Viewpoint: Dr Kailash Chand: GMC should focus on improvement not sanctions

Writing exclusively for GPonline, BMA deputy chairman Dr Kailash Chand argues GPs care passionately about their patients, and like them we want to ensure that they receive the best standards of care regardless of the GP practice they are registered with.

Dr Chand: 'The focus of the GMC should be on enabling improvement in those GP practices that need help.' Pic: Michele Jones

Where they are issues we need to understand the reasons for any shortcomings and act to support services to deliver high quality care to their patients.

We must not however create a counterproductive blame culture based on one or two isolated examples. Last week’s GMC announcement of proposed sanctions for GP practices has the potential to do just that.

The public profile of the medical profession has been damaged by negative media coverage

The overwhelming majority of England’s 8,000 GP practices provide excellent service to nearly one million patients who walk through their doors on a daily basis. But making headlines on the back of isolated examples would wrongly damage patient trust in wider GP services. A  recent report found that: 'In recent years, the public profile of the medical profession has been damaged by negative media coverage, focused on the supposed failings of foreign doctors, stories of criminality by medics and extensive coverage of high-profile fitness to practice cases'.

As someone who worked in general practice for decades, I understand how many doctors can be the victims of a target-driven NHS culture, and the pressures of increasing workloads in a climate of inadequate funding, understaffing, and increasing competition.

These factors can often affect the performance of GP practices through no fault of their own. For example, the BMA recently did a survey of 4,000 GP practices about the state of their facilities and found that many had been starved of investment for decades. Four out of ten said that their buildings were so cramped and inadequate they were actually struggling to deliver basic care to patients.

We heard from GPs who said that they had to play loud music in their waiting rooms so that patients didn't hear consultations taking place in overcrowded consulting rooms with thin walls nearby. This is just one example of how GPs are being prevented from delivering the high quality care that their patients deserve.

We need the government to step in and address the long term problems facing general practice

To tackle these kind of issues, we need the government to step in and address the long term problems facing general practice, rather than looking to allocate unnecessary blame. Professor Don Berwick’s 2013 review into patient safety in the NHS began by saying: ‘Abandon blame as a tool, NHS staff are not to blame—in the vast majority of cases it is the systems, procedures, conditions, environment and constraints they face that lead to patient safety problems’

If we are to ensure that our patients are receiving the best possible care we need to have in place a culture of support for our doctors, not one of blame. The focus of the GMC should be on enabling improvement in those GP practices that need help. To solve these long term problems, we need the government to commit to long term, sustained investment in general practice that addresses the fundamental challenges facing GP services.

The last thing GPs or their patients want is for practices to close when patients need high quality, local services.

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