By Dr Surina Chibber

(@Dr_Surina)

This week London Olympia hosted a lively and eventful Pulse Live conference 2016. The conference centre buzzed with enthusiastic partners, locums and salaried GPs coming together to participate in big debates and informative workshops.

Here are my top 5 highlights of an action packed 2 days.

1. GPC Chair Dr Chaand Nagpaul offered two welcome responses to my questions during his talk on the 2016 GP contract. Firstly, to the rising concern about unaffordable cost of indemnity, he assured the audience there would be action in the coming months. What this will be, and how it will impact on rising indemnity rates has not been disclosed. Secondly, the welcome advice for GPs to ignore the  locum rates cap conveyed a strong unified message against NHSE plans to collect this data.
2. The lively debate on whether non-doctors can help the current recruitment crisis in general practice highlighted important points. Many struggling practices are using non-doctors to help with the overwhelming workload. But are they really a cost effective solution? Although it is cheaper to employ non-doctors, we need to consider what is the real cost incurred to practices. Employing a non-doctor may be associated with longer appointment times, increased investigations and referrals. There is also an extra work load for the supervising doctor. 
3. Dr Peter Swinyards’ talk on key tips for struggling practices provided practical advice. The lack of GPs is having a significant impact on increasing and unmanageable workload. This pressing issue needs a solution. A strain on practices finances together with a doctor shortage means that many practices cannot afford locums, and locums cannot afford lower rates due to indemnity costs. The talk made me think of what specific support can be given to those GPs that are struggling within overwhelmed practices.
4. The impact of clinical guidelines on patient care and doctors’ autonomy was an interesting debate. It left many of us considering whether ‘tick box’ guidelines were resulting in unnecessary investigations and referrals. Some GPs felt that clinical guidelines actually offered protection when patients were requesting unnecessary interventions. 
5. Consultant cardiologist Dr Asseem Malhotra warned that GPs and patients were being put at risk because of an ‘epidemic of misinformation generated by the pharmaceutical industry’. He highlighted how NICE’s decision to promote statins for cardiovascular prevention has been supported by very little research. The best evidence for cardiovascular disease prevention in stable heart disease has actually been the mediterranean diet! But this evidence has been poorly conveyed to medical professionals and patients alike. Dr Malhotra warned that pharmaceutical companies have a ‘legal and ethical responsibility to provide profit for their shareholders, not benefits for patients’. 

Overall the whole conference allowed an enthusiastic sharing of ideas and offloading of concerns. It is clear that with the current struggles general practice faces, the much awaited rescue package has a lot to deliver before real improvement is going to be seen. Looking to the future, key issues affecting GPs involve the GMC, indemnity providers and NHS England. Therefore, my hope for the next Pulse conference is that representatives from these organisations are invited to take part in the debates. Now that is one event I would not want to miss!