Council 18/sept. 15

I spoke to

The media pressure being heaped upon GPs and the attitudes of the CQC/NICE/Department of Health being less than helpful. New GPs may be put off training because of the ongoing unpleasant press. Was there a need to engage these organisations and challenge the culture of trial by press release – no one is being helped by the present atmosphere.

Measuring funding of GP via % of total NHS spend is not that useful – if the total spend goes down, even an increase will be less overall. The RCGP needs to stop approving things that don’t work and detract from doing proper medicine. E.g. appraisal is largely wasteful. The RCGP should influence workload not just about patient care but about policies they have created which add needlessly to it.

RCGP and pharma – can we get rid of sponsorship for the conference – several medical conferences have no pharma funding. We should aim to have conferences cost neutral to the RCGP – GP speakers are unpaid after all.Pharma are able to influence college via supporting patient groups in turn supporting eg online learning. Caution is urged

Roland workforce report. Worshipping at the false god of technology (again). The telephone is pretty good – email is not proven to reduce workload and we lack safety data. We use the phone pretty well – we need less new tech and to be talking more about getting rid of things that don’t work – not starting new unproven things. You can’t have quality, instant access and continuity of care.

-Physican assistants are being paid only very slightly less than salaried GPs but with better pay and conditions. GPs are being outpriced for indemnity payments for out of hours work (including me). GPs are being urged to take responsibility for more staff members who are working semi-independently. This is moving towards a psychiatry model where a psychiatrist sees less patients but manages more other workers. I don’t think this is what we should be aiming for. There are some aspects of my work that I don’t need to do (and in some cases no one should be doing at all) but GPs are highly skilled in multimorbidity, complexity, overriding guidelines where irrelevant/not fitting/harmful, and seeing undifferentiated symptoms quickly. We need more members of our team to do the things we don’t have to do, but we should remember what it is that doctors do and why

– 7 day working – total DoH muddle between acute and emergency access. GPs doing more routine work 7/7 will mean less Gps doing urgent work OOH. This is silly considering how many areas are struggling to have enough OOH GPs.