Time and tide wait for no man, and though the last week of my tenure as Chair is approaching fast, I have still been able to attend some truly remarkable events over the last few days.
It was lovely to make my last trip as Chairman to Scotland to celebrate the work of my good friend Ken Lawton, Chair of Scottish Council, at the end of his excellent three year term. He’s been a wonderful supporter and has really led the Scottish Council with great skill and wisdom. Ken’s gala dinner also included giving awards to deserving GPs in Scotland. Meeting the winners was a wonderful experience and it was great to talk to GPs who continue to provide extremely good care in what are often very challenging circumstances. It was also good to see Bridget Osborne and David Johnston, Chairs of Wales and Northern Ireland Councils respectively. All three have contributed to the UK College as well as their own more than anyone knows. I am pleased that Ken will continue to serve the College as Deputy Chair of the Postgraduate .
Professional Development Board
I have worked hard to ensure that we have had the very best GPs, and the very best GP organisations re-engage with the College. Indeed I hope when I stand down in a weeks time I will have left the College in a stronger place, and I am particularly pleased for example that we have been able to elect Martin Marshall, former Deputy Chief Medical Officer and GP academic, as Chair of our Ethics Committee; Val Wass, Dean of the University of Keele Medical School, as Chair of International; Amanda Howe as Honorary Secretary; Helen Lester – one of the brains behind QOF, as Chair of CIRC.
As Clare prepares to begin her tenure, Has Joshi is stepping down as Vice Chair, and I am grateful for all of his dedication and hard work. In their places, we’ve got two wonderful new vice chairs – Nigel Mathers and Janet Hall - whose injection of new energy into the team will be a great support for Clare. Not only have we managed to appoint fantastic people, but we’ve also engaged better with key organisations including our colleagues taking forward research in the Society of Academic Primary Care, and the Primary Care clinical societies.
I am a firm believer in the doctrine that in order to lead you need the best people around you, not to be surrounded by yes men who will agree with you no matter what, but those who will challenge you and make you think carefully about the decisions you make. I have taken this from the writings of Abraham Lincoln and, most recently, John F Kennedy. I think the College Council and the Officers are stronger than they’ve ever been – strong leadership is team leadership – and the College is in very good hands. I’ll say more about that in my last email which will reach you after the AGM on Friday.
Nigel Sparrow’s excellent work leading the Professional Development Board has included the educational sessions on work and pensions. So far, 2700 delegates have been trained since the workshops were launched last year, which is excellent news for Nigel, his team, the delegates and their patients.
I believe that encouraging people to stay in work, and getting people back to work quickly is good for them, their families and the economy in general. Unfortunately we haven’t managed to radically change behaviours as yet – but we will carry on encouraging the benefits of the fit note.
It's now been more than six months since the fit note was introduced and I'd like to remind GPs about the impact it can have in helping people get back to work. The fit note is an important tool that clinicians can use to provide advice to patients, and their employers, on how a health condition affects their ability to work and what practical steps might be taken to help them work as they recover. The knowledge that work is generally good for health and wellbeing has been available for several years now and it is important that we ensure our practices use the evidence and make best use of the potential the fit note has to improve the health and wellbeing of our patients. The DWP worked in partnership with the college to develop guidance for the fit note, and if you have not read it already I would recommend it to you - it can be viewed online at
www.dwp.gov.uk/fitnote
GPs interested in learning more about dealing with health and work in consultation may want to attend the RCGP 'Health and Work in General Practice' training. (Find out more and register online at www.rcgp.org.uk/news_and_events/courses__events/health_and_work_training.aspx)
I am very pleased to tell you that e-GP, the curriculum-based e-learning programme developed by the College in partnership with e-Learning for Healthcare, has won a silver award at the prestigious e-Learning AGE awards. These awards are highly regarded in the e-learning industry and the awards ceremony was held in London last Thursday. e-GP won a silver award in the category of Excellence in the production of learning content - Public Sector. Other award winners in the 'excellence in content' categories included British Airways, Marks & Spencer and Volkswagen Group. The Royal College of Anaesthetists won a bronze award for their e-LfH project.
I would like to thank Ben Riley, our Medical Director of e-Learning, Bill Reith, as Chair responsible, and the staff team for all the hard work that they have put into this project. I am often told that it is a fantastic resource for GPs, and it is wonderful that this has been so publically recognised. Ben in particular has worked extremely closely with our partners, e-LfH, as well as with all of the editors and authors who have provided the content which has been judged to be of such excellent quality.
More information about the awards can be found on the e-Learning AGE website: http://www.elearningage.co.uk/winners.aspx
Last Monday night I had the great privilege of attending the Pride of Britain Awards, for which I was on the judging panel. The Awards really are a fantastic event, recognising the remarkable achievements of real people who strive to improve the lives of those around them, and I was in awe of all of the award winners. The ceremony, hosted by Carol Vorderman was fantastic, and it would be a lie to say that I wasn’t a little bit starstruck meeting a cavalcade of famous faces.
The experience of judging the winners with Simon Cowell was surreal to say the least, but I did find myself making an unexpected comparison; he has such an incisive mind, he makes a diagnosis and he comes up with a treatment – just like a GP. Unsurprisingly, we agreed on all counts(!) It was also nice to discuss the achievements of these inspiring people with my fellow Baggies follower Adrian Chiles.
I will continue to keep you updated here once I step down from office.
My next email to you will be my last as Chairman of Council. Until then, as ever, I and the College really do value your opinions and feedback enormously, and I urge you to get in touch if you have any comments or questions for me.
Showing posts with label Steve Field. Show all posts
Showing posts with label Steve Field. Show all posts
Tuesday, 16 November 2010
Friday, 5 November 2010
The importance of research
I had expected that, as I approach the end of my tenure, my diary commitments would begin winding down. This, alas, was not to be and this week has been as busy as ever.
But nevertheless, my time as Chairman will soon be at an end, and I have been thrilled with how Clare Gerada has been taking forward so much crucial College work. Her work on Commissioning in particular has been invaluable, and it fills me with confidence to know that the College will be in her capable hands.
Last week I had the great honour and pleasure of giving the David Bruce Lecture to the Army Medical Services at the Royal Military Academy in Sandhurst. I gave an academic lecture celebrating general practice and focused on the critical role GPs can play in the care of the most vulnerable people in our society, particularly the homeless, travellers, sex workers and refugees.
As someone who has a great interest in history, to give the David Bruce lecture was a particular treat. Sir David Bruce started off his career like me, working in a warehouse in Manchester before going to medical school! He was a GP in Reigate and then joined the Army. He investigated and treated Malta-fever (later named Brucellosis after him). He identified the cause of sleeping sickness and saved countless lives by introducing typhoid and tetanus inoculation for the troops in the First World War. What a man!
Giving the lecture also gave me an opportunity to once again thank the army medical services for their hard work, commitment and bravery in looking after our troops both in Iraq and Afghanistan. I am always so humbled by the skill of our military colleagues who work in difficult, often frightening circumstances, and I was grateful for the opportunity to speak to them.
This week I was called to give evidence on commissioning to the Health Select Committee. Of all the times I have been called as a witness to the Health Select Committee, this was probably the most difficult and challenging I have experienced; the commissioning agenda is in many ways polarized, and it was apparent to me that there was a degree of political point-scoring taking place. If you would like to read the transcript, or watch the video of the evidence session, then they are available through the parliament website; I think you will find it interesting viewing, not least because as it highlights the value of open questions – there were very few of them! The video is a good teaching aid for trainees which will work as a trigger for discussion – also giving evidence was the excellent Richard Vautrey from the BMA.
You can read the transcript and view the video here: http://www.parliamentlive.tv/Main/Player.aspx?meetingId=6842
Dr Knut Schroeder, a GP and Fellow of the College has produced a new publication Diagnosing Your Health Symptoms for Dummies which I want to bring your attention to. This new guide has been endorsed by the College as part of our ongoing agenda of helping to empower patients and their families. I have been quite vocal on the issue of public health, and really believe that giving patients the information and support needed to make informed decisions about their own health and the healthcare they receive is a vital to improving the public’s general health. This guide is an accessible way to help patients to begin to take control of their own health, and I’d urge all of you to take a look.
On Wednesday night I hosted a working dinner for College Officers and the Society of Academic Primary Care. Throughout my time as Chair I have worked to create stronger links between the College and our academic colleagues. I am pleased that College has re-engaged with the academic departments – I felt that we had drifted apart and wanted to take the chance as Chairman to work more closely with the GPs and the many other professionals who research in primary care – this isn’t just about GPs.
We have seen an extraordinary few years of research which will make massive difference to patients’ lives, one recent example being Willie Hamilton’s excellent award winning study into identifying early symptoms of ovarian cancer which I believe will lead to the earlier diagnosis by GPs of what has been called the ‘silent killer’. Willie is I guess a modern day David Bruce.
Research, academia and evidence-based practice are all important parts of the work that all medical professionals do, we just sometimes fail to recognise that we are an academic discipline – all jobbing GPs across the country aim to provide the highest quality evidence based care for our patients – we need to value and celebrate the work of our colleagues who produce that evidence. Our RCGP Clinical Innovation and Research Centre at the College (CIRC) is becoming enormously influential, and our Conference this year had more clinical and academic sessions than ever before.
I want to thank CIRC for their continuing support; I and the College continue to advise the Government and our four health departments on clinical matters, and a lot of the information we use comes directly from CIRC and the academic departments. I’m always hugely impressed with their abilities; I’ve often had to request up-to-date information which I’ve received at the drop of a hat, and much of our success is owed to their hard work.
Yesterday I attended our MRCGP Examiners’ Annual Conference in Stratford-upon-Avon, which is an opportunity to meet with another group of GPs who are committed to raising standards. Again, I have been hugely impressed with how the exam has been developed over the last year, and with the continuing academic rigour with which it has been approached.
But nevertheless, my time as Chairman will soon be at an end, and I have been thrilled with how Clare Gerada has been taking forward so much crucial College work. Her work on Commissioning in particular has been invaluable, and it fills me with confidence to know that the College will be in her capable hands.
Last week I had the great honour and pleasure of giving the David Bruce Lecture to the Army Medical Services at the Royal Military Academy in Sandhurst. I gave an academic lecture celebrating general practice and focused on the critical role GPs can play in the care of the most vulnerable people in our society, particularly the homeless, travellers, sex workers and refugees.
As someone who has a great interest in history, to give the David Bruce lecture was a particular treat. Sir David Bruce started off his career like me, working in a warehouse in Manchester before going to medical school! He was a GP in Reigate and then joined the Army. He investigated and treated Malta-fever (later named Brucellosis after him). He identified the cause of sleeping sickness and saved countless lives by introducing typhoid and tetanus inoculation for the troops in the First World War. What a man!
Giving the lecture also gave me an opportunity to once again thank the army medical services for their hard work, commitment and bravery in looking after our troops both in Iraq and Afghanistan. I am always so humbled by the skill of our military colleagues who work in difficult, often frightening circumstances, and I was grateful for the opportunity to speak to them.
This week I was called to give evidence on commissioning to the Health Select Committee. Of all the times I have been called as a witness to the Health Select Committee, this was probably the most difficult and challenging I have experienced; the commissioning agenda is in many ways polarized, and it was apparent to me that there was a degree of political point-scoring taking place. If you would like to read the transcript, or watch the video of the evidence session, then they are available through the parliament website; I think you will find it interesting viewing, not least because as it highlights the value of open questions – there were very few of them! The video is a good teaching aid for trainees which will work as a trigger for discussion – also giving evidence was the excellent Richard Vautrey from the BMA.
You can read the transcript and view the video here: http://www.parliamentlive.tv/Main/Player.aspx?meetingId=6842
Dr Knut Schroeder, a GP and Fellow of the College has produced a new publication Diagnosing Your Health Symptoms for Dummies which I want to bring your attention to. This new guide has been endorsed by the College as part of our ongoing agenda of helping to empower patients and their families. I have been quite vocal on the issue of public health, and really believe that giving patients the information and support needed to make informed decisions about their own health and the healthcare they receive is a vital to improving the public’s general health. This guide is an accessible way to help patients to begin to take control of their own health, and I’d urge all of you to take a look.
On Wednesday night I hosted a working dinner for College Officers and the Society of Academic Primary Care. Throughout my time as Chair I have worked to create stronger links between the College and our academic colleagues. I am pleased that College has re-engaged with the academic departments – I felt that we had drifted apart and wanted to take the chance as Chairman to work more closely with the GPs and the many other professionals who research in primary care – this isn’t just about GPs.
We have seen an extraordinary few years of research which will make massive difference to patients’ lives, one recent example being Willie Hamilton’s excellent award winning study into identifying early symptoms of ovarian cancer which I believe will lead to the earlier diagnosis by GPs of what has been called the ‘silent killer’. Willie is I guess a modern day David Bruce.
Research, academia and evidence-based practice are all important parts of the work that all medical professionals do, we just sometimes fail to recognise that we are an academic discipline – all jobbing GPs across the country aim to provide the highest quality evidence based care for our patients – we need to value and celebrate the work of our colleagues who produce that evidence. Our RCGP Clinical Innovation and Research Centre at the College (CIRC) is becoming enormously influential, and our Conference this year had more clinical and academic sessions than ever before.
I want to thank CIRC for their continuing support; I and the College continue to advise the Government and our four health departments on clinical matters, and a lot of the information we use comes directly from CIRC and the academic departments. I’m always hugely impressed with their abilities; I’ve often had to request up-to-date information which I’ve received at the drop of a hat, and much of our success is owed to their hard work.
Yesterday I attended our MRCGP Examiners’ Annual Conference in Stratford-upon-Avon, which is an opportunity to meet with another group of GPs who are committed to raising standards. Again, I have been hugely impressed with how the exam has been developed over the last year, and with the continuing academic rigour with which it has been approached.
Wednesday, 27 October 2010
The Primary Care Federations Toolkit
Yesterday, we saw the launch of the College’s Primary Care Federations Toolkit.
This Toolkit provides a really useful compendium of practical advice for existing and fledgling Federations, drawing upon the experience of Federations so far. With the brilliant support of The King’s Fund, The Nuffield Trust and Hempsons Solicitors, and under the leadership of Maureen Baker it is goes further than our original vision and is given the timely momentum created by the White Paper in England. Clearly Federations are not just for England, they are an excellent model for practices working together to provide high quality care wherever you work in the UK or even further afield.
In the years since we published the Roadmap I have watched with interest to see the ways in which so many of you, and your practices have embraced the idea of Federations, and the range of federated models that have emerged. I have also had the privilege of visiting some of them to pinch ideas and watch them win national awards.
Many of you are already working in Federations and I know that even more are actively considering coming together in this way. I really believe that Federations, as providers of services, can work well alongside Consortia, and that the opportunities for Federations to maximise benefits for patients are enormous.
Have a look - I recommend the Toolkit as an essential resource in taking general practice forward to the next level.
You can have a look at the Toolkit here: FEDERATIONS TOOLKIT
I also spent yesterday morning at the launch of the Dementia Action Alliance and the National Dementia Declaration, which maps out the huge challenges currently presented to our society by dementia, and some of the outcomes the Alliance, of which the College is a member, is seeking to achieve for patients with dementia and their carers. It was fantastic to hear one of my real heroes – Tony Robinson – speaking passionately about the need to better support patients with dementia; he challenged the minister Paul Burstow who responded with strong words of commitment and by also signing the declaration!
I am so proud that the College is one of the forty-five organisations that make up the Dementia Action Alliance; there are 750,000 people with dementia in the UK and this number is set to grow to over one million people by 2025. And while the financial cost of dementia in the UK is £20 billion each year and growing, still there remains a disparity in the quality of care patients receive across the country.
The overuse of anti-psychotic drugs in the treatment of patients with dementia – the ‘chemical cosh’ – has been one of the central causes of concern in treating patients with dementia. I don’t believe that its simply about GPs over prescribing as some of the newspapers have claimed. It’s more complicated than that. We need a whole new look at how patients with dementia are managed, how patients that live in care homes are looked after; better training for care home staff, medicines reviews with pharmacists, better and rapid access to specialist advice and support, as well as more time for GPs. But we do need to ensure that we are all up to date in the management of patients who have dementia - an important aspect of our CPD.
I have given a number of media interviews on this, ranging from BBC’s Panorama (to be aired next week) and the Daily Mail, to ITN Lunchtime News today and, as you may have seen reported in the media today, the Alliance has pledged to cut the over-prescription of these drugs, and to reduce the number of dementia sufferers confined to hospital beds.
This pledge is part of the seven main recommendations marked out in the Declaration, which exist as the basis for a ‘national action plan’. These recommendations are designed to improve the overall quality of life for patients with dementia and their carers, and include giving patients more control over decisions; helping them to feel valued and understood; enabling them to remain part of a community and keeping them safe in the knowledge that research is continuing.
As you can see, dementia is an issue that the College takes very seriously, and I would like to commend the continuing dedication of Professor Louise Robinson, our Clinical Champion for Ageing and Older People, and of Susan Went, who is leading intercollegiate work in Healthcare Quality Improvement for care homes between the College, the Royal College of Physicians and the Royal College of Psychiatrists.
You can read the letter here: LINK
You can read the Declaration here: LINK
As always, both I and the College value your opinions and feedback enormously, and I urge you to get in touch if you have any comments or questions for me.
Best wishes,
Steve
This Toolkit provides a really useful compendium of practical advice for existing and fledgling Federations, drawing upon the experience of Federations so far. With the brilliant support of The King’s Fund, The Nuffield Trust and Hempsons Solicitors, and under the leadership of Maureen Baker it is goes further than our original vision and is given the timely momentum created by the White Paper in England. Clearly Federations are not just for England, they are an excellent model for practices working together to provide high quality care wherever you work in the UK or even further afield.
In the years since we published the Roadmap I have watched with interest to see the ways in which so many of you, and your practices have embraced the idea of Federations, and the range of federated models that have emerged. I have also had the privilege of visiting some of them to pinch ideas and watch them win national awards.
Many of you are already working in Federations and I know that even more are actively considering coming together in this way. I really believe that Federations, as providers of services, can work well alongside Consortia, and that the opportunities for Federations to maximise benefits for patients are enormous.
Have a look - I recommend the Toolkit as an essential resource in taking general practice forward to the next level.
You can have a look at the Toolkit here: FEDERATIONS TOOLKIT
 |
© Justin Grainge Photography (2010) |
I also spent yesterday morning at the launch of the Dementia Action Alliance and the National Dementia Declaration, which maps out the huge challenges currently presented to our society by dementia, and some of the outcomes the Alliance, of which the College is a member, is seeking to achieve for patients with dementia and their carers. It was fantastic to hear one of my real heroes – Tony Robinson – speaking passionately about the need to better support patients with dementia; he challenged the minister Paul Burstow who responded with strong words of commitment and by also signing the declaration!
I am so proud that the College is one of the forty-five organisations that make up the Dementia Action Alliance; there are 750,000 people with dementia in the UK and this number is set to grow to over one million people by 2025. And while the financial cost of dementia in the UK is £20 billion each year and growing, still there remains a disparity in the quality of care patients receive across the country.
The overuse of anti-psychotic drugs in the treatment of patients with dementia – the ‘chemical cosh’ – has been one of the central causes of concern in treating patients with dementia. I don’t believe that its simply about GPs over prescribing as some of the newspapers have claimed. It’s more complicated than that. We need a whole new look at how patients with dementia are managed, how patients that live in care homes are looked after; better training for care home staff, medicines reviews with pharmacists, better and rapid access to specialist advice and support, as well as more time for GPs. But we do need to ensure that we are all up to date in the management of patients who have dementia - an important aspect of our CPD.
I have given a number of media interviews on this, ranging from BBC’s Panorama (to be aired next week) and the Daily Mail, to ITN Lunchtime News today and, as you may have seen reported in the media today, the Alliance has pledged to cut the over-prescription of these drugs, and to reduce the number of dementia sufferers confined to hospital beds.
This pledge is part of the seven main recommendations marked out in the Declaration, which exist as the basis for a ‘national action plan’. These recommendations are designed to improve the overall quality of life for patients with dementia and their carers, and include giving patients more control over decisions; helping them to feel valued and understood; enabling them to remain part of a community and keeping them safe in the knowledge that research is continuing.
As you can see, dementia is an issue that the College takes very seriously, and I would like to commend the continuing dedication of Professor Louise Robinson, our Clinical Champion for Ageing and Older People, and of Susan Went, who is leading intercollegiate work in Healthcare Quality Improvement for care homes between the College, the Royal College of Physicians and the Royal College of Psychiatrists.
You can read the letter here: LINK
You can read the Declaration here: LINK
As always, both I and the College value your opinions and feedback enormously, and I urge you to get in touch if you have any comments or questions for me.
Best wishes,
Steve
Friday, 6 August 2010
White Paper Supporting Consultations
As you know, we started our consultation on the Government’s White Paper last week. I want to thank those of you already taking part. Your responses are invaluable, and will enable us to formulate our response to the Department of Health.
The RCGP is a UK College, indeed we are an international College, and although the White Paper legislation will affect only England, I really do encourage members from around the UK and beyond to consider the implications and to take part. Only this week I had some very helpful feedback from a member in Europe, who was keen to be kept informed as developments unfold. Your thoughts, concerns and examples of good practice, wherever you are in the UK are always gratefully received and fully considered.
Some of you have expressed concern about the potential impact on our most vulnerable patients, and I want to draw your attention to an initial equalities impact statement on the DH website:
http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_117350.pdf
It’s been a huge week media wise, particularly surrounding the King’s Fund’s call for GPs to take a more active role in maternity care. The findings were disappointing, but confirmed what we already knew - that the role of GPs in maternity care has dramatically declined over the past 30 years to the extent that there are some areas of the country where it is now practically non-existent.
I said that the best way forward is to establish effective maternity care teams in which GPs play a key role along with midwives, consultants and other healthcare professionals. This would obviously require significant changes to the way in which maternity care services are currently organised and we are already working with our colleagues at the Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists to see how we can deliver more effective and seamless care for pregnant women and their babies.
Today was the first meeting at the Department of Health looking at the new Public Health White Paper for England – indeed it was the first time anyone from the College had been invited to a meeting to discuss public health – usually we have to remind people that GPs have a key role in public health alongside our specialist colleagues.
There are big opportunities to take forward the public’s health agenda now that a new public health service is being set up and our public health colleagues will be based in local Government, but I fear that if we’re not careful commissioning groups will feel that public health is being covered by someone else.
What I said to our colleagues today was that public health and population health is important to GPs, and must then also be important for commissioning groups. I guess the Health and Wellbeing Board will be very important. There is some brilliant work going on around the country being led by GPs, an excellent example being the Big Bolton Health Check, which has made a real difference to patients’ lives.
To that end, I’ve been trying to raise the profile of public and population health with GPs and the important role of GPs with others, and a series of talks and a number of articles. You might be interested to know that in the Observer on Sunday there will be an opinion piece in which I will talk more about the importance of individuals taking more responsibility for their health and for the health of their children.
I hope you will be interested in an article I have co-written with Professor Roger Boyle, the DH clinical director for cardiovascular disease, for the BJGP, called ‘cardiovascular disease beyond the QOF’. You can read some of Pulse Magazine’s coverage of the article at:
http://www.pulsetoday.co.uk/story.asp?sectioncode=19&storycode=4125548
Here at Princes Gate, most of our kit is now boxed up and the rooms are emptying in advance of our move at the end of next week. The team here are developing a comprehensive communications plan to keep you fully informed on how to get in touch with us, and how to make arrangements for accommodation.
Orchestrating the move has been a mammoth exercise, and I do hope that the move will result in communication inside the college improving; it’s been very difficult working in poor accommodation, spread across four sites. I’ll certainly miss staying in the college; things really won’t be the same, but I think it’s for the best and is part of the story of the College’s growth.
Our future address will be: 1 Bow Churchyard, London EC4M 9DQ. The new switchboard number will be 020 3188 7400 and our new fax number will be 020 3188 7401.
As always, I value your opinions and feedback enormously – wherever you live and work – and I urge you to get in touch if you have any comments or questions for me.
The RCGP is a UK College, indeed we are an international College, and although the White Paper legislation will affect only England, I really do encourage members from around the UK and beyond to consider the implications and to take part. Only this week I had some very helpful feedback from a member in Europe, who was keen to be kept informed as developments unfold. Your thoughts, concerns and examples of good practice, wherever you are in the UK are always gratefully received and fully considered.
Some of you have expressed concern about the potential impact on our most vulnerable patients, and I want to draw your attention to an initial equalities impact statement on the DH website:
http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_117350.pdf
It’s been a huge week media wise, particularly surrounding the King’s Fund’s call for GPs to take a more active role in maternity care. The findings were disappointing, but confirmed what we already knew - that the role of GPs in maternity care has dramatically declined over the past 30 years to the extent that there are some areas of the country where it is now practically non-existent.
I said that the best way forward is to establish effective maternity care teams in which GPs play a key role along with midwives, consultants and other healthcare professionals. This would obviously require significant changes to the way in which maternity care services are currently organised and we are already working with our colleagues at the Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists to see how we can deliver more effective and seamless care for pregnant women and their babies.
Today was the first meeting at the Department of Health looking at the new Public Health White Paper for England – indeed it was the first time anyone from the College had been invited to a meeting to discuss public health – usually we have to remind people that GPs have a key role in public health alongside our specialist colleagues.
There are big opportunities to take forward the public’s health agenda now that a new public health service is being set up and our public health colleagues will be based in local Government, but I fear that if we’re not careful commissioning groups will feel that public health is being covered by someone else.
What I said to our colleagues today was that public health and population health is important to GPs, and must then also be important for commissioning groups. I guess the Health and Wellbeing Board will be very important. There is some brilliant work going on around the country being led by GPs, an excellent example being the Big Bolton Health Check, which has made a real difference to patients’ lives.
To that end, I’ve been trying to raise the profile of public and population health with GPs and the important role of GPs with others, and a series of talks and a number of articles. You might be interested to know that in the Observer on Sunday there will be an opinion piece in which I will talk more about the importance of individuals taking more responsibility for their health and for the health of their children.
I hope you will be interested in an article I have co-written with Professor Roger Boyle, the DH clinical director for cardiovascular disease, for the BJGP, called ‘cardiovascular disease beyond the QOF’. You can read some of Pulse Magazine’s coverage of the article at:
http://www.pulsetoday.co.uk/story.asp?sectioncode=19&storycode=4125548
Here at Princes Gate, most of our kit is now boxed up and the rooms are emptying in advance of our move at the end of next week. The team here are developing a comprehensive communications plan to keep you fully informed on how to get in touch with us, and how to make arrangements for accommodation.
Orchestrating the move has been a mammoth exercise, and I do hope that the move will result in communication inside the college improving; it’s been very difficult working in poor accommodation, spread across four sites. I’ll certainly miss staying in the college; things really won’t be the same, but I think it’s for the best and is part of the story of the College’s growth.
Our future address will be: 1 Bow Churchyard, London EC4M 9DQ. The new switchboard number will be 020 3188 7400 and our new fax number will be 020 3188 7401.
As always, I value your opinions and feedback enormously – wherever you live and work – and I urge you to get in touch if you have any comments or questions for me.
Friday, 23 July 2010
The White Paper
I think it would be fair to say that the last ten days have been defined by the release of the White Paper. This is one of the biggest, if not the biggest, changes to the structure of the NHS since it was formed. We are awaiting the publication of five accompanying papers, which are due out by the end of next week.
The White Paper, Equality and excellence: Liberating the NHS, was launched at Downing Street last week – I had the privilege of attending and being able to speak to the Prime Minister and the Secretary of State about the paper. I must say that I got the sense from our new PM that he really does believe that putting GPs and other clinicians in charge of the NHS will deliver a less bureaucratic and better quality service. Both he and the Secretary of State expressed ambition for the NHS to be a more patient focused, more personalised system with GPs right at the heart of everything that happens. I know people may be sceptical, but David Cameron did say that the NHS is his number one priority – time will tell- and of course the financial squeeze could have a bigger impact on health than we can see, but, I came away thinking that we do seem to have the politicians at the top of government supporting GPs – and they have gone public too!
It was also interesting that they both talked about the influence of the Liberal party on their original plans, and the need for much more patient and public engagement in commissioning. It was a good opportunity to talk to the whole ministerial team and the senior civil servants without the gaze of the publicity machine, and to share concerns as well as discussing the opportunities.
I believe that the White Paper presents a real opportunity for GPs and for our patients. Over the past three years I’ve met with politicians from all political parties and have given them critical feedback when needed, as well as congratulating them when appropriate. I have known Andrew Lansley for some time, meeting with him and his shadow team on a regular basis and I know that these plans had been developed before the country plunged into the current financial crisis. Contrary to the belief of a few our colleagues that I have met around the country, I do not view these changes as a ‘stitch-up’, with politicians setting us up to fail, rather than they are desiring to give GPs more influence. I won’t stop giving the government critical feedback and challenge when needed, and I will continue to feedback from you to the civil servants and politicians as I have been doing over the past three years. I have sometimes had over 2,000 responses from you all, for which I thank you for – I read them all – thank goodness for long train journeys!
I have every confidence that our GP colleagues across the country will get involved with the consultation and provide their invaluable input at this crucial time. We met with Laurence Buckman and Richard Vautrey from the GPC last week to discuss the White Paper and other issues we continue to discuss developments with other organisations, including the medical Royal Colleges.
What we have seen so far leads us all to believe that GPs in England might at long last gain real influence to control budgets and commission services, enabling patients to receive high quality care and better continuity of care. We obviously need to study this in great detail but I hope we can provide our influence so that GPs can at long last take centre stage in the running of the health service.
The Outcomes Paper was released on Monday, and the Commissioning Paper just came out yesterday, so we’ll be ploughing through the fine detail of both of these important documents. The Outcomes Paper indicates to me that our practice accreditation programme will be something that will help GPs across the country.
I acknowledge that most GPs will want to continue providing high quality care wherever they live in England, whilst some GPs will want to become more involved. Clearly, we need to learn lessons from the previous attempts at commissioning and fund holding but GPs will want to work with specialist medical colleagues, nurses and, indeed, supportive and high quality managers to make this happen.
I believe that with collaboration with our specialist colleagues, nurses and other professionals working in primary care to tailor services appropriately for patients, and given the right resources and support, we CAN deliver an effective and cost-effective NHS.
Amanda Howe, our excellent Honorary Secretary, will be leading a full consultation on the entire White Paper, and Clare Gerada and I will be starting a more formal email, in addition to this one, to give you factual information as we did with pandemic flu.
But of course, all GPs still have the day job to think about. I am thrilled that the Health Work and Wellbeing initiative is gathering pace, and I am delighted that so many GPs have put themselves forward to contribute to this invaluable scheme. I am delighted that Dame Carol Black’s independent Review of the health of Britain’s working age people has such an impact on improving the lives of people in work, and in helping people get back to work.
I spoke to Carol yesterday; the early evidence from the Post Office and other big employers is that most GPs are continuing to fill in the new Fit Note as though they were sick notes, but in some areas there has been a more radical change. I ask you to think about the Fit Notes when you fill them in; it’s important to try to keep people in work if we possibly can – it’s better for their health, and it’s better for the economy.
I wanted to give you an update on the move from Princes Gate, to explain how our interim and long-term plans will impact on you as members.
As you know, Princes Gate has now been sold and the new building at Euston Square – which is to be developed into a world-class facility – has been purchased. The improvement works and refurbishment that will take place mean that we will not be able to move into our new permanent home until Summer 2012, so, as you have seen in RCGP News, in the meantime we will be based at Bow Churchyard, in the City of London.
I want to take this opportunity to assure you that members' subscriptions will not be used to finance the move or the refurbishment to Euston Square. There is a capital appeal to raise additional funds for Euston Square (over and above the proceeds from the Princes Gate sale). Many of you have already approached the College asking how you can make donations, all of the information on which can be found at www.rcgpfundraising.org.
We all know how stressful moving can be, but the move should not affect your ability to contact the College when you need to. The details, such as our new phone numbers, will be sent to you as soon as they are confirmed. I will, of course, keep you posted on all the changes before they happen.
I want to offer my sincerest congratulations to David Sowden, who has become chair of the Conference of Postgraduate Medical Deans of the United Kingdom, and I wish him every luck in this new role.
As always, I value your opinions and feedback enormously, and I urge you to get in touch if you have any comments or questions for me. Sincere apologies for to those of you from Wales, Northern Ireland and Scotland and indeed those international members from around the world – I value your thoughts too wherever you live and work.
The White Paper, Equality and excellence: Liberating the NHS, was launched at Downing Street last week – I had the privilege of attending and being able to speak to the Prime Minister and the Secretary of State about the paper. I must say that I got the sense from our new PM that he really does believe that putting GPs and other clinicians in charge of the NHS will deliver a less bureaucratic and better quality service. Both he and the Secretary of State expressed ambition for the NHS to be a more patient focused, more personalised system with GPs right at the heart of everything that happens. I know people may be sceptical, but David Cameron did say that the NHS is his number one priority – time will tell- and of course the financial squeeze could have a bigger impact on health than we can see, but, I came away thinking that we do seem to have the politicians at the top of government supporting GPs – and they have gone public too!
It was also interesting that they both talked about the influence of the Liberal party on their original plans, and the need for much more patient and public engagement in commissioning. It was a good opportunity to talk to the whole ministerial team and the senior civil servants without the gaze of the publicity machine, and to share concerns as well as discussing the opportunities.
I believe that the White Paper presents a real opportunity for GPs and for our patients. Over the past three years I’ve met with politicians from all political parties and have given them critical feedback when needed, as well as congratulating them when appropriate. I have known Andrew Lansley for some time, meeting with him and his shadow team on a regular basis and I know that these plans had been developed before the country plunged into the current financial crisis. Contrary to the belief of a few our colleagues that I have met around the country, I do not view these changes as a ‘stitch-up’, with politicians setting us up to fail, rather than they are desiring to give GPs more influence. I won’t stop giving the government critical feedback and challenge when needed, and I will continue to feedback from you to the civil servants and politicians as I have been doing over the past three years. I have sometimes had over 2,000 responses from you all, for which I thank you for – I read them all – thank goodness for long train journeys!
I have every confidence that our GP colleagues across the country will get involved with the consultation and provide their invaluable input at this crucial time. We met with Laurence Buckman and Richard Vautrey from the GPC last week to discuss the White Paper and other issues we continue to discuss developments with other organisations, including the medical Royal Colleges.
What we have seen so far leads us all to believe that GPs in England might at long last gain real influence to control budgets and commission services, enabling patients to receive high quality care and better continuity of care. We obviously need to study this in great detail but I hope we can provide our influence so that GPs can at long last take centre stage in the running of the health service.
The Outcomes Paper was released on Monday, and the Commissioning Paper just came out yesterday, so we’ll be ploughing through the fine detail of both of these important documents. The Outcomes Paper indicates to me that our practice accreditation programme will be something that will help GPs across the country.
I acknowledge that most GPs will want to continue providing high quality care wherever they live in England, whilst some GPs will want to become more involved. Clearly, we need to learn lessons from the previous attempts at commissioning and fund holding but GPs will want to work with specialist medical colleagues, nurses and, indeed, supportive and high quality managers to make this happen.
I believe that with collaboration with our specialist colleagues, nurses and other professionals working in primary care to tailor services appropriately for patients, and given the right resources and support, we CAN deliver an effective and cost-effective NHS.
Amanda Howe, our excellent Honorary Secretary, will be leading a full consultation on the entire White Paper, and Clare Gerada and I will be starting a more formal email, in addition to this one, to give you factual information as we did with pandemic flu.
But of course, all GPs still have the day job to think about. I am thrilled that the Health Work and Wellbeing initiative is gathering pace, and I am delighted that so many GPs have put themselves forward to contribute to this invaluable scheme. I am delighted that Dame Carol Black’s independent Review of the health of Britain’s working age people has such an impact on improving the lives of people in work, and in helping people get back to work.
I spoke to Carol yesterday; the early evidence from the Post Office and other big employers is that most GPs are continuing to fill in the new Fit Note as though they were sick notes, but in some areas there has been a more radical change. I ask you to think about the Fit Notes when you fill them in; it’s important to try to keep people in work if we possibly can – it’s better for their health, and it’s better for the economy.
I wanted to give you an update on the move from Princes Gate, to explain how our interim and long-term plans will impact on you as members.
As you know, Princes Gate has now been sold and the new building at Euston Square – which is to be developed into a world-class facility – has been purchased. The improvement works and refurbishment that will take place mean that we will not be able to move into our new permanent home until Summer 2012, so, as you have seen in RCGP News, in the meantime we will be based at Bow Churchyard, in the City of London.
I want to take this opportunity to assure you that members' subscriptions will not be used to finance the move or the refurbishment to Euston Square. There is a capital appeal to raise additional funds for Euston Square (over and above the proceeds from the Princes Gate sale). Many of you have already approached the College asking how you can make donations, all of the information on which can be found at www.rcgpfundraising.org.
We all know how stressful moving can be, but the move should not affect your ability to contact the College when you need to. The details, such as our new phone numbers, will be sent to you as soon as they are confirmed. I will, of course, keep you posted on all the changes before they happen.
I want to offer my sincerest congratulations to David Sowden, who has become chair of the Conference of Postgraduate Medical Deans of the United Kingdom, and I wish him every luck in this new role.
As always, I value your opinions and feedback enormously, and I urge you to get in touch if you have any comments or questions for me. Sincere apologies for to those of you from Wales, Northern Ireland and Scotland and indeed those international members from around the world – I value your thoughts too wherever you live and work.
Friday, 29 January 2010
The end of January
One of the joys of being Chairman of the college is that I am privileged to see how general practice is delivered across the length and breadth of the country (and pinch some of the good ideas for my own practice). There is lots of good work going on, and in particular this week, I was energized by my visit to Tower Hamlets PCT. I met with the directors of the PCT and was impressed by the collaborative work taking place, particularly between their Chief Executive Alwen Williams, Medical Director Doug Russell and their colleagues. Dr Victoria Tzortziou Brown, a member of our council and a local GP, had invited me over. At a time where we hear that the London SHA are coming up with silly ideas of reducing consultation times to eight minutes, it was reassuring that in this PCT they want to support GPs and recognise that spending longer with patients who are complex and have a number of co morbidities is the way forward. It was impressive to see their managers and doctors working together to provide excellent and innovative care for their patients 24 hours a day.
There is a certain irony in the fact that the view from the Chief Executive’s office window is dominated by the behemoth that is Bart’s Hospital. The provision of care is often dominated – both physically and professionally – by the specialists and the specialties, but there is a growing and strong feeling that GPs need to get more involved in commissioning care, so that we can get more high quality care into the community. It seems that this is happening in Tower Hamlets.
On the same theme – I went back to Croydon last week to meet with Dr Agnelo Fernandes, our RCGP Clinical Champion in Urgent Care and was inspired by the excellent work that is taking place. The individual GPs in Croydon and their GP Federation are doing great things, including their award-winning work improving access to diagnostics. The Croydon GP Federation just demonstrates how collaborative work – even across many practices – gives excellent benefits both for individual patients and the population as a whole.
I’ve been doing a number of surgeries this week and I was delighted that a woman we resuscitated at Bellevue managed to get out of hospital and came back to see me. She couldn’t remember any of the drama that unfolded, but she certainly looks better. Her case gave me a real sense of the excellent work that can be achieved when the practice team work together for the benefit of our patients.
Having a relationship with the media has its benefits, and its inevitable pitfalls, and this week I’ve been misquoted a few times in the medical press. It’s unfortunate sometimes that in supporting an idea, you can be misinterpreted. I firmly support the Cancer Reform Strategy, and Mike Richards’ work. But I think that if you look at the statistics – and by that I mean the Cancer Outcomes of one year and 5 years – we can do better. This isn’t an issue about bashing GPs around the head which is how it came across in the press, it’s about everybody doing as much as we possibly can to get patients to approach us when they have relevant symptoms and then either refer or investigate as appropriate and as quickly as possible. One of the things I think is a good idea is the Critical Events Analysis – sometimes called Significant Event – when someone is diagnosed with a cancer. It’s important to ask: Is there anything we could have done better? Could the hospital have worked more efficiently?
The Out of Hours debate continues, and I am hoping that the Report, produced by myself and David Colin-Thomé for the Minister will be published in the next couple of weeks. What has been heartening throughout this debate is how the three leading UK political parties have praised the role of GPs, in and out of hours. There has, however, been a bit of a setback with regard to 5-year GP Training, and there is still some work to do to convince out specialist colleagues that we need longer training to prepare GPs for the numerous extra responsibilities they now take on as more care moves into primary care. The College’s curriculum ensures that good GPs enter practise, but many tell us that they’re not confident in their work and not gaining crucial experience in key areas, for example in the treatment of acutely ill children. But we will soldier on in the knowledge that all of the international evidence agrees that by having the right number of GPs in the right place at the right time, patient care is better and less expensive than secondary- or tertiary-dominated care. These are points that I also raised to the NHS Chief Executive David Nicholson and Jim Easton Director General Jim Easton, who has the remit for finding savings, while improving quality and productivity.
Well, it’s the end of a busy week, I’ve finished this afternoon’s surgery a bit late, but I’m looking forward to a restful weekend, and a win for the Baggies.
As always, I value your opinions and feedback enormously, and I urge you to get in touch if you have any comments or questions for me.
Tuesday, 17 November 2009
RCGP Conference and Beyond
It’s been an exhilarating, if exhausting, week. Our Conference last week in Glasgow was an enormous success, and as ever it was a brilliant opportunity to meet many of you there. I was particularly impressed to see how many associates-in-training had attended the Conference this year and to see the excellent small group work taking place.
I would like to take this opportunity to offer my enormous thanks to Clare Gerada, who has worked tirelessly with her team over the past year to organise what was a fantastic, inspirational conference. Clare’s vision, creativity and hard work ensured that the Conference was such an enormous success, and without her continued commitment and enthusiasm it would not have been possible.
I would also like to thank the in-house staff at the RCGP for their efforts in ensuring the Conference went without a hitch, and Profile Productions, our organisers, for their invaluable assistance.
Of course, the Conference is not céilidhs and coffee mornings – I also found time to attend some excellent speeches and presentations. I felt that one of the big successes of the Conference were the variety of Revalidation themed sessions.
The headline Revalidation workshop – Revalidation Ready? – was a particular highlight, and demonstrated an encouraging shift in attitudes toward Revalidation as it edges ever closer. There seemed to be a general feeling of confidence and positivity among the attendees, where previously there was anxiety and fear. This is a fantastic development, and one which I support wholeheartedly.
There was a good response to the CPD credit scheme, and any remaining concerns are now in the hands of others. With this now in place, the RCGP is ready to lead the way in ensuring that we have an appropriate appraisal scheme and systems of CPD. I believe very firmly that Revalidation is actually about professional development and not about finding another Harold Shipman.
It’s difficult to single out any particular presentations, but I must mention Gordon Moore’s. His views on the US healthcare system offered invaluable insight and were enormously thought provoking.
Of course, discussions on the issue of Practice Boundaries dominated the Conference. I’ve commented widely on this issue to the media, and it was a key feature of my keynote speech. There are a small number of patients who want the continuity of care provided by GPs but can’t get it because technically their home is not where they spend most of their time. There are patients who wish to choose a high quality practice but currently are having difficulty in doing so because of how boundaries are drawn. We said we’d work with the DH to look at solutions, and I know that the GPC has also indicated its willingness to discuss the issues with them. Providing excellent patient care should, and must always remain our priority, and continuity of care is vital in achieving this – isn’t it fantastic that people are calling for more opportunities to have the high quality and continuity of care provided by GPs.
I’ve returned from the Conference to a flurry of media interest, and have given a number of interviews over the last week to discuss issues raised at the Conference. On Wednesday I was interviewed by CBS to discuss the UK’s swine flu vaccination programme. The CBS interview aired late last week, and in it I talk about the contrast between the UK and US response to swine flu, and our comparative vaccination programmes.
In my keynote speech, I commended the current UK programme and its ability to target those most at need, in comparison to the US programme, which I said was "the survival of the fittest and the richest".
It’s a contentious issue, and one which is very close to the heart of a particularly angry American woman who got in touch with me this week in order to respond to my comments. She wrote:
I suppose this just highlights the old cliché that you can’t please all of the people all of the time…
I believe that we are very fortunate to have a national health service with general practice at its heart. It made me very proud to see you all at the Conference and to hear about the brilliant work you’re doing day to day to raise standards of care for our patients ever higher. I look forward to seeing you all again at the Conference next year.
As always, both I and the College value your opinions and feedback enormously, and I urge you to get in touch if you have any comments or questions for me.
I would also like to thank the in-house staff at the RCGP for their efforts in ensuring the Conference went without a hitch, and Profile Productions, our organisers, for their invaluable assistance.
Of course, the Conference is not céilidhs and coffee mornings – I also found time to attend some excellent speeches and presentations. I felt that one of the big successes of the Conference were the variety of Revalidation themed sessions.
The headline Revalidation workshop – Revalidation Ready? – was a particular highlight, and demonstrated an encouraging shift in attitudes toward Revalidation as it edges ever closer. There seemed to be a general feeling of confidence and positivity among the attendees, where previously there was anxiety and fear. This is a fantastic development, and one which I support wholeheartedly.
There was a good response to the CPD credit scheme, and any remaining concerns are now in the hands of others. With this now in place, the RCGP is ready to lead the way in ensuring that we have an appropriate appraisal scheme and systems of CPD. I believe very firmly that Revalidation is actually about professional development and not about finding another Harold Shipman.
It’s difficult to single out any particular presentations, but I must mention Gordon Moore’s. His views on the US healthcare system offered invaluable insight and were enormously thought provoking.
Of course, discussions on the issue of Practice Boundaries dominated the Conference. I’ve commented widely on this issue to the media, and it was a key feature of my keynote speech. There are a small number of patients who want the continuity of care provided by GPs but can’t get it because technically their home is not where they spend most of their time. There are patients who wish to choose a high quality practice but currently are having difficulty in doing so because of how boundaries are drawn. We said we’d work with the DH to look at solutions, and I know that the GPC has also indicated its willingness to discuss the issues with them. Providing excellent patient care should, and must always remain our priority, and continuity of care is vital in achieving this – isn’t it fantastic that people are calling for more opportunities to have the high quality and continuity of care provided by GPs.
I’ve returned from the Conference to a flurry of media interest, and have given a number of interviews over the last week to discuss issues raised at the Conference. On Wednesday I was interviewed by CBS to discuss the UK’s swine flu vaccination programme. The CBS interview aired late last week, and in it I talk about the contrast between the UK and US response to swine flu, and our comparative vaccination programmes.
In my keynote speech, I commended the current UK programme and its ability to target those most at need, in comparison to the US programme, which I said was "the survival of the fittest and the richest".
It’s a contentious issue, and one which is very close to the heart of a particularly angry American woman who got in touch with me this week in order to respond to my comments. She wrote:
“You and the rest of the world can go jump in a lake. Any idiot that opens his mouth - publicly criticizing hard-working Americans - should do just a little more research into what has really been happening in my country. And.....here's a BIG clue for you! You are NOT going to see it on CNN or any of the mainstream media. I never thought I would live to see the day when our media was as corrupt as Russia's was when I was growing up. You will need to do a little seeking to find the real stories - basically, they will be the OPPOSITE of what you are apparently basing your uninformed opinions on.”
I suppose this just highlights the old cliché that you can’t please all of the people all of the time…
I believe that we are very fortunate to have a national health service with general practice at its heart. It made me very proud to see you all at the Conference and to hear about the brilliant work you’re doing day to day to raise standards of care for our patients ever higher. I look forward to seeing you all again at the Conference next year.
As always, both I and the College value your opinions and feedback enormously, and I urge you to get in touch if you have any comments or questions for me.
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