RCGP Council 21th/Feb/2014

I raised three main things.
1) Care data. Concerns about the differences in security and purposes of data use in England compared to the devolved nations.
This is to be taken back to NHS England for further discussion.
I would suggest that if RCGP members have concerns they should feed back to RCGP asap so that their views can be expressed via college. Prof Nigel Mathers is leading on this.
2) Last meeting, I asked if the DOIs which are made for all council members could be made public, and if minutes could be published.
The minutes will be published once agreed (so will always be one meeting cycle out.). DOI publication will be addressed.
3) Motion was raised to set up a new standing group for the examination and scrutiny of overdiagnosis and overtreatment. This was passed comfortably. Some faculties had been very supportive. Others were concerned about costs. The group will run virtually, or via google hangout etc, meeting at the annual conference in person. It was suggested that it should be a time limited group. I think that as a standing group was voted in, that’s what should exist. In any case, we need to involve people from now (ie – if you’d like to be involved, tell me). We need to be clear that
-overdiagnosis/overtreatment is twinned with underdiagnosis/undercare. This is key to reducing health inequalities and directing resources at the people most likely to benefit
-the GP contact and RCGP policies need to have the questions of harms considered (eg healthchecks, dementia screening)
-grassroots GPs need support from College to achieve professional practice – part of which is being able to ignore harmful or unhelpful guidelines and treat people holistically. Guidelines for primary care need to be written by primary care and patients.

Bottom line
– already have several fab people who are keen to be involved. There are a lack of women and BME doctors. Are you a GP who would like to be involved? Please email me margaret@margaretmccartney.com
We need patients to be involved at heart. The College has a PPG. I will speak to College to ask if we can get their help, or do we need other people to give their views?
-we need a document to present to the next meeting about
-aims of the group
-focus of the group
-working practice of the group
-intended outcomes of the group.

We can formally launch in Liverpool in Sept but keen to get as much done as possible before then.

4 Responses to “RCGP Council 21th/Feb/2014”

  1. John Cosgrove February 22, 2014 at 1:34 pm #

    Great work, Margaret, well done. I do hope the overdiagnosis/overtreatment group is a standing group. Council was wise to approve it as such.

    Pressures to overdiagnose and overtreat are growing daily and will need continued scrutiny.

  2. Mark Kasozimusoke February 22, 2014 at 7:27 pm #

    Fantastic work. So glad to hear about the overdiagnosis/overtreatment group. This is a problem which spans across secondary and tertiary care and no doubt filters back to the patient in the surgery. Despite the increased awareness of polypharmacy we Physicians find it difficult to veer away from the latest ‘evidence’. In Geriatrics we are in a perpetual battle to balance risk & benefit of certain interventions with little data that is applicable to the frailer octogenarian. Given our ageing population and the relentless advance of new treatments and ‘guidelines’ is it not necessary to adopt a more integrated approach rather than focusing just on primary care….? Will the BGS be involved in helping to write these guidelines ?

  3. margaretadmin February 22, 2014 at 10:18 pm #

    hello Mark, still in early stages of planning but I think it would be fabulous to have strong links with other specialities so that we can work together. Ash from FPH has also suggested working with him. can you email me? margaret@margaretmccartney.com

  4. Mike Wistow July 14, 2014 at 12:00 pm #


    I have just read the article “Re: Evidence based medicine: a movement in crisis?” and tracked through to this site this site via Google. I am not a clinician, though I have some experience of working in Healthcare in the past ten years.

    How’s your lateral thinking? If it is of interest to you, I chaired the national organisation for research in the Probation Service in the 1990’s, working with academics, Home Office policymakers and academics to pull together an understanding of effective practice with offenders to prevent them re-offending. This was in the early days of what would over the past couple of years be called Big Data. We used both quantitative and qualitative analysis to determine effective practice, shared findings through a variety of methods and helped to shape Home Office policy based on evidence of approaches to reducing re-offending. Generically this came to be known as What Works – ‘What Works, With Whom, and in What Circumstances’ – the focus being a statement, not a question.

    The Probation Service is small (tiny by comparison with health) – but that meant we could move quickly and engage at a national level easily. It has always struck me that there are principles and lessons that transfer across to health.

    If this is of any interest to you, please drop me an e-mail to arrange a phone call/meeting.

    Best wishes