Update on the College’s response to recent shielding letter

30 October 2020

I would like to begin by firstly thanking Professor John Gillies and Drs Scott Jamieson and Graham Kramer for their blogs over the past few weeks. I’ve always been keen to open up my weekly blog to incorporate the voices of others from across Scotland, all of whom are doing fantastic and varied work which truly reflects the diverse nature of general practice as a profession.

In the coming weeks you will hear from more inspirational GPs about their own experiences and fields of interest, but this week I wanted to take the opportunity to write to you directly about work that is underway at the College. 

Shielding guidance

I am writing to the Cabinet Secretary for Health and Sport to express my disappointment about the letter that has been issued from the CMO office to those who were previously advised to shield during the first wave of COVID-19.

RCGP Scotland was not aware of the plans for this letter, which advises patients that they should speak with their GP to obtain a fit note if they still did not feel safe to return to work following a discussion with their employer about making the workplace as COVID-secure as possible.

The letter also contained information around vitamin D and flu vaccines. We were disappointed that GPs were not notified about this correspondence going out to the public, which in some areas has further fuelled public disgruntlement, through no fault of general practice. We are now (as we would have predicted) receiving widespread reports of the further and unplanned workload that this is generating.

I have been updating you all via my weekly blogs and Scottish Council on the very many government forums which I, and other College Officers, have actively participated in during this pandemic.

We have been very involved in co-creating advice and guidance which has gone out to practices and have provided extensive and constructive feedback on the initial crisis response and more recently on the recovery and redesign of services work.

We have prioritised collaborative working and made ourselves accessible for consultation around these issues, often at the expense of other key work. This makes the lack of consultation with us on the issue of how to best-support the ex-shielded group all the more frustrating.

Workload concerns

At the government meetings that I and colleagues have attended, we have consistently expressed our concerns over the challenges which general practice teams have been facing throughout the pandemic and especially now as we enter the winter months.

We are aware that for many, workloads have returned to pre-pandemic levels with staff absence and ongoing IPC measures resulting in reduced capacity within practice.

The impact on wellbeing and morale that another potential workload increase will have on our profession is significant, not to mention the longer-term impact on recruitment and retention in the profession, the secondary impacts this will have on the wider health service and of course, most importantly, on our ability to continue to provide high quality, safe and person-centred care.

Constructive engagement

While we cannot change the fact that this letter has now been issued, we will continue to constructively engage in how we mitigate against these unintended consequences, seek to influence and improve future communication, support GPs, and of course, support our patients.

I have requested to meet with the Cabinet Secretary for Health and Sport to discuss this and other key issues affecting the profession. We also met this week with our colleagues in SGPC who share our concerns and we are considering how we can support practices with this in as practical and efficient a way as possible.

Next week, I am meeting with the MDDUS to discuss some of the medico-legal complexities of the shielding work and the use of sickness certification, and I will of course keep you updated. 

Building the future of general practice

Last week, I was delighted to be able to attend the RCGP virtual annual conference 'Building the future of general practice'. It is always strange to do virtual speaking events, with our words going out into the ether, without any sense of how they are being received!

Like many of you, I really miss that sense of connection and the opportunity to meet up with friends and colleagues from across the UK, taking time out of our busy clinical lives to listen and learn and be inspired.

In this ‘new normal’ we were only able to catch up with colleagues over a virtual coffee, but there was still the opportunity to hear from a wide range of speakers and engage in some interesting debate. A silver lining of the digital format is the ease of being able to join these events, even from our consulting rooms, when previously travel and time have been significant constraints.

Despite the change in format, and the competing priorities of our busy working lives, the conference was very well attended, with 2,500 delegates signing up to attend and 1,500 online at any one time.

One of the afternoon sessions focussed on health inequalities which I contributed to, alongside Dr James Matheson and Dr Zana Khan, inspiring colleagues from the RCGP Health Inequalities group.

James set the context of general practice in deprived areas and specifically in the context of COVID-19, Zana gave a very powerful and personal account of racial disparities in healthcare and I spoke on ‘A compassionate road to recovery’.

From early next week all of the content from the day will be hosted on the RCGP eLearning platform and will be free for members to access.

I also recorded a short thought piece for the conference on the future of general practice.

The next online conference, A Fresh Approach to General Practice, will take place on 11-12 February 2021 and bookings are now open.

Post written by

Dr Carey Lunan, Chair RCGP Scotland

Dr Carey Lunan is a GP partner in one of Edinburgh's Deep End practices and is the current Chair of RCGP Scotland.

Prior to this, she held the role of Executive Officer for Patients and Public and Interface working. She also sits on the RCGP Ethics Committee.

Her priorities during her time as Chair include a focus on practitioner wellbeing, improving the interface between primary and secondary care, and growing and retaining the GP workforce.

She has made tackling health inequalities a high priority and has consistently called for the need to engage the public in a national conversation about the realistic role of the modern NHS and the importance of collective social responsibility.

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