We (the TPDs) attended a meeting hosted by the Deanery regarding the topic of leadership as part of the GP training.  A number of questions were raised: what is leadership, why should we be looking at leadership and how are we/could we incorporate leadership into our training programmes?  The deanery has been looking at leadership in detail over recent months and now have webpage with useful tips and links.  There was a general concensus that we do not always recognise that what we are teaching on the half day release is indeed related to leadership.  It was also apparent, after listening to the First5 GPs who spoke at the meeting, that very few of us think that we are “leaders” – even though as part of our day to day job as GPs we need numerous leadership skills in order to function effectively.


There is no way of doing justice to the topic of leadership in such a short post, however, if you are interested and wanted to find out more there a number of websites which are worth checking out such as the NHS Leadership Academy, the RCGP and the London Leadership Academy toolkit.



GMS contract 2014/15

The General Medical Services (GMS) contract for 2014/15 has now been published.  This contains all the relevant guidance about the new contract changes agreed between the Government and GPs.  For those of you in General Practice over the next year you may well come across concepts such as the “Named GPs for over 75s” and Quality and Outcomes Framework (QOF) changes.


It has been a busy week with the publication, by NHS England, of the Urgent and Emergency Care Review and also the GP Contract for 2014/15.  The role of GPs in providing prompt same day access was highlighted in both reports, forming part of a plan to ease some of the pressure currently faced by emergency departments and also addressing the desire to reduced unplanned admissions.


The GP contract included some significant changes including the removal of a number of QOF points and areas.  The “headline” change would seem to be the enhanced service to reduce unplanned admissions and to provide proactive case management for patients identified by risk profiling.  Specific ways to support this would be direct telephone access to a patient’s GP for Emergency Departments and Paramedics and improving same day access.  In addition, all patients aged 75 years of age or older will have a named accountable GP who will co-ordinate their care and Practice boundaries will be removed.  NHS England will co-ordinate urgent same day care for those patients registered away from their home.  The push to harness the power of the internet continues and patients should have online access to their summary care record and be able to book online appointments and request medication (see the RGCP document Patient Online: The Road Map).


It is important to note that money is being recycled to enable these changes rather than new funding being directed to General Practice.  Perhaps with this in mind, the RCGP have started a campaign “Put Patients First: Back General Practice” to campaign for additional resources.  There is a lot interesting information in the campaign brief and you can sign receive updates either through Twitter or Facebook.


There will be a lot of changes in General Practice over the coming months, some of which will be very challenging.  I think that as GP trainees it is important you consider how you would approach these challenges and what the pros and cons may be.

Diagnosing Dementia

In April 2013 the NHS Commissioning Board produced a new direct enhanced service with the purpose of identifying, assessing and referring patients with a possible diagnosis of dementia.  Paying GPs to undertake the new DES appears to be one of the key parts of the government’s approach to improving care for people with dementia.


It is not, however, without its critics.  The lack of evidence to support screening for dementia and the pros and cons of an early diagnosis have been highlighted in recent weeks: BJGP and an interesting analysis from Dr Shibley Rahman.


Many of you will be working in GP Practices over the coming months that are taking part in this DES and it may be worthwhile thinking about the benefits and drawbacks for us as doctors, patients and society in general.


Further resources can be found here: DoH, NICE and RCGP.  I would also like to thank Dr Samir Shah, Consultant Psychiatrist, for providing us with his top ten tips for GP trainees involved in caring for patients with dementia.


Long Term Conditions, Prof Nigel Mathers

The slides from Prof Nigel Mathers’ presentation on Long Term Conditions can be found here.  I can honestly say that this presentation was a revelation to some of the GPs and GP trainees in the audience and has really stimulated some discussion and thought as to how we can work along side our patients.  Other presentations available include an Overview of General Practice (Dr Mark Purvis), First5 Kick-start Your Career (Dr Katharine Rowell) and Employment Law (Paul Gregory).


Review of Urgent and Emergency Services in England

There has been a strong focus on urgent and emergency care in recent weeks.  A large part of that focus has been targeted on access to GPs, especially out of hours provision.  NHS England have now published their evidence base which they claim has “identified areas for improvement in the current system”.  They have also published their own possible solutions.


As GP trainees you will all be involved in providing out of hours, and urgent care, in the Practices where you work.  You will also be directly affected by the outcomes of the review.  So, why not take a look at what is proposed and consider completing and sending back the NHS England survey.  This topic covers a couple of the curriculum  headings: Patient safety and quality of care and The GP in the wider professional environment.


Other links related to this topic include articles from pulse, the BMA and the BBC.