Building a general best practice

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Sunday mail The campaign for GPs to ‘open up’ has led, in part, to the infamous NHS England letter on GPs seeing patients face to face. This week he did an opinion piece on the “refuseniks” of the GP, led by “rabble-rousing” Impulse.

As much as we’ll be wearing this as a badge of honor, something concerns me about it. Some sections of the media and politicians have presented themselves as the voice of patients, GPs on the other side.

And their message is convincing: “why don’t general practitioners see us? (Telegraph columnists and Mail on Sunday); “Patients want to be able to get in touch with their GP through an app” (Matt Hancock); “Patients want to have access to their GP seven days a week” (Jeremy Hunt). These are easy-to-sell posts when you remove all the context.

Of course, general practitioners know the context. But regardless of the truth being on the GP side, the negative message is harder to sell. People don’t want to hear that there aren’t enough GPs to provide all the services you want, or that opening surgeries would lead to worse outcomes overall, or that a bout of seven days simply spreads the non-existent resources even more. As a result, GPs become the lazy moaners who refuse to change.

It is a ridiculous situation. Because objectively, GPs are much more qualified to talk about what patients want and need. They relate to patients and they talk to more patients than anyone else. They also understand what is possible with the available resources. Yet they are being usurped by much less qualified people to discuss these things.

As I argued in my editorial for the magazine’s June issue, GPs need to start winning hearts and minds with a positive message. The point is, GPs are dictated because there is no viable alternative. I understand why the likes of the BMA and RCGP have been unable to provide such a vision. While the profession is in this state of permanent crisis, it constantly fights against fires, while having to take into account the political pressures it is under.

Pulse is therefore taking the opportunity to live up to the reputation that the Mail has given us – to wake up, if not a populace, then very tired, disgruntled and disenfranchised general practitioners. And that is why we are launching our new campaign for the summer: “Build a general best practice”.

The campaign will aim to develop principles around general medicine: the goal of general medicine; what services should be provided in general medicine; what should be the relationship with the patients; how to ensure security; what contractual model should be put in place; and how to ensure job satisfaction for general practitioners, among others.

We will then, alongside the readers, shape a new system that implements these principles. What it will look like, we don’t know. It may involve a fully salaried service, it may involve one hour consultations, it may involve full remote triage – that will be up to our readers.

We are going to start from scratch. It won’t be about picking out the parts of the current system that we don’t like: CQC inspections won’t be mentioned (unless readers actually believe that CQC inspections would be part of the perfect model of general practice – which is, shall we say, improbable).

The only metrics we will put in place are that we will work with the current number of people in the UK and the current number of GPs. This is because it is not something that can be changed by decision makers; in the same way, our model will make it possible to increase the budgets, because this falls within the power of the decision makers.

There will be two elements to this: the first will be a panel of GPs representing the spectrum of general practice – not only in terms of contract types, age, ethnicity, gender, but also their interests within general practice; the second will be a series of four weekly surveys for Pulse readers, asking you to agree or disagree with the policy statements developed by the panel.

Once we have formulated our general practice model, we will feature it in the September issue of Pulse.

We will send it to policy makers, ministers, MPs, mainstream media, BMA, RCGP and other general medicine groups. We will provide updates in the monthly magazine on the response.

More importantly, this will become Pulse’s de facto “manifesto” and inform our editorial line going forward.

Below are some dates for the agenda. And I urge you to get involved. If you would like to receive surveys, or are interested in participating in the panel, or – more importantly – have any suggestions on how we can do this better, please contact me at [email protected]

We know how ambitious this can sound. But I think this work will be worth it. Let’s take a positive view of general medicine and show the power that we “scum” can do together.

Dates for the agenda:

June 30 – Expert group meets to discuss initial position statements regarding general practice

July 1 – First survey sent to Pulse readers with list of statements

July 7 – Second panel meeting to discuss next step

July 9 – Second survey sent to Pulse readers with list of statements

July 21 – Third panel meeting to discuss next step

July 23 – Third survey sent to Pulse readers with list of statements

July 28 – Fourth panel meeting to discuss next step

July 30 – Fourth survey sent to Pulse readers with list of statements

September 1 – Publication of the campaign in Pulse print and online

Jaimie Kaffash is editor-in-chief of Pulse. Follow him on Twitter @jkaffash or email him at [email protected].

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