RCGP news

This page shows a summary of the latest news from the Royal College of General Practitioners RSS News Feed.

College hits back at anti-GP media coverage on prescribing

Sections of today’s media are once again criticising GPs, this time for their prescribing skills. You can read the full College response below.

The College will continue to defend hardworking GPs against the current onslaught of criticism - and continue our calls on the four governments of the UK to invest properly in general practice and provide better support for GPs in delivering patient care

Professor Martin Marshall, Chair of the Royal College of GPs, said: “Prescribing is a core skill for GPs and many of our nurse and pharmacist colleagues in primary care, and doing whatever we can to prescribe the most appropriate medicine for our patients, in an evidence-based way, is something we strive to do on a daily basis – and in the vast majority of cases, this review shows this is happening.

“With our growing and ageing population, with more patients living with multiple, chronic conditions, many people are taking several medications in order to manage their various health illnesses, and the interaction between various medicines is something prescribers will take into account. In most cases, these medicines are necessary, appropriate and of benefit for the patient – but the aspiration to reduce the number of medications a patient is taking, where safe and possible, is a good one.

“GPs will only ever prescribe medication to patients in conversation with them, and after a frank discussion about the risks and benefits of the treatment – and when alternative options have been explored. What GPs and other members of the practice team often need, however, is better access for their patients to alternative, non-pharmacological treatments, which can be patchy across the country.

“We welcome some of the recommendations in this report, particularly the commitment to provide further resources and training to support appropriate prescribing in primary care, and the development of clinical guidelines to support patient-centred care.”

Banbridge doctor wins GP of the Year Award

The Royal College of General Practitioners, which represents over 1500 GPs across Northern Ireland, is proud to announce that Dr Jonathan Dillon of Banbridge Medical Practice has been awarded GP of the Year 2021.

RCGPNI’s GP of the Year Award is nominated and judged by patients, to recognise the tireless work GPs and their practice teams have done throughout this pandemic, going above and beyond to support patients.

In addition to this, across the region, GPs have been an essential part of the pandemic response and have vaccinated almost half of our population and supported new ways of working in the community to help reduce waiting lists.

Dr Jonathan Dillon, 2021 GP of the Year, commented:

“I am honoured and humbled to be awarded GP of the Year, however I was more delighted that one of my patients took time out of their busy lives to nominate me and I would like to sincerely thank them for that. I also want to thank the fantastic team at Banbridge Medical Practice for their tireless work at this challenging time. This is an Award for all of our practice team.”

“Sometimes in General Practice and particularly now, the demand is so high and there are so many barriers that it can feel like you are never making a difference. Negativity on social media is at an all-time high, but it really makes the long hours and difficult work worthwhile to know that your patients genuinely appreciate and value the care you provide. I also want to thank my parents, my wife and my three children for all their support, particularly over the last year of long hours. I could not have done it without them."

Dr Laurence Dorman, Chair of RCGP Northern Ireland, commented:

“We are delighted with the response to our annual awards this year, with more patient nominations for GP and Practice of the Year than in any other previous year. This highlights the value patients place on general practice and receiving high quality care in the community. I also want to congratulate my colleague, Dr Jonathan Dillon for being honoured as Northern Ireland’s GP of the Year. The person-centred care he provided had compassion and quality at its heart and this is a richly deserved accolade.”

GPs and patients are ‘on the same side’ over face to face appointments – but chronic GP shortages make it hard to guarantee safe care, says College

Please read below for our reaction to the Daily Mail’s campaign on face to face appointments.

We will continue to challenge unfair criticism of hardworking GPs in the media and elsewhere - and continue our calls on the Government to invest in general practice so that GPs can give patients the safe care they need.

Professor Martin Marshall, Chair of the Royal College of GPs and a GP in East London, said:

“GPs go into general practice to care for patients. We’re on the same side and we share their frustrations when they face long waiting times for an appointment or trying to get through to the surgery. They should have access to high quality GP care when they need it - but that care must also be safe, and the chronic shortage of GPs is making this increasingly difficult to guarantee.
 
“General practice has been open throughout the pandemic. The move to mainly remote consultations was in line with government guidelines and was necessary for infection control and to keep patients – and GP teams – as safe as possible. Face to face appointments and physical examinations have continued throughout, wherever clinically appropriate and safe to do so. The number of face to face consultations had continued to rise since the peak of the pandemic and the balance with remote is now roughly half and half.
 
“Crucially, remote consultations have enabled GPs to carry on working, providing care and essential services to millions of patients at a time when other parts of the NHS had to shut down, and when many patients were reluctant to use the NHS for fear of catching the virus.
“Remote care is not substandard, and GPs work incredibly hard to deliver the same high-quality, care for their patients, whether a consultation is remote or face to face. We hear a lot of negativity around remote consultations, but we rarely hear about those patients who are very satisfied with being seen remotely by a GP and appreciate the convenience because it means they don’t have to take time off work or arrange childcare. There are some patients who find it easier to discuss more personal details about their health in a remote setting.

“We know that many patients will always prefer to see their doctor face to face, and many GPs prefer this method too as it can be easier to pick up on soft signs which can be useful in making a diagnosis.
 
“However, despite the easing of restrictions, this pandemic is far from over and we cannot afford to be complacent. The rise in the number of Covid infections means that we must continue to remain cautious, and take precautions to reduce the spread of infection, particularly in health care settings such as GP surgeries where vulnerable patients are being seen on a daily basis. 
 
“Post-pandemic, GPs will continue to offer a blend of face-to-face and remote consultations, based on shared decision making between the GP and patient and depending on individual needs and circumstances.
 
“But the underlying issue is that general practice is overwhelmed. Supply has fallen way behind demand and our workforce is not sufficient to deliver care and meet the complex needs of a growing and ageing population.
 
“Successive governments have failed to invest in the family doctor service for more than a decade and GP numbers have been allowed to decline while our workload has escalated in volume and complexity. The number of full-time equivalent (FTE) GPs fell by 4.5% between September 2015 and March 2021, meaning that the ratio of patients to FTE GPs has increased by almost 10%. 
 
“GPs are finding it increasingly hard to deliver even safe care, let alone the personalised care that patients expect. This was the case before the pandemic, but the past 18 months have only exacerbated it and the pressures are now unsustainable. 
 
“Recruitment to GP training is looking positive but it takes time to train a GP and we are losing more colleagues than are coming up through the pipeline. The College’s own recent surveys show that six in ten GPs say their mental health has deteriorated in the last year - and 63% say they expect things to get worse over the next five years. 34% of GPs expect to leave within five years - a quarter due to stress and burnout - meaning over 14,000 GPs could be lost from frontline patient care.
 
“We have presented the Health Secretary and Chief Executive of NHS England with a five-point emergency rescue package for general practice that provides realistic solutions for halting the crisis and protecting the care of our patients by investing in the hardworking GPs and their teams who provide that care.
 
“We urgently need progress on the 2019 Conservative manifesto target of 6000 more full time equivalent (FTE) GPs in the next three years, and the recruitment and integration of at least 26,000 other members of staff into the general practice workforce by 2024.
 
“We are also calling for a system-wide programme to eradicate bureaucratic burdens and unnecessary workload, to prevent GP burnout and allow GPs more time to care for patients.
 
“GPs have been running on empty for too long, but patients deserve a family doctor and if general practice is allowed to collapse, the rest of the NHS won't be far behind it."

 
RCGP Scotland comment on Scottish Parliament debate on face to face GP services

Dr Chris Williams, Joint Chair of RCGP Scotland, said:

"At the beginning of the COVID-19 pandemic, GPs and their teams rapidly altered the way in which they deliver care to patients; scaling up, virtually overnight, the technology available for patients to access remote consultations. Offering remote consultations, either by telephone or virtually, has ensured that general practice has been able to continue to provide care safely throughout the pandemic. Face to face appointments have been available to patients when they have been deemed clinically necessary, usually following a telephone call with the practice or remote consultation with a member of the practice team.

"We recognise that many patients prefer face to face appointments; indeed, many GPs prefer to deliver care in this way too. RCGP Scotland is clear that the future of general practice should be a mixed model of remote and face to face appointments that meet the needs of the individual patient. We also want to ensure that our patients are able to spend more time with their GP - this is why we strive to deliver 15-minute appointments as standard.

"While we continue to work towards this favoured method of delivering GP services, we cannot lose sight of the fact that our health service is still operating under extremely difficult circumstances and unfortunately it simply isn't possible to deliver to the extent that we would like at the moment.

"The risks still posed by the incredibly high number of cases of COVID-19 in our community to our most vulnerable patients remains a very real and immediate concern. We have to do all that we can to ensure that general practice is a safe environment for all of our patients and that all those who are in need of care are able to access this as quickly and safely as possible. In many cases this means through remote consultations.

"General practice is currently experiencing unprecedented workload demands and with winter around the corner, these demands will undoubtedly increase. Earlier this year, a survey of our members reported that 73% of respondents are concerned that their workload will negatively affect their ability to deliver care for their patients this winter. The relentless circumstances within which GPs and their teams are caring for patients will undoubtedly have an impact on the retention of staff within our profession. We were already facing a workforce crisis before the pandemic and quite simply, we cannot afford to lose any more GPs.

"We believe that there is a key role in modern general practice for remote consultations and would oppose any moves to deny patients this option of accessing care by reinstating pre-pandemic ways of working.

"With COVID-19 still posing a threat, we view targets such as those suggested this afternoon in Parliament as meaningless. Updated guidance was issued to primary care last week from Public Health Scotland on social distancing within healthcare settings, with the view of GPs and their teams being able to offer more face to face appointments in time. Practices across Scotland are now working to ensure that they can implement this guidance as quickly and safely as possible.

"We would ask that patients bear with GPs and their teams as they consider and implement changes that will ultimately allow them to increase footfall within practices. GPs and their teams are also working within the confines of the physical spaces within which they work and as such, the processes that will be introduced are likely to differ across the country.

"Instead of arbitrary targets, which we feel would not benefit either patients or the wider health service, we need to see concerted and urgent action in a range of areas that would improve general practice and ultimately the standards of care that patients receive.

"Key to this is a need for credible workforce planning to ensure that we have an appropriately staffed service, which of course has to be underpinned by adequate funding. We have long called for 11% of the total NHS Scotland budget to be provided to general practice. Adequately resourcing the frontline of our health service will ensure that general practice can reach its full potential and help to manage demands on other parts of the healthcare system.

"We look forward to continuing to work with the Scottish Government and MSPs from across the political spectrum to ensure that general practice has what it needs to deliver the highest standard of patient care now and in the future."

College response on roll-out of Covid booster vaccine

The College has issued the following statement, following the Government’s confirmation of the Covid ‘booster’ vaccine programme for over 50s and clinically vulnerable patients

Professor Martin Marshall, Chair of the Royal College of GPs and a GP in East London, said: “The success of the Covid vaccination programme has been largely down to the hard work of GP teams - with the majority of vaccinations delivered in primary care - and it is crucial that patients continue to get as much protection as possible so that we can move from a pandemic to an endemic Covid situation.

"We appreciate the need for speed with the roll-out but appeal to patients to wait until they are called for the vaccine and not to contact their surgery. GPs themselves have only just had this news confirmed and need to accommodate arrangements around the existing needs of patients.

"General practice was already facing a really tough winter and GPs will need support to manage the additional challenges of the booster programme in addition to our existing and huge workload pressures. In tandem, we’ll also be running the largest-ever flu vaccination, with 36 million people entitled to a vaccine on the NHS, so it’s vital that GP teams are able to rely on sufficient flu vaccine supplies to keep everything running like clockwork.

"Today’s announcement shows that this pandemic is far from over and also demonstrates the urgent need for the Government to deliver on its pledges and get additional resource and support into general practice as quickly as possible. Patient care must be safe, and we need to prevent more GPs from burning out or having to leave the profession for the sake of their own health.”

Chronic shortage of GPs is the reason patients are facing long waiting times for appointments, says College

The College has responded to comments made by the Secretary of State for Health and Social Care for England, Sajid Javid, about face to face GP appointments

Professor Martin Marshall, Chair of the Royal College of GPs and a GP in East London, said: “GPs and patients are on the same side here and we share their frustrations when they face long waiting times for an appointment or trying to get through to the surgery.

"The real issue here is not about face to face consultations, but the chronic shortage of GPs caused by a decade of under-investment in the family doctor service by successive governments.

"We need the Secretary of State to ensure that the Government urgently delivers on its election manifesto promise of 6,000 additional GPs and 26,000 extra members of the wider practice team. We also need initiatives to reduce bureaucratic burdens and prevent more GPs from burning out and leaving the profession

"General practice has been open throughout the pandemic and the move to mainly remote consultations from the start of Covid-19 was in line with government guidelines. It was necessary for infection control and to keep patients – and GP teams – as safe as possible.

"Remote consultations have enabled GPs and their teams to carry on delivering essential care and services when other NHS services had to shut down. Face to face appointments and physical examinations have continued throughout, wherever clinically appropriate and safe to do so.

"Remote care is not substandard, and GPs work incredibly hard to deliver the same high-quality, care for their patients, whether a consultation is remote or face to face.

"We rarely hear about those patients who are very satisfied with being seen remotely by a GP and appreciate the convenience because it means they don’t have to take time off work or arrange childcare. There are some patients who find it easier to discuss more personal details about their health in a remote setting.

"We know that many patients will always prefer to see their doctor face to face, and many GPs prefer this method too as it can be easier to pick up on soft signs which can be useful in making a diagnosis.

"Face to face consulting is at the heart of general practice and will always be an essential part of it. Over half of all GP appointments are now face to face and there is room for both methods post-pandemic, based on shared decision making between the patient and their GP in line with individual health needs and circumstances.

"Despite the easing of restrictions, this pandemic is far from over and we cannot afford to be complacent. The rise in the number of Covid infections means that we must continue to remain cautious, and take precautions to reduce the spread of infection, particularly in health care settings such as GP surgeries where vulnerable patients are being seen on a daily basis."

Media attacks on GPs ‘poison’ relationship with patients, says College Chair in powerful defence of the profession

College Chair Martin Marshall has written a scathing counter attack in the BMJ on the ‘war of attrition’ being waged against GPs by sections of the media.

You can also read it below.

The College is featuring prominently in the national media, setting the record straight on face to face appointments and calling on the Government to invest properly in general practice so that GPs can give patients the care they need, without burning out and jeopardising their own health.

Martin Marshall: Media attacks on GPs threaten the doctor-patient relationship

There’ve been numerous times in the past when GPs have unwittingly become the target of media criticism, but the current onslaught is the worst I can remember in over 30 years of being a GP.

As well as being offensive and inaccurate, it is also irresponsible as it poisons the relationship that GPs have with their patients and undermines the trust and confidence they have in us.

You need to be pretty thick-skinned to be a GP, but these almost daily attacks on our professionalism, commitment, and integrity are demoralising and wear you down. Some colleagues have described it as a “war of attrition” and, after 18 months on the frontline of a pandemic, they simply haven’t got the energy to fight back. Nor do demoralised and exhausted GPs have the luxury of newspaper columns where they can vent.

I need to emphasise that not all sections of the media have waded into the affray, some titles and journalists have actually been very supportive of general practice.

But the allegations levelled against us have, in the main, been reprehensible. As well as being described as “lazy,” “idle” and denying patients appointments so that we can “play golf,” we have been accused of not giving our patients the same level of care that vets give to animals and of “costing lives” by seeing patients remotely.

All this vitriol just for following government guidelines and trying to keep patients, and our practice teams, safe. General practice has been open throughout the pandemic, albeit in different way. As a result of the shift to largely remote consultations, GPs have been able to carry on working and providing essential care and services when many other parts of the NHS had to shut down. In addition, two thirds of all covid vaccinations have been delivered in primary care.

When criticism and accusations come from fellow clinicians or other parts of the NHS, they are particularly wounding. Other doctors who criticise us clearly know little about the pressures general practice is under, and being pitted against each other is so destructive at a time when the entire NHS needs to pull together more than ever.

While journalists and columnists are portraying themselves as the patients’ champion, they need to realise that these relentless attacks can have a much deeper impact. They can demoralise GPs to the point that they dread going to work or hasten their decision to leave the profession. At the other end of the scale, medical students are put off from choosing general practice—with serious consequences for patient care in the future—and those who do, often find themselves being denigrated and treated as “lesser” medics by their peers.

The real issue is that we are now seeing the fallout of over a decade of under investment in our service. Successive governments have allowed GP numbers to fall while volume and complexity of patient demand has risen and continues to do so. GPs have long been criticised for working “part time” when, in reality, the job of a modern GP to provide safe, effective, and personalised care for patients is becoming increasingly undoable.

The solution is for the government to deliver on its 2019 election manifesto commitment of 6,000 additional GPs and 26,000 more members of the wider practice team. We also need initiatives to reduce unnecessary bureaucracy for existing GPs to prevent burnout or their leaving the profession.

But the media can also play its part by campaigning to save general practice rather than plunging it further into the abyss.

With the strength of the media behind us rather than against us, GPs could gain the support we need to deliver the high quality and safe care that patients need and deserve, without jeopardising our own health.

College response on Covid vaccines for children and young people aged 12 and over

The College has issued the following statement, in response to the Chief Medical Officer’s decision to extend the Covid vaccination programme to children and young people aged 12 and over.

Professor Martin Marshall, Chair of the Royal College of GPs and a GP in East London, said: “The Covid vaccination programme has been a game changer in overcoming this virus and the response from the public - and the hardworking GP teams who have delivered it - has been phenomenal.

“Whereas the evidence for previous groups has been clear, the clinical risks and benefits of vaccination for this group are much more finely balanced. The decision to vaccinate children should be an individual one made by parents and their children and it is essential that they are supported to understand the pros and cons and to make an informed choice. However, we would encourage children and their parents to consider the potential benefits that vaccination can bring, both in terms of their individual health, and looking at wider factors such as schooling.

“It is important that parents, children and young people are not pressurised into a decision or castigated for it, whether they opt for the vaccine or not.

“There is still a sizeable minority of adults who have yet to receive a first dose and we are particularly concerned about the numbers of unvaccinated patients being admitted to hospital with Covid or other conditions. Every effort must be made to encourage these adults to have the vaccine as a priority.”

Media depiction of virtual appointments irresponsible and causing unnecessary concern, warns College

College Chair Martin Marshall has appeared in national media over the weekend to defend the role of remote consultations in general practice. Martin wrote to the Sunday Times to make the case.

Read the full letter here.

The suggestion that virtual consultations with GPs are “costing lives” is irresponsible and will cause unnecessary concern (News, last week). Care delivered by means of a telephone or video is not substandard. GPs work incredibly hard to deliver the same high-quality care whether a consultation is remote or face to face.

During the pandemic remote consultations have been necessary to protect patients and GPs. Face-to-face appointments have been offered when clinically appropriate and safe.

Most patients will be relieved that, when the Covid crisis is over, GPs will continue to offer a blend of face-to-face and remote consultations. General practice is overwhelmed. The workforce is not sufficient to deliver care. People who criticise GPs clearly know little about the pressures they are facing, and seeing doctors pitted against one another in the media is demoralising for GPs and damaging for patient trust and confidence.

Media vitriol is harming patient trust as well as GP morale, says College

We are outraged at the media coverage on remote consultations that is running in some of the nationals and online today.

College Chair Martin Marshall has a written an opinion piece in HSJ, defending hardworking GPs who - largely as a result of remote consultations - have continued to deliver essential care and services to patients throughout the pandemic.

He hits back at the ‘constant barrage of vitriol’ against GPs in the media and makes the point that the real issue in general practice is not about face-to-face versus remote consultations, but about chronic GP shortages caused by more than a decade of under-investment.

You can read it in full here:

The unexpected death of any patient receiving NHS care is always shocking and while we cannot comment on individual cases, our condolences go to anyone who has lost a loved one during the pandemic. 

However, media coverage of coroners’ reports (Concern raised over death of five patients seen remotely by GPs, HSJ 9 Sept) is contributing to a worrying narrative that has been gradually building up over the course of the pandemic: that remote consultations are substandard, harmful to patients and are being used by ‘lazy’ GPs as an excuse for not seeing patents face to face in the surgery.

As well as being inaccurate and untrue, this narrative in itself is harmful as it undermines public trust and confidence in remote consultations when thousands of patients are being assessed effectively and safely in this way in general practice every day – and have been since long before the pandemic. 

Patients are being led to believe that they haven’t had a ‘real’ consultation unless they’ve seen their doctor in person and this can leave them feeling ‘fobbed off’ or cause them unnecessary worry and distress that they haven’t been properly diagnosed.

Remote care is not substandard, and GPs work incredibly hard to deliver the same high-quality, care for their patients, whether a consultation is remote or face to face. Another misconception is that remote consultations take less GP time, when many actually take longer.

The move to mainly remote consultations from the start of the pandemic was in line with government guidelines. It was necessary for infection control and to keep patients – and GP teams – as safe as possible. Face to face appointments and physical examinations have continued throughout, wherever clinically appropriate and safe to do so.

Crucially, remote consultations have enabled GPs to carry on working, providing care and essential services to millions of patients at a time when other parts of the NHS had to shut down, and when many patients were reluctant to use the NHS for fear of catching the virus.

We hear a lot of negativity around remote consultations, but we rarely hear about those patients who are very satisfied with being seen remotely by a GP and appreciate the convenience because it means they don’t have to take time off work or arrange childcare. There are some patients who find it easier to discuss more personal details about their health in a remote setting.

We know that many patients will always prefer to see their doctor face to face, and many GPs prefer this method too as it can be easier to pick up on soft signs which can be useful in making a diagnosis.

Face to face consulting is at the heart of general practice and will always be an essential part of it. Over half of all GP appointments are now face to face and there is room for both methods post-pandemic, based on shared decision making between the patient and their GP in line with individual health needs and circumstances.

Despite the easing of restrictions, this pandemic is far from over and we cannot afford to be complacent. The rise in the number of Covid infections means that we must continue to remain cautious, and take precautions to reduce the spread of infection, particularly in health care settings such as GP surgeries where vulnerable patients are being seen on a daily basis.

What we cannot allow to continue is the concerted and totally unwarranted campaign of criticism that has been waged against GPs by large swathes of the national media throughout the pandemic.

Patients and GPs are on the same side and we share their frustrations at having to face long waits for appointments or when they can’t even get through to the surgery.

The real issue here is that the GP workforce is no longer big enough to meet the demands of a growing and ageing population. This was the case before the pandemic and the past 18 months have further exacerbated it.

Successive governments have failed to invest in our service for more than a decade and GP numbers have declined while our workload has escalated in volume and complexity. The number of full-time equivalent (FTE) GPs fell by 4.5% between September 2015 and March 2021, meaning that the ratio of patients to FTE GPs has increased by almost 10%. 

NHS pressures are not confined to hospitals and we urgently need the current Government to deliver on its 2019 election manifesto pledge of 6,000 additional GPs and 26,000 more members of the wider practice team.

The constant barrage of vitriol being aimed at our profession from various quarters is degrading and demoralising to hardworking GPs who are trying to do the best they can for their patients in the face of enormous pressures.

We need the media to back general practice so that GPs get the support they need to deliver the care that patients need and deserve.

Professor Martin Marshall is Chair of the Royal College of GPs and a GP in East London