Personal passions, urgent care and specialty advice

9 October 2020

"Damn Flanders!" exclaimed Homer. Last weekend, my boys and I were sitting on the sofa, roaring our heads off, all at Homer Simpson’s expense. Another incident had happened during the cartoon show which allowed Homer’s next-door neighbour, Ned Flanders, the opportunity to show off how perfect his family was, compared to the chaos of the Simpson’s home.

As a medical student, when reading the newspaper, my favourite bit was (and still is now) the obituary section. This is not a morbid fascination, but a genuine interest in the lives of other members of society. I was always bemused at the medical entries.

You can picture them now: flew spitfires in WW2, awarded medals for bravery, put himself through medical school and got first class honours, discovered an eponymous disease, became personal physician to the Queen while maintaining his (reflecting the attitudes at that time they were usually men!) concert grade piano skills.

I’m always fascinated when I meet GPs who have interests outside of medicine. My colleague Dr Lloyd Gilpin, the hugely respected Chair of Down Federation, built a hover craft from scratch before his GP registrar year.

He has practical handiwork skills that I definitely do not have! Dr Finbar McGrady is an international standard triathlete and we have numerous talented musicians including my predecessor Dr Grainne Doran who directs her chamber choir Canticulae and Dr Phil Cooke whose home music video posts on Facebook always cheer me up!

What are your passions outside medicine? When I was in university I was obsessed with the guitar. When working as a Senior House Officer I saved a lump of money and ear-marked it for installing central heating in my tiny house in Arthur Street, Hillsborough.

Unfortunately, my sensible plans came unstuck when I was in London sitting my Diploma in Geriatric Medicine, held in Royal College of Physicians headquarters near Regents Park (It is worth noting our own headquarters in 30 Euston Square are much nicer and well worth a visit!).

I had time after the exam to nip down to Denmark Street (aka Tin Pan Alley) where, in Hanks Music Shop, I met my dream guitar and subsequently blew my entire central heating budget on a 1959 Martin D-18. It is such a sweet-sounding instrument, so if any of you are into guitar and want to talk more about one of my favourite subjects, please get in touch with me.

At time of writing this I am mourning the death of Eddie Van Halen, so if you are a guitarist or music lover in general, you will understand.

Managing urgent care

The pace of change in our health service is rapid and your College is representing you at the highest levels to ensure your voice and the voice of general practice is heard loud and clear.

It is important to know that the No More Silos work, to review and reform urgent and emergency care, has now been formally endorsed by the Health Minister.

The outcome of this work will help ensure that, when we have patients who need their care escalated, there is a clear pathway which meets the needs of our patients and directs them to the correct place. This is frequently not Emergency Departments and we as GPs want to engage constructively with this work.

We are very grateful to our Local Medical Committee leads who have done some incredible work with their Trust counterparts in all five Trust areas.

All Trusts should now have embedded various pathways to help you when you need specialist advice so please look out for these now and use them as much as possible.

I personally feel that our secondary care colleagues are genuinely keener than ever to engage with us and help understand more the challenges we face.

Access to specialty advice

At the last meeting of the No More Silos network, where RCGPNI have a seat, I had a good discussion with Dr Donagh McDonagh.

We are lucky as a profession to have dedicated GPs like Donagh who ensure IT systems, like our Clinical Communication Gateway (CCG), function smoothly and helps ensure our referrals have robust audit trails and can be clearly followed. The 'advice function' of CCG is a new one and has been very successful in some specialties.

CCG is a relatively old technology and we have been able to highlight that one of the significant drawbacks of CCG is that the information only goes one way.

We all know that one-way conversation is sub-optimal, so we will continue to represent your interests with commissioners to facilitate the best ways we can communicate with our colleagues in secondary care.

Can you be more 'green'?

One of the benefits of our new digital approach to life as a whole during the pandemic is its undoubted positive environmental impact. I am making fewer car journeys and have reduced my own use of paper. Have you ever considered how to make your practice greener?

I have often thought about metered dose inhaler (MDI) recycling schemes and there is a great website which has links to support you do this and provides other general tips to make your practice greener. If you have developed a new environmentally beneficial way to run your practice, please get in touch and we can share best practice together.

Environmental issues are always robustly debated in RCGP Council and while we all want to reduce our emissions, practical considerations are heard from members working in very remote areas (such as North Scotland) who cannot simply stop using diesel powered cars quickly.

Northern Ireland Confederation 2020

The annual Northern Ireland Confederation (NICON) conference was held virtually this year for the first time. I presented our Interface Principles (791 KB PDF) to NICON in 2019 and felt it was like the Balmoral Show of healthcare!

The virtual event worked very well, and it was a real honour to present at a clinical leadership session chaired by Sarah Rutherford, Medical Student Chair NI Health Leaders Forum. It was great to have the opportunity to state why I came into medical leadership and why I feel general practice is something worth celebrating.

When it comes to topics I love to talk about, general practice even pips my love of guitars! Are you considering leadership or have questions you want to ask? Please get in touch with me and I would be happy to share my personal experiences.

I also represented the College in a panel session about the role of COVID Centres.

As you know, the College endorses the principle of COVID Centres and separating 'hot' from 'cold' so we can keep patients and practices safe. However, the model does not come without its challenges. I was particularly keen to emphasise the workforce pressures in general practice and highlighted our rapidly increasing workload as winter approaches.

First and foremost, GPs must be supported to provide core services and we have urged the Department to consider how additional support might be redirected to support COVID Centres if the virus continues to rapidly spread and staffing becomes even more difficult.

Abortion services

On Tuesday, Ursula and I met with Len Allamby, Chief Commissioner from NI Human Rights Commission, to discuss the provision of abortion services in NI.

As I have mentioned in previous blogs, women can self-direct to Early Medical Abortion services using the central phone number provided by Informing Choices NI on 028 9031 6100. Currently, the Department of Health has not commissioned Trusts to provide services and last week, the Northern Trust withdrew its provision.

Are you a GP in the Northern Trust and have patients who have been affected by this decision? If so, please get in touch as it is important that there is equity of service to patients across the entire region.

Primary care data

Throughout the NICON conference it was gratifying to hear from so many sectors about the importance of good primary care. Our practice data has been a vital resource in the overall response to the pandemic.

How we collect data to send back to HSCB will change slightly next week so please familiarise yourself with this important change and ensure we are playing this vital role. Please check your emails from HSCB - this is very important.

Assessment of children

We have represented you through various media on how general practice is still open and the challenges this presents.

One of the areas which concerns me the most is the safe assessment of children. Dr Karl McKeever, Clinical Director at Belfast Trust, has linked into the No More Silos group and right across the country there should now be good access to paediatric hubs.

Frequently these will offer a much better service than was offered through normal outpatient service before COVID-19.

Please contact your local paediatric colleagues to learn more about how to access these and share with us any good experiences or tips. RCGP has developed new guidelines for assessing children (513 KB PDF) and you can access them on the website.

Safely managing children in primary care is an enormous responsibility so please make every effort to safety net and ensure all children in contact with our services are as safe as possible.

Thank you

Our passions outside medicine are important as they ground us in the real world and ensure our minds remain sharp and focused.

I feel they are vital to maintaining our resilience so please don’t neglect them during these busy and difficult times. While we can never emulate the achievements of the various famous obituary doctors I used to read about, please take time to acknowledge the great job you are all doing at the moment.

Whether you are leading your practice team or working in out of hours, we all have a leadership role to play and as your colleague I thank you all for your amazing dedication and skill. 

General practice is definitely the best profession in the world to be part of and something I will never tire of shouting about!


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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