I was privileged to attend the RCGP council meeting on your behalf again today. I will apologise for a reduced information gathering process than previously given my leave just before the meeting but thank fellow members and others from sending me information and challenges to raise in the meeting. If interested, see the #RCGPCouncil hashtag here.

Constitutional items

Council started by welcoming new members, saying goodbye to departing members and noting the change of guard as Prof Helen Stokes-Lampard as Chair and Prof Mayur Lakhani as President both demit office by the next council meeting. Prof Martin Marshall (Chair-elect) and Prof Amanda Howe (President-elect) take on the new roles in November.

I would like to thank as well a local peer in Dr Christine Johnson who demits office as the faculty representative for the RCGP Vale of Trent. Christine has been like a mentor to me personally and supported me in many of my roles including this one. I thank her for her time and commitment.

A recap of the Trustee board meetings and the Chief Operating Officer report took into account issues raised at the last council meeting specifically the changes made by the Sultan of Brunei and the subsequent removal of awards. This has led to Brunei closing the RCGP input in the country which was a recognised risk.

Council members raised concerns about the RCGP handling of international activities and pushed for a debate on the matter at the next council meeting rather than updates.

Transparency concerns were raised both in terms of perception and action. We heard how only 3% of respondents to a First5 survey (10% response rate) commented the RCGP was transparent. This is a shocking number. This is punctuated by a fellow nationally elected representative noting 3 years ago Council agreed to release meeting minutes of council via the website, but this has not yet happened.

Policy

Brexit and the changes were discussed. Given the fast-changing element of this area there is little I feel worthy to note aside from the engagement of our Chair and Treasurer at the party political conferences with Conservative and Labour parties only.

PCNs were discussed with the release of the maturity matrix but a challenge that limited information on infrastructure is forthcoming and a request to raise this.

Helen commented about the confirmation of GPs as specialists on 17.9.19 including an aim for change at the GMC perspective.

Further to this, a nationally elected representative asked that the GMC was taken to task on compiling a register of conflicts of interest for doctors especially as this was a recommendation previously from the Health Select committee.

Vice-chair hustings

With Prof Martin Marshal taking on the Chair of the college role he will demit as Vice-Chair for external affairs. As a result, I experienced my first hustings as I missed the Chair hustings at last council.

It was interesting watching the process as each candidate is given a strict 5 minutes to state the case for their appointment.

The final candidates were Dr Saquib Anwar, Dr Gary Howsam and Dr Joanne Reeve.

I note I am a seconder for Dr Saquib Anwar. He shared his parent’s journey that guided him to have his values for equality. He listed his various roles in the past with other organisations like the GMC, NHS England and as previous AiT Chair. He hopes to bring perspective to the officers as a working GP. He recognised the ‘ivory tower’ view held by some of the college and his hopes to tackle this for the benefit of members.

Next Dr Gary Howsam gave a jovial approach and talked about the role, the focus on the patient and his values. He outlined his skill with previous roles in the CCG and leadership boards including getting stuff done. His speech marked his skill and passion for the role.

Finally, Prof Joanne Reeve opened by asking us to consider shutting down General practice for five minutes. He talked about her experience sharing general practice with others, her academic achievements and a focus on the core principles of GP, academic scholarship and partnerships with others.

The election from Monday 23.10 till 30.10 for council members only.

Roger Jones the current editor of the BJGP gave his final report as he steps down next year after 10 years in the role. He noted the prestige the BJGP enjoys an impact factor but recognised the changes in publishing with open access and plan S.

Devolved nations reports – these I will leave to my colleagues from the devolved nations to explore in greater detail.

Council then debated three papers on the Fit For Future work on the workforce, digital planning and innovation. 

The workforce debate was thorough looking at challenges of supervision, appraisal impact, and GP training. I spoke on the document on a technology roadmap. Several great points were made on rolling update for hardware, safeguarding, and training. I focused after these points on patient digital literacy, recording of consultations and storage of data and disaster planning for when the tech fails. 

I do support this paper including the education aims of supporting our peers to perform digital consultations. 

Finally, the paper on innovation was challenged on terminology but recognised the importance of research and leading the times. 

After lunch, there was a brief pause as Chair-elect Martin Marshall commended the work by our current Chair of council Helen Stokes-Lampard. The standing ovation she received I feel is well deserved and join others in congratulating her in what she has achieved. 

RCGP position on the use of NEWS2 for the deteriorating adult patient. 

The RCGP suggested accepting the use of NEWS2 on a voluntary basis with other recommendations on recording physiological measurements and further research on the use of NEWS2

Key challenges and comments about patient safety but also concerns about the integrity of communication of physiological measurements. 

Issues such as flag fatigue (like sepsis warnings), the lack of primary care-based research, false negatives, being asked to and the prospect of using a junior alerting tool with senior clinicians (yes the GP).

Due to contentious views, a vote was arranged based on recommendation 2: the voluntary uptake of NEWS2 as a common communication tool for use with colleagues with the dissemination of evidence-based information to increase understanding of NEWS2.

The vote was should this recommendation remain as above.

The results were a majority no. I voted no. 

So the RCGP Council will not recommend the use of NEWS2 by primary care.

Council then discussed the formation of an international professional diploma of family medicine. A good discussion which should help lead the debate. 

The next item was a position statement on screening by organisations which have not been approved by the UK National Screening committee. The college suggested several initiatives to prevent such actions and support GPs in dealing with these issues including collaboration with the BMA on Quality Matters style letters to send to such organisations. 

Interestingly a nationally elected member started the discussion with a motion to put. This stops all debate and takes the council to a vote which was passed by the majority. 

A similar paper on Genomic data companies was also discussed but no vote performed. 

The next paper on the type 1 objections and national data opt-out was discussed. The paper complicated council which was a mark on the content. 

The next paper on local functions conversation and focus on changes at a faculty level.

The South Yorkshire, North Trent faculty brought a paper on climate change. The paper outlined multiple actions focused on awareness of climate change and responsible use in line with several recommendations already made by the RCGP, and made the recommendation to create a short life working group to focus on a climate emergency. 

This went to a vote and passed by majority.

We heard on the report from the Presidents Listening Exercise. This was a confidential paper in content but a balanced document that took account of the challenges in General Practice by our President Prof Mayur Lakhani. This was not discussed as it is a completed report but comments can be fed directly. 

Other papers were noted on MAP and Fellowship and mentoring scheme. These will be brought back to council for further discussion at a later time. 

Despite running late we then discussed a paper on the College sponsorship policy. This with the aim to have a consultation on sponsorship to members in Oct-Nov 2019 with a  view to present to council in Feb 2020. 

Further papers where for noting with a testament to a demitting patient representative to the council- Robina Shah. 

If you have any questions or comments on this review please contact me. Next council meeting is in November and I hope to bring a motion to council on the way we vote in our Chair of council.

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