1. Awareness of injury in childbirth in Primary Care Prof Helen Stokes-Lampard PhD FRCGP Chair Royal College of GPs

2. Conflicts of interest I am Chair of RCGP & a Trustee
I am GP Partner (GMS)
I am a Prof at University of Birmingham & visiting Prof St George’s HMS London
I was a governor of Birmingham Women’s Hospital FT

3. RCGP & HSL Priorities
Campaign: Put patients first, back General Practice, delivery & 4 nations
Workforce: Recruit, retain, return & resilience
Workload: AHPs, innovation, safety
Interface: primary & secondary care
Extending GP Training
Exam review (10yrs MRCGP)
Joy in General Practice…

4. OASI: Why the increasing rates ?
A decade of increasing rates of diagnosis
Is this due to a worsening of care or an increased awareness?
Good to see discussion in maternity units
Need more discussion in Primary Care about it as we have reduced stigma for IBS, mental health, urinary incontinence, sexual functioning, ED…

5. GPs in Maternity Care
See women during their pregnancy for other care and >99% 1st line care prenatal and postnatally
GPs rarely undertake routine mat care
Frequently no postgrad O&G placements
Changing demographics: ↑ age = Increase likelihood of other long term issues
RCGP / RCOG / RCM consensus statement 2011

6. Multimorbidity

7. RCGP statement 2017
GPs are the only professionals that have a responsibility for on-going care throughout a woman’s life-course and they provide continuity of care and have access to a chronological medical record. Many women already have a good long-term relationship with the primary health care team, for example around LTC, care of other children, preventive health and … prescribing and immunisation, including during pregnancy
Strategic policy should reinforce the value of continuity of care, with women retaining relationships with GPs during pregnancy, and the crucial role of GPs in continuing care for women with underlying long-term medical conditions

8. Cont..
Fragmentation of the primary health care team over recent years and changes in the delivery of 24-hour care can lead to poor working relationships between GPs, midwives and HVs… there should be a conscious effort... to foster team working and communication for the benefit of the pregnant or postnatal women
Those involved in commissioning should ensure that women are put at the centre of their care and that common-sense commissioning decisions are made to ensure that women get the right care, from the right person, at the right time and in the right place
Policy should reiterate the importance of sharing information about the medical, emotional and social history of the woman that is relevant to her maternity care.. to facilitate risk assessment and decision making about maternity care.. the ambition should be to work towards a shared electronic clinical record between all providers of maternity care.

9. RCGP Curriculum 3.06 women’s health “Clinical Management
Demonstrate knowledge of women’s health problems, conditions and diseases, and recognise that some non-gender specific issues present differently in women, such as depression, alcoholism, eating disorders and domestic violence”

10. What might help? Media – lets start public conversations
Lots of excellent secondary care learning tools - time for some in Primary Care?
CIRC e-learning modules (free to all to access or restricted access)
£18-£20k to commission & launch (2x15/1/30min modules)

11. RCGP Clinical Champions
Programme of rolling topics that we highlight – either as spotlights or priorities
Clinical focus on women’s health in 2017
Appointing a new Champion by mid April

12. Thank you…