RCGP Council 23/11/09

I had to leave early in the afternoon but left notes which were read at appropriate times.

C10 priorities read 

  1. Deliver practical solutions to sustain and equip GPs to provide the best possible patient care and shape the future of general practice
  2. Develop the College into a dynamic and inclusive membership community
  3. Promote the contribution of general practice and the role of the GP
  4. Ensure members experience College membership as good value

can I suggest tweaks 

  1. TEST AND DELIVER  practical, evidence based interventions to sustain and equip GPs to provide the best possible patient care and shape the future of general practice
  2. Develop the College into a dynamic and inclusive membership community which actively campaigns for the sustainability of general practice 
  3. Promote the contribution of general practice and the role of the GP
  4. Ensure members experience College membership as good value through visible active campaigning from College for evidence based policy making in healthcare 

C11

It seems to me that this policy is a reaction to the politics of the last decade – against the industrial medicine of QOF, the priority of access over continuity, and the target based culture which a generation of GPs have grown up with. 

I think we simply don’t know whether the new ways of working will result in patients feeling that they have a relationship with a HCP that they know/trust.

Instead I would like to go back to what I always go back to: the fact that we are busier than ever BUT WHY . Some of this we know  – more complicated patients living longer with more monitored diseases. But much is structural – there is loads of non clinical bureaucracy that we seem to end up doing because no one else will – while someone else is doing what we do really well  ie seeing patients. This is topsy turvy and isn’t right. 

Surely we need to work on having other professionals to take the stuff away from us that we really don’t need to be doing at all – and improving IT in particular to make use more efficient? We should beware of making GPs take on even more responsibility without power to effect it properly.

I would think about 

  • the importance of a patient knowing who their doctor is and being able to trust them
  • the need for doctors to be doing high value care – and for technology and IT to assist them, not strangle them in that mission – and for us to identify what stops this 
  • the need to have our tasks based on evidence and cost effectiveness
  • the need for ethical and moral ground in what we do 
  • the need for evidence when considering the introduction of people with new roles in primary care, and the potential for unintended consequences – hence the need to test and evaluate independently 

C15 

I am not sure I really understand what fellowship is, or why it is better than being a member, apart from having different letters after your name. If there are concerns about inequality/elitism etc is it not just better to get rid of it? 

I know loads of amazing people who would never dream of applying. 

C20

International strategy – I am very concerned. 

I do not think that the RCGP has a role in making profit from other countries on the basis of selling services. I think the RCGP has a role in helping other countries develop their own colleges and then collaborating internationally. 

I am worried that the model is imperial and think there should be a debate about what the core purpose is of the international strategy. 

I also would like to see detailed finances in relation to : meetings with overseas governments, travel and accommodation for overseas business and number of staff. I would also like to know if meetings have been minuted, and either this, or a list of people who have been met with, is available. 

C6 Brunei 

Fully agree with all recommendations. 

like NAO – key now is to have thorough insight BEFORE not after events

I think there needs to be some kind of log of learning – we need to ensure we don’t repeat mistakes and understand why errors happened. 

Do we need some kind of annual summary log of issues and the actions so that we can understand what we are doing and what we are trying to prevent? 

In a few years there may be no one on TB or officers who ‘were there at the time’ – we need to build into the institutional memory. 

Can I suggest that every year an update is provided of learning events like this, and the change in policy or procedures which resulted. This is a biography of RCGP structural learning which should be available to any future council member, officer, lay rep, or TB board member, etc. 

motion to council passed regarding DOI registers with the GMC – now the work begins (again)

Debate and determine the motion:

That the RCGP calls on the GMC to ensure that;

  • all doctors registered in the UK make a declaration of interest as a condition of registration
  • doctors can update their declaration at any time, and must review it at least annually
  • these declarations are held on a register, which is publicly available and searchable, and where retrospective years declarations remain available

The RCGP confirms its belief that;

  • all healthcare professionals should make similar declarations
  • a central register could then be used by others, e.g. journals and employers, which would save time, avoid duplication, and improve reliability and audit
  • the cost of such declarations should be met by central Government

Proposed: Dr Margaret McCartney, West Coast of Scotland Faculty

Seconded: Dr John Cosgrove, Midlands Faculty

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