So primary care is: 1. in the midst of a pandemic 2. staring down the barrel of a second wave 3. delivering the biggest flu campaign ever 4. Preparing for usual winter pressures 5. Continuing to manage post-lockdown rebound in demand 6. Delivering enhanced care home support

Whilst 7. Being told to maintain F2F access PLUS total triage and 8. Facing an ongoing threat to our workforce from self isolation rules, and then NHSE expect PCN’s to deliver on new DES specifications from today as well

At what point do we agree that it’s not possible to all that, or at least not do it well or safely, and have an open conversation about what realistic priorities are for general practice right now? And where do we have those conversations? Who would be listening if we did?