In our regular news review Emma and Nick look at what the BMA, GPs and NHS England might want from a new contract deal in England.

The current five-year deal comes to an end in March 2024, and this week English LMCs will be gathering in London to set out a vision for what they want the BMA to push for in upcoming contract negotiations that will decide what happens next.

Emma and Nick look at what we already know about the BMA’s priorities for negotiations, some of the other things LMCs will be discussing, including options of last resort if a contract agreement can’t be reached, and what could happen around primary care networks.

Elsewhere they also look at what has been up for debate at the separate England LMCs conference that took place on Thursday - including motions around the GP workforce, safety in general practice and the impact of integrated care systems.

And they talk about the latest general practice appointment data for England published this week, which for the first time will include details of appointments at individual practices.

Finally, there’s some good news about fruit and veg in London.

This episode was presented by GPonline editor Emma Bower and news editor Nick Bostock. It was produced by Czarina Deen.

Useful links

• Full coverage of England LMCs conference 2022
• How practice-level appointments data threatens unfair pressure on GPs
• Would a GP contract based on item of service payments benefit general practice?
• What forms of industrial action could GPs take?
• Doctors tell BMA to pull GP practices out of PCNs by 2023
• How practice-level appointments data threatens unfair pressure on GPs

Good news

We are always keen to highlight positive news and the good work that is going on in general practice. If you are up to anything in your practice or working life that you think deserves attention - or you would like to give a shout out to an individual, practice or other organisation that is making a difference to patient care or your local community, then do get in touch. You can email us at [email protected].

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This week Emma speaks to new RCGP chair Professor Kamila Hawthorne. Professor Hawthorne takes over as college chair from Professor Martin Marshall this week – on 19 November – so this is one of her first interviews in the role.

Professor Hawthorne has been a GP for 34 years and practises in South Wales. She is a professor and head of graduate entry medicine at the University of Swansea - a role she has been seconded from for her three-year term as RCGP chair - and also a Bevan commissioner.

She has been heavily involved with the college for many years and was vice chair from 2015 to 2018 when she was responsible for professional development.

During this conversation Professor Hawthorne explains why she decided to become a GP, what her key priorities will be in her first year as chair in her first year in the post and what she hopes to achieve over her full three-year term.

With a background in medical education she also talks about how she feels medical education needs to change to develop the doctors of the future, one of her research areas of interest - health inequalities - and whether she feels positive about the future of the profession.

This episode was presented by GPonline editor Emma Bower. It was produced by Czarina Deen.

Useful links

Home Office to look at 'umbrella bodies' sponsoring IMG GPs to remain in UK

Royal College of GPs website

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Today on the podcast we’re looking at personalised care and health coaching and how they could help practices and PCNs to improve health outcomes and population health in their patch.

Emma is talking to Sheffield GP Dr Ollie Hart, who is also clinical director of a primary care network in the city.

Ollie has been heavily involved in promoting and developing patient-centred care in Sheffield. In partnership with another GP he also runs a business called Peak Health Coaching, which trains healthcare professionals in coaching and person-centred care and is one of the Personalised Care Institute’s approved training providers.

During this conversation Ollie explains:

●     What personalised care is

●     What patient activation is and how to understand patient activation measures

●     How coaching can help patients

●     The benefits of patient-centred care for GPs

●     Using coaching as part of a multidisciplinary team

Ollie is a global health and wellbeing ambassador for parkrun so he also explains the benefits of becoming a ‘parkrun practice’.

This episode was presented by GPonline editor Emma Bower. It was produced by Czarina Deen.

Useful links

●     Personalised Care Institute

●     Ollie’s company Peak Health Coaching

●     How shared decision making can help GPs better meet patients' needs

●     Becoming a parkrun practice

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On our regular news round-up Emma and Nick look at the review into how the GMC handled the case of Dr Manjula Arora – the GP who served a month’s suspension over a claim she had been promised a laptop – and the GMC’s response to the findings.

They talk about what’s going on with patient access to their prospective records online after a week of confusion that’s seen the 1 November deadline when IT suppliers were due to turn on this functionality for all of their practices missed.

And they look at reimbursement for locum GPs to cover sick leave, and why a huge gap between the level of reimbursement practices receive and the actual cost of locum cover means GP partners with burnout are being forced to consider returning to their job before they feel ready.

This episode was presented by GPonline editor Emma Bower and news editor Nick Bostock. It was produced by Czarina Deen.

Get involved

We are always keen to highlight positive news and the good work that is going on in general practice on both the podcast and GPonline.com. If you are up to anything in your practice or working life that you think deserves attention - or you would like to give a shout out to an individual, practice or other organisation or group that you think is making a real difference to patient care or your local community, then please do get in touch. Email us at [email protected].

Useful links

●     GMC missed 'multiple opportunities' to stop GP's needless suspension

●     Arora laptop case must become GMC 'never event', warns doctor leading official review

●     Practices handed temporary opt-out deadline for patient access to records

●     Financial trap could force GP partners to work through burnout

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Emma is joined by a very special guest Professor Sir David Haslam to discuss his new book Side Effects: How Our Healthcare Lost Its Way and How We Fix It.

Along with being a GP for over 35 years Sir David has held a number of senior posts including being both chair and president of the Royal College of GPs, president of the BMA and chair of the National Institute for Health and Care Excellence (NICE), a post he held from 2013 to 2019.

His new book explores what good healthcare should achieve and how we can create a system that is affordable, fair and provides good quality care.

This interview looks at some of the really important themes raised in the book, including why the cost of healthcare will always continue to rise, why we need to better value primary care and public health, tackling health inequalities, over-medicalisation and whether we have our priorities right when it comes to end-of-life care.

This episode was presented by GPonline editor Emma Bower. It was produced by Czarina Deen.

Useful links

Side Effects: How Our Healthcare Lost Its Way and How We Fix It on Amazon

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This week on the podcast Nick and Emma look at the final report from the House of Commons Health and Social Care committee’s investigation into the future of general practice and explain its findings and key recommendations. They also discuss the former chair of that committee – Jeremy Hunt’s – appointment as chancellor.

Emma highlights a really important interview from GPonline with Chris Milligan, the husband of GP Dr Gail Milligan who took her own life earlier this year.

They also talk about recommendations from the GMC that could increase the number of doctors that are able to work in general practice, and the RCGP’s latest push to get the Home Office to resolve the visa problems affecting international medical graduate GP trainees.

Finally, there’s a good news story about a GP from Glasgow who has written a book with his three young daughters to help educate children about the human body and raise money for local charities.

This episode was presented by GPonline’s editor Emma Bower and news editor Nick Bostock. It was produced by Czarina Deen.

Useful links

●     My GP wife worked herself to death – something needs to change

●     Where can GPs access help and support if they are struggling to cope?

●     General practice is 'systemically toxic', MPs warn in devastating report on GP crisis

●     GMC backs overhaul to widen pool of doctors able to work in primary care

●     Over 4,300 GPs sign RCGP letter calling on Home Office to resolve IMG visa problems

Scottish GP writes children's anatomy book in collaboration with his three daughters

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This week Emma is speaking to Dr Devina Maru and Dr Liam Loftus who are both GP trainees and co-founders of The BIg GP Consultation.

Devina and Liam set up The Big GP Consultation as a platform for GP trainees and early career GPs to discuss their vision for general practice – and to come up with ideas and solutions for how to address some of the many challenges facing the profession both now and in the future.

In this interview they explain why they set up the initiative, changes they would like to see to GP training and general practice, how new GPs could be better supported and how they’re hoping to get more engagement with the project to ensure the ideas that they have come up with become a reality.

This episode was presented by GPonline editor Emma Bower. It was produced by Czarina Deen.

Useful links

●     The Big GP Consultation website

●     The Big GP Consultation can be found on Twitter @BigGPConsult

●     GP trainees set out vision to lift general practice from crisis

●     What does a positive future for general practice look like – a view from the next generation

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This week on the podcast Emma and Nick are talking about some new figures showing there has been a surge in vacant GP posts in London, which has left half of the capital’s practices operating with fewer doctors than they need when demand is at an all time high.

They also discuss what the RCGP believes needs to happen to boost GP retention and what the latest NHS appointments data tells us about levels of workload in general practice in England. Plus they look at NHS England’s plans to help boost capacity this winter and the BMA’s decision to ballot junior doctors on industrial action.

This episode was presented by GPonline editor Emma Bower and news editor Nick Bostock. It was produced by Czarina Deen.

Useful links

●     London faces growing GP workforce gap as workload continues to soar

●     Government must take 'urgent action' on GP retention, says RCGP

●     GP workload far beyond pre-pandemic level as winter pressure looms

●     Coffey targets rapid GP access over face-to-face appointments

●     NHS sets out priorities for extra GP funding this winter

●     PCN contract overhaul defers two-week appointment target until April 2023

●     Junior doctors to be balloted on industrial action in early January

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This week on the podcast Emma speaks to Dr Helen Garr, the medical director of NHS Practitioner Health, the NHS service that looks after doctors and dentists - and also other NHS staff - who are experiencing mental ill health.

In this conversation Emma and Helen talk about the impact that pressures on the NHS are having on doctors’ wellbeing and how this is affecting GPs in particular.

Helen also explains what doctors and other NHS staff can do if they are suffering from burnout, how to prevent burnout, what people can do if they are worried about a colleague and how NHS Practitioner Health supports doctors who seek help from the service.

She also outlines how she thinks the NHS could change to help ensure better mental health for doctors and other staff.

Trigger warning: This episode includes a discussion about suicide and the issue of suicide in the medical profession.

There is lots of practical and useful advice in this conversation, so we’ve included some time stamps below if you want to go back and listen to bits again, or find specific things on your first listen.

●     2.07 Helen explains the increase in the number of GPs coming to NHS Practitioner Health and the conditions they are presenting with.

●     4.41 Helen discusses suicide in doctors and explains why doctors are at higher risk of suicide.

●     11.12 The impact of a doctor’s suicide on colleagues and what people should do if they are concerned about a colleague’s mental health.

●     15.16 Steps practices can take to make the working environment more supportive.

●     17.55 Warning signs of burnout.

●     21.36 What to do if you are burnt out.

●     24.55 What can you do to prevent burn out.

●     30.10 How the NHS needs to change to better support doctors and staff.

●     33.37 What happens when a doctor contacts NHS Practitioner Health and how the service can help.

●     39.11 How staff other than doctors can access NHS Practitioner Health.

Useful resources

●     NHS Practitioner Health

●     Looking After You Too (NHS England’s free coaching programme for primary care staff)

●     Where can GPs get help and support if they are struggling to cope? (Free access article on GPonline that contains a list of all organisations that offer support to doctors experiencing mental ill health)

●     Wellbeing and Coping (website Helen refers to in the interview as ‘wellbeing and doing’)

●     GPs tell how coaching helped them manage practices during COVID-19 (article on GPonline about the Looking After You Too programme)

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This week the team discusses the government’s latest push to improve access in general practice and some of the problems with the plans. They look at a groundbreaking new system that is being piloted in Devon, which will see work paused for practices facing extreme workload pressures. GP leaders have suggested the system could be rolled out nationwide within a year.

And they talk about what plans to cap energy costs could mean for practices and what doctors say the government needs to do to address the workload and workforce crises in general practice.

This episode is presented by GPonline editor Emma Bower and news editor Nick Bostock. It was produced by Czarina Deen.

Useful links

●     Practices face two-week access target with 300 fewer GPs than last year

●     Government unveils two-week access target for GP appointments

●     GPs agree groundbreaking system to pause work for practices facing extreme pressure

●     Practices could see energy costs slashed as government unveils business price cap

●     'This job is making us ill': Coffey told 16m patients could lose their GP

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