Being Honest

‘If you tell the truth, you don’t have to remember anything.’

– Mark Twain


Being open and transparent is part of the GP Federation’s values and culture As a clinically led organisation we are governed by Good Medical Practice and the NMC Code of Conduct. The Federation demonstrated these principles in our open responses to dealing with a nurse acting beyond her competencies and an inadvertent high strength opiate prescription. Both of these were notified to the appropriate authorities and shared widely with colleagues for learning.

With the recent Westminster shenanigans it was interesting to learn that the Ministerial Code states that “holders of public office” should be “truthful”. I can list several health ministers who fall far short of that. For example


‘5000 extra GPs by 2020’

This headline grabbing promise made during the 2015 election campaign continues to be quoted,, despite the fact that between 2016/17 GP numbers fell and the reality is that 200 practices have closed due to staffing issues in recent years. This target has now been passed on to a “must do” for our local STP with 591 extra GPS needed in the East. The emphasis should be that it will be harder to see a GP in the near future…


Honest about pressure in Primary Care

Who do you call when a colleague calls in sick at the last minute with a full list?  Personally I dread my phone going off before 8.00 in the morning! The reality that most practices are one colleague short of being unsustainable needs to be communicated to patients. I have found that patients do appreciate the situation and I think it is helpful for us to work closely with our PPGs around this.

There are other ways we can mitigate risk e.g. employing a widening skill mix and using teams of colleagues, so that if one is off it has less impact. Synchronizing systems across practices makes it easier for staff to work across teams and obviously closer links between practices helps too.


Honest about funding

It was refreshing to read that Simon Stevens in a recent reported speech to trust leaders stated, ”…that the NHS can no longer do everything that is being asked of it”. This honesty has not been appreciated by the politicians but it would be helpful if other NHS and CCG staff were as open and frank with the public.

The Federation now runs three general practices and we have learned that managing expectations has been a major component. For example in Haverhill we have had constructive meetings with the local council and patient participation groups, being honest about what we can offer with the staff that we have, and the steps we are taking to address this.

We are writing an honest letter to patients explaining what it is reasonable to expect.

Managing patient demand, particularly unnecessary patient demand, on hard pressed GPs should be a priority for statutory bodies such as NHS England, CCGs and LMC. It is disappointing that they have not delivered on this in a meaningful way, addressing increased demand from Secondary Care and from the public.


Failure to support Primary Care risks wrecking the NHS.