Sackwell and Binthorpe bulletin: Clarifying the face-to-face advice

Hi primary care frontline colleagues! It’s Penny here again, the friendly face of the Primary Care Support and Strategic Integration Unit (PCSSIU). 

In this edition of the bulletin, I thought it would be good to share some of the many questions you send us. Do keep them coming.

I’m constantly asked what we’re doing in the primary care support unit to prevent GPs from leaving the profession. It’s a great question. Here are just a few of the initiatives we have in place.

The PCSSIU offers a range of support for GPs and practice staff suffering from stress and burnout through our accredited partners. These include wellbeing and resilience sessions and a range of ‘quick guides’ containing tips and strategies for managing your time, being a more effective leader, and coping cheerfully with relentless pressure. 

We work with national and professional bodies on strategies to encourage new entrants to the profession and to persuade recently retired GPs to come out of retirement. We frequently hear how you value the support and advice of older GPs who can share the benefit of their experience and tell you ‘What it was like in my day’ and ‘Why you shouldn’t do it that way’.

PCNs have made a huge difference to GP workloads already and that can only improve as Covid pressures begin to ease. Anecdotal evidence suggests that a single practice pharmacist or paramedic can do the work of three GPs at a fraction of the cost.

Our social media and poster campaigns also play a significant part in maintaining morale and boosting job satisfaction. We have had excellent feedback on our recent campaigns, including What Else Would You Do? and What’s So Great About Canada and New Zealand Anyway? 

Finally, we know from our surveys that you really appreciate being kept up to date through regular communications by email and in newsletters like this. When we asked recently, ‘Would you like to continue to receive this bulletin or would you prefer to risk contract sanctions and lost income by missing an important item of information?’ 97% of you chose to opt in. The figures speak for themselves.

Returning to ‘business as usual’
Several of you have asked ‘Do we need to return to routine general practice or can we just rely on volunteers to keep the money rolling in from Covid vaccinations?’

We have an official answer to that question from the national primary care team at NHS England. You should by now have received a letter from Nikki Kanani and Ed Waller, but just in case PCSE has mislaid your contact details, I’ve summarised the main points below.

• Thank you for all you’ve done, etc. It has been noted.
• Uptake of Covid vaccines is falling, so it’s time to return to ‘business as usual’.
• You must see patients face to face when it’s clinically appropriate. You are usually best placed to make that decision, but the BMA, the RCGP, NHS England and your local CCG/ICS will sometimes be best placed to decide what a best-placed decision looks like.
• National communications campaigns will direct patients who didn’t come forward during Covid to seek an immediate appointment with their GP if they’re worried about anything they’ve just read about in a national communications campaign.
• You will be expected to manage symptomatic Covid patients in the community. Note that this is now part of routine care, not additional work.
• Uptake of vaccines is falling, so it’s up to you to redouble your efforts to get them to vulnerable groups including care home staff and others who don’t yet know that they want them or actively don’t want them.
• We value your professional judgment, so we will continue to provide guidance on how to set your clinical priorities.
• Thanks again. Do take care, etc. 

Training matters. Period
I’ve had a query from a GP specialising in menstrual disorders who wants to whether she needs to complete mandatory training before running a virtual menopause clinic. 

The answer, of course, is yes. End-of-life care, fire safety, blood transfusion, sepsis and anti-radicalisation training are as relevant online as they are face to face. 

What if a patient were to report a large blood spillage? How many hypoclorite tablets would you advise them to dissolve in a litre of water – one, 10, 50? Fumbling for an answer would seriously undermine your professional credibility. 

What would you do if a patient had to tackle a chip-pan fire during one of your sessions? Could you tell them which type of extinguisher to use? Would you want disfiguring burns or secondary infection on your conscience?

And, if the worst were to happen, would you want to be the one to explain to their next of kin that despite 10 years of medical training, you weren’t adequately prepared to deal with the situation? 

Training is training, and it’s mandatory for a reason. 

Penny Stint is primary care enablement lead for the Primary Care Support and Strategic Integration Unit (PCSSIU) at the Sackwell & Binthorpe ICS. As told to Julian Patterson