General practice in the post Covid world #covid19rftlks

A permanent reduction in red tape and bureaucracy to give GPs the time they need to manage the aftermath of COVID-19 at a community level is one of the calls in a new Royal College of GPs’ report looking at how the pandemic will shape the future of general practice.

The report makes the case that throughout the pandemic, general practice has shown it functions well with fewer bureaucratic processes, such as contractual and regulatory compliance activities. While it recognises the need for regulation and other processes to ensure patient safety and quality of care, the College says there also needs to be a shift to a ‘higher trust’ model that gives GPs more time to deliver patient care.

Full report: General practice in the post Covid world: Challenges and opportunities for general practice

RCGP press release: RCGP calls for less arduous regulation and more trust in the profession post-COVID

Postnatal Maternal and Infant Care during the COVID-19 Pandemic: A guide for General Practice #covid19rftlks

Royal College of Practitioners | 3 June 2020 | Postnatal Maternal and Infant Care during the COVID-19 Pandemic: A guide for General Practice

Maternal postnatal checks, the 6-8-week infant examination and routine childhood vaccinations should continue as high priority services during the COVID-19 pandemic.
It is critical not to overlook serious issues for mother and infant, and to protect against the resurgence of other vaccine-preventable disease.
This advisory guide is intended to help General Practitioners who deliver these services during the pandemic.

Postnatal Maternal and Infant Care during the COVID-19 Pandemic: A guide for General Practice

Full details from RCGP

High stress and low satisfaction with workload among UK GPs.

Feeling the strain: what the Commonwealth Fund’s 2019 international survey of general practitioners means for the UK  | The Health Foundation 

This document presents UK-focused analysis of ‘The Commonwealth Fund’s 2019 International Health Policy Survey of Primary Care Doctors in 11 Countries’. This includes responses to several UK-specific questions funded by the Health Foundation.  The survey asked GPs’ views on their working lives, changes in how they deliver services and the quality of care they can provide to patients.

Key points
  • The Commonwealth Fund surveyed 13,200 primary care physicians across 11 countries between January and June 2019. This included 1,001 general practitioners (GPs) from the UK. The Health Foundation analysed the data and reports on the findings from a UK perspective.
  • In some aspects of care, the UK performs strongly and is an international leader. Almost all UK GPs surveyed use electronic medical records, and use of data to review and improve care is relatively high.
  • The survey also highlights areas of major concern for the NHS. Just 6% of UK GPs report feeling ‘extremely’ or ‘very satisfied’ with their workload – the lowest of any country surveyed. Only France has lower overall GP satisfaction with practising medicine. GPs in the UK also report high stress levels, and feel that the quality of care that they and the wider NHS can provide is declining.
  • A high proportion of surveyed UK GPs plan to quit or reduce their working hours in the near future. 49% of UK GP respondents plan to reduce their weekly clinical hours in the next 3 years (compared to 10% who plan to increase them).
  • UK GPs continue to report shorter appointment lengths than the majority of their international colleagues. Just 5% of UK GPs surveyed feel ‘extremely’ or ‘very satisfied’ with the amount of time they can spend with their patients, significantly lower than the satisfaction reported by GPs in the other 10 countries surveyed.
  • Workload pressures are growing across general practice, and UK GPs report that they are doing more of all types of patient consultations (including face-to-face, telephone triage and telephone consulting). Policymakers expect GPs to be offering video and email consultations to patients who want them in the near future, but the survey suggests that this is currently a long way from happening. Only 11% of UK GPs report that their surgeries provide care through video consultation.

See also: Health Foundation press release

Improving primary and community care

Realising the neighbourhood NHS: delivering a new deal for primary care in England | The Institute of Public Policy Research

This paper provides new evidence and ideas to improve the provision of primary and community care.  It argues there should be a ‘new deal’ for general practice which should consist of:

  • creating neighbourhood care providers to deliver the ‘neighbourhood NHS’
  • offering all GPs the right to NHS employment
  • reforming new GP roles to create career progression, time to care and realistic workload
  • a radical transformation of the primary care infrastructure.

£1.5 billion to deliver Government commitment for 50 million more general practice appointments

Government and NHS commit an additional £1.5 billion in total for general practice | Department of Health and Social Carestethoscope-1584223_1920

The Government and NHS England have committed at least an additional £1.5 billion for general practice over the next four years for additional staff, a key step towards delivering 50 million more appointments in general practice by 2024.

In addition to the Government’s commitment to invest in general practice under the Long Term Plan, this funding is for the recruitment of 6,000 more primary care professionals as well as for initiatives to support the recruitment and retention of doctors in general practice.

In agreement with the profession, the General Practice Contract for 2020/21 will also offer more check-ups for new mums as part of a major deal with England’s family doctors.

Also included in the agreement are regular visits for care home residents, assessing medication and new incentives to increase uptake of vaccinations and learning disability health checks, expand social prescribing referrals, and improve prescription safety checks.

Expanding the new workforce will allow GPs to focus on the sickest patients and will in time allow them to provide longer appointments to people who need one.

Full story at Department of Health and Social Care

The Health Foundation: Quality improvement in general practice

The Health Foundation | January  2020| Quality improvement in general practice

A press release from The Health Foundation outlines the importance of quality improvement (QI) to general practice. The charity has recently funded a piece of research from the London School of Hygiene & Tropical Medicine (LSHTM) that looks at draws on survey responses from over 2,300 GPs and over 1,400 practice managers across the UK, along with interviews and other qualitative research. The findings provide a unique insight into the state of quality improvement in general practice, and a better understanding of how to help the sector strengthen its improvement capability.

The researchers found that most GPs and practice managers see improving quality as a core aspect of their work. Almost all of them (99%) reported their practices being involved in some form of improvement activity, with the driver for much of this work coming from within practices rather than external prompts. Further, many respondents (60% of GPs and 71% of practice managers) said they were working collaboratively with neighbouring practices to improve services (Source: The Health Foundation).

See also:

RCGP Long waiting times for GP appointments are unacceptable, says College, as it calls on Government to prioritise general practice which has been ‘running on empty for too long’

Quality improvement in general practice: what do GPs and practice managers think?

New framework launched provides core capabilities clarity for advanced level nurses in primary care/general practice, promoting a high standard of patient care

Skills for Health | January 2019 | New framework launched provides core capabilities clarity for advanced level nurses in primary care/general practice, promoting a high standard of patient care

A framework launched this week provides clarity around the core capabilities required by advanced level nurses working in primary care/general practice and will promote a high standard of care for those utilising the services. It will allow nurses to showcase their advanced level knowledge, skills and behaviours which will be essential in the development of the multi-professional teams to provide excellent prevention and care for people accessing their services.

This framework sets a standard regarding the academic knowledge, skills and behaviours required to enable the highest standards of practice within primary care and general practice. It will support nurses working at an advanced level to demonstrate and evidence their capabilities to service commissioners, employers, people utilising health care and the public. (Source: Skills for Health).
Image source:

Royal College of General Practitioners  & Skills for Health

The Core Capabilities Framework for Advanced Clinical Practice (Nurses) Working in General Practice/Primary Care in England 

Further information is available from Skills for Health 


How to build effective teams in General Practice

This guide draws on insights from research, policy analysis and leadership practice to outline ways in which practices can create and sustain effective teams, as they come together to form primary care networks | The Kings Fund

The need for collaboration and communication underpins much of the guide and links to further reading and case studies to support each section are provided. The guide looks at the following questions:

  1. What are the fundamentals of effective teams?
  2. Which roles should you recruit?
  3. How can you make best use of new roles?
  4. How can teams communicate effectively?
  5. Do you need to re-design your physical space?
  6. How can you ensure supportive management and accountability?
  7. How can you work across organisations?
  8. How should you engage with your patients?
  9. How can you manage yourselves effectively?

Full document: How to build effective teams in general practice

The state of medical education and practice in the UK

New publication from General Medical Council (GMC) reveals 45% of GPs work less than full time, and 36% have reduced their hours in the past year as report highlights doctors are making choices for a better work-life balance.

Image source:

This report highlights changing approaches to work-life balance and career development which impact on UK health services’ ability to plan for patient demand. Against a backdrop of rising workloads and the need to recruit and retain a sustainable medical workforce, the report finds doctors moving away from traditional career and training paths. Among notable trends is the rise in the number of doctors choosing to spend time working as a locum, practising medicine abroad, or even taking a year out, rather than going straight into specialty or GP training after the completion of their initial training.

Full report: The State Of Medical Education And Practice In The UK: 2019

See also: GMC press release: Doctors’ career choices a ‘new reality’ which health services cannot ignore

A quarter of cancer patients experience avoidable delay to diagnosis

One in four cancer patients experienced a delay to their diagnosis that could have been avoided, according to a new study | via Cancer Research UK

A new study, published in Cancer Epidemiology, looked at data the national cancer registry of around 14,300 people diagnosed with cancer in England in one year.

It found that nearly 3,400 patients experienced a delay that could have been avoided. Half of these patients waited around two months longer to be diagnosed compared with those who didn’t have an avoidable delay.

The reasons for delays are complex but researchers on this study attempted to identify what could go wrong. The study authors asked GPs to identify when the delay happened – before the patient saw their GP, while they were still being assessed by the GP practice or after they had referred them.

The data showed 13% of all avoidable delays happened before the patient saw their GP and 38% after the GP referred them to hospital. The other half (49%) happened while the patient was being assessed by the GP surgery including waiting for tests to be done and results to be sent back.

Full story at Cancer Research UK

Research article: Swann et al. | The frequency, nature and impact of GP-assessed avoidable delays in a population-based cohort of cancer patients | Cancer Epidemiology | published online 3 December 2019.