the immediate crisis and into recovery, GPs must be enabled to shape the systems in which we deliver care.

Please fill out this short survey to help us make sure GPs can do what they do best.


It’s excellent to hear that the PRINCIPLE trial now has more than 2,500 participants and rising fast. More than 1,000 GP practices across the UK are set up to recruit into the study, and it is good to see a large proportion are RCGP Research Surveillance Centre (RSC) practices. 
The trial has just started a new arm, investigating inhaled corticosteroid (budesonide) effectiveness in early COVID-19 illness. There is a desperate need to identify effective treatments for early COVID-19 in a primary care setting and I would encourage you to identify potential patients. The trial is eligible across the UK to people aged over 50 with certain comorbidities, or anyone aged over 65. Potential participants can be recruited by their practice or signposted to the study by their GP, pharmacist or care home or even refer themselves. 
Details on registering a practice can be found on the PRINCIPLE trial website.

Gender pay gap

You’d be forgiven for missing the publication this week of Mend the Gap: The Independent Review into Gender Pay Gaps in Medicine in England (6.28 MB PDF), commissioned by the government in 2017.

The review’s findings are stark, with a headline gender pay gap for GPs of 33.5%. These findings present a real challenge to general practice, so it’s disappointing that the report attracted such little attention. 

The College will work with national bodies, practices and others, building on the report’s recommendations to address the root causes of the gender pay gap, and build a workforce which is fit for the future.

Consulting in a nutshell

Our consulting rooms are more pressured places than when most of the existing consultation literature was written, given the shortage of time and resources, and the need for trainees to pass their MRCGP. 
Former RCGP President - and giant of general practice - Roger Neighbour has simplified the approach to consulting in his new book 'Consulting in a Nutshell'. 
Roger is renowned for his legendary 'Inner trilogy' starting with the 'Inner Consultation' - a must have for any GP. His latest book on consulting is a particularly useful read for GPs in training, and those starting out in their careers. His approach is easy to understand and learn, yet flexible and robust enough to cope with contemporary stresses and remote consultations.

See further information on the book and purchase availability.

Roger’s Big Interview in GP Frontline from April is still available.

RCGP member portal improvements

We’re making improvements to our member portal, which means your account will be unavailable from today until 16:00 on Sunday 20 December. Between these times, it will not be possible to book a place on RCGP webinars and events.

You can still access eLearning and the trainee portfolio during this time.

If you attempt to log into your member account during this time, you may see an error stating "Your username and password is incorrect". Please do not attempt to reset your username or password.

Apologies in advance for any inconvenience caused and thank you for your patience.

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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