The job of a GP will become ‘manageable’ again, College Chair Martin Marshall tells members as he steps down

Professor Martin Marshall steps down as College Chair today after three years.

Speaking to the College’s Annual General meeting, he reflected on his experience of leading the RCGP through the turbulence of the pandemic. He said that the College would continue its work to make the job of being a GP ‘manageable’ again and to ‘return to a time when GPs can deliver the best quality, personalised care that our patients need without a detrimental impact on our own health and wellbeing’.

With the College set to mark its 70th anniversary this Saturday (19 November), he said the College’s mission remained the same as in 1952: to deliver compassionate care with knowledge. 

You can read the speech in full below.

Professor Marshall is succeeded by Professor Kamila Hawthorne, who works as a GP in the Welsh valleys, and is the first South Asian female Chair of the College.

AGM Chair’s report, Professor Martin Marshall

Good morning everyone. As I demit office my first reflection is gosh, doesn’t 3 years pass quickly!

The privilege of leading your own College and your own professional body is afforded to relatively few people and when I decided to stand for election, I thought long and hard about what I wanted to achieve during my tenure if elected.

Little did I realise when I stood here in 2019, just how those three years would unfold.

I remember in early 2020, when the size and scale of the pandemic was becoming scarily apparent, I turned plaintively to one of my fellow officers, who will remain nameless, and said that I didn’t want to be known as the ‘Pandemic Chair’ when I had so much else I wanted to achieve.

His response was ‘you will be, get over it’. Wise advice – and I followed it.

In terms of what the College has achieved over the past three years, you could argue that surviving the pandemic was an achievement in itself. But we’ve done so much more than that, we’ve thrived, we’ve supported our members and general practices through one of the toughest periods since the College was established, and we’ve come out a stronger organisation.

And history will judge general practice to have played a fundamentally important role through the pandemic. We had to dramatically change our model of delivering care but we kept the service running, we rose to new challenges and new conditions like Long Covid, and there is no doubt that without the expertise, experience and organisational skills of GPs in rolling out the Covid vaccination programmes, the return to ‘normal’ would not have happened, or at least not as quickly – as publicly acknowledged by Chief Medical Officer for England Chris Whitty and his counterparts in Scotland, Wales and Northern Ireland.

I’ve spoken countless times about how the College reacted quickly to support our members – and indeed non-members - on a practical level by launching new resources such as our dedicated Covid hub and providing more ‘pastoral’ support, including an online communities forum and our GP Live events' series. We wanted to keep GPs connected with the College and with each other during the unprecedented challenges we were all facing. Our Faculties continue to have a strong focus on GP wellbeing as part of the CPD and events portfolio they offer to their local members.

And of course, the College demonstrated its agility in devising and implementing the new Recorded Consultation Assessment, enabling thousands of trainees to CCT as planned and join the workforce.

When some politicians and certain parts of the media launched undeserved attacks on general practice over face to face appointments, we rebutted those stories and explained why changes were necessary. In three months alone, the College featured in over 10,000 news articles and on TV and radio programmes hitting back at the media attacks and drawing attention to the pressures that GPs are under.

Covid was a massive challenge but we know pandemics pass. The bigger challenge for all of us has been the workload crisis in general practice, a crisis that has been building for over a decade and which is to a large part a consequence simply of rising need and demand for general practice services and inadequate investment in those services. This is a crisis which is clearly impacting on patients directly and on the mental and physical health of GPs and our teams. It is a crisis that has reoriented the main role of the College from pushing for higher standards in clinical care for patients, to supporting practices to adapt and change.

In May, we launched Fit for the Future: a new plan for GPs and their patients to put pressure on politicians and decision makers in England to commit to providing GPs and patients with the support we need. It follows our 2019 Fit for the Future (PDF file, 1.1 MB) vision which set out how, with the right tools and support, we can revitalise and reform general practice by 2030, so that we can continue to deliver world class patient care.

Under the Fit for the Future ‘umbrella’, we have now released three hard hitting policy reports including one on Retaining the GP Workforce. It analyses what we know so far about the retention crisis and puts forward key recommendations for government. As a consequence, last week NHS England announced a review of recruitment and retention schemes, which is a positive step and we will engage with this.

In August, we called on government to change the visa rules for overseas GPs - 4,367 GPs signed our open letter to the Home Secretary; 543 IMGs and 149 practices told us about their experiences; and over 150 members of the public wrote to their MP on the issue.

Using the stories our members have shared with us, we launched our ‘Fit for the Future Opening the door to international doctors’ report. Thanks to our campaigning work, we have gained traction in Parliament and the Immigration Minister has announced that the Home Office is prepared to consider new sponsorship arrangements, which is hopefully a step in the right direction. At a time when a growing number of international medical graduates are entering general practice, this is such important work for our College.

Just a few weeks ago, the Health Select Committee report on the future of general practice was published. The result was another fantastic result for our influencing work.

It includes a wide range of recommendations that we made in our written and oral submissions, and support for many of the solutions we have been calling for to tackle the unsustainable pressures general practice is under, and the importance of ensuring GPs are able to build strong and trusting relationships with patients.

After an unprecedented level of change at the top of Government over recent months, we are working hard to try to build relationships with the new health Ministers and their teams.

Of course, the College’s lobbying activity spans the UK and I wish to acknowledge the work of David Shackles and Chris Williams in Scotland, Rowena Christmas in Wales and Laurence Dorman who recently stepped down as Chair of the College in Northern Ireland in robustly representing their members within their own administrations. A very warm welcome to our new Chair in NI Ursula Mason, who we hope will see a more sustained government during her tenure than her predecessor.

Covid and the workload crisis haven’t completely dominated our work for the last 3 years. As a team we’ve used both as catalysts to take forward several of our 2019 College priorities. In particular, I’m proud of the extent to which we’ve put the importance of trusting relationships between patients and their GPs back on the agenda at a time when care is becoming increasingly transactional. We’ve also promoted both the current contribution and the potential of general practices to improving the health of their communities by addressing the social determinants of health and growing inequalities, essentially restating the commitment of previous college leaders like William Pickles, John Fry and Julian Tudor Hart.

I was delighted to have an opportunity to deliver a keynote speech, run a conference session and launch a new report on RBC at the hugely successful 27th WONCA Europe/RCGP Annual Conference in June. The event surpassed all our expectations, with over 2800 delegates from 79 countries attending the event in person and over 300 remote participants. The packed programme included Professor Victoria Tkachenko, who joined remotely from Kyiv and gave an impassioned address about the challenges of trying to deliver care in a war zone.

And whilst focusing on our mission, to improve care for patients, the College continues to develop as a progressive membership organisation, including our ongoing Member Value Proposition work which has given us more insight into the needs of our members at all career stages than ever before, providing us with an excellent platform for improving member engagement and participation.

Over the last three years we have seen tangible and positive results from our Equality Diversity and Inclusion work, with much more diverse representation on our College groups, faculties and committees.

College Council is in a strong position, working remotely during the height of the pandemic and now in a hybrid fashion. I have been honoured to work with such a group of dedicated and passionate GPs who are committed to supporting the profession and promoting the value of general practice as a specialty. The level of debate has been staggering, including on wider societal issues such as the climate emergency.

None of this work would be possible without the efforts of all those who keep the College running - the Trustee Board led by Mike Holmes; the Executive Management Team led by Chief Operating Officer Valerie Vaughan-Dick, and the hardworking staff team across the UK. After 8 years at the College Valerie will be leaving us shortly to become the new CEO at the Royal Institute of British Architects. She has been a steady hand on the tiller, especially during the last turbulent three years, and we are sorry to see her go but wish her the very best for the future.

A big thank you to the amazing Officer team, a remarkable group of individuals and an outstanding team, and I am extremely grateful to them all for their leadership, counsel and friendship. Clare has brought energy and wisdom, Margaret an ability to engage people like no other, Michael a depth of knowledge combined with an Ulsterman’s fortitude and Steve an encyclopaedic understanding of the College and a rare ability to make teams tick.

And I must single out Gary Howsam, Vice Chair for External Affairs, who also demits office today. Gary, you have been an incredible ‘wingman’ and your in-depth knowledge of the local and regional health landscape has been invaluable, as has your resilience and sense of humour, even in the darkest of times.

Gary will be succeeded by Victoria Tzortziou Brown who returns to the Officer team, having previously served as Honorary Secretary. Welcome back Victoria.

Tomorrow marks the 70th anniversary of the RCGP. Our College was established in response to serious challenges for general practice and patient care.

Seventy years on, we are facing different, but equally serious, challenges. But our mission remains the same as in 1952: Cum scientia caritas - to deliver compassionate care with knowledge, as does our purpose, to encourage, foster and maintain the highest possible standards of general practice.

Over the past 70 years, we have achieved what our founders set out to do, firmly establishing our own medical specialty and raising the standards of general practice to what they are today.

We have also encouraged, stimulated and provoked, developing our reputation as a thought and action leader, a respected and impactful influencer. Today, people are now talking about our agendas, with policymakers and even the media repeating our messages back to us.

Our sheer persistence has laid the foundations for change and your College will continue to support its members, defend them when necessary and promote their contribution always. We will work to make the job of a being a GP manageable, stimulating and fulfilling once again, returning to a time when we can deliver the best quality, personalised care that our patients need without a detrimental impact on our own health and wellbeing.

I wish my successor Kamila Hawthorne all the very best. She is a powerful and ardent advocate for frontline GPs and for our specialty and I leave you in excellent hands.

I’d like to end by paying tribute to the GP colleagues who we lost to the pandemic and whose sacrifice will never be forgotten.

And to our 54,000 hardworking and dedicated members and the practice teams who support them in providing the best possible care to their patients, often in the toughest circumstances imaginable.

I am confident that the work of the College will ensure that things WILL get better.

Thank you for the privilege of serving you over the past three years, for certainly being your ‘Pandemic Chair’ and hopefully a bit more than that too.

Further information

RCGP Press office: 020 3188 7633

Notes to editor

The Royal College of General Practitioners is a network of more than 54,000 family doctors working to improve care for patients. We work to encourage and maintain the highest standards of general medical practice and act as the voice of GPs on education, training, research and clinical standards.