Helen Stokes-Lampard, the new chair of the RCGP, gives her views on general practice
Helen Stokes-Lampard graduated from St George’s London medical school in 1996. She stayed on for one year as president of the student union and successfully campaigned with the BMA and the National Union of Students against the introduction of student tuition fees in the late 1990s. After three years working in obstetrics and gynaecology, she switched to the academic primary care training pathway. Shortly after, she became involved in the Royal College of General Practitioners (RCGP) and was elected as national representative for GPs in training. Helen took up her new post as chair of council for the RCGP in November 2016 (fig 1 ).
Congratulations on being elected as the new chair of council for the Royal College of General Practitioners (RCGP). What are your priorities for your tenure?
Dealing with the funding and staffing shortfalls that are faced in general practice. Our campaign “Put patients first: back general practice,” is putting pressure on NHS England to increase funding for general practice. I strongly believe that the medical profession needs to work together because the health service is under such strain. General practice is the first port of call for many patients, so if we fail, the knock on effect on the rest of the NHS will be catastrophic. Together, we are so much stronger.
Fewer medical students are choosing to become general practitioners, but the workload has gone up substantially because of the ageing and expanding population in the UK. We have to break the cycle of students not choosing the specialty. It takes a long time to train a GP, so more money invested in the service to fund innovative ways of working in the short term would make a huge difference. For instance, this money could pay for pharmacists who could prescribe and review patients who take multiple medicines, which would free up GPs’ time.
I am also concerned about low morale. I am anxious to change this because being a GP is a huge privilege—we help people through not only the darkest times in their lives, but also the joyful ones. I want to remind GPs of the great satisfaction we should take from these encounters and the trust our patients have in us.
What do you think are the essential qualities of being a GP?
You need to have an interest in people and not just diseases. You should be continuously learning, because medicine is constantly changing, and you will be dealing with a wider range of conditions than other doctors. You also have to cope with uncertainty, because the value of performing tests or making firm diagnoses can be unclear in the early stages of a disease. Patients can present with symptoms that match hundreds of conditions. You need to be comfortable with not always being able to provide quick fixes or answers, and you need to have enough knowledge to balance that risk—which is what makes good general practice so challenging.
How should a career in general practice be promoted to medical students?
The UK has some fantastic examples of good teaching practice, and we should encourage the medical schools who do it best to share their methods. The RCGP has launched a campaign called #ThinkGP to challenge students’ preconceptions that being a GP is easy or boring. The specialty is intellectually stimulating and offers a range of opportunities, such as a portfolio career where you can combine clinical work with a non-clinical special interest.
It should be a ridiculously attractive specialty but a stigma persists from the 1950s, when GP training was not as thorough as hospital training. But that’s all changed now. In my view, a person’s choice of job should be treated in the same way as their protected characteristics—just as you would not dream of making fun of someone’s race or gender, you shouldn’t mock their choice of specialty. We need every type of doctor to have a balanced and effective NHS.
Should GP training be longer?
This has been widely accepted as a necessary change by the RCGP. The state of the NHS’s finances, however, has meant that we have not been able to implement it. I think training should become four years long as soon as possible, because many newly qualified GPs do not feel confident when starting general practice. They would like more help in dealing with the complexity of the job, more placements in child health and mental health, as well as extra time to develop their personal areas of interest.
What are your thoughts on the future of general practice?
People will always need doctors who understand them holistically, but we need to evolve how we deliver the service to meet rising and more complex demand. GP practices might need to be larger and encompass more services. In some areas this is already becoming the norm. Local problems should have local solutions, however, and this large scale model of practice might not suit all communities.
What advice would you give to students thinking about pursuing general practice?
Worry less about your career pathway and enjoy what you are doing at any one time. Make sure you have time to have fun as well as work hard, because it is a long career and you need to pace yourself. Also, don’t plan too much. Some of the biggest developments in my career have been down to serendipity rather than sticking to a predefined plan.Matt Billingsley, editor, Student BMJ
Competing interests: None declared.
Provenance and peer review: Not commissioned; not externally peer reviewed.