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Posts tagged ‘RCGP Scotland’

GP Career Flow

RCGP Scotland has been developing the idea that to tackle to GP recruitment crisis it will be necessary to look at actions that will be effective from start to finish of a GPs career. This concept has been developed from evidence of effectiveness of a similar approach to remote and rural health care in an international context of the GP pipeline. It was also the basis of some of the recommendations of the RCGP Scotland Being Rural  document. This concept was developed further with other stakeholders and developed into a Mind-map: –

GP Career Flow v2.1

This has informed a long list of possible actions to support GP recruitment: – (more…)


Quality at Garscadden Burn

This post arose from an email from Dr Peter Cawston (@petermakeslinks) who wrote a report (Garscadden Burn GP Report 2015-16 ) on how his practice has used freedom from the limitations of the Quality Outcomes Framework (QOF) to explore a more holistic and meaningful model of quality for his inner-city deprived patient population.

I am deeply impressed by the drive and committment his practice has shown to develop this. It is clear they have made financial sacrifices as well as a great deal of committment in time to activities that would normally lie outside the remit of  the General Medical Services contract.

At a time when a new model of quality is emerging to replace QOF I find this hugely encouraging. Thank you Peter for allowing me to share.

Read Garscadden Burn Medical Practice 17c Report 2015-16 here.


Dr Sue Farrar

Dr Sue Farrar

On Friday 17th April 2015 RCGP Scotland had the pleasure of holding a new members and fellows ceremony and also an awards ceremony for the RCGP Scotland Alistair Donald Award, RCGP Scotland GP of the year and the RCGP Fraser Rose Medal.

The RCGP Scotland GP of the year was won by Dr Sue Farrar.

The RCGP Scotland Alastair Donald Award by Dr Jane Bruce.

Dr Jane Bruce

Dr Jane Bruce

Prof Ryuki Kassai

Prof. Ryuki Kassai

Fellows were represented from faculties across the country and across the world. We were delighted to present Prof. Ryuki Kassai, of the University of Fukushima, Japan with his fellowship.

Drs Kate Dawson & Louise Scott

Drs Kate Dawson & Louise Scott

My address is here: –

It is my great pleasure to welcome you to our college for this celebration of achievement.  We have members and fellows here today from Scotland, England, Northern Ireland, Wales across the world.

I am delighted that we have the opportunity to celebrate 3 important milestones in our careers: membership, fellowship and individual award winners.

I know how hard the new members have worked to get here today. Not only to get into medical school and qualify but also to take on what must be one of the most demanding specialty curricula and exams. However I am confident your endeavour will have equipped you well to start your career as independent practitioners. I hope that now you have completed specialty training, you will see the college in a much wider context than just the AKT, CSA , workplace based assessment and wrestling with the ePortfolio! We have a great deal to offer you.

The college is a membership organisation; it exists to ensure we are all the best GPs we can be for our patients: setting standards, encouraging innovation and providing education and leadership.

It is for these attributes that the new Fellows are being recognised here today. I hope the process of fellowship has given you an opportunity for a reflective pause in your career and us a chance to appreciate and celebrate what you have have reached out to do for your patients and for our profession.

The College was created in 1952, giving a clear identity for general practice across the UK. Scotland has played a significant part. The first Professor of General Practice, worldwide, was Richard Scott, appointed here in Edinburgh in 1963, and the first vocational training schemes were pioneered in Inverness some years later. It was RCGP Scotland who originated the Quality Practice Award in 1995 and it is from my predecessor, John Gillies, that we take the Essence of General Practice. We are supporting the work of the “GPs at the Deep End” group who have been hugely influential in raising issues of health inequalities and at the other end of the spectrum leading policy on Remote and Rural practice. In fact, today Dr Gillies and Dr David Hogg of Arran are speaking at the WONCA Rural conference in Dubrovnik, presenting our work.

I know that the values of general practice have remained constant since 1952 but by necessity we have adapted our work to a changing environment. Patients are living longer. In the next 5 years the population between the ages of 70-75 will increase by 21%. And patients now live with multiple long term conditions. Scottish research shows on average people have 2 or more long term conditions by the age of 65, increasing to 3 or more at 75 years. The NHS England Five Year Forward View and Scottish 2020 Vision both call for integration of services and for radical changes to the way care is delivered. General practice will be key to making these changes.

We face difficulties meeting these challenges. Scottish GPs now see 24m patient contacts per year, 11% more than 10 years ago. At the same time, funding for general practice has fallen from 9.8 to 7.8% of the NHS Scotland budget and recruitment is static. The widening funding gulf & increasing workload are proven disincentives for doctors to choose our specialty.

RCGP Scotland has 3 priorities: –

  • Firstly, we will continue to campaign [i] for recognition of the role of general practice and for fair resources to build our workforce and capacity to do our work.
  • Secondly, we will work for new quality and governance structures, recognising the need to audit our care, but moving to a more nuanced measure of the care we give. We propose a system that is peer based and values driven. Where clusters of practices define the values they aspire to and then undertake audit and quality improvement to demonstrate their practice is congruent with those values.
  • Thirdly, we will work to ensure general practice is valued as the central hub of the NHS. Our interface with others is essential for good patient care and the functioning of the NHS. We will work to improve not only the mechanisms for us to get clinical decision support from our hospital colleagues, but also the way others in the community access our assistance.

Writing in the BMJ recently, Glasgow GP Dr Margaret McCartney wrote[ii]: –

General practice encompasses health and sickness, benefit and harm, living and dying. You are a prescriber, diagnostician, and font of evidence—but also an advocate and avoider of medical harm. You get things wrong sometimes, as everyone does. But you also have days when your heart sings.”

When we leave here we all have the opportunity to contribute to the future of general practice. Our college is uniquely placed to help. Please consider this: –

  • What might that look like for you?
  • How can you make the college a good fit for your career?
  • Is there a local First5 group?
  • Can you offer help with representation with other stakeholders?
  • Can you contribute to consultations on policy issues?
  • Can you get involved in the activities of your local faculty or at a national level?
  • Will you lead the college in the future?

I trust you will. Thank you.Princess St Gdns April 2015

[i] http://www.rcgp.org.uk/campaign-home.aspx

[ii] Margaret McCartney: General practice is still the best job in the world BMJ 2015;350:h1721 http://www.bmj.com/content/350/bmj.h1721

A grat day in a great venue and I hope one that we can repeat in future years.

The Changing Role of General Practice in Delivering Care in a Community Setting – Cum Scientia Caritas

 This is my contribution to the Scotland Policy Conferences Keynote Seminar: Next steps for primary care in Scotland  held on Wednesday, 21st January 2015 at the Crowne Plaza, the Roxburghe, 38 Charlotte Square, Edinburgh .

I was a GP Trainee in 1991, and I vividly remember being taught that there were 3 studies of the treatment for patients with Myocardial Infarction that each showed patients were better off with treatment at home rather than admission to hospital. I became adept at treating crashing left ventricular heart failure at home, at a time when GPs were most valued for their role in unscheduled care. My goodness things have changed since then.


Assisted Suicide – time to act?

On 24th April 2014 I was asked to speak at a Symposium on the Assisted Suicide (Scotland) Bill. The target audience were legal and medical professional practitioners. In effect those who might be called upon to administer, implement and enforce any system which permitted assisted suicide. It was hoped to add to the public debate in an informed way.

The event was held under the joint auspices of Ampersand Advocates and the Mason Institute (University of Edinburgh School of Law).  The event took place at the Royal College of Physicians, George Street, Edinburgh.

The first session focused on the principles underlying the Bill. I was there as RCGP Scotland, Deputy Chair (policy) to present the college’s position. (more…)

Dr Alastair Donald Award

On Friday 9th November 2012 I was delighted to be awarded the Dr Alastair Donald Award by RCGP Scotland at the annual gala dinner. It was a lovely night but the PA was not the best and I fear that what I said might not have been heard. So here is a copy of my notes: –

I have a new role model – Dr Alastair Donald.
His obituary by our colleagues at the Royal College of Physicians said: –
“The key role Alastair played was to harness the disparate and sometimes mercurial talents of others, to create and establish high quality postgraduate training programmes for General Practice.”