#primarycare month is an NHS England (London) campaign to promote and publicise the many exceptional things going on in primary care across the capital.

Primary care is an absolute priority for the NHS, and especially for London. Working with the Healthy London Partnership, strategic clinical networks and other key groups throughout March, we aim to shed some light on the people and services that make up primary care in a modern NHS. This includes visiting GP practices, meeting with MPs to discuss local issues and highlighting areas of transformation that will improve the standard of care Londoners receive. Here, Dr. Henrietta Hughes, talks about her dual role as GP and Medical Director for North Central and East London at NHS England (London).

My role at NHS England is the Medical Director for North Central and East London and I also work as a GP.  I had originally planned to have a career in Obstetrics and Gynaecology, but after I met my husband everything changed.  He was then in the Army and his postings and my projected rotation to different hospitals meant that we would only rarely see each other.  We both changed careers and I chose General Practice.  I underestimated how exciting this path would be. I could never have foreseen having such an interesting and enjoyable career combination and to be lucky enough to work with such a fantastic group of people who have the interests of the population of London at the heart of everything we do.

General Practice is fascinating, challenging and emotionally rewarding.  In primary care we are uniquely privileged to be able to build relationships with people over time and in many cases to know several generations of the same family.  This builds trust and enables people to be able to talk about things that they might never have told anyone before.   As a GP you see the best of times and the worst of times and it is so vital to give people a good experience of care because a poor experience can be remembered for life.

The definition of General Practice is;  ‘Anything that someone wants to discuss with their GP’.  This is usually medical and often social such as housing, education and relationships. But some people have come to see me to discuss investments, property decisions and for one patient in particular it was about books.  At each consultation we would recommend books to each other and then discuss our thoughts at the next appointment.  Sadly he became very unwell and with his last recommendation I knew that I had to read the book very quickly so that we would be able to discuss it.  His final consultation was not long before he died and we were aware that we were sharing our thoughts for the last time.

In London there are some specific challenges with the rich cultural diversity that means we need to deliver care in a personalised way.  I am passionate about increasing the quality of care people in London receive and improving the links between General Practice and secondary care. In my Medical Director role at NHS England I get a bird’s eye view of the whole health system.  I review policies before they are implemented to sense check them from a clinical perspective and as a GP I also see the impact of changes as they affect service users.  In the London Medical Directorate nearly 8000 GPs have been successfully Revalidated by the GMC which is a testament to the excellent and dedicated GPs in London.

There are many skills I developed as a GP that I bring to my work at NHS England including listening, negotiating and being able to manage uncertainty and complexity.  Building relationships is key and I work with many different organisations to disseminate good practice and manage quality issues.  It is critical to have flexibility of thought and to be prepared for every eventuality.  This also includes illness in colleagues when the office turns into a consulting room but fortunately we have not needed to use our defibrillator.

Dr Henrietta Hughes, GP and Medical Director NC/E Area Team (London Region) NHS England.

Dr Henrietta Hughes is an experienced GP and Medical Director at NHS England, London Region.  Her background is in appraisal and education and she is the Responsible Officer for nearly 3000 GPs in North Central and East London. Previously she was the Acting Medical Director in the North Central London Cluster, the Associate Editor of the Journal of Family Planning and Reproductive Healthcare and the Lead Appraiser at Camden PCT.  She has experience in Hospital and Community roles as well as in Primary Care. She is passionate about improving the quality of care for people in London by disseminating good practice, improving the skills and reflection of practitioners and by managing variation in quality.  She has published articles on a wide range of health related issues and written chapters in two books.