notes from council

please note  – there is no point saying something twice, so if other people make the same comment and it’s accepted, it just wastes time to repeat it . This is what I said today

• Sponsorship review

I want the RCGP to stop all sponsorship of the conference and educational modules – including by charities.

I have posted a letter Carl Heneghan and I have written to the Chair on twitter to explain why. Three main reasons 1) professionalism, independence, autonomy 2) skewing of education towards things with a product rather than things we should know about 3) let’s do the right thing and lead before it’s forced

I thought all members should have a vote/at least be allowed to express views – and I made clear that many I’m in touch with were frustrated by process where they have to go through faculty boards -some feel ignored –  I don’t see why judgement should be made by trustee board -the RCGP is  A MEMBERSHIP ORGANISATION and I think we should allow all members to express their views 

• Future of general practice  

we’re full – said a speaker – yes but what are we full of? Our days are filled with things that a) don’t need to be done at all  b) are not patient care but could be done by someone else e.g. prescriptions ‘out of stock’ , pointless forms, etc

THERE IS NO POINT IN OTHER HCP SEEING PATIENTS WHEN GPS END UP DOING NONSENSE AND NOT SEEING PATIENTS WHICH IS WHAT WE WERE TRAINED TO DO (cross at this, I keep saying it, nothing seems to change)

I gave the example of AF screening. I was at a meeting, told ‘only takes a second’ – this is abject nonsense. First of all, it is NOT recommended by the UK NSC. Second, it may be net harmful – we do not know, that’s why there is a trial starting. Third, there is an opportunity cost – large implications for workload – and four, it is backed by industry and I think we should take independent guidance (UKNSC) first.

we need to stop doing things that don’t work – and don’t start doing things that we don’t know work – especially when we have clear guidance and a trial aiming to answer that question

• person centred care is WHAT WE USED TO DO BEOFRE QOF 

we have become qof centred, innovation centred, financial centred, LES centred 

c’mon – and what about the evidence

e.g. evidence – activation levels – association only, one RCT I can find was of CBT! please don’t let start doing things that we don’t know are helpful

SDM – need tools we can use – not grand ideas that are too complicated for everyday use

written care plan – v little evidence of hard benefits and opp cost ++ 

‘social prescribing’ – irritates me for many reasons –

it’s a doctor centred, doctor controlled, doctor as entry term which gives doctors power- we should be relinquishing 

and :

“Social prescribing is being widely advocated and implemented but current evidence fails to provide sufficient detail to judge either success or value for money. If social prescribing is to realise its potential, future evaluations must be comparative by design and consider when, by whom, for whom, how well and at what cost.”

we should not need to ‘prescribe’ what should be normal access to healthy lifestyles – the are social, political issues – and we should not allow access to them primarily through GPs – this should be for the community and everyone.