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This week has seen the gathering in Belfast of GP grassroots representatives from across the UK at a time of immense change for general practice. While contractual divergence across the four nations is defining clear differences in the way services are provided, the UK Conference of LMCs (local medical committees) has spent almost two days debating shared challenges and things that unite us.BMA GPs committee chair Richard Vautrey kicked proceedings off with a review of activity for the past year in the four nations and underlined the fact that we have listened, we have acted and we have delivered.The conference heard an excellent debate focusing on the tragic and increasing trend of suicides of GPs and called for the proper resourcing of support services for hard-pressed GPs. During the next day and a half there were various motions relating among other issues to screening, information governance, data protection, sessional GPs, education, training, appraisal and revalidation.There was a very useful and informative debate about the effect of Brexit on medicine in the UK and across Europe, with especially bleak forecasts for service delivery in the event of no deal. It was resolved to engage with regulators to anonymise all performance processes to minimise unconscious bias on the regulatory and performance system. And there was input from dispensing doctors with the conference supporting their call for the provision of the IT solutions necessary for their proper integration into the electronic prescribing system.The conference expressed its full support for the partnership model of general practice, not only in England where this has been given a boost by the new contract deal, but across the entire UK where practices provide the bedrock of NHS care to patients.The was a renewed call for the GMC to recognise general practice as a specialty in its own right, while in the realms of care delivery a call went out for a rebalancing of continuity as a priority over immediacy of access, while further points were made about inappropriate and unfunded transfer of care from secondary into primary care. A further motion called for general practice not to be dragged into being the solution for the pressures on others parts of the urgent care system.Firm motions demanding improvements to pension arrangements for partners, salaried doctors and locums were passed and a motion cautioning against the wholesale dependence on remote and electronic working was supported.We heard excellent reports on activities in Northern Ireland and Scotland, before the conference rose in a standing ovation to salute the final annual report speech given by Charlotte Jones who steps down in July as chair of GPC Wales after six years of incredible work on behalf of GPs in the principality and across the entire UK. We all owe her a huge debt of thanks and her unique style of leadership will be sorely missed.Conference heard of goings on in the Highlands and passed a motion unanimously condemning bullying in the NHS and called for action to prevent this.And so after an intense day and a half of discussion and debate across an enormous range of issues that affect UK GPs, delegates finally headed off for their planes, boats and trains on their journeys home. The conference demonstrated once again the vibrant engagement from grassroots GPs right through to policy makers and contract negotiators. It demonstrates GP representation at its best and across the four nations of the UK it is clear that as a profession we stand united.
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