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I'll bring college back in touch with grassroots

The debate within the profession over the RCGP's plans for practice accreditation and revalidation echoes the discussion going on inside the college, and a perceived divide between its leadership and its grassroots members.

There are concerns that the increasingly bureaucratic demands on practices will make it harder to deliver high-quality clinical care to patients.

Almost every practice already does the QOF across 19 clinical areas, all to demonstrate quality of care. The college's plans for revalidation represent the biggest and most significant change to the regulation of GPs since regulation began, with every GP having to document significant-event analyses, case reviews, clinical audit, patient satisfaction surveys, 360-degree multi-source feedback, proof of continuing education and so on.

So coming on top of all this, I am not sure what the RCGP's latest plan for voluntary practice accreditation will achieve. We already have QOF teams to annually visit and assess practices. And any new scheme is always expensive - the cost of IT alone for Choose and Book and the QOF ran into millions.

And this is just one area where there is dissatisfaction with the RCGP leadership.

Grassroots GPs are unhappy that with the college's support, the Government has increased GP training posts when there is a shortage of GP jobs, while expanding the role of nurses and physician assistants.

There is a serious risk to patients if physician assistants and nurses take over the traditional role of the GP in polyclinics or GP-led health centres. When patients start dying from missed diagnoses, late referrals and inappropriate management, then will the Government admit it was a mistake to replace doctors with cheaper, lesser-trained labour? Quality care costs money.

I am running for president of the RCGP with the aim of representing the views of grassroots GPs and ensuring the college is first and foremost the advocate of its members.

The constitution of the RCGP states that the college was established to 'encourage, foster and maintain the highest possible standards in general medical practice'. This should still be the college's overriding aim and the focus of all our efforts. This is best achieved by encouraging the development of GPs and the promotion of our profession.

Persistent Government regulation of general practice, especially if supported by the RCGP leadership, may lead to disillusionment and burned-out GPs, harming our profession and endangering the lives of our patients.

Less GP regulation, more GP support. My manifesto at gives a voice to grassroots GPs and provides solutions for a united RCGP.

From Dr Una Coales, Stockwell, south London

Hilary De Lyon, RCGP chief executive and returning officer said: 'It would be inappropriate to comment while the election is ongoing. The role of president is largely ceremonial. Unlike other royal colleges, it is the RCGP chair of council (currently Professor Steve Field) who provides political, academic and governance leader-ship. The other candidates are Dr Iona Heath and Dr Has Joshi.'


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