Saturday 20 June 2015

Notes from RCGP Council meeting 20 June 2015

The agenda for today's meeting was packed, including, I am pleased to say, a paper on transparency which I wrote with +Jonathan Leach and +Kirsty Baldwin.

#OpenRCGP discussion paper:
Balancing transparency with information security

"First of all, I would like to thank my co-authors Jonathan Leach and Kirsty Baldwin for their invaluable input, and also Officers and staff, including Paul Rees, for their enthusiastic encouragement.

"I have been receiving Council papers for over 10 years. Throughout that time, I and colleagues have had some uncertainty about how confidential individual College documents are, and therefore a frustration that we did not feel free to share them with other members.

"There are some practical details to be worked out. We are looking for feedback from Council on our proposals to allow us to continue developing these proposals

"Our proposals therefore form two main strands:
  • clarity as to exactly how confidential individual documents should be
    • reduce the risk of unwitting leaks
    • and minimise unnecessary restriction
    • this builds on good practice by groups such as the Trustee Board and the Planning and Resources Committee
  • publication of Council documents
    • moving from a position of sharing with members only what we are obliged to share, to sharing with members as much as possible so as to improve engagement and foster a sense of ownership commensurate with their membership fees
    • builds on the decision at the Council meeting in February 2015 to publish minutes
    • as part of this, our 3rd proposal is for a staff observer to Tweet from Council
      • builds on Council’s views on Social Media use during Council meetings aired in September
"We would be grateful for Council’s thoughts on these proposals.

My understanding of Council rules as they stand is that I am free only to disclose my comments, hence the one-sided nature of my notes here.

"New deal for General Practice"

Jeremy Hunt had set out what he described as a new deal for General Practice the day before. I have already analysed this announcement on these pages and found it wanting. I told Council that it contained neither anything new nor a deal and that I continued to be dismayed at his apparently fixed idea that healthcare is a commodity. Indeed, his assertion that he could not change consumer expectations was particularly disappointing and he is probably referring more to an unwillingness to risk losing votes by being honest with patients about what they might reasonably expect from the NHS.


I welcomed a paper on overdiagnosis from +Margaret Mccartney and +Julian Treadwell on behalf of the RCGP Overdiagnosis group. It proposes tests to be applied to every policy proposed by RCGP. I advised that these include a test of opportunity cost: i.e. if new work is proposed, what old work should GPs stop doing?

GP workload & fatigue

I welcomed a paper linking GP workload with patient safety. I warned that there is a fine line between making such a link and acknowledging that GP is relatively low risk, without fuelling further risk intolerance, which itself has been a major driver of pressure on GP services.

I warned that making a link to "missed and delayed diagnoses" implies a precision and urgency of diagnosis that is often not appropriate in General Practice and risks encouraging over-investigation, -diagnosis and -treatment. I recommended instead referring to "reduced quality of diagnosis" and "unacceptable delay in treatment."

Skill mix in General Practice and Primary Care

I warned that many members are nervous about proposals to increase the skill mix in General Practice. We must reassure them that we are the Royal College of General Practitioners and will put their interests first.

I advised that changing the name, remit or democratic processes of College would be a big decision and should only be considered after a full a careful consultation with the membership as a whole. Until then, the involvement of non-GPs in the democratic processes of College should be limited to observing.


Anonymous said...

Nothing about the MRCGP CSA profits?

John Cosgrove said...

Please note my comment above that I can only report what I have said, but that I am working hard to improve transparency of College and Council for the future.

Anonymous said...

Well said on the 'new deal' I agree on pt expectations. Perhaps he's just embarrassed?