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A vision developing from the RCGP

Short-term boost

The RCGP have often been accused of sitting on the fence, failing to provide a vision for general practice at a time when GPs are crying out for leadership. I think there is often justification in these accusations. So hearing the chair of the College, Professor Martin Marshall, live in person at Pulse LIVE this week – following his strong appearance at the health select committee last month – was really refreshing for me.

First, there was no sugar coating of the situation in general practice. His contention that there is a ‘very real threat’ that general practice could end up like dentistry – with it becoming almost impossible for patients to find NHS practitioners and having to go private for most care – was one of the starkest warnings I have heard about the future of the profession.

But what I found most refreshing was his laying out of the College’s five principles of general practice going forward: the need to upscale; greater use of multidisciplinary working; better use of technology; more integration and more support from secondary care; and the need for GPs to be involved in population health.

What was most interesting about these principles is that not everyone will agree – for too long, I feel the College has been guilty of campaigning for more outstanding achievement in the field of excellence. There are definite arguments against larger scale general practice, and relying on non-GPs to provide care is not necessarily a position the profession should be advocating.

To see the College coming off the fence, and advocating principles that can be translated into policy is a good thing. This is, of course, only a start. We would ideally like to see a development of what this will mean. But I’d much rather see the College annoying members for what they are saying that what they are not. 

Jaimie Kaffash is editor of Pulse. Follow him on Twitter @jkaffash or email him at


Patrufini Duffy 27 April, 2022 4:00 pm

The RCGP versus a bunch of Harvard graduates planted in the DoH, you know, the “advisers” – is a zero contest. The plan is set. The handshakes made. And slippery slope oiled. This NHS cake is too large and too juicy for bystanders to not set their positions. And to execute it, General Practice must fail. Each health secretary played their part in that. A selfish, narcissistic and ill lot. Who each have private cover, and for whom the NHS means little. Now we have an ex-investment banker leading the ship. Brilliant. And the Government will not aid in your survival, they’re all in on it. The sweet nothings and camouflage is transparent to the aware. To grind it down. Then re-procure it. You know, the Operose model. They only employ people in NHSE who are in on the game. The puppeteers. But what they don’t realise, is you will still need a work horse for time immemorial. You cant keep importing them. That won’t pass. And a premium will come in 10 years for that Generalist. Fragmentation is wholly disatisying, as is working at scale, it’s a fixed ideology based on little. Patients and the public are already seeing through this nonsense and those services that just deliver numbers and metrics. Plan wisely, your independent time will come. The Government will learn it’s lesson, either through anarchy, rebellion or investigation of this clever destruction. The sell-off is no different to any other UK sector, but with more golden handshakes to be made, and massive collateral damage to come.

Hello My name is 28 April, 2022 10:03 am

Problem is, he is just plain wrong!

Michael Mullineux 28 April, 2022 11:29 am

Not really vision, just more establishment groupthink

David Evans 29 April, 2022 9:30 am

4.00 pm 27 4 2920

Your plan is ?

The only option is to manage demand in a constructive and timely manner.
We have to think outside the box otherwise those guys from Harvard will be calling the shots.

All the options put forward by Professor Martin need serious consideration and time is running out.

Doing nothing is going to have serious consequences for the destiny of UK General Practice

Finola ONeill 30 April, 2022 9:18 am

Evans, all that is needed is more funding to surgeries through core contracts and we will sort out the rest. General Practice does 90% of NHS consultations for 8% of budget. There is nothing to “fix’ FFS except giving us some more funding so we can do 95%. We don’t need additional roles. The PCN and urgent care paramedics need to go back to the failing ambulance services, the pharmacists to the failing community pharmacies, the physios to the 8 month waiting list hospital physio dept and we need some funding for more receptionists to answer our phones; the biggest bugbear for patients is they can’t bloody get through.
Working at scale my backside. This is bullshit. There is nothing to fucking fix except the ridiculous underfunding of the core contract, the media smear campaign and Martin Marshall’s logic.
3% more of the NHS budget. More receptionists. Longer appointments and more time to get our work done and GPs wouldn’t all be driven to half time work, locum work and leaving the profession.
We probably already have enough trained GPs.
What we don’t have is a sustainable working day that doesn’t make you want to kill yourself every time you get through it.
And population health is bloody public health and central government’s work.
Obesity, diabetes, mental health; need decent community facilities + fast food, processed food, sugar tax; advertising bans, etc.
We do secondary prevention.
Public health policy and the government bloody doing anything right is primary prevention.
My advice about what to eat is not going to get the 50% of our obese population losing weight.

David Jarvis 4 May, 2022 10:52 am

On the obesity crisis if all but a few practices go private could we build the free practice at the top of a large hill that you have to walk up to get there. Multiple problems fixed in one go. I’ll take the top of Coniston Old Man.