Amanda was due to speak at our event that was postponed due to Covid-19, so has kindly shared what she was due to say in the below blog.
Professor Amanda Howe, President RCGP
The Royal College of General Practitioners pledged itself to the Equally Well Charter in September 2018 – we promised to support and promote Equally Well UK as a learning network to bring about a sustained and significant improvement in the physical health support offered to people with a mental health condition. General practice is where most people come into contact with health services. We provide holistic, person-centred care through multidisciplinary teams, who at all levels aim to value and reach out to the most vulnerable of our population. The College committed to providing clinical advice to support the vital work of Equally Well UK – and always aims to contribute positively to reducing health inequalities in people with severe and enduring mental illness.
How do we usually do this? GP teams are committed to being proactive about health risks and ongoing medical needs, and understand that patients with mental health problems are potentially more at risk and need this input. Practices have ways to contact and encourage engagement with those who do not attend for regular reviews for whatever reason. Social prescribing and broader community approaches to support vulnerable people may also be helpful – over the next year we shall be looking at the social prescribing agenda and the new ‘Academy’ with a mental health lens, to make sure this is visible and addressed. Mental health services also need much more input, as getting effective care for people with mental health problems is the first step – then they can engage with other health needs and move forward.
One big issue is the extent to which current policies address the broader social determinants of health, which often underlie or exacerbate mental health problems. Ten years on from its original report, the recent Marmot reviewi showed that health inequalities had increased, that life expectancy had declined for the poorest 10% of UK women, and that lack of public sector investment was closely correlated to early morbidity and mortality. Primary care teams are downstream of some of the damage which can make people psychologically vulnerable for the rest of their lives, and even when they are excellent at supportive care, the alleviation of poverty might be a better intervention.
GPs want to do their best for their patients, but as more people are living with multiple, long-term conditions, standard 10-minute consultations are no longer fit for purpose to deliver the complex, high-quality care our patients deserve. We often find ourselves trying to cram far too much into 10 minutes, not only in trying to deliver holistic care, but fitting in the increasing number of things we are expected to do during a consultation.
No GP wants to hurry an appointment; having to doing so is stressful and dissatisfying for the GP, and it can leave patients feeling as though they have been rushed. So we need more time with our patients. The College has therefore called for 15-minute appointments for those patients who need them.
We also need the Government to deliver their pledges of more funding for general practice and 6,000 more GPs as a matter of urgency – and we look to the forthcoming NHS People Plan for details on their strategy to tackle GP workload and retain our existing GP workforce, so that the NHS remains fit for the future.
Obviously at present COVID19 is a huge challenge for all – but we must still campaign for better resources to help us give effective care to those who are most vulnerable.