Networking and community

Written by Dr Jude Danby

A family doctor at heart, energised by patients' stories. I was for 27 years a Bradford GP, a partner in a multicultural practice. I loved learning from my patients, including visiting their home villages in Pakistan.

I served as GP representative on the UKCC Maternity Committee promoting GP involvement in maternity care and was proud when our multidisciplinary team received a Beacon Award for Integrated Maternity Care.

Medico political activities included local LMC Vice Chair, speaking against the illusion of choice and for equitable funding.

In 2015, experiencing the NHS as a patient and needing recovery time after major surgery; I took retirement from partnership.

Deciding to retain my license, I marketed myself as a locum GP trainer, limiting commitment to 30 weeks in the year. This left me time for family as well as my other passions; horn playing and Italy.

I covered for colleagues on sabbatical, maternity and sick leave. When locum trainer work was unavailable, I worked in the extended hours hub, completing the minimum sessions requirement for Appraisal.

Now I am a 'COVID Conscript' working for the COVID Clinical Assessment Service (CCAS) taking calls to NHS111 but unsure about what comes next.

I hope that LCARM can help later career GPs in the post COVID world by:

• recognition of the wisdom of experience
• grasping the morale lifting potential of being called back as 'The Cavalry'
• promoting ways to enjoy a 'finite' workload - a chance to start on time, finish on time, no outstanding tasks, less takeaway stress
• sharing ways to enjoy reduced intensity of work without excessive time pressure, no more 10-minute consultations
• embracing working at distance, with the multiple possibilities this offers
• encouraging later career GPs across a range of possibilities, clinical, pastoral, administrative, educational, mentorship, remedial

There is a workforce willing to stay engaged in all these types of care but very reluctant to resume any organisational responsibility nor submit to an over pressured pace of work.

Many GPs like narrative, let us try to find a way to capture our wisdom through sharing our stories.

Written by Dr Stephen Nickless

The years since I retired have been the most enjoyable and creative of my professional life. At a friend's suggestion I trained to teach general English and business English to adult learners. These courses revolutionised my approach to teaching and reawakened my lifelong interest in language. I now know quite a lot about both conversation analysis and corpus linguistics.

I did my GP training in Sussex but spent the rest of my working life in rather more culturally and linguistically diverse contexts in London. I enjoyed the challenge of establishing a trusting professional relationship with patients who spoke very little English and saw the world through very different eyes. My patients included many refugees - from Nazi Europe, the Balkan wars, Somalia, Iraq and Afghanistan.

Since 2013 I have been a volunteer at the Refugee Council where I organise a weekly 'professional development group' for refugee doctors. We prepare them for the range of patients and problems they will encounter when working in the NHS, introduce them to UK professional culture and help them to hone their communication skills in preparation for their Professional and Linguistic Assessments Board (PLAB) requalifying examinations.

Last year the GMC recognised the Australian Occupational English Test (OET) as proof of competence in English. This exam was new to the UK so I worked with a language teacher to create teaching materials for our English classes. I created case notes which could be role-played as consultations and then used to practice writing referral and discharge letters. We published these as 'Dear Doctor, English writing skills for clinical practice and the Occupational English Test'. This book should be useful to any doctor planning to work in English for the first time.

None of this was planned when I retired - I simply took advice from friends and seized opportunities when they presented themselves. Retired GPs have an amazing range of transferrable skills which were hard won and should not be wasted. I count myself fortunate to have found something which challenges me intellectually, fulfils me as a person and is congruent with the humanistic and vaguely socialistic values which motivated my medical practice.

Written by Dr Jillian Creasy

I began writing medico-legal reports (MLRs) for Freedom from Torture (FfT) shortly before giving up doing GP locums at the age of 59. I was torn between finding it hard to keep up with 'the knowledge' required for GP-ing and the wish to continue as a doctor in some way. I had been involved with asylum seekers in some of my salaried and locum jobs and with City of Sanctuary as a City Councillor. A friend at a Medact conference encouraged me to apply to FfT. It has allowed me to ease into semi-retirement by providing fresh intellectual stimulation, being part of a team and the satisfaction of helping clients.

Freedom from Torture is a national organisation with regional offices including in Manchester. It provides holistic support for survivors of torture, most of whom are asylum seekers, including medico-legal reports to help them gain refugee status. The initial training is thorough (on-line modules prior to a three day course). This is followed by shadowing, mentoring and good support from doctors, lawyers and admin staff. All reports are reviewed by a doctor and lawyer which means continuous learning and feedback are built into the work.

Clients are referred by a solicitor and the cases screened for suitability. If accepted and after legal aid has been confirmed, the doctor sees the client for at least one long appointment. There is a move to reduce the number of appointments but it still feels luxurious to have hours rather than minutes to gather the story and do a detailed examination. We work with specially trained interpreters. The most onerous part is reading the legal papers, writing a long report and revising it after comments from the reviewers. People often ask me how I can bear hearing the traumatic stories. Somehow the writing and sharing with the team help me to process the emotional aspects.

Volunteer MLR writers typically write three or four reports a year, which can be spaced to accommodate holidays or other commitments, so it is very flexible. I now have a paid role and have taken on training, mentoring and reviewing as well as writing MLRs.

Written by Dr Anita Campbell

I was a portfolio GP for much of my career. I did not retire but my career changed into one which no longer required me to have a licence to practise and I ceased clinical practice. I was a GP trainer, GP appraiser and medical manager; I dealt with doctors in difficulty and I realised, that with this experience, I had skills for working with colleagues, which could continue after I took my NHS pension at normal retirement age.

Talking to GPs during their appraisals, I have become aware of the increasing expectations of GPs. This is not only from patients but also from increasing regulation. Some of us saw the need for coaching and mentoring GPs. Initially trained as a coach by NHS England, I thought that was a future role where I could use my skills. This was not the case and I kept my skills going with pro bono work with health professionals, not just GPs. Another opportunity came along to gain a coaching qualification through the NHS Leadership Academy. I developed my skills, passed the assessment and still there was no joined up thinking and paid work. I was still convinced there was a need amongst GPs for this kind of support and challenge.

There was nothing quite like the buzz I felt when I had worked through a model framework of coaching with a colleague, see them take ownership of the issue, develop their ideas and decide on a plan and achieve their goal. The goal and resulting plan can be survival oriented, it can be career development oriented and of course it can be both.

It is only now, that the NHS is starting to develop their thinking about GP retention. The NHS is facilitating mentoring schemes for GPs. It is still very patchy and I can only hope that coaching and mentoring becomes more widely available. I now have a future in this second phase of my career as my LMC is providing mentoring for GPs and I am a mentor with a great group of colleagues with supervision and support myself.

Written by Dr Ian Jutting

I enjoyed participating in the Tunbridge Wells GP Vocational Training Scheme (VTS) and was fortunate to be appointed as a partner in a local practice immediately afterwards. I was involved with the development of several services and specialist clinics over the years. I later became a GP trainer, a stimulating role that I continued until retirement in 2015. I did out-of-hours sessions which were interesting, at the sharp end of community medicine. I also ran a health screening clinic away from my busy practice. I was a uniformed volunteer doctor with St John Ambulance, also a British Association for Immediate Care Schemes (BAICS) doctor as a trained voluntary medical responder, attending emergencies at the request of the South-East Coast Ambulance Service for several years.

I have always enjoyed providing patient care. By the time I could take my NHS pension, my days had become long and pressured. I knew that I needed to reduce my work commitments. I reduced to part-time working for my NHS practice for six months prior to retiring. The voluntary emergency work ceased while I moved to a support role within St John Ambulance. I continued health screening clinics one day a week for a further year before fully retiring from clinical practice.

Meanwhile, I helped support the Health Education England Kent, Surrey and Sussex GP Training School, undertaking Annual Review of Competency Progression (ARCP) panel work on an ad hoc basis for a further year. It was important for me to gradually reduce my commitments. I maintained my contact with primary care by supporting the local RCGP faculty.

When the COVID-19 pandemic emerged, I responded to the NHS call for returners and have been employed by the COVID Clinical Assessment Service (CCAS) of the NHS 111 service during the emergency. This has been an interesting and stimulating experience.

Outside medicine I have other interests including playing the recorder of all sizes from descant to contrabass in various recorder groups. I also enjoy undertaking electronic projects, having a small workshop at home. It is also good to have time with my family!