RCGP Council 24/6/17

1) COI and relationship council to trustee board
I asked that published literature makes clear that Trustee Board (who are reviewing sponsorship guidance) must report to Council.

2) 5YFW evidence based nonsense
On discussion of the 5 year forward view, I was most concerned that:
there 5 Year Forward View seems to be still regarded positively yet it contains numerous uncosted and non evidenced policy making – especially with regard to ‘innovations’ in technology. If we spend money on this there is less to go elsewhere on evidence based interventions and we all lose out
instead money seems to be getting poured into management consultancies
we need to move urgently to evidence based policy making
we are window dressing a cliff edge to general practice

3) Physican assistants
I said that: positive anecdotes don’t cut it: needs systematic review, investigation of harms and assessment of opportunity costs
If I were designing a true assistant role, I would not start here – GP work involves so much bureaucracy that could be done by someone else trained to do so and allow more time for patient care by GPs

4) mental health
My concern is that the fragmentation of mental health and voluntary sector schemes make it very hard to ensure vulnerable people get cared for and the organisation of negotiation between schemes often seems to fall to GP; also an editorial in the BMJ co authored by Professor Hawthorne implies that training for GPs can only take place in secondary care: this is misleading

5) sponsorship policy
Agreed with John Cosgrove – who said we shouldn’t divide into commercial vs non commercial sponsorship but should look more broadly at organisations who seek power in our work for whatever reason. So e.g. an insurance company or make up brand – different from any drug or tech company. Call to look to Nordic countries for great examples of minimal or no sponsorship, or Evidence Live or Preventing Overdiagnosis conferences for simillar.

6) leadership. without critical thinking it’s nothing. Needs to be able to demand evidence, think critically and be worth following.

7) overdiagnosis group – widely appreciated but bottom line is that we need support internally applying the 5 tests and agreed to discuss this within the college as we are at the limits of the group as to what we can do – agreed would discuss further . Part of proposals are for council staff and CIRC to be more involved with applying the ‘five tests’ of the overdiagnosis group and to work more closely with devolved faculties. Agreed.

8) private screening paper – very supportive comments from council, widely accepted and praised, and discussions to be had about moving this forward with other organisations.

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