MWord Issue 102 – Dr Michelle Drage’s latest update for GPs and practice teams

  • Mword

Covering: industrial action, how hard GPs and practice teams have worked through the challenges of 2022 and more.

20 December 2022

Dear Colleague,

I want to address the big issue of the day, to share some resources and thoughts, and trying not to be trite, especially for those on duty over the next week or so, to send you into the holiday season with a spirited message from me and my team here at Londonwide LMCs. I hope I’ve got the balance about right.

  1. Industrial action
  2. Patient and public-facing video resource: Managing your health this winter
  3. Long Covid Doctors for Action and BMA Survey
  4. Londonwide LMCs’ GP Professional Support Network
  5. Enough is enough – Make it Safe
  6. And finally……
  1. Industrial action
    Last week and today’s nurses strikes and tomorrow’s ambulance strike show the significant pressures on both the health system, and the increasingly unbearable pressure on the staff within it.Unlike LMCs, the BMA is the recognised trade union for GPs under industrial legislation and is therefore in a legal position to offer a view. At the end of last week the General Practitioners Committee UK passed this resolution:”GPCUK notes the unprecedented action taken by the Royal College of Nursing today and asks the GPCUK executive to issue a public statement outlining the following:

    1. GPs across the UK fully support the industrial action proposed to be undertaken by ambulance workers in England and Wales and stand in solidarity with their demands for fair pay, safe staffing and a safe NHS.
    2. Believes it is unacceptable and unsafe that General Practitioners in England, have been asked to undertake emergency cover for the transport of patients to hospital during the proposed industrial action adding to the already unsustainable pressure that General Practice is experiencing.
    3. GPs are increasingly being forced to transport acutely unwell patients to secondary care in their own personal transport with no emergency equipment due to unacceptable ambulance delays across the UK, it is only a matter of time before a fatality occurs
    4. GPCUK implores on the government and employers to work with unions to resolve disputes with healthcare workers in a fair and acceptable manner.”
  2. Patient and public-facing video resource: Managing your health this winter
    Our latest video explains to patients their options for accessing care this winter, including pharmacies, self-care and where it’s appropriate to go to A&E. It’s important that patients can appreciate what general practice is there for and in particular, that it is not an emergency service. I would encourage you to use it on your practice website, social media and waiting room screens.
  3. Long Covid Doctors for Action and BMA Survey
    I really do encourage GPs with post-Covid health problems, including long-Covid, to answer this Long Covid Doctors for Action and BMA Survey.
  4. Londonwide LMCs’ GP Professional Support Network
    We continue to support practices with mergers, regulatory investigations, contractual issues and much more. And please remember, our GP Professional Support Network is there if you are struggling personally.
  5. Enough is enough – Make it Safe
    We always knew that a pandemic would impact on our workload for at least three winters especially when conflated with flu and winter viruses. Perhaps fewer of us would have predicted that in its tail we would be faced with implementing London’s first polio emergency public health measures in decades; with dealing with high levels of very sick children with respiratory infections like RSV and HMPV; with an increase in reported invasive group Strep A and associated yet understandable parent anxiety.But these last torrid couple of weeks tell only part of our story. Figures clearly show that we continue to see more and more patients with fewer and fewer clinical and non-clinical staff.Partners, employed GPs, locum GPs, ANPs, GPNs, ACPs, PMs and admin staff, whether providing care face to face or remotely, in and out of contracted hours, we daily have to move mountains to get even the most basic functions of our core roles done through the chaos of multiple, irrelevant system demands and the holding of ever-increasing levels of complex clinical risk and demand including that unreasonably transferred or displaced from secondary care. Being on the frontline like this has meant many of us have become, or are becoming, stressed and ill.

    2022 is the year general practice became unsafe. Unsafe for patients, and unsafe for us.

    So today it is with a sense of sadness that you’re getting this KEY MESSAGE from me:

    It is increasingly important that GPs and practice teams are clear and consistent about the safe upper limits of patient contacts, to enable safe practise safely for patients, and for practitioners. The updated BMA’s “Safe Working in General Practice” outlines that 25 contacts is the safe limit. Combined with comments in NHS England Board papers late this year that “Demand for Primary Care [by which we mean General Practice] has never been greater and, in places, currently outstrips supply, resulting in some people struggling to access services.” it is clear that we need to mnage our patients’ safety in the face of political game playing.

  6. And finally……
    I have lost count of the number of times the various new Prime Ministers and Health Secretaries that we have seen come and go this past year have missed obvious opportunities to thank us for the care we provide, and for the sacrifices we and our teams have made and continue to make. We know that patients still value and need community based general practice and their local neighbourhood practices, though it’s harder than ever to notice the unassuming majority who come and go from their appointments while remaining quietly grateful.But take heart, more and more patients are seeing the problems in the NHS as being driven by spending decisions in Westminster rather than being the fault of those delivering the care, as you can see here.

From me and the whole Londonwide team, thank you for all you have endured and all you do, Season’s Greetings to you and your loved ones, and here’s hoping that 2023 will turn out to be a safer and more peaceful year.

As ever, I welcome your feedback at The team of experts, leaders and support staff here at Londonwide LMCs remain by your side.

With best wishes




Dr Michelle Drage MBBS FRCGP
CEO, Londonwide LMCs