Over a year since the start of the pandemic, we had hoped to be attending the LMC UK conference in person, but alas this was not to be. After some serious IT failings on day one, the virtual conference ran smoothly, mainly due to some excellent chairing from Mark Corcoran and Katie Bramall-Stainer.
The tone of the conference was set by the GPC chair’s speech, thanking GPs for their hard work during the pandemic and acknowledging that we are the ‘bedrock of the NHS’.
Richard Vautrey went on to speak about the need to now rest and recharge before we can deal with restoration and recovery. We also need to focus on retention, ensure we are enabled to work remotely (especially locums) and sort out pensions and premises. You can watch the presentation on what the sessional GPs committee have been working on for the past year.
As usual, there were lively debates across many issues affecting GPs.
- Calls for honesty with the public about the backlog of work within the NHS, post-COVID.
- Continuation of ‘appraisal-lite’ for another couple of years, if not forever.
- Meaningful support to retain GPs, including priority access to healthcare, careers guidance and psychological input.
- A move to 15-minute consultations as standard.
• Calls for IT funding to ensure fit-for-purpose + assessment of the deluge of work caused by e-consultations.
- Calls for better engagement and representation by GPC and LMCs, with a suggestion that LMCs should reconsider charging non-salaried sessional GPs.
- Green general practice solutions, including active travel, improving re-use, recycling and making premises carbon neutral.
- Commitment to addressing the gender pay gap and updates on how solutions are implemented.
- Calls for the DDRB process to be extended to non-practice based salaried GPs (eg some out-of-hours doctors) and assurance that all salaried GPs receive their recommended pay uplift.
- Request for changes to GPC to be more representative of LMCs and grassroots GPs, but not to leave the BMA.
- Zero tolerance to racism against healthcare staff and an urgent call to address the lower pass rates among colleagues of BAME origin in the mandatory RCGP assessments.
- A challenge to the Welsh Government imposing unreasonable conditions on locums’ access to medical indemnity and calls for a solution to indemnity to be found in Northern Ireland as soon as possible.
We spent a couple of hours discussing solutions to ‘dealing with the tsunami of workload’ and captured the mood of the room with less binary voting than when debating motions.
- There is an urgent need to capture practice activity data: 93% agreed/strongly agreed.
- Realistic patient expectations of what can be provided by both in hours and out-of-hours general practice are essential: 96% agreed/strongly agreed.
- The benefit to patients by increasing the ways they can access general practice (online consultations, direct booking by urgent care services) outweighs the increase in demand that this creates and the associated workload pressures: 65% disagreed/strongly disagreed, but 23% agreed/strongly agreed.
- All workload discussions must consider the system as a whole and not the needs of either general practice or secondary care in isolation: 61% agreed/strongly agreed.
- The interface points between primary, secondary and intermediate care must be formally defined by GPC, not left to LMCs: 59% agreed/strongly agreed.
- Assuming that the work is clinically safe and appropriately funded, general practice should be accepting more work from secondary care: 79% disagreed/strongly disagreed.
- Practices have all the tools they need to control workload, they just need to learn to say no: 73% disagreed/strongly disagreed.
Questions for GPC
Finally, there was the chance to ask questions to GPC UK and just generally be heard in the session. The topics below were covered.
- The ‘postcode lottery’ around sick-pay reimbursement of those suffering from long COVID.
- A proposal that ‘education, collaboration and communication’ with the public is the way to manage GP workload, and a call for IT solutions and occupational health access for all.
- A need for IT that is fit-for-purpose (and clinical systems that are a help rather than a hindrance).
- Filtering of work, to allow GPs to just do what they need to do and sabbaticals for all GPs.
- A need to find out why GPs are leaving permanent roles.
- Our unsustainable workload and a call for respect, not claps.
- Worries about the disintegration of healthcare with the arrival of integrated care systems.
Lastly, we had a reminder of the sterling work our GP charities (Cameron, Claire Wand and Dain Funds) have been doing over the past year and the importance of any of us accessing this help and support when in difficulty.
The virtual platform served us well, empowering a more diverse group of LMC members to attend and speak.
However, I’m sure we all missed the chance to catch up with our geographically distant colleagues and discuss all the problems facing general practice over a cup of coffee. Hopefully, we will be able to meet together in person next year.
L-J is a member of the sessional GPs committee and locum GP in the south west.