Visit beautiful Fermanagh!

4 December 2020 

Thank you all so much for the incredible care you are all providing to our patients. I have been speaking to many of you and I know how tired we all feel. 'Frazzled' was the great word one of our colleagues recently used.

It has been such a difficult year, but despite this I keep hearing wonderful accounts from patients about the personal, professional and special care you have been providing.

It is amazing to be a member of such a talented and dedicated group of professionals - thank you.

Meeting with Finance Minister Conor Murphy

On your behalf, Dr Ursula Mason and I met with the Finance Minister Conor Murphy on Tuesday. We took the opportunity to highlight issues which we view as cross-departmental.

It was great to highlight the implementation of Multi-Disciplinary Teams (MDTs) as a key way of addressing health inequalities across the entire region and to emphasise the importance of committing full, recurrent funding. This will allow the model to be introduced across the entire region and become embedded as the new normal of how services are provided to our patients in the community.

I was pleased to have the chance to highlight to him the sometimes less well recognised aspects of this strategy such as proactive work by social work assistants, collaboration between the community and voluntary sectors and the commitments to increasing district nursing and health visiting staff.

We also discussed our ever-growing waiting lists which are impacting so negatively on our patients’ lives. Ursula provided an update on her experience as Chair of South Belfast Federation and shared the results of a recent survey of Belfast GPs’ working experiences.

Unsurprisingly, waiting lists were top of their list of issues which affect patient care and we were able to highlight how general practice has innovated through our Elective Care work, providing services such as vasectomy, family planning and dermatology in the community.

Again, recurrent funding will be required to make this a reality and the meeting was an excellent opportunity to highlight how general practice should sit at the forefront of our health and social care. .

Loneliness Strategy

Do you remember the days before the pandemic when patients booked face-to-face appointments? One of the frequent scenarios I experienced was when after several appointments and with no obvious pathology detected, it became apparent that my patient was lonely.

Loneliness is pervasive in our society and has undoubtedly been exacerbated by the restrictions in social contact. It is an important health issue in its own right as lonely people have a 50% increased risk of early death compared to those with good social connections - making it a comparable risk factor for early mortality to obesity.

Over the past few years, previous RCGP Chair Professor Helen Stokes-Lampard highlighted this issue throughout her three year tenure, most memorably at our Annual Conference in 2017 with her description of 'Enid Based Care'.

We are proud to stand with other significant charitable and statutory bodies to raise awareness of this issue. We view general practice as well placed to meet the needs of our patients who experience loneliness, but we must be resourced to address this. In our view, longer appointment times and MDTs rolled out in full to all our practice teams will be a good start.

Next week, the Campaign to End Loneliness will be launching its new report on loneliness in Northern Ireland, and we will be taking action to call for a Loneliness Strategy for NI. To attend the launch event, you can register online.

Visit beautiful Fermanagh!

The years after I gained my CCT, I literally followed my nose to work in different and interesting places. It helped me develop enormously as a doctor to see how other practices worked and delivered their patient care. 

Last week, I had a very helpful meeting with Dr Paul Bradley, Chair of South West Federation, and his colleagues to hear first-hand the challenges facing GP practices in Fermanagh and the South West. Like many rural areas, it has been very difficult for Paul and his colleagues to attract GPs to work in their area. 

We were able to highlight the South West as a case study to the Finance Minister and it was sobering to hear that an audit comparing contact rates from November 2019 against November 2020 showed one practice providing 19% more contacts.

We are all aware that telephone and remote working does not necessarily make for shorter or quicker appointments, so it would be good to hear if you are experiencing similar demand increases. Please contact me and share your experience.

I regret never working in the South West area - I simply ran out of time! Knowing the GPs and practices in that area, I know it would be a very exciting and rewarding area to work in. The roads infrastructure has improved vastly over the past 10 years and I am aware that two of our GP colleagues commute from Portadown. 

Many of the practices in the South West are very innovative with links to their communities and are involved in medical education - hosting one of the Sub-Deanery pilot schemes. If you are working as a sessional GP and always fancied experiencing working out West, please get in touch and we will link you with Rachel Forbes from South West Federation for more information. Once you do, please share your experience with me. As a special enticement, I promise to pay for your lunch if you work there for the first time!

COVID-19 vaccine

The imminent arrival of the COVID-19 vaccine has given our entire country hope and we will rise to this challenge if we are supported to do so. 

On Tuesday, Dr Alan Stout and I met Patricia Donnelly from the Department of Health to discuss the roll out of the COVID-19 vaccine. It was a very helpful and encouraging meeting. There are no final decisions made yet, as much depends on vaccine stocks, but it looks like general practice will not be required to deliver the Pfizer vaccine and instead will concentrate on delivery of the Astra Zeneca vaccine, once approved by MHRA. 

This is welcome, as the storage and reconstruction of the Pfizer vaccine will be very difficult to deliver. You will have received information from HSCB about identifying our over-80 patients and to start getting ready for a 4 January 2021 commencement date. 

Patricia was most helpful and has indicated that the Department has a good link with the Emergency Planning Committee. 

This group have very good links with councils and the voluntary sector, so if you feel your practice would benefit from their use please get in touch as per the HSCB letter. If you have difficulty please contact us in the office and we will ensure you are directed to get the support you need. 

Republic Of Ireland Faculty Winter Meeting

It was fantastic to virtually travel to Dublin on Saturday to share experiences with our ROI colleagues and to hear the winning entries from the Sheppard Memorial Prize. 

The undergraduate prize was won by Anita Lucey, who shared her experiences working as a GP Receptionist and how difficult a role that had become during the pandemic. Our practice teams are so reliant on our reception colleagues, so it was interesting to hear Anita’s experiences. 

She highlighted that many staff value the opportunity to be part of a team and influence how the practice care is delivered so it emphasises to us all to involve our reception teams.

Read more about the winning awards.

Have you innovated how your reception staff deliver care? I am very keen to reach out to our Republic of Ireland GP colleagues and we can easily establish a Zoom meeting. Please get in touch so we can share your experiences.

Support for AiT members and interesting educational events

Are you an AiT who is interested in shaping the future of general practice? As 2020 ends, we want to sincerely thank Dr Katie Henderson for her work as AiT representative over the past year. 

We wish Katie every success in her career and look forward to sharing her successes. As a result, we are currently recruiting for an AiT representative to advocate on behalf of trainees in Northern Ireland. You will have a voice both locally and nationally to influence the trainee experience and input into tailored RCGP events and trainee needs/gaps in the member offering. Find out more (37.5 KB PDF). Please contact Fiona if you have any queries.

An upcoming webinar in January looks very interesting and will be of huge use to our AiTs and training doctors on 'How to read an RCT paper: All you need to know to be able to understand RCTs' by Professor Michael Harris. There is a small fee to join but it would be excellent exam material. Book your place.

We also are delighted to be collaborating with British Liver Trust to deliver a free webinar on Liver disease. This will be held on 14 January from 19:00 - 20:00. Please ensure you secure your place.

The management of heart failure has changed dramatically since I worked in hospital and Dr Patricia Campbell is holding a virtual meeting on Wed 16 December between 19:00 - 20:00. As well as being a renowned international expert in heart failure, Patricia is an excellent and engaging speaker and is very keen to engage more with primary care and see how we work best together so I can recommend her greatly. To register please email Joanne Fitzpatrick.

If you are interested in the international aspect of general practice, it’s worth looking at this 'Principles of Primary Care International CPD' course from University of Exeter. Of note, there are fully funded scholarships to attend and applications close on 15 December.

Are you aware of the free educational resources we provide as part of your membership? Published quarterly, our Essential Knowledge Updates (EKU) take GPs through new and changing knowledge areas to support you with your CPD and revalidation. Have a look at this short video, or read more on our website.

Thank you to our out of hours colleagues

I hope you all get some well-earned rest over the weekend. Thank you to all who are working in out of hours or Covid Assessment Centres. Of note, the ADASTRA system will be down across NI on 8 December. 

CCG referrals will still be accessed as normal but because the receiving clinician will not have access to NIECR, it is even more important we share good handover letters with our colleagues - ideally with your own personal mobile number just in case more information is required.

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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