Heather’s notes from RCGP Council 8 March 2024

Wow! What a momentous day! You’ve no doubt already seen the news on Twitter: RCGP Council has voted to revise its position on Physician Associates! It was actually a fairly packed agenda, and we discussed a couple of other very interesting papers as well. I’ll run through it in order…

Physician Associates

The Council paper had been kept confidential until after the vote, but I am told it will shortly be uploaded to the members’ section of the website, so if you’re a member you will hopefully soon be able to find it on the Council page on MyRCGP. 

Mindful that Physician Associates would be on the March Council agenda, and cognisant that this is a topic which has aroused strong feelings in many of our members, I felt that as a Nationally Elected Member of Council I should consult my electorate to inform my position. In January I created my own informal survey of RCGP members – if you haven’t seen it, my results are presented here. This proved to be tremendously useful, as it meant I could represent your views with confidence and authority, and the results seemed to be taken seriously within the Council chamber. (One Council member came up to me in the ladies’ loos to congratulate me on doing it!) I am so grateful to the 457 RCGP members who spent time filling out my survey. You have all helped to drive change within our College. Thank you!

Due to the intense (and appropriate) scrutiny of the management of conflicts of interests, Council members had to submit a written declaration of their interests in advance of the meeting, and then separately had to re-state relevant interests before speaking.

I spoke to the motion as follows:

I’m Heather Ryan, nationally elected member. When I joined my former partnership, there was a PA at the surgery, who left fairly shortly afterwards, and I didn’t have much involvement with them. I occasionally let PA students sit in with me in the Secure Unit. I’m a private GP and we don’t employ PAs. My husband was a Nationally Elected Council Member when Council voted on PAs last time.

As a Nationally Elected Member of Council, I was keen to ensure I was representing my electorate on this contentious issue. So I undertook my own survey of RCGP members, advertising on social media platforms. I got 457 responses, all of whom self-declared they were members of the College. Respondents were asked how well they felt that RCGP was currently representing their views on PAs, on a scale from 1 (not at all) to 5 (very well). The majority – 72.9% – felt that RCGP was not representing their views at all, and a further 69 respondents (15.1%) gave a less strong but still negative response. Only 5 of those 457 doctors felt that RCGP is currently representing their views on PAs very well.

So, our members are not happy. What can we do better?

95.2% of the doctors who responded to my survey felt that RCGP should undertake a formal consultation of its members’ views on PAs. Most respondents felt that RCGP’s position should be that any incorporation of PAs into Primary Care should not be at the detriment of GP trainees’ learning opportunities, and, sadly, several respondents gave me examples of how their own GP training had already been affected.

The view of my members is that GMC regulation of PAs will add to the confusion amongst patients and clinicians, so in vote 4 I will vote for option B despite the caveat that it is likely to delay the registration of PAs. It is better that we get it right, than that we get it wrong quickly*.

Council, at this critical time for our profession, we must ensure that we take our members with us in any decisions we make. For that reason, I beg you to please vote yes to the questions put to us today, and in particular, vote yes to a public consultation.

* My questionnaire didn’t ask about this specifically, but colleagues made their feelings clear via other channels!

Most Council members spoke, and those who didn’t speak nevertheless had to declare their conflicts of interest before we voted.

The outcome of our vote was, as summarised in the RCGP press release, that RCGP’s position on PAs is now as follows:

  • RCGP opposes GMC regulation of PAs
  • GPs must be able to choose if they supervise PAs
  • The training of GPs must be prioritised over training of PAs
  • PAs must be considered additional members of the team – not substitutes for GPs
  • PAs do not replace GPs 
  • RCGP will undertake a formal consultation of its members’ views on PAs, including scope of practice and supervision

Most of the credit for today’s victory goes to the incredible Victoria Tzortziou-Brown, RCGP Vice Chair for External Affairs, who showed great leadership and courage in bringing this paper to Council in its current form.

Approval of Standing Orders

Fair play to the RCGP officer team: after the excitement of November’s AGM and Council meeting, I was really impressed by how they approached the revision of the Standing Orders. The concerns I raised about the process for bringing motions to Council were incorporated into the next draft of the Standing Orders; and then the Hon Sec hosted a webinar for Council members in which the proposed changes were discussed, following which further amendments were made. As a result, I was happy to support the new Standing Orders, and I spoke to commend the Officers for the way in which they had engaged Council members with the process.

There was also some discussion about how declarations of interest will be managed going forwards. In principle it was agreed that Council members’ declarations of interest should be made available to the wider RCGP membership, though there are some practical and governance questions about how this can be implemented, so it’s unclear exactly what form this will take or how quickly it will happen.

Health inequalities

This was a great paper which prompted a lot of thoughtful discussion. It was humbling to be reminded of the depth and variety of expertise we have on Council. Points raised included culturally competent care for patients with learning disability; and how GP surgeries should not make showing photo ID or proof of address a condition of registration, as this risks excluding the very patients who most need healthcare.

I spoke to make the following points:

  • I am pleased to see the call for targeted recruitment and retention schemes to support maintaining GP numbers in deprived areas
  • In North West England we have several successful ‘deprivation’-focused GP training posts, plus local initiatives to ensure GP trainees gain some experience of working with disadvantaged communities – such as arranging for trainees to spend time with a homelessness outreach worker, and a scheme I have until recently facilitated in the mental health unit in which I work, where GPST3 trainees would spend an afternoon with me
  • I am pleased to see that the paper discusses the difficulty that some patient groups can have in booking an appointment. Interestingly the paper doesn’t talk much about the challenges that older people can face when contacting their GP surgery. I do my private work in a very affluent area, yet many of the patients who consult me are wealthy, educated older patients who report that they have really struggled to access their NHS GP because they cannot, or do not want to, use eConsult. The word “elderly” only appeared once in this paper, and I would ask that the needs of older adults, who are at risk of digital exclusion regardless of their socioeconomic status, are not forgotten.

GP retention

Council ended on a high note with an excellent paper which summarised the College’s recent policy work on GP retention. I was particularly pleased to see that RCGP is calling for all international medical graduates qualifying as GPs to have the right to apply for indefinite leave to remain in the UK. Such a scheme would address the ludicrous situation we currently have, in which newly-qualified GPs risk deportation if they can’t find a job quickly enough after they complete their training.

One Council member spoke very well about how one of the groups with the worst retention rate is female GPs aged between 30 and 45, and factors which may be contributing to this, including the cost and difficulty of arranging childcare; recent changes to the retained GP scheme; and the reduction in availability of locum work.

I said the following:

I think this is a great paper – thank you for bringing it, Kamila. I was particularly pleased to see the mention of flexible working and I would echo [other member’s] comments. I was a GP partner when I had my eldest child, and I found it really difficult to stay in a substantive GP role because core contracted hours are 8am to 6.30pm and in the remote ex-mining area I lived in, nurseries and childminders didn’t offer long enough opening hours. I was fortunate that my husband, also a GP, picked up the slack – but he once had to take our 8-month-old on an emergency home visit to a nursing home. Given that childcare options are often worse in deprived areas such as the one I worked in, support for flexible working may well help mitigate the impact of the inverse care law. 

As a GP educator in Sefton, where a high proportion of our GP trainees are international medical graduates, I was also pleased to see the suggestions put forward about how we might tackle the visa trap which sees excellent newly-qualified GPs threatened with deportation if they can’t find a job quickly enough.

That said, when we discussed this paper at our Faculty Board meeting on Wednesday, one of our members drily said, “if you want to retain GPs, you need somewhere for them to work”. I think this superb paper would be even better if it were clearer about the fact that we will not be able to retain GPs unless General Practice as a whole is funded adequately, because at the moment, our very profession is fighting for its survival.

One GP also contacted me to point out that the Performers’ List puts barriers in the way of retention, especially for doctors in low volume or niche roles. I would urge RCGP to consider its position regarding the Performers’ List.

Conclusion


I remain, as ever, your humble and obedient servant: as a Nationally Elected Council Member, I am here to represent you, so please do keep your feedback and suggestions coming! The outcome of today’s Physician Associate paper feels like a big step forward, but our work isn’t over; keep your eyes peeled for the member consultation!

Heather’s notes from RCGP Council 18 November 2023

Today was my first meeting as a Nationally Elected Council Member at RCGP. Thank you so much for electing me; I know it sounds trite, but it is such a tremendous privilege that you trust me to represent your views. 

The day started with the Annual General Meeting – probably the longest and best-attended RCGP AGM in living memory – and then progressed to the Council meeting. Because the AGM took longer than expected, there was a great deal of time pressure during the Council meeting. One item is therefore going to be carried over to the next meeting. At one point, it was suggested that Council members’ speeches be compressed to one minute apiece – as opposed to the usual two minutes – but after one item it became evident that this wasn’t conducive to high-quality debate, and speeches reverted to a two-minute limit.

Before I start discussing individual items, I need to explain the terms under which I write this blog. Although Council members are free to talk and Tweet about non-confidential items, the actual Council papers are not allowed to be released to non-members, and I cannot write about confidential or particularly sensitive items.

Council members can report the gist of the debate, but a variant of the Chatham House rule is used: we can’t quote named individuals without their permission. As a Council member I also have to adhere to the principle of collective responsibility, and if I don’t, I can be sanctioned; so, although I will be reporting what I said when I spoke about each item, and I can report how I voted, I will not be openly critical of decisions that Council has reached. My opportunity to influence the outcome is by speaking and voting in the Council chamber, rather than by undermining democratically-made decisions afterwards.

The Annual General Meeting

The lead-up to the AGM was eventful. A week or so before the meeting, concerns started to circulate about the content of some proposed changes to the College byelaws. Many of us were concerned that the wording of the proposed changes would undermine Council’s decision-making power in relation to the term and election of members of Trustee Board. This may sound trivial, but Trustee Board is tremendously important and makes many of the key decisions which materially affect members, so I feared that proposals which would weaken the ability of Council to hold Trustee Board to account could ultimately undermine Council members’ ability to represent their constituents. Concerns were also raised about proposals to raise the ceiling for membership fee increases to £750 per year. Concerns were raised about these proposals, including by high-profile GPs like Margaret McCartney.

Less than three days before the AGM, those who had registered to attend online received emails containing updated papers. Many Council members, including myself, had not registered for online attendance, and so didn’t receive this update, although it was also available on the RCGP’s web page about the AGM. I only found out about it because a friend mentioned it.

Happily, most of the contentious byelaw changes had been removed, and a very helpful document was released explaining some of the changes. I Tweeted about this at the time.

So, the AGM promised to be eventful, and it didn’t disappoint! It was very well-attended, with around 60 members online, as well as the significant number who attended in person. My husband dialled in from home and spoke; it felt odd to be facing him across the virtual Council chamber! The main discussion centred around the proposed resolutions near the end of the agenda. The new version of resolution 5, which proposed only a modest increase in themembers’  fee ceiling, was passed.

Resolution 6, which centred around changes to bylaws governing Trustee Board, was not passed, with 67 members voting to move to next business without approving it, and only 22 in favour of continuing to discuss it (most or all of whom would presumably have voted for it). I will paste the text of what I said in the Council chamber, which seemed to capture the mood of many of my colleagues as well (one thanked me over coffee for my “statesmanlike intervention” in the debate!).

I’m delighted to see that many of the more contentious proposals, such as the proposals that, either deliberately or due to poor wording, risked weakening the power of Council over Trustee Board elections, have been removed. That is a great credit to the leadership team of our College and I am grateful. I am grateful for the hard work of our Honorary Secretary, the Trustee Board, and the Governance Committee, and I do not doubt that they acted in good faith.

However, I remain concerned by the way in which the proposals were originally made, and by the way this has played out over the past week. The proposed changes were in my view really very significant, and had the potential to significantly weaken Council’s relationship with the Trustee Board. The fact that these changes were quietly tabled on the AGM agenda, without any prior discussion with Faculties or at Council, has led to a great deal of ill feeling and distrust amongst our membership. The way that the papers were originally laid out did not make clear the magnitude of the changes being proposed.

The fact that the AGM papers were then changed less than 3 days before the AGM, while commendable in one sense, further added to the sense that the decision-making processes of the Trustee Board are sometimes opaque even to Council members.

I would also respectfully suggest that the process by which these changes were brought to the AGM in this way should be treated by the College as a significant event.

Resolution 9 had been withdrawn by the Honorary Secretary before the meeting because of feedback from members and Faculties that they would like more time to discuss the proposal.

Resolution 10 proposed to change the arrangements by which Council members can oust Officers in whom they have no confidence. Although this bylaw change seemed broadly sensible overall, some members, myself included, were unhappy with the stipulation that, in order for a vote of no confidence to succeed, two-thirds of Council members present at the meeting would need to support it. I put it to the Officers that, if 65% of the Council chamber had no confidence in one of them, they would no longer be able to execute their duties with authority, and they would no doubt resign anyway. To require a simple majority would make more sense. On reflection, the Officers decided to withdraw Resolution 10 and indicated that they would likely bring it back to a future meeting in a modified form.

Council

After a quick break – sadly only coffee and pastries, though I think a few of us would have welcomed a stiff drink – the Council meeting began. The following issues were discussed:

Proposed changes to the Council Standing Orders

This item was withdrawn by the Chair in light of the fact that many of the proposed resolutions in the AGM had not passed. The plan is to bring it back to a future Council meeting. However, I spoke to put my concerns on record. Essentially, the proposed changes would have allowed the Chair of Council and Hon Sec ultimate right of veto over proposed motions to Council. I expressed concern that this would  take power away from Faculties and Council members; this proposal would concentrate too much power in the hands of these two Officers and weakens Council. Concerningly, there was nothing about how a Council representative might be able to appeal such a veto. 

This is a subject close to my heart because I have been trying for several months to bring a Faculty motion to Council, and have had it declined, seemingly with no right of appeal, even though my own Faculty had proposed it and another Faculty had seconded it.

The Chair kindly suggested that I should email her to further discuss my concerns. I must say that I am very impressed so far by how accessible Kamila is to Council members and how willing she is to help.

The Simulated Consultation Assessment

Unsurprisingly, the recent technical outage, which led to multiple candidates being unable to complete part or all of their exam, was a hot topic. Many Council members recounted horror stories which their constituents had shared with them. We are acutely aware that some of the affected candidates risk having their CCT date delayed through no fault of their own. I called for the Officers to find solutions which would allow trainees to get their results as soon as possible. Many trainees managed to complete most but not all stations – can results be extrapolated from the stations they completed? For those who completed few or no stations, can an urgent resit be arranged? I also asked about arrangements for trainees who did eventually manage to log in and sit the exam, but with hours of stress and failed logins beforehand.

The gist of it is as follows:

  • The disruption to the exam was due to an external IT provider outage in Europe.
  • The RCGP leadership team and the exams team understand how badly trainees’ lives have been affected and are very keen to find solutions.
  • The GMC has the final say on which solutions are acceptable, because the SCA is a licensing exam. RCGP explored the possibility of offering an urgent resit for affected candidates; this was vetoed by the GMC as, with so few candidates sitting the resit, the GMC were not confident that the pass mark would be statistically sound, and so the GMC framed this as a potential threat to patient safety.
  • The RCGP is therefore urgently exploring other potential solutions, but needs the input of other stakeholders – the GMC, and a psychometrician. Modelling is required to understand whether results can be reasonably extrapolated, in the case of trainees who completed most but not all stations; and also to understand what impact on marks there may be for trainees who struggled to log in but did eventually manage to sit the exam. There will hopefully be an update in the next few days.
  • Officers are also considering financial arrangements. For example, many on social media have asked if candidates will be refunded their exam fee as well as being offered a free repeat sitting; this has not yet been decided and it may be several days before a decision is reached.
  • In summary, RCGP is taking the situation very seriously, but is constrained by the GMC and its rules around licensing exams.

Gaza

Many members spoke about the conflict in the Middle East. There is a petition currently circulating which calls on Council to call for a ceasefire and to make other statements about the conflict. It was explained to us that the College is a charity, and so is bound very strictly by Charity Commission rules which state that charities can only campaign on political issues when to do so would advance the charity’s objectives. If these rules are broken, the Trustees of the charity are personally liable. However, the Officers recognised the strength of feeling on the subject, and plan to explore next steps outside of this meeting..

Paper C4 – Developing our policy activity for priority 4 of the strategy: Respond to the climate emergency

The RCGP’s Strategic Plan for 2023-2026 consists of four priorities, one of which is to respond to the climate emergency. The purpose of this paper was to explore how we might achieve this as a College. Unfortunately this was at the point in the meeting in which we had been told to speak for no longer than a minute, so I didn’t manage to say everything I had hoped to. In essence, I said:

I welcome this paper and I am grateful to Victoria and everyone on the policy team for bringing this to Council.

As a GP in a secure mental health unit, I recently did a quality improvement project around switching patients from MDIs to DPIs. This was a very easy sell and I was able to get good engagement from colleagues, because the project had other benefits for our patients – DPIs being easier to use and better tolerated by many of our patients, which will hopefully reduce workload in the long term.

Given the workload and workforce crisis, and the political sensitivities around RCGP being seen to ask NHS GPs to take on yet another thing, I would strongly advocate that the College focus on “win-win” initiatives which save practices time and/or money as well as helping the environment. The focus on avoiding overdiagnosis is very welcome in this context.

I enjoyed hearing others’ contributions. I was particularly shocked to learn that electronic prescribing has not yet been rolled out across all of the devolved nations. This is a great example of a change which would reduce GP workload while also being more green.

Paper C13 – MVP update – Supporting our AHP colleagues

This paper had been the subject of fierce online debate in the days preceding Council, as the RestoreGP Twitter account had leaked excerpts of the paper which suggested that RCGP was exploring the feasibility of extending Fellowship to AHPs. I found this a deeply unpalatable suggestion and planned to speak against it. I was relieved, then, when the Honorary Secretary, Michael Mulholland, opened the discussion by explaining that the reference to Fellowship in the paper was a typo and there had never been any plans for this to happen.

Once that contentious proposal was taken off the table, Council was broadly positive about this paper. Potential outcomes include a “Primary Care Summit” at which stakeholders can further discuss what collaboration might look like; and exploring the possibility of some kind of practice-level affiliation with RCGP.

I spoke to this motion as follows:

I think we need to tread incredibly carefully to avoid alienating our core membership. We are the Royal College of General Practitioners and I believe we must stay true to our charitable objective, which is “To encourage, foster and maintain the highest possible standards in general medical practice”. The paper talks about language, and I strongly believe that we should use the language General Practice – not Primary Care, which is much broader.

I’m relieved to hear that there is no proposal to give AHPs Fellowship – the backlash online shows that this was perceived as very inflammatory and would alienate many GP members. As we take this initiative forward, we need to take great care in how we communicate with our members to ensure we take members with us on this. I second [another member’s] suggestion that RCGP needs to explain this was a typo and apologise for the upset caused.

I was pleased to hear about the proposal for practice-level membership. As a GP who co-owns a private practice, I ask that the needs of private GP surgeries are not forgotten when you develop your practice membership.

Conclusion

I hope this blog has given you a useful insight into the decision-making processes at the College, and how I am trying to represent you. If you’ve got any questions or would like to chat, get in touch!

Nits – sorting facts from fiction!

Autumn term is well underway and talk at the school gates is turning to nits (or rather head lice – nits being their eggs). Many parents feel itchy as soon as they receive the first WhatsApp message about them, whether or not they or their child are affected!

Did you know…

1. The most reliable way of detecting head lice is by using a nit comb. A 2008 study showed that “detection combing” is almost four times more effective than just looking at your child’s scalp.

2. Old eggs can remain glued to the hair for up to 6 months, even after successful treatment has eradicated the head lice – so experts advise that you only treat your child if you see a living, moving louse.

3. There is no evidence that head lice prefer clean hair, despite the urban myths.

4. Head lice are more common in girls than boys, and the peak age for infestation is around 7-8 years.

5. Many parents use essential oils such as tea tree oil to repel nits. However, there is no good evidence that this works (but your child will smell nice!).

6. The use of other treatments to prevent nits is controversial. One trial in 2014 showed that 1% 1,2-octanediol spray (which is sold as Hedrin Protect & Go Spray) gave a significant amount of protection from head louse infestation – though it did not always prevent it. However, the official NHS website advises against using chemical sprays regularly to prevent nits in case they irritate the scalp. For what it’s worth, in the 2014 trial, very few children had any problem with the spray, and so we (Heather and John) do choose to use it on our children.

7. If your child has a confirmed head louse infestation, there are various methods you can use to treat it. Evidence suggests that mechanical removal of lice (e.g. by wet-combing with a nit comb) is less effective than chemical methods. However, some parents prefer to try a chemical-free option first, using kits like “BugBuster” or the “NittyGritty” comb.

8. Agents such as dimethicone and cyclomethicone have been shown to be highly effective in clinical trials. Rather than being conventional insecticides, these chemicals work by suffocating the lice or by damaging their skeleton. These treatments are great because, unlike traditional insecticides, head lice can’t develop resistance. Treatments available over the counter include Full Marks Solution and Hedrin 4% dimeticone lotion.

9. There is growing concern that head lice are developing resistance to insecticide treatments such as malathion and permethrin, so we would not recommend them. Make sure you read the label or speak to the pharmacist so you understand what you are buying.

10. Experts suggest that there is no need to use a course of head louse treatment on your child because there are cases of lice at school – the advice is to use a nit comb to check the hair and treat only if you find a live louse.

11. Although head lice are unpleasant and cause itching, they almost never cause serious health problems. If your child gets nits, don’t panic!

I hope this has been helpful. Here are some helpful links and references:

https://www.nhsggc.org.uk/…/stafford-head-lice-2012.pdf

https://bmjopen.bmj.com/content/4/5/e004634

https://pubmed.ncbi.nlm.nih.gov/10937452/

https://www.nhs.uk/conditions/head-lice-and-nits/

Why Britons are going private to see GPs

As a recent YouGov survey has revealed that one in eight Britons has paid for private healthcare in the preceding year, a new private GP service has opened in Merseyside.

Formby GP is a private GP service in Freshfield, run by married couple Dr Heather Ryan and Dr John Cosgrove. Heather and John launched Formby GP in January. Clinical Director Dr John Cosgrove says, “It’s no surprise that patients are turning to the private sector.

Recent media coverage of private services has focused on the potentially steep costs involved – some private providers charge up to £550 per hour. Formby GP, however, charges just £120 for a standard unhurried consultation, and £200 for a home visit within the practice area.

The team at Formby GP describe their service as “ethical”. Managing Director Dr Heather Ryan, added, “We like to think we are offering something a bit different. Some other private GP services target healthy young people by offering “wellness” treatments and screening packages. If tests are done inappropriately, they risk causing unnecessary worry, and may pick up so-called problems which weren’t causing any symptoms and would never have caused any harm.

“At Formby GP, we aim to be a traditional GP practice, focused on treating medical problems. We won’t try to sell you tests and treatments that you don’t need.”

Many people do not realise that private doctors can often refer patients back into the NHS. Dr Ryan explains, “We are able to refer patients for specialist NHS treatment. This includes urgent suspected cancer referrals.”

Clinical Director Dr John Cosgrove added, “It’s no surprise that patients and doctors alike are moving into the private sector. In recent years, NHS General Practice has become a lot busier. NHS GPs are now required to offer rapid consultations by phone and email. They cannot also offer the face to face consultations that both GPs and their patients value most. At the same time, because their workload is overwhelming, the number of NHS GPs have been decreasing for years. Many of those NHS GPs that remain are just exhausted, and surgeries struggle to offer the care that patients and GPs would both want.

“We set up Formby GP to offer face to face consultations, whether in the surgery or in patients’ home, on request. Our patients tell us that we are delivering!”

ENDS

How can it be “ethical” to charge patients?

Access to our service will, unlike the NHS, be limited by ability to pay. However, NHS GP is not without barriers, especially now, as it can be limited by the ability to pick up the phone or internet at the correct time, or to prioritise one’s own needs appropriately.

Pillars of medical ethics

We are aware of the risks of describing ourselves as “ethical”. It is common to consider questions of medical ethics under four “pillars”: autonomy, non-maleficence, beneficence and justice.

Justice

We believe it is for society rather than individual GPs to ensure justice of access to general practice, whether that be by ensuring that all patients have the means to pay for care, or whether that be by providing excellent NHS general practice.

A growing private GP sector will support just access to primary care by providing additional capacity (we will increase my working commitment significantly, for example), and perhaps also by helping to define expectations of NHS GP by providing a contrast.

Non-malificence

What possibly sets us apart is our commitment to non-maleficence (“first do no harm“), perhaps not always a priority for private healthcare providers, for whom there can be a temptation to sell tests and treatments without certainty that they will not cause undue anxiety, or that any condition so found definitely merits the side effects and risks of treatment.

Safety and value for money

So yes, we have to charge our patients. But we will do our utmost to ensure that we do not charge patients for appointments, tests or treatments that are not completely necessary. That way, our patients get value for money whilst receiving medical care as safe and high quality as possible.

Do GPs work 7 days a week?

NHS General Practice is available 24/7, via GP Out of Hours services – both Heather and John have done GP Out of Hours work in the past (Heather during the second wave of the pandemic in 2020).

Most NHS GPs work incredibly hard – 10 to 12 hour working days are not uncommon, and many GPs do log on to their computer at the weekend to catch up on paperwork and filing results, even if they are not working in Out of Hours. The reason that many patients are struggling to access NHS General Practice are complex and are not due to GPs being lazy – rather, issues like funding, recruitment, and retention contribute.

Heather and John both work in the NHS too, and will mostly be working for Formby GP at times they would not otherwise be working. Furthermore, we plan to offer a 7 day advice service to subscribers.

One of the advantages for us in doing private work is that it gives us a high degree of control and flexibility about when we work, which is particularly important to us because we have a child with health needs which require us to be available a lot of the time. The alternative for us isn’t doing more NHS work.

On a personal note, we have recently had a very positive experience at Ormskirk Hospital when our child was unwell. We are grateful to everyone who works in the NHS for the incredible work that they do.

Do we offer “MOTs”?

Bodies are so much more complex than cars! Before every consultation, we will check your blood pressure, pulse and weight (amongst other things). You probably don’t need us to tell you to lead a healthy lifestyle!

When considering tests, our usual approach is to recommend targeted testing for conditions that you seem to be at increased risk of. Typically this would be based on new symptoms you have noticed, but your family history, lifestyle and occupation might also give clues.

Some private clinics perform a vast array of tests on every adult that consults them. We believe we can add more value by being more judicious, thus saving you money and worry, and – most importantly – harmful treatment for conditions that might never have troubled you. This is why we describe Formby GP as “ethical”.

When appropriate, we can organise extensive blood tests, ECGs, x-rays and scans and more, and we will work towards offering more and more of these on site.

Opening tomorrow!

Our appointment booking page is now live, just in time for our opening day tomorrow! You can find it on our website at www.FormbyGP.com/book.

We will very soon be launching our Priority Club. As well as a guarantee that we will offer you an appointment within a reasonable timeframe, access to our community forum, and half price text consultations, we will waive our prescription charges for Priority Club members. We are making final adjustments to our back office systems and will let you know when this is ready, probably within the next few days.

For those who have signed up for our email updates since the last message: welcome! Here is a quick recap.

We understand that most patients want to see a doctor face-to-face, so we offer face-to-face appointments as standard. You will be able to contact us and book a GP appointment face-to-face, no questions asked. You will be able to see us in our discreet premises in Freshfield, or we can visit you at home. If you would prefer to speak to us via phone, video call, or text, we will offer these modalities too.

If you need investigations (such as X-rays) or referrals, we can arrange these – either privately, or via the NHS in many circumstances.

We know that your time and money are precious. We will not recommend investigations or treatments that you don’t need. We believe in offering tests and treatments that are more likely to help you than to harm you! If you have symptoms or concerns, or a family history of a particular condition, we will talk to you so we can decide together which tests and/or treatments are appropriate.

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