Reducing 'Undoable Workload' Biggest Priority for New RCGP Chair

Siobhan Harris


November 27, 2019

GPs are on the NHS frontline.

Countless surveys show they are working harder and longer against a backdrop of too little investment, and a recruitment shortage.

So, what does the future look like for GPs? At the moment there are no lack of funding promises from the political parties and reacting to them all is a new voice putting across GPs’ views - Professor Martin Marshall.


Prof Martin Marshall

He's just taken over as chair of the Royal College of General Practitioners, replacing Professor Helen Stokes-Lampard.

Prof Marshall has been a GP for nearly 30 years and is currently practising in East London. Medscape UK asked him about his new role and vision for the future for GPs.


Many GPs are working under heavy pressures now in terms of overwork and underfunding. What do you see as the greatest challenges for them?

'Undoable' workload, caused by a combination of high demand, increased complexity, and excessive paperwork, is the single biggest challenge facing general practice at the moment, and one that I will prioritise tackling during my tenure as Chair of the College.

We’ve launched a manifesto aimed at all political parties ahead of the General Election, and amongst other things, we’re calling for at least 5000 more GPs, 5000 GP training places per year, and 15-minute appointments as standard so that we can have more time with patients.

Do you think GPs could perhaps cut their own workload by limiting what they offer in practice?

I don’t like the idea of imposing limits on what GPs do, but I do think GPs need time and space to use their clinical judgement based on a patient’s individual circumstances, and a robust evidence base. There will be cases where patients don’t need medical interventions but they have, perhaps, come to expect one, which poses risks of overdiagnosis and overtreatment. We should only be intervening when the evidence suggests the intervention works. We need to have a society-wide conversation about this, not just amongst health professionals but including patients as well, as it is important they are on board.

What is the RCGP’s vision for the future for GPs? Can changes in working practices and the use of technology help alleviate workload but give more time to patients?

RCGP’s vision for the future for GPs is a sustainable frontline service, with an expanded workforce and primary care teams to help GPs manage high workload, have more time with patients, and deliver continuity of care for those patients who need it.

Technology certainly has its place in primary care and GPs have always been trailblazers in implementing new innovations, in the best interests of both patients and efficiency, but we must be careful not to take a zealous approach to rolling out new technologies, such as online consulting. We need to ensure they are safe, effective and alleviate pressures across the health service, not add to them. Technology should assist with time consuming administrative work and support existing services, not undermine them.

Despite the strains that GPs are under would you still recommend general practice as a specialism to medical students?

Absolutely. Being a GP is one of the most privileged and stimulating of jobs. General practice is in a tough place and has been for a long time but I believe that general practice is in a much better place than we were a few years ago. We still have a long way to go, particularly in getting resources to the frontline where they are needed, but I am hopeful about where we are heading. Being a GP is diverse, energetic, and challenging. I believe it is still the best job in the world.

Can you tell us about your path to becoming chair of the RCGP?

I’m a GP based in Newham, East London. I qualified in 1987 and completed my GP training in 1991. I spent the last 30 years working as a GP and in healthcare policy and clinical academia. I was Deputy Chief Medical Officer at the Department of Health in England from 2006-2007 and non-executive director at the CQC between 2008 and 2012. I have been the leader of Improvement Science London, an initiative to promote and embed the science of improvement across the NHS and academia, and for the last 7 years a professor of healthcare improvement at UCL. I have written more than 200 publications in the academic discipline of quality of care, and in 2016 I was elected as the vice-chair at the RCGP. I’m optimistic and plan on using my enthusiasm to make sure that as general practice turns the corner, it does so in the right direction.


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