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RCGP gets a level Field

RCGP chair Professor Steve Field talks health inequalities, revalidation and extended hours

By Steve Nowottny

RCGP chair Professor Steve Field talks health inequalities, revalidation and extended hours

Professor Steve Field is a very busy man.

This week, he's conducting a media blitz, his first round of interviews since taking over as RCGP chair last month.

But he's due at another key meeting shortly on Lord Darzi's Next Stage Review and this morning he's running late – thanks to a defective train some-where outside Birmingham.

He apologises effusively, promises to talk fast, and segues neatly into a discussion of his West Midlands home.

As regional postgraduate dean for NHS West Midlands Workforce Deanery and a still-practising GP at an academic practice in Edgbaston, Professor Field is unashamedly proud of his Brummie roots.

‘I was brought up on the edge of an estate in a deprived part of the Black Country,' he says. ‘So my drive is about improving the health of individuals and populations.

‘If we can get the health of people where I come from as good as where we are sitting now in Kensington, we've won.'

The message is clear: whatever else you throw at him, the elitist tag won't stick. It's hard to accuse someone whose dream career is to play centre half for West Bromwich Albion of being stuck in an ivory tower.

Revalidation

It's been a rocky road for the RCGP over the past year – ‘star ratings hurt us', he admits – but the next big flashpoint is likely to be the thorny issue of revalidation. It's early days, but the college is working with the GMC to determine what standards should be set.

‘I don't believe in big bang examinations,' he says. ‘I'm absolutely determined this isn't going to be something that could be used as a witch-hunt.'

Relicensure will be based on appraisal, he says. Talks are at an early stage, but when pushed, he says: ‘One way would be for the college to provide assessments GPs can voluntarily do to show they've reached a certain standard.

‘There is a tiny number of GPs who are not up to the appropriate standards,' he says. ‘These should be sorted by the current systems, but appraisals are not being used consistently across the country.'

GPs in the West Country have reported problems with their appraisals, he says, and a number of PCTs seem to have stopped holding them altogether.

‘These GPs aren't getting the benefit of a positive appraisal. Appraisal needs to be better, more consistent and universal.'

The Darzi show

The other key priority for the RCGP at the moment is the Darzi review – ‘the biggest show in town at the moment'.

He's supportive, he says, and keen for the college to play a key expert role. ‘I was just concerned Darzi wasn't getting the general practice advice he needed,' he says. ‘The college should step up and provide solutions and, where necessary, say no.'

What does he make of the push for extended opening?

‘I don't think we should ever come out with sweeping statements, without an evidence base for what patients really want or need,' he says.

And what does the evidence say? ‘Healthcare needs to be provided locally, not from a national perspective,' he answers, picking his words carefully.

‘In my practice area, we've had nobody suggest we should be opening late. We have had some patients concerned that if we open up late in the evening, will that mean services will be affected during the day?'

On Darzi's other big idea, polyclinics, he is even more ambivalent, claiming he is ‘not wedded' to any one model. But as co-author of the RCGP's blueprint for the future of general practice, published in September, he believes closer co-operation between practices is inevitable.

‘Singlehanded GPs should be working more closely, sharing clinical issues, and that could be done through a federated model,' he says.

There's more, much more: on the need for GPs to promote general practice; on the college's plans for CPD; on attracting new members.

But he's 10 minutes late and we're out of time.

‘Sorry,' he says apologetically, as he's whisked away to his next appointment. ‘They know I can talk all day.'

Professor Field on...


Revalidation:
‘We wouldn't want to see revalidation dissuading and annoying good GPs.'

Star ratings:
‘There is a benefit in GP practices being able to say they've reached a standard, just like we've done for years, but no, I'm not into star ratings.'

Listening to members:
‘I've talked to thousands of doctors about what they want the college to do, and they say strong leadership, pulling no punches.'

Ivory towers:
‘Have you seen my office? It's a tiny little pokey thing upstairs.'

Professor Field: determined revalidation will not be used as a witch-hunt Professor Field: determined revalidation will not be used as a witch-hunt My drive is about improving the health of individuals and populations.

My drive is about improving the health of individuals and populations.

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