It’s getting uncomfortable

A few months ago the BBC reported that “The poll of more than 900,000 patients found that, in the last two years, the proportion saying it was not easy to get through on the phone rose from 18% to 24%.”  The Telegraph, not a particularly pro public sector paper started an article under the headline “GP services are imploding as surgeries ‘at risk of closure'” with the paragraph

Two-week waits for GP appointments have become ‘common’, doctors have warned, while thousands could be left without a family doctor entirely due to financial cutbacks.

Then there is this interesting poll suggesting that one in ten GPs is planning to emigrate.

The Guardian rounds up our little press review with the news of falling GP numbers due to a recruitment crisis.

Since then there has been the confirmation via survey that overloaded GPs cannot cope any more and risk burnout.

I am not surprised that patients are getting upset with their GPs. For 8 years I saw a daily battle for appointments being fought  all over the East End, with long queues in front of practices at 07:30 in the morning (I recently saw a lady who brought a camping chair and her breakfast).

Over the last few years there has been a relentless onslaught on my profession from politicians and  – undoubtedly synchronised – from the usual corners of the press. The reason for this is beyond me. Primary care – as it is practiced in the UK – is the most cost effective way to deliver health care and so I naively presumed a government that has austerity as the main driver for its policy decisions would embrace and foster such a system. It’s widely recognised that ever pound invested in primary care saves 5 pounds in secondary and tertiary care, so investment into general practice is a financial no-brainer.  GPs were initially reassured that things would get better before the 2010 election after David Cameron promised  “With the Conservatives there will be no more of the tiresome, meddlesome, top-down re-structures that have dominated the last decade of the NHS“. What the nation got was the 2012 Health and Social Care Act, reducing general practice’s core funding and introducing a seven day GP service on a smaller budget.

It is getting uncomfortable in primary care, both for patients and providers. A+E is struggling like never before. If Brexit would really become a reality, then I would predict a considerable amount of EU doctors starting to think about their future in the country and the health system they love, risking another 20,000 doctors leaving (often serving areas that are struggling to attract graduates). There are about 3,000 GPs from the EU working in primary care, arriving every morning in their practice to do what they without doubt feel is the best job in the world, for patients they have been looking after for decades, in cities, towns and villages they have made their homes.

With another sudden, significant loss of doctors, the current crisis in the NHS would feel a gentle breeze, compared with the storm that’s coming, so better wrap up warm and batten down the hatches.


Great ideas, no followup

As suggested by the course facilitator, I had a look at some of the e-learning projects that the OU is associated within the OER movement. Unfortunately the majority seem to be dying a slow death by lack of funding and uptake, as the seem not to have been updated for a few years. xDelia, Cloudworks, Coherere and Compendium all must have felt like a good idea at the time, but it looks like their websites are now all gathering dust. This reflects the fickle world of open educational resources: it’s not enough to rent some domain space and plonk some content in there. You have to have both the funds, the manpower and the motivation to keep these up to date and relevant. So many excellent e-learning content, devised with good intentions and a lot of money, is now languishing in abandoned directories on web servers, but even making them available for free doesn’t make them more attractive (or easy to find). That’s why the RCGP invests in regular update cycles of their courses and their content management systems: there is no point in having a few gigabytes of learning lying around, gathering dust. It needs to be curated, edited and updated regularly, otherwise it will end like one of the previously mentioned projects.

Sad really.

EKU wins Gold!

I have been intricately involved with the production and curation of the RCGP’s Essential Knowledge Updates since 2008, first as the clinical lead for the programme, then in a more supervisory role and it has always been one of my favourite projects of the RCGP. Like the College’s Online Learning Environment it’s been growing steadily and currently has now has ca 28000 GP users who keep themselves regularly updated. Unsurprisingly I was rather chuffed when EKU won the Gold Award for Best eLearning Project (third sector) at the annual E-Learning Awards in London. Being picked as the best programme from fifty entries was a huge boost for the amazing team I get to work with and it felt great to attend the ceremony and pick up the award.

elearning awards photo
From L to R: Angela Lamont, eLearning Awards Presenter, Dr Thomas Round, EKU Development Fellow, Dragana Milosevic, Education & Projects Manager, myself with a rather angulated bow-tie and Dr Chris Elfes, EKC Clinical Lead & EKU Steering Group Chair.


Lipoedema On The Radio

I have been lucky enough to work with the amazing people from Lipoedema UK for the last 12 months, curating and authoring a joint project for the RCGP’s elearning site, the Online Learning Environment. For some reason outside my realm of understanding, this has suddenly brought me in front of the dashing Dr Mark Porter, his producer and a microphone to talk about Lipoedema on Britain’s best medical radio programme, ‘Inside Health’.

Thanks to an amazing editing job by the show’s producer, it actually turned out quite ok. It was great fun to walk around the hallowed halls of Radio 4, almost trip over Terry Wogan and feel incredibly glamorous for exactly 14 minutes.

Thanks to the team of ‘Inside Health’ for making my 5 minutes of limited fame sound for once quite professional.

RCGP Conference Harrogate 2013

So, in an never ending cycle that revolves around Harrogate, Liverpool and Glasgow, this year the great RCGP circus arrived in Harrogate, that loveliest of Yorkshire spa towns. It was great to catch up with friends, colleagues and fellow GPs and do some communal moaning about the state of general practice and engage in some gossiping. There were some amazing talks and presentations, and as usual there is plenty to take back to the surgery. This year I learned:

  • Maureen Baker, our new chair of council is excellent and the next three years will be cracking
  • There will be no extra money
  • Delivering end of life care at home is not only better for the patient but also saves oodles of cash
  • More practices should sign up to be sentinels for the RCGP Research and Surveillance Centre to improve early warning for influenza epidemcis
  • Jeremy Hunt has hypnotic powers
  • Ben Goldacre is even better when he is sleep deprived
  • The RCGP should not save money on comedians or food

Can’t wait for next year!

EKU 9 is out!

Hi all,

EKU 9 has been released into the wild. Have a look here, it’s stuffed full of goodness, high in fibre, 100% natural and excellent for the wellbeing of your patients and your CPD folder. It’s especially hand selected contents are:

  • Diagnosis & Management of Maturity Onset Diabetes of the Young (MODY)
  • Management of Non-Cystic Fibrosis Bronchiecstasis
  • Stable Angina: Methods, Evidence & Guidance
  • HIV in Primary Care
  • Long Term Benzodiazepine Withdrawal
  • Older Persons’ Substance Misuse: Our Invisible Addicts
  • Management of Hypertension in Adults in Primary Care
  • Non-Alcoholic Fatty Liver Disease

I am sure you will agree with me that this looks like an excellent menu.

Now go and check it out.

RCGP Council Elections

Last week I received the notification that I will be on the national ballot for this years RCGP council election. This of course very exciting, but as the other members are rather better known and more distinguished, it’s going to be rather unlikely that I will make it into august ranks of RCGP councillors. Nevertheless, if you’re interested what my motivations are, have a look here.

Thanks for stopping by,