Month: November 2015

Bristol and Exeter Student GP societies: working hard to promote general practice

Alice James is a 4th year medical student at Bristol University. She is passionate about promoting general practice to other students in her role as Chair of the University GP Society (Bristol GPSoc) and student representative for the Severn Faculty RCGP. Nilakshini is a 4th year medical student based in Exeter and is passionate about general practice. She believes it’s time to put the stigma associated with primary care behind us and start giving recognition for the challenging and exciting career that it really is. The Bristol and Exeter Student GP societies aim to inspire members to consider a...

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Junior doctors’ dispute – learning from previous experience

Peter Sykes is a retired surgeon and author. His latest light hearted novel, entitled ‘First do no harm’ is set against the industrial action that beset the NHS in the 1970s. His website is Recently junior doctors voted overwhelmingly in favour of industrial action. It is a situation that they will not have encountered previously, indeed one that many will wish they didn’t have to face. They have many factors to consider when, as individuals, they decide just how militant they are prepared to be. No doubt they will weigh the pros and cons carefully. They may be helped in coming to their decision by considering the lessons learned during the last major dispute with the Government when, as now, junior doctors took industrial action. In the 1970s, a situation arose that was remarkably similar to that at present. The juniors were negotiating with a Government whose main priority was to reduce public spending because of a burgeoning national debt. Harold Wilson and Denis Healey, Prime Minister and Chancellor respectively, were in the embarrassing situation of having to go ‘cap in hand’ to the International Monetary Fund for a loan to keep the country afloat. A strict wages policy was in place. In the weeks before the ballot, as now, there was relatively little coverage of the dispute in the press though the general public were thought to be...

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BJGP article on practices in special measures: CQC response

Devin Gray is a National Medical Director’s Clinical Fellow and a GP trainee, interested in driving system-level change to achieve better care and outcomes for patients. This article was co-authored with Professor Nigel Sparrow OBE, Senior National GP Advisor and Responsible Officer, CQC and Professor Steve Field CBE, Chief Inspector of General Practice, CQC. Thank you for the BJGP article, “CQC Inspections: unintended consequences of being placed in special measures”.1 The CQC welcomes opening the door to dialogue and discussion about practices being placed in special measures and wholeheartedly agrees with the need to work effectively together in enabling improvement. Improving care under pressure With unprecedented pressures in General Practice and across the whole NHS, we are aware of the context. Preparation for a CQC inspection may feel to some GPs as yet another task there is little time or resources for. So why engage with regulation? At the CQC we are passionate about improving standards of quality and safety in healthcare. Through our work, we are for the first time able to provide a comprehensive description of what good care looks like.2 We support change and improvement by identifying and championing examples of good and outstanding practice, as demonstrated by our Outstanding Practice Toolkit,3 and by celebrating innovative ways of working in an ever resource-squeezed environment. The intention of special measures We do not underestimate the difficulties of being rated...

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Refugee medicine: time to get our act together

Rebecca Farrington first worked overseas with refugees 20 years ago for MSF.  She is now a GPwSI in refugee mental health having worked in the UK as a GP with people seeking asylum for 10 years. She combines this with a clinical lecturer role at the University of Manchester and GP locums. Last month I joined Turkish, Dutch, Swiss and Irish GPs to run workshops about refugee children at Wonca Europe in Istanbul. The topic is hot and was mentioned by many speakers. Wonca produced a valuable statement encouraging doctors across the continent to uphold a migrant’s rights to equitable care “unconditionally and based on a set of core values” fundamental to the practice of family medicine. So how can we in the UK respond to the challenges? Delivery of primary care for asylum seekers in the UK is fragmented.  We have NGOs and foreign aid agencies in our cities struggling to find NHS care for the most vulnerable. There is undoubtedly goodwill amongst the GPs I meet, interest from trainees and First 5 doctors in knowing more, but there is little in the way of infrastructure and training. GPs are expected to ‘get on with it’, but asylum seekers are challenging patients. They don’t trust you and can’t navigate your system. They are often distressed, some having experienced trauma that is beyond your comprehension. Their priorities can be...

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