Abstract
The RCGP Annual Primary Care Conference is traditionally a -day event attracting a good number of primary healthcare professionals including GPs, associates-in-training (AiTs), general practice staff, allied healthcare professionals, medical students and international GPs. It is an event that attracts the largest number of UK GPs in one sitting! The 2019 conference was unarguably the best and biggest conference hosted on British soil and held in Liverpool, a city which is now quite proficient at hosting the College.
I am grateful to the Leicester RCGP Faculty for their kind travel bursary to attend this conference. I am grateful to them for this. It was the 13th RCGP conference and the last to be presided over by our outgoing Chair of the College, whose work and charisma I admire: Professor Helen Stokes-Lampard.
The conference was held at the ACC Liverpool in the former Kings Dock, strategically situated on the banks of Liverpool's UNESCO world heritage waterfront (Fig. 1). The conference weekend coincided with England and Wales playing in the semi-finals of the Rugby World Cup and many attendees, me included, were eager to leave the conference and watch the matches. The conference also coincided with the political heat of Brexit and our future relationship with Europe. A heady mix!
Delegates attending the conference.
Fit for the future
The plenary session began with an energetic and inspiring speech from the outgoing Chair of the College, Professor Stokes-Lampard who reflected on her 3 years in office and gave an apt ‘message of hope with a note of caution’. Another significant aspect of her speech was around improving primary care and making it fit for the future. This was in tune with a published policy document from the College suggesting proactive ways of ensuring that general practice is fit for the future. She cautioned politicians about ‘vote-winning gimmicks’ in their bid to reduce GP appointment waiting times, which vary across the four nations. She was very specific in highlighting that the services we provide are overstretched and that ‘history has taught us that access targets do not work and doing this will ultimately set general practice back 20 years’. Professor Stokes-Lampard will take on a new role as head of the National Council for Social Prescribing from November 2019, a cause she has been an advocate for during her 3 years as RCGP chair. We wish her the very best in this new role.
The speech by Dame Clare Marx, Chair of General Medical Council (GMC) resonated with that of Professor Stokes-Lampard both in passion and in describing plans for the future of doctors generally. The process for ensuring a unified register for doctors as advocated by the RCGP chair has already been kick-started by the GMC and will involve amending the Health Act. I agree that this will help improve the relationship between the different tiers of doctors and truly reflect GPs as generalist specialists.
Next was the ministerial address via a video link with Matt Hancock, Secretary of State for Health and Social Care who, as expected, made lots of promises about how his party will help ease overstretched services. Side talks around me suggested that lots of GPs disagree with the government’s approach to the recruitment of 5000 more GPs by 2020, which after the conference had shifted to 6000 more GPs by 2025! Despite the disagreement, the Secretary of State agreed with Professor Stokes-Lampard about the need to improve information technology (IT) services in primary care and ensure a good interface between primary and secondary care.
Professor Becky Malby, Professor in Health Systems Innovation, London South Bank University, took to the stage in an even more energetic session. I wish she had had more time. She reflected on health inequality in the UK, organisational change and leadership development in the healthcare sector. She highlighted the need to make appointment systems in general practice as individualised as possible. She noted that frequent attenders might be doing so not because of complex needs, but because practices tolerate them. Therein lies my passion as an academic with a research interest in community geriatric care. I do not think the current structure of primary care is meeting the needs of most people. This issue is tackled in the RCGP ‘Fit for the Future’ policy document.
The second-day plenary session was tagged as NHS question time and the panel was composed of First5® chair, BMA lead and various heads of committee from the RCGP. The main thrust of this session considered future leaders of the NHS, including how to groom leaders from an early stage of GP training with provision for the mentorship of First5® GPs and early career academic GPs. It is important that GP trainees see themselves as leaders and continue to engage with opportunities that help hone leadership skills. I liked a quote from this session, paraphrased here ‘… just as personalised care improves patients’ outcomes; individualised doctor care and mentorship will improve the quality of doctors providing this personalised care …’.
Professor Sir Michael Marmot of the Institute of Health Equity at University College London stole the show with his amazing oratory and jocular skills. He spoke extensively on social justice, health equity and the social determinants of health. He highlighted how socio-economic factors interact with health-seeking behaviours and habits.
Concurrent sessions
Despite the nearly 2000 delegates in attendance, there were lots of opportunities to attend break-out sessions in smaller groups. I found the session on learning from the military very useful, as it incorporated hi-fidelity simulation to re-create frontline care used in teaching military GPs. This technique was used to teach resilience and promote immersive learning.
There were over 300 posters from brilliant research on a variety of clinical topics, educational and training issues. I spent the bulk of my time looking through the educational section and found lots of interesting studies looking at the use of IT and artificial intelligence. I made sure I found time to present my poster on community anticipatory care with good engagement from some senior GPs who came to my stand.
The RCGP clinical research paper of the year award was on ‘Emollient bath additives for the treatment of childhood eczema (BATHE): Multicentre pragmatic parallel group randomised controlled trial of clinical and cost effectiveness’ by Dr Miriam Santer and her brilliant team from the universities of Nottingham, Bristol, Southampton and Cardiff. They found no evidence of clinical benefit from the inclusion of emollient bath additives in the standard management of childhood eczema. This will surely encourage improvement in the cost effectiveness of childhood eczema management.
Socials for AiTs
The conference was a good opportunity to meet new colleagues and socialise with long-term friends, especially those not seen recently. In my case, I met a friend from medical school back at the University of Ibadan, Nigeria and a family physician who attended as an international delegate. It was fun to meet up with him and share our ‘trans Mediterranean’ experiences. There was an AiT social event at the end of the Thursday session and an early morning run and walk to keep fit on Friday morning. The conference was widely tweeted using #RCGPAC
Conclusion
It was personally a rewarding time to experience the beauty of general practice and to reflect on the current challenges in a bid to improve on our gains, reduce our losses and strengthen our position as the gate keepers of healthcare in the United Kingdom. We expect more engagement with politicians and policy advisors as we continue to deliver on the ideal of compassion with knowledge, which is the motto of our great College: Cum Scientia Caritas.
I look forward to the next conference in Glasgow from the 1st to 3rd of October 2020.
Many thanks to the Leicester RCGP Faculty for being generous in sponsoring my attendance at this year’s conference.
