RCGP sponsorship policy:

The Trustee Board have decided to review this after concerns were brought my myself and others to Council about sponsorship of conference and education.

I’m concerned that because the Trustee Board are also responsible for finances it will be difficult to disentangle the two responsibilities. While the Trustee Board are also responsible for reputational risk, but are not directly elected by members. For these reasons I felt that the review should be designed and led by more than just Trustee Board. I will write again to the Chair of Council regarding this.

Membership by assessment: I raised various concerns about proposals to change criteria: especially doctors who are struggling. I think competence based assessments are already in place and ‘grading’ of Fellowship would have adverse consequences.

Referral management:

Two problems: 1) is this being done to reduce demand. If being done because of austerity politics, then it is crucial that rationing is made explicit and the public are given full information about why. And referral management systems don’t reduce demand and research hasn’t assessed harms. 2) Is it being done to improve quality: if so, this should be done in different ways, again there is evidence that referral management systems don’t improve quality, and we have seldom learned from the past in terms of what does help.

and again, when do we measure harms – so much of my work is now taken up with trying to deal with specialities (especially psychiatry) who want to refer patients away from them.

RCGP Clinical Priorities

I’m concerned that the Overdiagnosis principles haven’t been applied to the current iteration of clinical priorities. For example, in sepsis, some of the tools being applied to GP have not been tested for accuracy or safety. It was agreed this will be reviewed.