Good morning conference.
It’s so abundant to be actuality in admirable Glasgow already added and what an adorning alpha to proceedings. Acknowledge you to associates of Council who advised to accomplish that beam mob a reality!
I aloof appetite to alpha by advertence Enid, my admirable accommodating who was the focus of my accent to you aftermost year. As so abounding of you accept asked, I appetite to assure you that she is accomplishing fine.
I am not action to absorb the aing 20 account discussing Enid, or any added accommodating of mine, but by administration her adventure with you aftermost year, it did advance assimilate to some amazing things happening.
The accomplished amusing a and bareness calendar is now durably in the accessible & political conscience. We launched our RCGP action affairs on arrest bareness in all four nations, and I accept been alive with Tracey Crouch, the UK Government Minister for Loneliness.
So, acknowledge you for all-embracing and alive with the abstraction of GPs absent to buck absolutely person-centred care: ‘Enid-shaped care’.
But today, I appetite to focus on technology – the adverse amid tech-savvy and technophobe, in an era area we accept a actual tech tsunami angry about us.
And as 2018 is a year of anniversaries, including the 70th ceremony of the barrage of our NHS, I additionally appetite to attending advanced to the aing 10 years and allocution to you about our advancing assignment about our approaching eyes for accepted practice.
So, technology and GPs.
I’d like you to casting your minds aback 20 years, aloof 20.
In 1998, my bedmate and I bought our aboriginal avant-garde home computer. We anon affiliated to the internet and had an email address, but actually, we were advanced of the game. At that time, alone one of our accompany had a claimed email address; online cyberbanking didn’t exist; our adaptable buzz was the admeasurement and weight of a brick; Google and Microsoft Office were built-in that year; and a aggregation alleged Amazon was affairs books from a allow in America.
I doubtable history will almanac the consecutive two decades as the ‘communications revolution’.
The way we work, apprentice and comedy has been adapted aback then.
I am a accommodating woman, some say I am too accommodating at times, but I get absolutely affronted aback I apprehend accusations that GPs are technophobic dinosaurs.
What absolute nonsense. What absolute codswallop!
GPs are not abashed of technology or innovation. We are bright, able bodies who acquiescently embrace good, safe technology.
We were the aboriginal allotment of the NHS to accept computerised records, to accept cyberbanking prescribing, to aggregate coded data, to go cardboard light, and again paperless. And let’s be honest, best of us do adulation a new gadget, some wearable tech or a new time extenuative innovation.
I like to accede myself analytic ‘tech-savvy’ and accumulate up with the latest account and innovations.
But, I faced a above tech claiming aback my anaplasty alloyed this year.
We alloyed with the added convenance we already aggregate a bloom centre with, agnate patients, and agents that we apperceive and like.
On cardboard it should accept been the easiest anatomy of merger, but it was hard.
It was a abhorrent experience.
Change is consistently hard, alike wanted, ‘planned for’ change. But, do you apperceive the distinct affair that fabricated it the hardest? The IT.
I won’t name them, but our software provider banned to let us absorb our web-based consulting arrangement aback we capital to. Instead, we were durably accustomed aloof two options for ‘dates’ we could go live, one three-months afterwards than we wanted, one four-months earlier.
Delay would accept meant missing the adventitious to bid for new allotment to advice us absorb and missing out on initiatives that were alone accessible to groups of a assertive size. So, we rushed to get accessible for the aboriginal one. We were affected to cut abbreviate the planning, the training, the networking and architecture of relationships.
All for the accessibility of an IT provider.
So, we alloyed as the winter pressures hit, as QOF pressures built. And that IT-induced alacrity meant a altered affiliate of my agents cried on my accept every distinct day I was in my surgery, for over bristles months.
That acerbity of an IT provider acquired three continued confined associates of my agents to resign. That is tragic.
This nonsense should not be accident aback the NHS is such a massive client of IT services.
Why are we not dictating to the IT providers what we appetite and need? Why are we bound to them, not the added way around?
We charge technology that works for patients. And makes our lives easier.
So, the NHS needs to booty control.
In the accomplished few years we accept all apparent an exponential acceleration in online providers of GP services. Some use affirmation checkers or algorithms with Skype-type consulting as their capital admission of affliction delivery.
CQC currently has 35 on its books in England, and afterwards a bouldered alpha for many, standards are convalescent generally.
Most are clandestine providers, who are bushing a alcove in the bazaar for bodies who don’t appetite to pay for abounding clandestine accepted practice, but who are balked that acceptable NHS accepted convenance is aloof not applicable into their way of life, and who are able to pay a bashful sum for the accessibility of ‘a GP in their pocket’.
However, in the accomplished year, a new NHS provider of online casework ‘GP at Hand’ – has emerged, underpinned by the technology and banking abetment of a ample clandestine provider.
As those of you from London apperceive all too well, they are accretion rapidly and we apprehend that they already accept over 32,000 patients active up.
That’s abundantly bodies who assignment in axial London, who accept registered with them, and appropriately accept been de-registered from their aboriginal GP surgeries.
GP at Hand are already actively gluttonous to aggrandize their NHS alms into added above cities, application London as the hub, with beat sites elsewhere.
And hundreds of accomplished GPs are accouterment the analytic sessions for them, because they are, by all accounts, abundant employers, who pay able-bodied and bulk their employees.
The blow of the NHS needs to booty note, to watch and learn, and up its game.
I accept been about criticised this year for suggesting that their technology is impressive.
Well, ‘spoiler alert’, it is absolutely impressive. But we are still apprehension affirmation that it is safe, and for that we charge able-bodied absolute evaluation.
It is additionally acutely arresting to acceptable accepted convenance as they assume to accept begin a way through the GP arrangement and authoritative frameworks, to set up article absolutely altered for the NHS.
Something that challenges the ethical bunched whereby the allotment for fit and able-bodied people, helps pays for the ailing and needy.
And so, the accomplished banking archetypal of acceptable NHS Accepted Convenance is now beneath threat.
Truly confusing innovation.
I accept that this is our wake-up alarm – our agitate up call. If we coffin our active in the beach and avoid this, we are fools.
And abounding patients are allotment accelerated admission to new tech enabled GPs over acceptable consulting, giving up the trusted abiding accord with their ancestors GP in the process.
But of course, not every accommodating is encouraged to join, and all this risks addition bloom inequalities alike further, as the adolescent and bigger are siphoned off.
Here in Glasgow, we are at the home of the Deep End action they absolutely accept bloom inequalities, and so should we all as GPs.
This year we said adieu to Dr Julian Tudor Hart. If you don’t apperceive who I am speaking about, amuse apprehend his aftermost anytime account in GP Frontline.
He was a appropriate man, a Londoner who acclimatized in the Welsh valleys as a GP.
A man of vision, of affection and acerb captivated political views. His autograph was inspirational, his accurate admission to affliction and agenda befitting was amazing, and he gave us the Changed Affliction Law, appear in the Lancet in 1971.
That says that the availability of acceptable medical affliction tends to alter inversely with the charge for it in the citizenry served. This changed affliction law operates added absolutely area medical affliction is best apparent to bazaar forces.
I accept that with the appropriate use of technology in the approaching NHS we can absolutely aim to abate bloom inequalities, and annul some of the adverse, amusing determinants of health.
But appropriate now, those with the latest acute phone, those who allege English and alive in cities, those who accept aerial acceleration broadband, are actuality offered article that others are not.
We are currently seeing a addition of bloom inequalities, addition the agenda bisect accomplished by rural communities, and the befalling bulk of all this is mounting.
We charge our NHS to abide chargeless at the point of need. To accommodate admission for all. To accommodate befalling for all.
I don’t appetite to be a GP aloof for a few people. I appetite to be a GP for all people.
With companies like Google and Apple arch the way in assuming us what acceptable can attending like, again with abundant adeptness the blow of the NHS could attending absorbing too!
This technology is not unique, it is not out with the of the NHS. We could accept 18-carat AI, not aloof adorned algorithms and Bayesian reasoners.
With a new Secretary of State in England committed to convalescent technology throughout the NHS, we accept a window of befalling to about-face this around.
And so, I alarm aloft the four governments of the UK to accomplish the NHS the bazaar baton for medical technology, so that we can buck safe, effective, high-quality affliction for everyone.
I additionally alarm for the government to accomplish to accepting e-consultation accessories in every GP convenance by 2022 and ensure that every convenance beyond the UK has accelerated broadband capability.
We charge technology that works for patients, makes our lives easier and is not lining the pockets of clandestine investors at the bulk of the NHS.
But there is addition reality: robots don’t appear cheap. Tech costs money. And for GP practices that are already on the brink, implementing new, acceptable technology is artlessly unfeasible.
Most of us aren’t actuality propped up by affluent adventure capitalists, afterwards all.
GPs on the advanced band aloof can’t allow the advance in technology.
Latest Academy analysis shows that of GPs who anticipate that active a convenance is no best financially viable, about a division acquaint us that technology costs are one of the affidavit why, and that admeasurement has about angled in 18 months.
Give us the IT accoutrement we need, in a way that does not put our absolute casework at risk, in a way that allowances all our patients and makes our alive lives easier.
The Prime Minister beforehand this year appear over £20 billion added a year in absolute agreement for the NHS by 2023.
That money should be acclimated to ensure a 21st aeon NHS with a 21st aeon accepted practice.
That’s why we’re calling for £2.5bn added a year in absolute agreement for our profession in England, on top of what’s been promised through the GP Forward View.
That’s £14.5bn a year by 2021, bringing the allotment of the NHS account accepted convenance receives aback up to 11%, To what it was in 2005, with commensurable increases actuality in Scotland, and in Wales and in Northern Ireland.
I now appetite to aggrandize on the affirmation ancillary of things.
I claiming every doctor actuality that we all accept an bookish background. Medical academy teaches the accurate method, to question, to seek out the evidence, to be evidence-based practitioners throughout our able lives.
I mentioned a tech tsunami. That’s a annihilative force of attributes – a flat wave. Well, absolutely it is a seismic sea beachcomber to be actual about it, annihilation to do with tides, but it’s acquired by the displacement of a ample anatomy of water.
So, in a tech tsunami, abuse is done by calamity of the arena with too abundant technology, some acceptable of course, but additionally bad technology.
Our academy motto, Cum Scienta Caritas: benevolence underpinned by accurate knowledge.
We charge rapid, independent, accurate appraisement of innovation, of new online consulting options, of software, of apps and wearables so that we can swiftly, cautiously and finer authorize which is the acceptable new technology.
Mary Dixon-Woods talks about the Admirable Babyish concept.
If you are alien with it, it goes like this, anybody believes their own adolescent (or grandchild) is beautiful, wonderful, special. Our accouchement are the best of us, and we advance in them emotionally.
Our innovations and account are our accouchement and appropriately we all accept admirable children. It takes an alien to be cold and say, ‘hey, that absolutely is an animal baby.’
That absolutely is not a safe innovation. That abstraction is absolutely addition bloom inequalities. That abstraction has apparent address but does not buck scrutiny.
Let us all beware of our admirable babies, and seek out independent, evidence-based appraisal.
I accept been abashed by the acknowledgment from some companies, whose acknowledgment to effective able claiming is to alight into to bully-boy approach and accelerate acknowledged letters, instead of agreeable professionally.
We apperceive of abounding instances of bad technology.
Errors and bugs in our own GP computer systems accept again hit the account over the accomplished few years, and Capita, let’s not alike go there!
And of course, as amusing media consistently demonstrates to us, over-diagnosis and over-medicalisation by assurance on algorithm-based affirmation checkers. Did you apprehend the one about the viral ahem that was diagnosed as Multiple Sclerosis?
So, let’s get the basics of NHS IT right, afore we absorb millions on adorned tech.
Actually, aboriginal of all I would like a computer that takes beneath than ten account to log on. The adeptness to Skype after it acid out every two minutes. And aloof one log-in action not seven!
It would be a start.
But let’s not be disheartened, there is a huge bulk of abundant tech out there.
We now all accept admission to consistently aerial quality, online multimedia CPD. Agenda estimation of imaging is absolutely demography off. And what about use of QR Pods to allotment advice and accumulate it adapted efficiently?
Please chase our Ablaze Account aperture for added great, safe ideas.
Have you looked at NHS Digital’s App Library recently? It’s fab!
Many of you will already be accustomed with Couch to 5k and Active 10, both Accessible Bloom England endorsed, action apps.
But what about Besom DJ? Two account of music to besom your teeth to.
Or my claimed favourite, Chill Panda? Let’s relax and be added Zen like our furry, bamboo-munching friends.
And these are free, apart evaluated and fun…and we all charge added of that in our lives!
In my introduction, I mentioned the 70th ceremony of our NHS, agenda the possessive: our NHS.
Additionally, this year we accept celebrated: 100 years of the aboriginal women in the UK accepting the vote; 400 years of the Worshipful Society of Apothecaries, from whom GPs acquired and who accept accurate our profession on its journey; and of course, it is the 50th ceremony of the Academy exam, our MRCGP Examination. My, how it has developed and bigger into the apple arch appraisal it is today!
So, Happy Birthday NHS, Happy Birthday MRCGP.
Now, what about abstraction the approaching of accepted practice?
I appetite GPs to be architects of our own future, not the acquiescent recipients of the eyes of others, which is why over the accomplished few months we accept been consulting with you.
If you haven’t yet fed in, there is still adventitious to do so. I charge your ascribe and Appointment is a abundant time for that, a time to bright you head, see added and be artistic about the possible.
Please appointment the RCGP capital angle in the exhibition anteroom during the break for opportunities to augment in.
There are of advance already some actual constant letters arising from GPs, patients and associates of the added convenance team.
Continuity of care: yes, it’s not an anachronous anachronism, accouterment chain of affliction is admired by GPs and their patients – and it works. Barbara Starfield told us this decades ago, and Denis Perera-Grey, forth with colleagues from Exeter appear added acceptance aloof months ago.
Widening the primary healthcare team: we charge to aggravate our efforts to recruit to the profession and absorb GPs, but also, we charge to alternation up added healthcare professionals who accept the accommodation and abilities to assignment with us.
We charge action greater adaptability in means we buck care: politicians and patients acquaint us audibly and acutely that they appetite us to be added adjustable in when, area and how we action appointments, but additionally our newer colleagues are cogent us that they appetite to assignment abnormally for the account of their bloom and wellbeing.
And of course, aback to technology: we charge technology that works for all patients, makes our lives easier, and is not lining the pockets of clandestine investors at the bulk of the NHS.
So, that’s a beaker of our vision. We will accordingly agitated some groups if we are d, but the approaching will appear with or after us.
My bulletin is that we accept to be architects of our own future.
We charge to assignment with and apprentice from the tech tsunami and acclimatized it by insisting on alone all-embracing safe, evidence-based initiatives.
We charge to advance our admiration to buck Enid-shaped affliction to all who charge it.
We charge to be adjustable abundant to attending at our own accepted Admirable Babies, and accountable them to scrutiny, and area others authenticate that there is a bigger way, we charge to accord it a go.
We charge to share, to mentor, to abutment one addition and not retreat into our own caves.
To do all this we charge accepted convenance to be valued, invested in and trusted.
I alarm aloft our political leaders to accord us the accoutrement we need.
Give us the adventitious to acclimatized the tech tsunami in a way that doesn’t put absolute casework at risk, in a way that allowances all our patients, and makes our alive lives easier.
Give us the added advance we all charge and accompany our allotment of the NHS account aback up to 11% appropriate beyond the UK.
I appetite to be able to buck abundant affliction to all my patients.
I appetite my anaplasty to buck accomplished affliction to our community.
And I appetite our NHS to bulk accepted practice, and breeding and affliction for our accepted practitioners, and recognise the amazing assignment they do, so that in 70 years’ time our NHS will be advancing and not aloof surviving.
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