For East and West Sussex LMCs
Dr Russell Brown
18 December 2014
The GPC held its final meeting of 2014 today.
CQC was discussed, in the context of the banding and inspection regime. CQC wish to meet with GPC to discuss how best to move forward. I am not sure, personally, that moving forwards should be the preferred option. I maintain that, rather than being not fit for purpose, the CQC is an organisation without a properly defined purpose it could be fit for. Nevertheless, hopefully engagement will result in improvements to an incompetent process.
Co-commissioning guidance has been published by GPC in the last week. To reiterate my comments of last month, it is absolutely imperative that all GPs make sure they are fully informed and fully involved in this matter. Colleagues will be aware that six of the seven Sussex CCGS have written to the Area Team expressing a desire to pause until more detail is available, such that their member practices are better placed to make a properly informed decision about the way forward. This reflects well on the CCGs and their understanding of the need for robust engagement with their member practices. I was delighted that they were able to listen to their members in a way that some other areas of the country have not experienced.
Work continues on developing a strategy on the thorny issue of "Workforce". Recent publications by the Centre for Workforce Intelligence and HEE confirm the parlous state of GP recruitment and retention. A strategy document in draft form was discussed, covering a dozen areas. For my part, if there was a single thing that could be dealt with (if only life was so simple) it would be workload, specifically reducing it. Without doing that it is difficult to see how we can get the fun back into General Practice and make it a more positive career choice for young doctors. Despite the pressures we face, I can think of nothing I would rather do. Apart from retire, obviously. As a result of the debate, the document will be updated very soon. I will share it when I am able to.
An update on various issues around out of hours and unscheduled care were also discussed. There seems to be some movement in the understanding of other parties that GPs are just not physically able to take on more to relieve pressure in the system. This may seem difficult to believe in a week where there have been reports of an ambulance service recommending to patients that they ring their GP surgery first instead of 111, just in case they are open that evening. Such a fundamental misunderstanding of GP shows how far we still have to go. The duplication of service and uncertainty as to where to go and who to call for patients is the main problem. I hear calls for patient education but I can't see that this is the solution. Properly thought out integration of out of hours services, placing the patient at the centre of the process, must be the way forward. Piecemeal, often politically driven bolt-ons will only serve to further muddy the waters.
There are also moves to get General Practice recognised as a speciality in its own right, probably as Family Medicine. UK GP is so much broader and fuller than almost anywhere else in the world that it is incomprehensible to many of our European colleagues that we, along with Austria and Italy, do not recognise it as a speciality. I won't hold my breath.
Finally, over lunch, I was reflecting about my achievements this year at GPC. Struggling to think of anything concrete, it was pointed out to me by Julius that in order to measure achievement, one must first know what is being measured. I felt much better after that. I am able to share one definite achievement, though sadly not mine: after months of perseverance a colleague, who shall remain nameless, has managed to balance his or her pen on the microphone at his or her desk in the Council Chamber. I am sure you will all be pleased to hear that I refused to believe this without photographic proof, herewith replicated in all its glory:
The next GPC meeting is to be held on 15th January 2015. It only remains for me to wish all my constituents seasonal greetings. I hope we all have a peaceful and prosperous New Year.
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Dr Russell Brown